[JOE SANOK] You know what I learned from grad school about being a group practice boss? Nothing. But I did learn that managing consultants, marketing my group practice, accounts and growing a group practice was a full-time job over and above trying to be a good parent, partner, and clinician. That’s why I started Group Practice Boss and called in the experts to help others who have been or who are currently in this overwhelming situation of growing a successful group practice. Group Practice Boss offers ongoing business support and a close-knit community, which gives you access to live webinars, discounts on things like graphic design and software to streamline your business and monthly contests to keep you motivated. For more information on joining our next cohort, visit practiceofthepractice.com/grouppracticeboss. Again, that’s practiceofthepractice.com/grouppracticeboss. I look forward to seeing you there. This is the Practice of the Practice Podcast with Joe Sanok, session number 863. I’m Joe Sanok, your host and welcome to the Practice of the Practice Podcast. We are doing specialty month where we, this month and next month, so I guess it should be specialty months are going to be interviewing clinicians on their specialties. Today we have Anne Burkhart, who I’m so excited to have here. Anne is a Marriage and Family Therapist in Charlotte, North Carolina. She specializes in working with couples, healing and strengthening their relationship, adults, individuals strengthening their relationship with themselves and leading groups and workshops and self-esteem and communication. Anne, welcome to the Practice of the Practice podcast. [ANNE BURKART] Hi. Thanks Joe. So glad to be here today. [JOE] Yeah, I am so happy to have you here as well. You do a lot of work. I would love to hear more about how did you get into Marriage and Family Therapy? Why is that important to you? [ANNE] Yes, there’s a bit of a backstory with that. I came about it accidentally. This is really my third career in life. I taught first grade for a while, did sales for a while, and got to the point where I got my child off to college and thank goodness, after the first semester she wanted to go back for a second semester. As a parent, you breathe that sigh of relief, great, now what do I do with my life? Had a moment in there where starting to realize that as a single parent and empty nester at the same time recently going through the passing of our beloved, beloved family pet, dog, feeling lost in all of that and thinking, wow, I really need something more fulfilling going on in my life and thinking, well, volunteer work has been great. Let me lean into that, try to find some work in that. I have been doing a lot of board work and fundraising and things like that, and started down that path to find out that I was not qualified in many ways. Just being at that age where didn’t know technology, didn’t know how to do a spreadsheet, had never created a PowerPoint in my life, I went, oh, my word, what do I do? I have all these life experiences, which none of them fit on a resume. I’m not qualified to do anything. I remember going to bed one night it was Wednesday night, woke up about 2 o’clock in the morning and just suddenly sitting straight up in bed and hearing this voice go, you need to go to the local university tomorrow. I just went, okay, and went back to sleep and didn’t think twice about it. Got up the next morning instead of going into my office, I was doing sales at the time. Instead of going into my office, I just went down to the university, showed up at admissions and said, I’m just supposed to be here for some reason, and I don’t know what it is that looks like I’m supposed to go back to school. And very kindly, a young person there spent some time talking with me, said, “Hey, I think you need to speak with the person in this department. That’d be the right person to point you in the right direction.” Just showed up at that person’s doorstep. That professor sat down with me for about 15 minutes and said, “Hey, you need to go down to this program down the street. They have a master’s in Marriage and Family Therapy. I think that’s the spot for you.” I went down there and within three weeks I was enrolled and getting ready to start the summer semester. I had missed the GRE I had missed the application deadline. I had never taken the GRE none of that, but I got everything done. I remember signing up for the GRE on a Tuesday afternoon and taking it on Thursday morning and just everything fell into place and that was such a game changer for me in my life to go into those classes and realize that all of these experiences that I had, suddenly my life made sense and suddenly I realized, this is my purpose. This is where I’m supposed to be in my life. It all started from there, being able to embrace those moments and embrace the challenge and the difficulty as beautiful growth. That’s really where the name of my practice came from, Embrace Relationship Counseling, using that word. That’s what I did, and I just leaned into it as fully as I possibly could. Here I am years later with a job that I absolutely love and a place and a purpose in my life that I’m just truly, truly grateful for. [JOE] Now I know that you’re Gottman Level 3 trained and you focus on infidelity and trauma and things like that. I would love for you to just give us a quick tutorial, not that it would give justice to it, but for those that are interested in how you’re implementing the Gottman method what does that look like specifically around infidelity and trauma? [ANNE] Well, with Marriage and Family Therapy, we look at what’s been going on within the family and really what was going on within the marriage before those moments occurred before, especially with all the various types of infidelity, what was happening, who, what does each person, what are they bringing into the relationship and getting back to what is that story? What are the big T traumas or the little t traumas, what’s not been heard and understood that when that moment for infidelity or addiction or such, when it presented itself that it felt like it was the right option? So we peeled back to that a little bit and get to some vulnerability and understanding of who we are as a person and how that has affected us sometimes down to our core in creating a new relationship where people see each other hopefully in a different way, a kinder, more compassionate, empathetic way and the acceptance really starts as that new foundation. [JOE] Are there times when in your couple’s work, like what are some of the red flags that you notice when people are there and it’s very clear that there’s not going to be healing from that infidelity? [ANNE] That’s a really good question. The thought that comes to my mind is really, the only red flag that I have is when one person is so rigid in this place of it absolutely has to be this way for me, this is the only option. That to me is very often that’s the person’s trauma speaking and that indicates to me that while one person may have hope and the other person is saying, I’m willing to be here, being there to only present that rigid stance, this one method of fixing the relationship indicates to me that there, it really is counterproductive to begin couple’s therapy at that point, that there’s a lot of individual work and healing that may need to occur first for the couple’s therapy to be able to be effective for that. I personally, I never lose hope when I have both people sitting there going, okay, for this day, for this moment, we are willing to listen, to learn, to try to come to some type of, even tiny step forward in that day. And we do that, we take that step by step, but that rigid stance it’s very protective and sometimes that individual work needs to come first. [JOE] So when you when you think about people that are interested in doing couples work, what would you say would be some first things to really explore in regards to you’ve got a general therapist or someone that hasn’t done Gottman training or other types of really, like, in-depth additional certifications? Like what are things that they should just have a working knowledge on? [ANNE] I think the working knowledge that I think is most essential is really being more introspective. What do I, as the individual, especially the person making the phone call, what is my motivation? What do I want to achieve out of this? What are my wants and needs in this process? For me, as a therapist, I will generally speak with both people and the couple before that first appointment to see where they are in the process with this and to help to make sure that I’m the right match for them. Because them knowing more about what they want me to be able to specifically identify, it allows us to start with more clarity. I think that’s really important for couples to be able to do that. [JOE] When you think about how you live as a couple’s therapist outside of the sessions, like how does this work affect you and your friendships, your relationships, the way that you connect with people? What would you say that you carry on from the Gottman training that you’ve had that goes into your everyday life? [ANNE] Oh, to be honest with you, it is really hard for me sometimes to shut my brain down and pull out of work mode and to be in personal mode because it’s constantly going out to dinner and I’m looking at couples and I’m looking at body language, or I’m listening to them going, ooh, there’s a bit. Boy, he missed that one, or she missed this one and things like that. It does, just being a therapist, I find that I listen to conversations differently than I did before. As a couple’s therapist I am much, I feel that I’m much more in tune with watching dynamics between people, meta-communication, what they’re saying through other ways than just the word choice that they have and really just being able to lean into those distressing feelings. I work a lot with couples on listening to fear and sadness, anger, and that’s one of the Gottman principles and being able to do that with my friends, with my family, just being able to recognize, wow, this is a lot for you going on right now and to be able to offer that space to them in ways that I was not able to do before. [JOE] When couples that aren’t dealing with infidelity are working with you and they’re saying we’d like to avoid coming to you for post-infidelity, what are the things that you’re teaching them that you’re working with them on to strengthen their relationships before there’s maybe a break of trust? [ANNE] Generally, couples come in and they will say, we want to work on our communication. Really what they’re asking for that is, I really need some help in my voice being heard. That’s what we work on, how to speak in a way that our message is heard. With couples, I’ve phrased it with them along those lines that yes, you have something that you want to say, and sometimes we get in our own way, we trip over our own feet and how we deliver the message. That’s what communication is all about. It’s about how do we use word choice, tone of voice, asking for conversations instead of insisting for conversations, things like that to be able to speak in a way that we’re heard. When they start to look at it that way changes really start to happen. Once those first couple of changes happen, the momentum begins, people start to feel a little bit better, they start to relax and to trust the process and generally at that point, they are really able to start leaning in and seeing the benefit of the work. [BLUEPRINT] Providing great therapy day after day can be challenging even for the best of us. At Blueprint, they believe that nothing should get in the way of you doing your best work, which is why they created a platform that provides therapists with an array of clinical tools; things like therapy, worksheets, intervention ideas, and digital assessments that are designed to help you and your clients stay connected and confident throughout the care journey. Even better, Blueprint helps streamline your documentation so you can spend less time on your notes and more time on the things that matter. To learn more and request a 30-day free trial visit blueprint-health.com. Again, that’s www.blueprint-health.com. [JOE SANOK] What are some other core competencies that maybe not every therapist has, but you wish every therapist had in regards to couple’s work? [ANNE] Oh, that’s a really good question. I had someone tell me, I had two very important people in my life, therapists who said to me, at one point, one person said, Anne, this was somebody I was working with when I was going to school. She said, “Anne the other person can’t start talking until you stop.” And I realized as a therapist that that space can be very uncomfortable for clients, and it can be very uncomfortable for therapists. We feel like the silence it needs to be filled, and especially as a therapist, that we need to fill it with some nugget of wisdom or something like that potentially to prove our worth in some way. But the challenge in that is when we’re doing that, the client, it takes away from clients sometimes that ability to have a moment of reflection, of putting pieces together and to be able to see their picture, see their, I call it, see their puzzle. It’s like putting puzzle pieces together to see it in a new way and go, wow, so this is what I think you’re trying to get me to think about, or this is what I think you’re saying to me. It takes away that moment of growth for them. So I think it’s really important as a therapist for us to be able to sit in the silence and let them have that moment for themselves. The other thing that I was thinking of is that a therapist said to me one time working with something with my daughter, and she said, “Anne, you need to take the blinders off. You are so intent upon growth or accomplishment, looking one specific way that you are completely missing everything else that’s going on around outside of that.” I’ll share that with my couples. Sometimes it’s like healing and positive communication and breaking the cycles, it may not look in the way that you expect it to, and let’s talk about these other ways that it’s happening outside of this one specific way. When they start doing that, especially with Gottman, it helps to move them out of that negative sentiment override and into positive sentiment override. When we start looking at all those moments outside of that one way of measuring it a whole new world will open up for them. As a therapist, it is challenging to me when I’m sitting in there, and especially when you have a couple that is in a moment of crisis and look at this and go, where are the goods things that are happening that I can see as moments of hope so that they can feel that there are moments of hope. So yeah, I think those are really the two that I’m thinking of most. [JOE] Especially like the idea, not that I don’t like your second one, but the idea of having more space for silence and pause. Even recently, I just read this book called Truth in Comedy. So I’m in this Improv group and it’s this like classic Improv book that I had never heard of, but we’ve been doing this book club, and so I read Truth and Comedy and they were really talking about how new people to Improv will feel like they have to like, jump into a scene, be really loud, really fast, and try to get everything in. They were talking about pacing and setting the scene and doing a scene scape where you’re slowly, what are you doing in the space before you’re talking to the person? You’re organizing your desk, you’re fixing your tie, you’re putting on your pants, like whatever that it then allows your scene partner to really see where you’re at and what your vision for the scene is. Even in responding in scenes to just take that pace a little bit slower and not be talking over each other. It’s just, it’s amazing. Just on Tuesday night, I thought, I’m going to try to do that a little bit in one of the scenes. I did, and it slowed the scene down in a way that it just, like, you could tell people were like on the edge of their seat. I think that in therapy, it’s such a smart observation that you had that we feel like we have to have these nuggets of wisdom or prove our worth, and that really, that makes it about the therapist rather than, let’s just take our time here and sit with what you just told me. Maybe that person needs to have a moment to then say if that’s true, then this would be true. They need to think through it instead of having that therapist dive right in. So I love that idea of slowing it down a little bit and not feeling like you have to jump in right away. [ANNE] You know, generally in one of the earliest sessions that I have with couples, I’ll do some work on the three emotion brains and really looking at moving from threat brain into drive brain and the automatic reactions, usually defensive type reactions that we take as a way of keeping ourselves secure, though those moments that we move into fight, flight, freeze. With Gottman, that’s so often with my couples, when I’m sitting with them, that’s when I see the four horsemen begin coming in. It’s the, I need to get safe right now, these words or this look or this tone that’s coming in as is putting, feeling threatening to me, and I need to take him action immediately. That pause, Joe, is so important to be able to move through the sooth brain to take a different stance or a different pathway. I call it the power and the pause, just that little bit of time to let the emotions catch up with the logical brain and that moment of, I could respond like that and I know it doesn’t work, so let me try this instead. With a lot of couples, just teaching them to slow down the pace of the conversation, giving permission that it doesn’t have to be solved that night, that it can take multiple conversations, especially on these gridlock issues, to be able to work through to some type of understanding. It really seems to take the pressure off of them and allows them to move at paces where they can process information in new ways and to pause as they need to stay a little bit more emotionally regulated and bring a better sense of self into the conversation. [JOE] Well, for the last couple minutes here, I would love to hear about your work with individuals and strengthening their relationship with themselves. So I’ve been pretty public about my uncoupling that happened, and as a Gottman Level 2, therapists, it was hard to get a divorce. It’s like, I know the tech ops, I know these things but now being over a year out to see a lot of that as like, I’m very happy that it happened and I’m like, it’s allowed me to really do inner work that I wouldn’t have been able to do or maybe wouldn’t have had the urgency or desire or time to do. But would love to hear about your work with individuals what does that look like and what are maybe a handful of techniques that people can take into their therapy sessions? [ANNE] Yeah, so I read a book by Pauline Boss about grief a few years ago and the idea that people are sometimes were grieving people that are psychologically present, but physically not there, or they’re averse, they might physically be there and psychologically not be present with us. That led me along this path of looking at and viewing and practicing from this place of, we are always in a relationship. Either it’s with somebody who’s physically with us, but just psychologically not there. I have that a lot with folks working with older people as they start to move into later stages of life. Or somebody who might be physically with us, but psychologically checked out in that they’ve checked out of the relationship in some way. With my individuals, what I was finding is that very often they were coming in and wanting to do work around a person who was no longer present in some way. Either it was a parent with something from their childhood, or it was a relationship they had lost, or more importantly, the relationship that they’re longing to have, somebody who is yet to appear in their life. That really becomes more centered on, well, what is the relationship that you have with yourself that expecting or needing this other relationship to fill a certain part of you? What is that place that needs filling? What’s within that? What is missing and how is that affecting the decisions that you make in your life? That led to this women’s group that I have been doing for a couple of quarters now. I do it once per quarter. Because coming out of Covid, I was having so many clients come through who went, I need to go back out in the world. The world has opened up. I don’t have a clue. I don’t know anybody. I don’t know how to, I don’t know how to have relationships anymore. Had so many people saying, I feel so disconnected. I was like, great, well, let’s put all the disconnected people, let’s get in a group and see what we can do with this. And that’s where it was born. So we work on self-esteem, self-worth, self-doubt, things like that. It’s an eight-week group and women come out and just go, wow, I see my life so differently now. So the takeaway for clients is to really, I think just to learn how to be in touch with who you are and accepting of who you are. For me, that was a transformative moment in my life when I stopped fighting against this that I am unhireable or unworthy as an employee because I still can’t do an Excel spreadsheet. All my friends brought know that about me. I did finally learn how to do a PowerPoint. I can learn things like that. But really what I need to do was to embrace, was to accept this is who I am and these are the reasons why, and those can be good in my life if I choose to look at them that way. So really looking at how do I choose to accept the things that are present in my life that maybe I’ve been caring with me for years as moments of growth and opportunity, rather than things that I should be tucking away. And how do I start pulling them off the shelf and examining them one at a time as moments that can help me to be able to move forward? [JOE] So awesome. The last question I have Anne, is if every private practitioner in the world were listening right now, what would you want them to know? [ANNE] Oh my gosh, be true to yourself. It’s coming out, especially with a career and having a child, there was a lot of pressure about, oh, I need to make this much money, I need to do this, I’ve got to keep the lights on and that sort of thing. What I have found is that really following what feels so right for me as a therapist has just led to incredibly powerful connections with clients. It’s helped them, I think, be able to get to the places that they want and out of that, without looking for it or trying to force things to happen, opportunities come and just being willing to say, yes, we’ll give that a try, see what happens. But being your authentic self really is the place to lean into because that shows up with your clients, and I think it’s what really allows you to have a practice, to have a life that, like I have that, I love going to work every day and it’s wonderful. [JOE] So awesome. Well, if people want to follow your work where’s the best place to send them? [ANNE] Yes, Embrace Relationship Counseling is my website. They’ll find videos and blogs and all sorts of workshops and all that sort of thing that I’m doing on there. [JOE] Well, thank you so much for being on the Practice of the Practice Podcast. [ANNE] All right. Thanks Joe. Appreciate it. [JOE] We hope that your week is going great and that you continue to do some amazing things out in the private practice world, in your own life, and that you are inspired by these more clinical discussions that we’re having around particular topics. So make sure you tune in twice a week. We’re doing these discussions over the next month and a half, two months or so. It’s going to be awesome. We’re going to have all sorts of different discussions. If you missed the last one we just were talking about attention span and screen time with researcher Dr. Gloria Mark, so that just came out on Tuesday, so make sure you check that out if you didn’t check it out. Also wanted to make sure that you know all about today’s sponsor Blueprint. Blueprint does measurement-based care, and it’s proven to improve patient outcomes, but it’s also historically been time consuming and costly for you to implement. But at Blueprint, they believe that nothing should get in the way of delivering the highest quality care. Man, they can just help you out with the technology side with all sorts of other things. They have hundreds of symptom rating charts and giving you deeper insights into how your clients are progressing. You can request a demo over at bph.link/joe. Again, that’s bph.link/joe. Thank you so much for letting me into your ears and into your brain. Have a great day. I’ll talk to you soon. Special thanks to the band Silence is Sexy for your intro music. This podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the producers, the publishers, or the guests are rendering legal, accounting, clinical, or other professional information. If you want a professional, you should find one.