A Therapist Can't Say That
The podcast challenges common cliches and truisms in therapy by examining how they actually play out in real practice. Host Riva Stoudt explores the complexities behind therapeutic best practices that are often taken for granted. Each episode offers a candid and thought-provoking look at the unspoken aspects of therapy, encouraging listeners to question traditional assumptions.
Episodes
Introducing A Therapist Can't Say That
When you became a therapist, what did you think you were signing up for?Maybe grad school prepared you for the endless introspection, the awkward intake sessions, and the pile of unfinished notes that is somehow always waiting for you, even when you were pretty sure you just finished it.Maybe you weren’t too thrown by the onslaught of personal problems your Uber driver suddenly reveals to
Ep 02 - The Myth of the "Good Therapist" with Nancy Jane Smith
If you’re a therapist, even if you’re far from your practicum days, you can probably relate to the feeling of sitting in a session and being distracted by the thought of whether you’re living up to the standard of a good therapist.And you’ve probably had a moment where you’re sitting with a client or group and you heard something come out of your mouth and immediately thought, “That doesn
Ep 01 - Why I Started A Therapist Can't Say That
I got the idea for this podcast in late 2019. I had been in the field for several years at that point. Long enough to work through the first wave of impostor syndrome, experience my first episode of burnout, bounce back from burnout, get high on the grandiosity when I realized I really was helping people and changing their lives, go through the second wave of impostor syndrome when I real
Ep 03 - Uncharted Waters: The "Good Therapist" and Collective Trauma
The “good therapist” isn't necessarily the type of therapist you want to be.It's not the most actualized version of you as a therapist. It's not even necessarily a particularly effective therapist.The good therapist is about being seen as good and about being able to reassure ourselves that we are good when maybe we don't feel so sure.Maybe we bump up against the specter of the good thera
Ep 04 - Doing Our Own Work: Mental Health and Workplace Culture with Rebecca Ching, LMFT, PCC, Certified IFS Therapist
It’s something of a cliché that being a therapist comes with the obligation to do your own work. And it happens to be a cliché I agree with. And if you’re listening to this podcast, I’m guessing you do too.But what happens when the institutions and systems that train us, employ us, and regulate us act as barriers to actually doing that self-work?Today I’m talking with psychotherapist and
Ep 05 - How Are You Doing? Building A Culture Of Support
As therapists, we know about the power of silence and how much someone is saying when they aren’t saying anything at all. And we know how silence around something big, like a client’s suicide attempt, sends the message that this is too big or too scary to talk about.But if we mostly all agree that therapists are responsible for doing their own self-work, it’s necessary to facilitate conve
Ep 06 - Carrying the Weight of Moral Injury with Dr. K Hixson
Moral injury.It’s a term that often evokes images of soldiers deep in the fog of war or perhaps of a surgeon in scrubs holding their head in their hands in the hallway of a hospital emergency department. A therapist sitting quietly in their office or in the cubicle of a community mental health agency’s open office plan isn’t really what pops into most people’s heads when someone says the
Ep 07 - The Poison and The Cure: Expanding Our Understanding of the Wounded Healer
Therapists are tasked with being secret keepers.The first layer of secrecy seems easy and simple. Maintaining client confidentiality. You can probably recite the limits of confidentiality off the top of your head, and you probably do it regularly during intake sessions.Everything else goes in the vault. But the vault isn’t a what, it’s a who. The vault is us.We mostly talk about confident
Ep 08 - Why We Become Therapists with Ben Fineman and Carrie Wiita
There are so many ways, so many careers we can choose where helping people is the central thing.And the type of helping that we are interested in and pursue says at least as much about us, if not more, than the fact that we want to help in general.Yet, if you ask a therapist why we decided to get into this field, the answer you're most likely to get is to help people.But what are some of
Ep 09 - It's Complicated: Why We Become Therapists
Why do we become therapists?You wouldn’t necessarily think this is a spicy topic, but it is.Some therapists would say that we as therapists are just people who are unusually compassionate, empathetic, and giving, even selfless or altruistic. I don’t agree.I don't think we're more inherently compassionate or giving people than anybody else. Often, we're people who took on caregiver roles i
Ep 10 - Leave No Stone Unturned: The Healing Opportunity of Exposure Therapy with Allison Aosved
Trauma has become a huge buzzword over the past several years. In fact, I would say that trauma is having a moment.And because trauma is having a moment, there is a glut of people out there who are chomping at the bit to tell you what the best kind of treatment for your trauma is and what you should be looking for in a trauma therapist. And this has become a prime opportunity for people t
Ep 11 - Anti-exposure Bias in Trauma Therapy
In episode 10, Allison Aosved and I discussed exposure therapy for trauma, and the anti-exposure bias that we are seeing in the field.Today, I want to dig a little deeper into the context of that conversation, the factors that are contributing to anti-exposure bias, and how opinion on theoretical orientation inevitably shifts and swings over time, and how concerns about retraumatization a
Ep 12 - Subsequent Therapist Syndrome with Dr. Ofer Zur
Imagine you’re sitting in your office with a new client and the intake conversation turns to their previous therapist and they toss off a piece of information or a comment about something that their previous therapist did or said that really concerns you, maybe even alarms or disturbs you.How would you react? What would you do?If it occurred to you that might encourage your client to repo
Ep 13 - Why is Subsequent Therapist Syndrome Common in Our Field?
In the last episode, Dr. Ofer Zur stated that he estimates at least 50% of board complaints in some way involve the subsequent therapist encouraging a client to initiate a complaint against a prior therapist.And most of these cases do not involve egregious misconduct or predatory behavior.Many of these cases result from misunderstandings, clients who are unreliable reporters, gray areas,
Ep 14 - Growing Into the Light: In Memory of David Schnarch
Two years ago, on October 8, 2020, my teacher, David Schnarch died suddenly.Anyone who knew Dave even for a few moments, could see that he had an arresting presence. Tall and broad-shouldered with high contrast, salt and pepper hair, strong features, and an electric gaze that, when focused on you, elicited the distinct and disarming feeling that he was looking into some dusty and hidden b
Ep 15 - Is Ethical Marketing Possible? with Rachael Kay Albers
Here in 2022, therapists have largely resigned ourselves to the fact that we need to do some kind of marketing. We have been dragged into the world of social media, user generated content, and the imperative of the personal brand. And the necessity of marketing ourselves comes with a lot of uncertainty, discomfort, and unease.How do we market ethically? What does it actually mean to be au
Ep 16 - Marketing With Integrity
On episode 15, creative director and brand strategist Rachael Kay Albers said something that I have been turning over and over in my mind since:Marketing artificially accelerates the pace of human relationships.As soon as I heard her say that, something started to click for me about why therapists tend to dislike marketing, and it centers around the concept of artificiality.We see artific
Ep 17 - The Intimacy and Aliveness of Clinical Supervision with K Hixson
When you hear the phrase “clinical supervision” what do you think of?For me, the first thing that comes to mind is stacks of paperwork - or whatever the electronic version of that is. I think of the years-long slog of racking up hours while marching towards that finish line of professional legitimacy: licensure.It's not a very alive-sounding phrase, is it - “clinical supervision?” It sou
Ep 18 - Therapists as Makers of Culture
As I've been reflecting on the conversation Dr. K Hixson and I had about clinical supervision and reflecting on the past season of this podcast, I keep coming back to the piece we stumbled upon about clinical supervisors as culture makers, culture replicators, and culture changers.It feels very fitting that we got there because this podcast itself was born out of the desire to change the
EP 2.1: Balancing Goals and Healing in Therapy: Navigating the Tension with Silvana Espinoza Lau
In the final episode of my last season, Therapists As Makers of Culture, I asked you to think about what kind of professional culture you want to leave behind for the next generation of therapists and clients. We have an opportunity, with a little luck and intention and skill, to change something important about the structures of how things have been. We have an opportunity to lay the fou
EP 2.2 Deep Play: Exploring the Therapeutic Playground
For the last few weeks, I’ve been reflecting on the conversation I shared with you in episode 2.1 with Silvana Espinoza Lau about therapeutic goal setting.And what I’ve realized is that when you set out to look at the topic of setting goals in therapy in anything more than a superficial light, you relatively quickly start running into the question of what therapy is.Why, in order to exami
EP 2.3: Normalizing Vulnerability: The Power of Authenticity in Client Relationships with Onyx Fujii and Asher Pandjiris
If you’ve been in this field for even a couple of hours or so, you have almost certainly had someone try to impress upon you the importance of self-care. Not usually in the context of your self being valued for its own sake, but self-care that enables you to show up effectively for your clients.On the face of it, there’s not much to disagree with there. Yes, when we are adequately cared f
EP 2.4: What Happens When Our Clients Encounter Our Humanity?
Trauma therapists are often told that we have to prepare our clients for any and all disruptions to our schedules well in advance, to avoid causing harm to them or causing therapeutic rupture.But life happens. We have unexpected and unforeseen circumstances that mean that we may have to suddenly cancel sessions or rearrange our entire schedules around a new preschool pickup time. (Ask me
EP 2.5: Behind the Scenes: When Therapists Become Clients with Dr. Elena Herrera
Why is it so hard to be in therapy as a therapist?Why is it so hard sometimes to be a therapist for other therapists? What happens when we sit down and try to play this game we play with each other?I’ve been wanting to do an episode on therapists as clients since I conceived of this show, so I’m excited to share my conversation with Dr. Elena Herrera today.Dr. Herrera specializes in worki
EP 2.6: The Vulnerability of the Therapist as Client
Being in therapy as a therapist, and being a therapist for therapists, is a bit like magicians trying to entertain each other. We’ve studied the tricks and techniques. We’ve seen behind the curtain and we can’t pretend otherwise.There is enormous pressure for each of us to do our own work in therapy in order to be good clinicians for our clients, but therapists are truly a special populat
EP 2.7 - Let's Talk About Sex: A Humane Approach to Sexual Boundary Violations with Dr. Andrea Celenza
Sex with clients.It’s an interesting topic because it’s both very taboo and not at all polarizing. Many taboo topics are just that because discussion of them invites conflict. Sexual boundary transgressions aren’t like that. We can pretty much all agree that they’re wrong and bad.So then why is it so hard to talk about?I would argue that in this case, it’s because of fear of being in an
EP 2.8 - Paradox, Love, and the Therapeutic Journey
Inspired by my conversation in the last episode with Dr. Andrea Celenza, today I want to talk about tolerating paradoxes and about love in the context of therapy.In our conversation and in her book, Sexual Boundary Violations, Dr. Celenza discusses the concept of the “multiple irreducible levels of reality in the therapeutic relationship.” None of those multiple realities is more or less
EP 2.9 - Immediacy in Therapy: Breaking the Fourth Wall with Dr. K Hixson
Immediacy may seem like a stale topic, but I truly believe that it has the capacity to be the primary tool of magic in the therapeutic relationship.Immediacy is risky. Immediacy is counter-cultural. Immediacy is a disruption to our people-pleasing tendencies. Immediacy challenges us to stretch our tolerance for uncertainty. Immediacy is a key to unlocking difficult clients.Immediacy invit
EP 2.10 - Client Relationships in the Trenches: The Role of Self-Validated Intimacy
In the last episode with Dr. K Hixson, I said that our field is defined by the wish fulfillment fantasy of the parentified child. The parentified child wants nothing more than to get it right, manage the relationship, and have the parental figure be healed and available to youIf you are a therapist and you think that you were not, in some way, a parentified child, you’re probably wrong or
EP 2.11 - 10 Things I Have Learned in 10 Years as a Therapist – Part 1
Every therapist remembers their first client. Many look back and cringe at what a bad job they think they did. But for me, I look back and remember the magic I felt in the room with my very first client. Which isn’t to say I’ve never done a bad job with clients. I have, just like we all have.But after ten years of being a therapist, when the work I do has become part of the mundane fabric
EP 2.12: 10 Things I Have Learned in 10 Years as a Therapist – Part 2
To wrap up season two of A Therapist Can’t Say That, I’m continuing my reflections on my ten years as a therapist.I’ll be back in April with interviews on some juicy topics, but for now, here are lessons six through ten that I’ve learned over the last decade of doing this work. Listen to the full episode to hear:Why being overly passive for fear of screwing up might be the biggest mistake
Introducing The Kiln: Revolutionizing The Therapy Training Landscape
Co-conspirator and friend of the podcast, Dr. K Hixson, returns to share some exciting news about a true labor of love.We’ve joined up to create The Kiln, a comprehensive supervision and training program for pre-licensed therapists in Oregon. The Kiln will also offer continuing education to practicing clinicians.This venture was born out of our mutual frustrations and concerns with the di
Ep 3.1 - Between Mysticism and Modernity: Reclaiming the Jewishness of Therapy with hannah baer
Raise your hand if this sounds familiar: In a group of leftie social justice therapists, someone says that therapy is a profession founded by white men. Everyone else in the room nods along and acknowledges the white male hegemonic roots of the profession, then moves on to discuss other things. The problem with saying that white men founded therapy and is part of a white hegemonic legacy
Ep 3.2 - Finding Our Place in the Lineage of Therapeutic Practice
Since the last episode’s conversation with hannah baer about the Jewishness of therapy, I’ve been thinking a lot about lineage.When I first decided to do an episode on the topic, I was primarily motivated by wanting a deep sense of admiration for the Jewish pioneers of the field. Their contributions, which, like any minority group, tend to get erased as they are absorbed into the dominant
Ep 3.3 - Unraveling Popular Ideas: Challenging Neuroscientific Narratives in Therapy with Kristen Martin
If you’re a therapist in 2024, odds are you have given a client a neuroscientific explanation for a symptom they’re experiencing or an intervention you’re using. You’ve probably done it sometime in the last week. So have I. Neuroscience-based language is the lingua franca of our field nowadays.As a field, we have largely abandoned the languages of behaviorism or psychoanalysis, though the
Ep 3.4 - Therapy in the Shaky Landscape of Contemporary Neuroscience
As humans, we tend to like answers a lot more than we like questions. When we believe we have found answers, re-examining what we think of as truth is inherently destabilizing.In a relatively young field like neuroscience, paradigm shifts, misconceptions, corrections, retractions, and foundational remodels are inevitable. We already have more questions than answers, and each answer spawns
Ep 3.5 - From Childhood Wounds to Therapeutic Wisdom with Dr. Karen Maroda
I’ve said it before, and I’ll say it again: as a group, therapists tend to have some pretty similar formative childhood experiences.Our shared experiences as parentified children not only draw us to this field, but according to today’s guest, they fundamentally influence and shape how we practice once we become therapists. This understanding can foster a sense of connection and empathy am
Ep 3.6 - How to Stop Treating Your Clients Like Your Parents
How can we stop treating our clients like our parents? As therapists, we often share the experience of having been a parentified child, and this shared background fundamentally shapes the way we practice therapy, creating a unique bond and understanding among us.The relational patterns we developed as children, regardless of our current relationship with our parents, deeply influence how
Ep 3.7 - Getting Into It: Overt Conflict with Your Clients with Dr. K Hixson
Be honest. When you think about overt conflict with a client, is your first thought that it’s a site of exciting progress, full of potential for movement?No, of course not. I don’t either.If you’re like me, and I’m guessing a lot of you are, your first reaction to actual, or even hypothetical, conflict with a client is somewhere on a spectrum from deeply uncomfortable to scared. It's a sh
Ep 3.8 - The Medicine of Intimacy: Embracing Anger in Therapy
Imagine yourself saying, “I am angry at my client.” If you immediately need to add a whole bunch of context and caveats to make that statement feel okay, you’re not alone.Admitting that we get angry with clients is uncomfortable. It’s uncomfortable with colleagues and supervisors, and it’s definitely uncomfortable with clients. It’s even uncomfortable to admit just to ourselves.But anger
Ep 3.9 - Epistemic Justice in Diagnosis: Exploring Borderline Personality Disorder with Dr. Awais Aftab
Suppose you polled therapists and asked them what the most controversial diagnosis is in the current version of the DSM. Many of us would likely say Borderline Personality Disorder, and it would certainly be in almost everybody's top three.I’ve been wanting to do an episode on BPD for a bit because there is something about this controversial diagnosis that allows us to explore the challen
Ep 3.10 - What We Talk About When We Talk About Diagnosis
In my last episode, Dr. Awais Aftab and I explored the controversial nature of Borderline Personality Disorder as a diagnosis.One of the reasons I wanted to discuss BPD is that it opens the door for digging into psychiatric diagnosis itself, and that’s part of what I want to discuss more today.What is our purpose in using diagnosis? How does it benefit us as clinicians and the clients who
Ep 3.11 - Redefining Psychiatric Constructs with Dr. Miri Forbes
Everyone who has a foot in the world of psychiatric diagnosis seems to agree that our diagnostic system could, at the very least, use some updating, if not burning it down and starting over.So how do we approach developing constructs of psychiatric diagnoses that are more complex, more accurate, more flexible, and more context-specific than what we’ve been taught or what exists in the DSM
Ep 3.12 - Into the Hall of Mirrors: Deciding What (and When) to Pathologize
As I’ve been trying to wrap up this season of the podcast, I’ve been reflecting, in particular on my conversations about psychiatric diagnosis with Dr. Awais Aftab and Dr. Miri Forbes.I keep coming back to this question: How do we decide what human traits, behaviors, and subjective experiences to pathologize? What makes something about a person a problem that we try to fix?It’s a deeply c
MBNET: Confronting Interpersonal Trauma with Courage
Over the course of three seasons, we have talked plenty about trauma. And yet, somehow, I have never explicitly described or discussed the modality I use with clients, Mentalization-Based Narrative Exposure Therapy (MBNET).MBNET is a methodology that Dr. Kae Hixson and I synthesized from two different approaches that we were independently trained in, and it’s what we teach at The Kiln.On
Introducing The Kiln Podcast!
Dr. Kae Hixson and I started a new podcast! I wanted to give you a peek into what we’re up to.Welcome to The Kiln, where postgraduate education meets brave, bold, and imperfect therapy.We’re here to shake up professional culture—to make it braver and to help therapists rediscover their excitement for this work.At The Kiln, it’s okay to be imperfect. We’re building a learning community whe
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