Re-Directing Clinical Passion: Benefits and Pitfalls By Robin S. Rosenberg, PhD on 8/18/22 - 12:29 PM

“I want to help people!”

This is a desire that motivates all therapists in one form or another. Through direct service, we therapists help one individual, one couple, one family, and one group at a time. Depending on our caseload at any given moment, that adds up to a relatively small number compared to the number of people in our geographic region. We may also help people indirectly through teaching, supervising, writing, and consulting. These activities may help larger numbers of people, although we are less likely to see the fruits of our labors.

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Helping People on a Larger Scale

Through a series of chance circumstances, I had the opportunity to help, potentially, a much larger number of people. After being certified in hypnosis in 1997, I became interested in the growing academic psychological literature on virtual reality (VR). I noticed that hypnosis and VR have a number of elements in common, with both experiences giving access to alternative realities and both experiences feeling “real.”

While I was collaborating on research using VR, George Zimmerman was acquitted of Trayvon Martin’s murder. When some people responded to Black Lives Matter with “white lives matter” or “all lives matter,” I thought these comments reflected a profound lack of understanding of the lived experience of being Black in the U.S. (not that I presume to know the lived experience). I had the idea that VR could be used to help individuals understand the lived experiences of people different from themselves. I began discussing this idea with colleagues and others, offering my idea for others to do good in the world and to help people, if the idea was viable. To my surprise, a venture capitalist offered me enough money to do a proof-of-concept study to see whether the idea worked. I was thrilled. My hope was that if the data came out the way I hoped it would that I could make a difference on a bigger scale.

The study results were very promising and the reactions from participants were equally positive; we were able to change participants’ attitudes and deeply affect them so that they were more aware of how their biases affected others and were motivated and had new learning to treat people different from themselves more respectfully. These results left me facing a difficult choice. Should I close my practice and go full-time into the unchartered waters of building a company to provide this service as workplace training and the opportunity to make a difference on this scale, or let go of the idea and keep my practice open?

Values “High”

The opportunity to have a much bigger impact was enticing. In the language of Acceptance and Commitment Therapy (ACT), building a company to upskill employees for respectful and inclusive behavior, and making an impact on a large scale would be a values rush or high. How could I not choose to build the company?

If you’ve known entrepreneurs or start-up employees through your practice or personally, you know that startups are an emotional roller coaster. I’d seen it firsthand with clients and family members but living it myself was a different story. Yet I felt it was all worthwhile. What we were building was powerful and could help employees treat each other more inclusively. It felt like I was on a mission in a way I’d never experienced in my professional life.

The Downs

Right as we were about to launch the company to the public and start selling our program, COVID hit, with quarantines instituted for an unknown length of time. Work for most people moved from the office to the home. We struggled to adapt and survive. We figured out how to provide the VR experience so people could access it from home without a dedicated VR headset.

As we tried to sell our product to HR and DEI (diversity, equity, & inclusion) leaders, we found ourselves competing with higher priorities - companies were trying to address work fires about COVID-related remote work, as well as the murders of George Floyd, Ahmaud Arbery and Brionna Taylor and how these deaths affected employees. In the end, we didn’t get the traction that I’d hoped for.

The Values Crash

As the company’s money was running low and not enough was coming in, it was heartbreaking for me to realize that three years of work (and no income) would not come to fruition. Instead of a values rush, it was a values crash. In building the company, I’d felt a thrumming sense of purpose driven by the opportunity to influence many people on a deeper level. Now, I was looking at a return to doing clinical work, helping one individual, one couple at a time. I still loved my clinical work when I had left it behind three years earlier but returning to it felt like a let-down.

To me, to use a drug analogy, it was like going from a cocaine high to drinking weak tea. A bit of caffeine just didn’t cut it. I spent weeks, months, in a funk, doing an ACT values worksheet and felt that I had no values—at least not ones to which I wanted to take committed action. The fact that COVID continued to restrict life around me probably didn’t help my outlook. I knew I was grieving, but that knowledge only took me so far. I set a date for myself: come January, I’d start letting people know I was re-opening my practice.

In January, though, I was still struggling to find values and meaning in clinical work. Don’t get me wrong. I like doing clinical work and feel I’m generally helpful to people. But running a company was like directing a musical production with a full orchestra, while working directly with clients was like directing an intimate one-or-two-person show. Each activity is rewarding, but in different ways.

Talking with friends and family helped. Time helped. And getting intellectually stimulated about clinical work helped. I am someone who likes to do a deep dive into training and to learn a new set of skills or approach every few years. Three professional opportunities helped get me really excited about returning to clinical work.

Acceptance and Commitment Therapy
I had it in my sights to get more training in ACT, an approach to therapy that, in part, helps people articulate and then “live” their values. It seemed an apt fit, given my values crash. I had the good fortune to be accepted into an ACT peer consultation training group with experienced clinicians. This wonderful group of clinicians and the training spurred me to think about my eclectic approach in a deeper way. I became excited to use the ACT approach and techniques with clients.

Discernment Counseling
I also had the good fortune to watch videos of Bill Doherty, Ph.D. doing Discernment Counseling with a couple. Discernment Counseling is a specific modality for couples in which one or both spouses are considering divorce. The goal is to help the couple get clarity and confidence in the path they’d like to take their relationship. I’d received this training before starting my company but stopped when I closed my practice. What an honor to learn from him! The videos left me re-engaged and eager to see more couples for discernment counseling.

Ethical Lives of Clients
The third professional opportunity was hearing Bill Doherty speak about his recent book, which focuses on the ethical lives of clients that we, as therapists trained in an individualist culture, may not see or address. Reading his book and discussing his ideas with colleagues brought my systems training closer to the forefront, leading me to think more deeply about the ethical dilemmas our clients face that they may or may not see, and how to raise those issues.

Value Reflection

Although there are things I’d have done differently with my company, I’m proud of the work we did, and of what I learned. I know enough about the failure rate of startups to know that I’m in good company with the failure of my company.

I’m also thankful that I had the opportunity to re-find and re-commit to the values that initially led me to become a clinical psychologist and psychotherapist. It’s exciting to be re-energized by the work as well as intellectually stimulated. 

Useful References

Virtual Superheroes: Using Superpowers in Virtual Reality to Encourage Prosocial Behavior

Using Virtual Reality to Encourage Prosocial Behavior

VR for Civility Training: Envisioning a More Respectful Workplace  

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