Our Businesses, Our Selves
Learning to Love the Entrepreneurial Side of Therapy
by Lynn Godzki
One hot summer afternoon John, a psychotherapist in private practice for 17 years, came into my office looking frustrated, complaining that his practice was going nowhere. Not that he didn't like doing therapy--he still loved it--but he felt stuck and frustrated in the practice itself. His income had barely inched upward over the past few years, he wasn't getting his name and practice out in the world as he wanted, and he felt increasingly overwhelmed by paperwork, as if the business part of his practice were running him, not the other way around. When I asked him to explain what he meant, he sighed and described the chaos of his office: journals, newsletters, papers, insurance forms, notes, bills, and whatnot were stacked on the desk, the table, the chairs, the floor, to such an extent that it was difficult to get around. "I know I'm really good at what I do, and I have dreams of expanding my practice and developing more of a reputation in my field," he said despondently, "but I can't seem to get organized to do anything about it. I thought I'd feel more settled and directed by this age, but I don't."
John's experience wasn't at all unusual. Psychotherapists don't go into clinical practice because they're such great businesspeople. They want to be helpers and healers, not entrepreneurs. Although most of them recognize the advantages, in terms of autonomy and income, that working within a private practice brings, the business world and terms associated with it--such as profit, expansion, competition, even "success" itself--tend to make many of them uneasy. In short, therapists tend to regard business as alien to their practice.
I find that, with business coaching, therapists can learn to become very smart businesspeople. Far from being a struggle against their own better instincts or a betrayal of their own best principles, becoming more entrepreneurial can be deeply liberating. I can actually allow therapists to be more effective, less anxious, and less psychically split between their "good" clinical practice and their "bad" business.
After John finished describing his frustrations and the rat's nest of paper that was his office, I asked him to mentally take a step back, so he could better examine not only the state of his practice, but his relationship to it. Therapists tend to overidentify with their practices. As sole proprietors, they frequently do everything and take every role in the business--clinician, CEO, administrator, bookkeeper, secretary, janitor. With so much of themselves wrapped up in their practices, it isn't surprising that they tend to think they are their practices. This overidentification is one key reason why therapists feel unhappy in business. When the business is up, their mood goes up; when the business falls off, they crash, too. In their fused state, they often can't recognize the difference between what they want and what the business needs.