[JOE SANOK] I read an interesting article the other day about information fatigue and a growing number of us suffering from mental bandwidth depletion. There’s just too much information out there. You read one blog, then another one, and pretty soon you’re confused as to what you should or shouldn’t be doing. It’s tough out there. That’s why myself and the Practice of the Practice team have created a free 28-step private practice checklist for people who want to start their own practice, whether it’s a side gig or a full-time job. This free checklist will help you go from zero to 40K quickly with video walkthroughs and paste out emails, also useful steps for retaining clients and finding new ones. The best thing is it’s no nonsense. It’s no frills. It’s just everything you need to start seeing clients. Download it for free today by going to practiceofthepractice.com/new. Again, that’s practiceofthepractice.com/new. This is the Practice of the Practice Podcast with Joe Sanok, session number 869. I almost said this episode like session and episode. Well, I’m Joe Sanok, your host, and welcome to the show. I’m sure Mitch just left that fumble in there to show that I’m human, which you should know by now. Happy May 4th. May the 4th be with you. If you have not watched the Star Wars series that my friend Paul and I put out on our YouTube channel probably four years ago, you’ve got to check it out. It is amazing. We have all these different Star Wars people going to therapy. So Luke Skywalker comes in and it’s right after he met Obi-Wan Kenobi and he says, “I met this old guy who wants me to go away with him. He says he knows my dad. Should I go away with him?” He uses a different name and his therapist is like, “How well do you know this guy?” Or Darth Vader, he goes to therapy the day after he tells Luke that he’s his father and how he’d been an absent father, and then Luke tries to commit suicide and jumps off that bridge. So it’s a lot of really fun things. Just go over to Practice of the Practices YouTube channel if you want to check out any of those Star Wars counseling episodes with Star Wars characters. So it’s pretty awesome. [JOE] We are doing our specialty month. I’m so excited that Anna is with me today. Anna has been on the show before and is a specialist in EMDR therapy and trauma and life disruption. Anna’s a psychotherapist, consultant, entrepreneur, and has pivoted a lot in life. Anna, welcome to the Practice of the Practice Podcast. [ANNA SAVIANO] Hi, thanks so much for having me. [JOE] Yeah, absolutely. Well, I am so excited to have you on the show today. We’ve known each other because you came to Slow Down School, you’re in Audience Building Academy, but today we’re mostly talking clinical work, which you and I have talked a little bit about, but not nearly as much as we’ve talked about your life plot twist stuff. Why don’t we just start with, tell me a little bit about your clinical work and how you got into that. [ANNA] Yeah, for sure. I started as a lot of people do with an undergraduate Degree in Psychology and then promptly waiting tables and realizing that was not going to be my life plan. So went to grad school, Master’s in Counseling and ended up working my first job in a community mental health with sexual abuse and assault, so really pretty heavy stuff straight out of the gate. I spent a couple years there before I went into a group private practice setting where we specialized in borderline personality disorder, so just more trauma, more intensity. And I was EMDR trained also right at the beginning of my career, so that has been, yeah, like in my first year as a licensed therapist, so that is a modality I’ve always used and didn’t ever really practice without it. So I’ve always worked with pretty high intensity clients, lots of trauma, lots of abuse, assault, those kinds of things and really found the balance, I do DBT as well, that those two modalities really work nicely together for folks who have just a lot of stuff going on. [JOE] Well, and then being that you started with all that work, did you like that work initially or was that something that just, I know for a lot of us, like some of the things we do in our first couple years is just to have a professional job and — [ANNA] Well, yeah, and I graduated in 2009, so I took all the jobs I could get because they were few and far between. I worked in the psych hospital, I did not love that. But really working with trauma and abuse survivors, I have loved always since the beginning and I feel really lucky because I did not set out with lots of intention around where I was going to get a job because it was the recession and it was just take what you can get. But I was really lucky to work at an amazing nonprofit and then have been in Kansas City my whole career. So I have a pretty solid network and it’s been really great and I love the work that I do working with that populations, so I feel good about it. [JOE] When you started your practice what was the motivation to get your practice going and tell us a little bit about that. [ANNA] Sure. I was in a group practice and then I was in a co-op space, and then I had my own pretty disrupting life event and separated from my husband and had one person that we were office sharing and she was contracting with me. And really it was born out of that necessity to figure out some different ways of arranging my life because of what was happening in my personal life. I love having a team. I never wanted to practice alone. Actually at Killin’It Camp in 2019, was that the first one? [JOE] Yeah, in Colorado. [ANNA] I was talking to one of the consultants out there, she’s like, it sounds like you’re starting a group practice. I was like, is that what it sounds like? Maybe that is what I’m doing. And I love it. I have an amazing team. I have really liked getting to know new therapists. Most of the people on my team have come straight out of school, and so there’s a lot of supervision and a lot of teaching component to it, which I really enjoy. Then watching, everybody on our team has been trained in EMDR because I’m super passionate about that modality being part of people’s clinical toolbox. So it has just been really fun, especially after a decade plus of direct client care. It’s nice to have a little bit lighter caseload and do more business and supervision and team leading type things. That has been a lot of fun. [JOE] And how large is your team at this point? [ANNA] We have myself, one admin, six clinicians, and three interns. So 11 total, if that all adds up to 11, it’s 11 total. [JOE] Now, I think it’s great that you have everyone get EMDR trained. What else have you done to really preserve like, I guess I’m thinking when someone goes from solo to group, they can either go usually one of two directions where they go, well, I want to have more diversity, be able to have different types of people that can come here. Maybe they get more and more general with each therapist being specialized or they go like a direction where they say we want to be known for trauma, we want to be known for EMDR. It sounds like you went more that route. [ANNA] For sure. [JOE] So why did you go that route and then how did you preserve the DNA as you scaled? Because I feel like the DNA of a practice when it’s one person, it’s obviously easy, when it’s two it’s like, okay, I’m going to find someone I knew from school that’s also EMDR trained, but then as it scales 11 people or more, it gets, it can get sloppy. So how did you maintain that original core like this is who this business is? [ANNA] That’s a good question. Partly it is, we revisit, we definitely went that way and it’s a lot because in our area, like in our geography there are a lot, a lot of therapists. So we kind of, you sort of have to specialize to be known for anything. So that was part of the reason and because I believe strongly in the work that we do and that a lot of people can benefit from EMDR regardless of it being like major capital T type trauma or other adverse life experiences. As far as how we sort of maintain that original DNA, we talk a lot about it. We do a lot of conceptualization in our group supervision. We meet every two weeks as a team, regardless of who needs supervision or doesn’t, everybody comes. So we talk about understanding the presenting concerns of our clients and how do we approach it with a treatment method, a plan, understanding where they’re coming from in an organized way. We also talk, not as much, but some about the branding aspect of the business and who we want to be. We have a pretty solid set of standard operating procedures for keeping a consistent message in the community. When we go talk to a class, we do some, we’re pretty well connected with the university, and so we will go talk to classes of interns about what we do and that and trying to keep our messaging consistent across all the places, Instagram and our website and in real life community events. That allows us, I think, to keep that original trauma focused, here’s how we approach things, modality and mindset. [JOE] Now what do you wish, say every therapist, I’m thinking like what around trauma, EMDR, those sorts of topics, do you wish was the working knowledge of any person working clinically? [ANNA] Sure. I think, we actually just had a leadership retreat and we talked a lot about this exact idea of really wanting to redefine trauma, make it understood as not just limited to vets, first responders, child abuse, or things that are like very obviously traumatic that we all know about, but really to say some of the stuff that you went through as a kid might be still messing with you and it doesn’t have to have been “that bad.” I think that that’s, a lot of times what people will do is minimize or dismiss their experiences because, well, it wasn’t as bad as that guy, or it’s not as bad as what I know other people have gone through. We really want to shift that definition and also destigmatize it, of course, that you can feel better by doing some of this work. It doesn’t have to, you don’t have to like qualify by having really bad life experiences. [JOE] What else do you wish that people would know? [ANNA] I mean, the therapy’s awesome and then you don’t have to like be crazy or falling apart to really get a lot out of it. I think if there were more people viewing things that way, like the world would be a way better place. That’s my like real big one energy right there of like, how to make it better. [JOE] I guess I’m thinking, back to clinicians, what are some specific, are there specific skills that you think should be a working knowledge for any clinician? Because when we think about even little T trauma almost every one of our clients has something going on. So what skills would you want them to know? What techniques, mindsets, even just ways of interacting differently during an intake or questions to ask during an intake that maybe isn’t always pushed during grad school or isn’t always taught? For you, having started with EMDR from the beginning, it’s similar to me in my internship, my supervisor was Gottman Level Three trained. So from the beginning, Gottman was always a part of how I viewed the marriage lens. So I then have different ways of doing an intake with a couple than maybe someone who has never even heard of the Gottman’s. So for you, having been trained in EMDR, what would be some of those things that you would love for every therapist to start incorporating into their intakes or their treatment? [ANNA] Yeah, I am a huge proponent of a genogram. I want all of my clinicians for sure, and people who are practicing to do that because I think there’s so much information that is gathered that way that clients aren’t going to voluntarily tell us because they don’t think it’s important, you know how many marriages somebody had or their dad isn’t their real dad and they just have always called him dad, but it is relevant that they were adopted, relevant to our clinical work. So I always want people to do a genogram and understand that. And I am always listening for those adverse life events, the things that will contribute, in EMDR we call it negative cognition, but those self-thoughts and world thoughts that are getting in the way, “I’m not lovable, I’m not good enough, everybody sucks,” whatever those thoughts are that people get really early on. If you’re listening for that, you can hear it at the beginning of treatment and it really can shape how the work goes. I think it goes faster and people get more results more quickly and more benefit more quickly, because I can conceptualize it through that lens that EMDR provides of really listening for based on their life experiences, which they’re not identifying as terrible or traumatic, but we can hear, oh you grew up basically knowing that the world was not safe, you moved around too much or whatever. That’s going to really inform what your presenting concerns are and get at things I think much quicker than just doing work with cognitive distortions or exposure or whatever. [JOE] I think that’s such a good point. I think about in my own therapy, I went and saw Steve, my therapist years ago and wasn’t going for family issues and he had all these questions about family and I’m like, why are we always starting with the family, being, and he’s a Buddhist therapist that also is EMDR trained and has taught meditation for 20 or 30 years. So really was aligned with what I was looking for in a therapist. But he starts with the family and then he’s like, okay, so you were raised Catholic, your dad’s a behavioral psychologist who had a lot of star charts, so he is like pointing out all these achievement types of things and the traps I might have fallen. It was probably five or six sessions later, he asked a question that will always stay with me. He said, “Joe, if you never found another life hack, like what would happen?” I about had a heart attack. I mean, Anna, you know me, like, I’m looking for the life hacks, the shortcuts, the ways to do things. It was like, well, why would I do that? Life, life can be easier for me. It just, it gave me such a thing to unpack because he knew so much of the history that you’re talking about that a good trauma therapist does to say what’s really that dynamic that’s still informing you that, and do you want that to still inform you? For me, knowing that I’m naturally an Enneagram 3, achiever, I enjoy seeing what I can do, it’s shifted over the years into a much healthier Enneagram 3 where it’s not achievement for the sake of other people’s affirmation as much as just like, whoa, what could I do in the world? But that doesn’t just happen through not doing that 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] Now, I want to shift to, when you think about EMDR specialists, trauma specialists, what do you see them doing really well that you think that the world should know about in regards to specialists? Then also where do you think, especially specialists that are trained in trauma EMDR, where does that part of the field need to grow and expand? [ANNA] I think that what we are doing well right now is the work of de-stigmatizing, is really bringing to the front of mind for people who hadn’t maybe thought about it, that the pandemic was traumatic, that things that happened when you were younger count as trauma and you don’t have to live this way. Like, you don’t have to achieve just for the sake of achieving, you can do it, but with a, like you said, a healthier more holistic attitude and your life doesn’t depend on it. It can just be something you’re into. I think we’re doing a pretty good job of bringing people’s awareness to the potential work and the benefit that can come from that. [JOE] Where would you hope that it would go? [ANNA] Yeah, I mean, more of that for sure. I think that having highly trained, high-quality therapy therapists be accessible. We are a cash-pay practice. We don’t take insurance. There’s a lot of reasons for that. I know that it’s not great for some people and I think our health system is a disaster in that way, and I would like more accessibility for people that are doing the work we’re doing because it’s not fast. Some parts can be, but if you’re talking about people who do have a lot of capital T trauma, there are some people that I’ve been working with for years and they’ve gotten a lot better, but they also need and want ongoing support. So I think, I mean healthcare reform would be a thing that I would like to see happen, but that’s bigger than what you’re asking. I think as far as trauma therapist goes, I think that we have disconnected from what one another since the pandemic and trainings are online and there’s less real life interaction. I think people can get pretty siloed and pretty isolated in their work, and maybe this is just what I need is to hear from more people, but I think that’s, I think it’s not just me, to be well connected and to be consulting with one another and sharing resources and ideas and wins. It can be a lot to sit with all of the things that we sit with. So that self-care aspect and trying to avoid vicarious trauma ourselves is I think something that can always be done better. [JOE] Well, in the last little bit, I want to hear a little bit more about life plot twist and where that’s headed and how that grew. I know I got to be a part of seeing you come up with this through Audience Building Academy and Slow Down School, but maybe share with us a little bit about life plot twist and the genesis of that and where it’s headed. [ANNA] Sure, yeah. Man, it’s not headed, it has not headed anywhere super-fast as you know. We’ve been talking about it for a while, but getting there. I wanted to be able to talk to people who have experienced a big shift. I’ve thought about it as like the three D’s, death, divorce, and diagnosis. Death is pretty obvious. It could be death in the traditional sense, it could be death of a relationship or something like that. Divorce, obviously, and diagnosis, either a physical or mental health situation or just the like devastating self-awareness of realizing that you’ve been swimming in Catholic guilt for your whole life or something like that and like, maybe you don’t have to, but I found myself sitting with people and as we do saying the same things and seeing parallels and threads through different people and the aloneness of, I thought this was just me, this is some moral failing, I should be able to handle it better. All of those feelings or the sort of middle life awakening where you’re like, wait, what is this? Is this what life’s about? Is this what I’ve been working so hard for because I don’t love it? That crisis of identity are the people that I want to be connected to and be in community with. It has evolved over the course of the last year from just an idea and like trying to put together an email course and some struggles with that. My real dream is to get a podcast going, which I have some plans for because podcasts are like one of my top favorite things in the world. So that is where, that’s where we’re going. [JOE] I like it, I like it. Well, if there’s any way that I or our team can support you, like obviously we love podcasts, so, we just like ooze podcasts. Well, Anna in the last little bit here, the last question I always ask is if every private practitioner in the world were listening right now, what would you want them to know? [ANNA] I think, because we’re talking about trauma as a specialty, I think don’t be scared of it. Sometimes I hear people say like, oh, I don’t do trauma, or that’s not, that’s not my thing. Not everybody has to do everything but I think recognizing that that experience is pretty universal with our clients, that they have some traumatic event and to not be afraid of sitting with it because it is the most amazing magical work when you see people move through that, through EMDR or other things as well. But I’ve experienced the magic with EMDR and it’s just like the coolest. So that’s what I would like everybody to have the opportunity for. [JOE] That’s so awesome. Well, if people want to connect with you, if they want to read more about your work and follow your future podcast where should they go? [ANNA] Sure. I am on Instagram at Life Plot Twist. There’s also online, website, lifeplottwist.com and my group practice is Heartland Therapy Connection. We have a lot of great resources on there for trauma and blog posts and all that stuff. So that’s where I am. [JOE] Awesome. Well, I’m so glad I got to know you through Audience Building Academy, Slow Down School, Killin’It Camp. You’ve been to all of it. It’s awesome. Thank you so much for being on the show. [ANNA] Thank you for having me. [JOE] It’s so awesome to just hear the clinical background, what people wish every therapist knew, that just as a working knowledge and to be talking to so many people. If you haven’t checked out the last bit here, we have been diving in to specialties. Back in episode 862, we talked about screen time, we talked about toxic families in 866, talked about ACT and CVT and mindfulness. We’ve talked about first responders, all sorts of really awesome episodes that you’ll want to make sure that you check out. It was all through April and it’s going to continue throughout May. Thanks so much for hanging out with us. Also, we could not do the show without our sponsors, sponsors like Blueprint. Blueprint helps you streamline your documentation so that you can spend less time on your notes and more time on the things that matter through worksheets, intervention ideas, and digital assessments. [JOE] You can learn more and request a free trial over at blueprint-health.com. Again, that’s blueprint-health.com. Thank you so much for letting me into your ears and into your brain. Have an amazing 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.