11 Oct Choosing and Developing a Career as a Psychotherapist: Reflections on 50 Years and 100,000 Patient Encounters

Posted at 5:14 pm in Individual Therapy by jlbworks

By Philip Chanin, Ed.D., ABPP, CGP

Board Certified Clinical Psychologist

Assistant Clinical Professor, Department of Psychiatry

Vanderbilt University Medical Center




I played basketball at West End High School, including several games against Nashville psychotherapist Terry Huff, who was at David Lipscomb.  Graduating from West High in 1966, I wanted to continue playing basketball in college.  I knew I wasn’t good enough to play at Vanderbilt, so I enrolled at Amherst College in western Massachusetts.  As an undergraduate at Amherst, I took only one psychology course.  In my senior year, in the spring of 1970, I did take another psychology course, at Smith College, an encounter group, as this was a popular modality at that time.


Following graduation, I worked as the Sports Information Director at Amherst College, and also took several courses at the Graduate School of Education at the University of Massachusetts in Amherst.  In January of 1971, I took a position as a Head of Residence for 200 undergraduate women in a 22-story dormitory at UMass.  By the following winter I had completed coursework for a master’s degree in Higher Education, as most of the other Heads of Residence were planning to be college deans or administrators.


The School of Education was divided into 15 or so different programs.  This being the free-wheeling 1970’s, there was also a Non-Center for those who didn’t fit neatly into one of those programs.  I was accepted to the doctoral program in the Non-Center!  The following semester I took three courses in the Human Relations program. These included a course on Erik Erikson, a course on R.D. Laing and Social Phenomenology, and an encounter group course.  The graduate students I met in these classes were planning to become psychotherapists.  I realized that I had much more in common with them than with my fellow Heads of Residence.  Thus, I chose to pursue a psychotherapy career.  I had chosen a profession by picking a peer group!


For my doctoral thesis, I developed a counselor training program for the eight floor counselors in my dormitory.  I then graduated in 1975 with a doctorate in Counselor Education.  For the purpose of licensure, one of my professors wrote a letter for me, stating that essentially I had obtained a degree in Counseling Psychology.



After graduation, in the summer of 1975, I enrolled in an intensive five week course in Buddhist meditation at the Naropa Institute in Boulder, Colorado, taught by Jack Kornfield, Joseph Goldstein, and Sharon Salzberg.  We meditated three to four hours each day and all day on Sundays, when we had an audience with Naropa’s founder, Trungpa Rinpoche.  Jack, Joseph, and Sharon taught us not only about Buddhism, but also about mystical practitioners of many other traditions, including Thomas Merton, the Sufis, the Hasidic masters, and the desert monks of Palestine.  Meditation and Buddhism have informed my approach to psychotherapy ever since.


Again, this being the free-wheeling 1970’s, my doctoral program, focusing on Jungian therapy, gestalt therapy, counselor education and encounter groups, did not prepare me for licensure.  Thus, after graduating, I audited courses in abnormal psychology, statistics, and psychological testing. In order to enhance my job opportunities as a psychologist, I did three post-doctoral years of training, in Massachusetts and in Philadelphia.  I opened a private practice in Ardmore, on Philadelphia’s Main Line, in 1983.


In 1984 I relocated back to Massachusetts to get married, and took a job at a substance abuse treatment hospital on Spofford Lake, midway between Brattleboro, VT and Keene, NH.  Four years later I began a second private practice in Keene.  In 1990, the CEO at the hospital invited me to come back as a half time consultant at three times my former hourly rate, so that he could play basketball with me during lunchtime on the hospital basketball court!


Following the breakup of my marriage in 1990, I worked with my then therapist to decide what city I could move to, to open a new private practice.  I did pro and con lists for the cities I knew best–Boston, Philadelphia, Honolulu, where I had spent a summer during college, and Nashville.  I gave each city points between minus 10 and plus 10, for such aspects as weather, religious atmosphere, family, friends, and opportunities for private practice.  To my surprise, Nashville won my pro and con list.  So, in November of 1991, I relocated back to Nashville.


I had family in Nashville, but I did not know any professionals.  I began to network, and joined a group private practice on 21st Avenue.  I blocked out from 12 to 2 pm in my schedule every day in order to meet other therapists, psychiatrists, and divorce attorneys.  In that first year I went to 65 different restaurants, taking other professional out to lunch!  As I wanted to build my practice quickly, I began seeing not only adults but also children, adolescents, and families.  As I had not worked with children since my post-doctoral training, I hired my colleague Dr. Jay Woodman for weekly supervision.


My colleague Dr. Jane High took me to my first meeting of the Nashville Psychotherapy Institute shortly after I arrived in Nashville.  I then did not miss a single NPI meeting my first 10 years in Nashville.  I joined the Board of Directors in 1993 and became Chair of the Board in 1995.  NPI became the basis for both my personal and professional networks.


I wanted to get back into personal psychotherapy, and asked my colleague Dr. Judy Akin for a recommendation.  She said to me, “David Barton has an enviable practice.”  Thus, I began a 15-year therapy relationship with Dr. Barton.  Several years later, as I gradually moved my practice to exclusively adults, I asked Dr. Akin whom she would recommend as a supervisor.  She suggested Dr. Volney Gay at Vanderbilt, whom I then saw for weekly supervision of my difficult cases for the next six years.


After meeting Dr. Nilufer Yalman, who became my wife, I enrolled in the Advanced Psychodynamic Psychotherapy (APP) training program, organized by Marsha Robertson and Dr. John Waide.  Several years later, I began weekly supervision with Marsha.  Following Dr. Barton’s retirement, I began working with Dr. Tom Campbell for personal psychotherapy.  Nashville has four psychoanalytic training analysts—Doctors Gay, Campbell, Yalman and Marsha Robertson.  While I am not a psychoanalyst, all four to them have had great influence on my work as a psychotherapist.


Sometimes I am asked by patients how to choose a psychotherapist.  I usually say, “Find someone who has had a lot of personal psychotherapy.”  Over the course of my training and work as a psychologist, including three post-docs, I have spent 40 years in personal psychotherapy with nine different therapists.  Including my post-docs, I have also worked for 40 years with nine different supervisors, each of whom has contributed to the quality of work that I do with my patients in the office.


Around 2010, I first met Dr. Zach Bryant, who was relocating to Nashville.  We became friends and colleagues.  In 2011, I traded supervision of Zach’s cases in return for his designing my first website.  By 2016, I had decided to stop working as a provider for managed care companies, and I also hired a Franklin company, JLB, to design a new website for me.  I also began paying them for search engine optimization (SEO).  This has ensured a steady flow of new patients to my practice.


Zach Bryant spearheaded an effort to bring more group therapy to our psychotherapy community.  I joined a group therapy training group, 10 years ago, which he organized.  We fly in a trainer three weekends a year to work with us.  This has enriched my practice of group therapy, and I enjoy referring to the other group members whom I have gotten to know so well.


Several years after opening my Nashville practice, I began working with a patient who was in a battering relationship with her husband.  She shared a book with me, When Love Goes WrongWhat To Do When You Can’t Do Anything Right.  The book features interviews with several hundred women with controlling partners.  As I thought about my practice, I realized that every woman patient with whom I was working either currently or in the past had been with a controlling male partner.


Thus, in 1993, I began co-leading a group for “Partners and Ex-Partners of Controlling Men.”  Two years later, after reading another book, Trapped in the Mirror:  Adult Children of Narcissists in Their Struggle for Self, I said to my co-therapist, Dr. Jordan Lee, “We need to run a group for these women.  She responded, “Phil, aren’t we already running that group?”  Of course, she was right.  Women with controlling partners usually have had a narcissistic or controlling parent.   This group has now met in my office or on Zoom every Tuesday night for 30 years.  Over 100 women have participated in this group.  One group member, who was relocating out of state, wrote to me, saying, “This group has changed my life.”


In the early 1990’s, Jerry Campbell and Dr. David Yarian were co- leading men’s groups.  When David decided to stop co-leading, Jerry asked me if I would like to join him as a co-leader.  This began many years of doing men’s groups, first with Jerry and eventually on my own.  Men, especially, are often fearful of talking about their feelings with other men.  When they do choose to become involved, they usually enjoy and benefit from this experience.


About 15 years ago, I was approached by the Vanderbilt Medical Center about leading a weekly process group for the psychiatric residents.  This has been a very rewarding experience.  I begin with nine or so residents who are starting their second year of training, and I continue to work with them through their second, third, and fourth years, until they graduate.  I then start over with a new class of second year residents.


Ever since beginning my private practice in Nashville in 1991, I have sought out psychiatrists to whom I could refer my patients whom I think would benefit from medication.  I have developed mutually beneficial relationships with a number of psychotherapy-friendly psychiatrists.  In recent years I worked very closely with Dr. Mike Reed.  When I referred a patient to him, I would, with my patient’s permission, send him a long email summarizing my clinical impressions from my work with the patient.  Following his evaluation, Dr. Reed would send me a long email, summarizing his diagnosis, clinical impressions and recommendations.


At the time of Dr. Reed’s untimely death from cancer in 2021, he was working with 25 of my patients.  I needed to find them a new psychiatrist.  Fortunately, I was in contact with Dr. Ben Frock, with whom I had worked in a process group for three years during his psychiatric training at Vanderbilt.  I suggested to him that he reach out to Dr. Reed’s office about Dr. Reed’s now empty office.  Dr. Frock did move into Dr. Reed’s old office, and thus I now had another psychiatrist, in whom I had a lot of confidence, and to whom I could now refer my patients.  My patients who are working with him convey to me how impressed they are with Dr. Frock.


Shortly after joining my group private practice in Nashville, one of my colleagues, Dr. Phil Guinsburg, encouraged me to join a national organization, The American Academy of Psychotherapists.  Membership requires having had significant personal therapy and supervision.   I attended my first meeting in November, 1992.  In 1994 I joined a peer group of 15 therapists who are members of the Academy.  For the past 30 years, I have met with this group twice a year, each time for approximately 15 hours of peer group therapy.  This has been a very valuable experience, as we go through our life spans together and support each other through life’s achievements and inevitable losses.


In recent years one of the most gratifying aspects of my practice has been mentoring younger psychotherapists, helping them to get their necessary supervision hours for licensure and referring patients to them as they build their own practices.  As Erik Erikson wrote in his book Childhood and Society (1950), “The fashionable insistence on dramatizing the dependence of children on adults often blinds us to the dependence of the older generation on the younger one.  Mature man needs to be needed, and maturity needs guidance as well as encouragement from what has been produced and must be taken care of.  Generativity, then, is primarily the concern in establishing and guiding the next generation.”  (pp. 266-267)


Beginning in 2009, I invited NPI therapists Mary Arwen, Christina Oliver, and Julia Marx to join me in the office for weekly supervision and to work as co-therapists with me with individual patients,  couples, and groups.  I asked selected patients, whom I thought would benefit, if they would be okay with having a female co-therapist involved in their therapy.  Perhaps surprisingly, rarely did a patient decline this invitation.


In an email to me regarding this mentoring model, Christina wrote to me, “While there is much in the content and insight areas that is valuable, it’s the quieter aspects of the (supervisory) relationship that really make the difference.  Your encouragement, support, and belief in me have meant so much as I’ve worked to find my early identity as a therapist, and I am vastly better off right now than I would have been without that.”


As psychotherapists who are committed to continuing to learn and grow, we are exposed to many paradigms for understanding and working with our patients.  As I sit in my office and listen to patients, my mind moves toward whatever paradigm or approach seems to best fit with this particular patient’s dilemmas.  The two paradigms I utilize most often are Buddhist psychotherapy and the work of Terrence Real, in his books I Don’t Want to Talk About It, How Can I Get Through to You, The New Rules of Marriage, and Us.  Some of Real’s concepts, such as covert depression, performance-based self-esteem, and relational heroism have been immensely helpful to me, and often resonate with my patients.


NPI Founder Dr. David McMillan wrote an article entitled “NPI:  Where the Name Came From” (2013).  In this article, David states, “Hans Strupp once told me that all good therapists write about their work.  They read, reflect, and share with others what they are learning from their work with their patients.”  David also writes, “I hoped NPI would be a community where others discovered their special way to love, nurture, and heal.  And I hoped that a forum would develop where we could share the discoveries that emerged from our practices in Nashville.  All this to say, I hoped NPI would feature and nourish our members to help them to put out their unique ideas.”


I began writing articles for the NPI newsletter during my year as Chair of the Board.  As the years have gone by and I’ve continued to learn from my patients, I have been motivated to write about what I have learned.  I have continued to submit articles to NPI Reflects, and also put these articles on my website.  Almost every day I am sending these articles to my patients, as they communicate what I have learned from individual patients, couples, and groups, over 50 years of practice.


Sometimes I am asked whether other cities have organizations like the Nashville Psychotherapy Institute.  When I have practiced in other towns and cities, what I’ve found is that there are often associations for the separate disciplines of psychology, psychiatry, and social work.  But NPI is unique, in my experience, as an interdisciplinary organization that fosters collegial relationships, monthly luncheons, and continuing education events.  I feel a great deal of appreciation to Dr. McMillan, Dr. Roy Hutton, and the other visionaries who founded this wonderful organization.  We are all blessed to be part of it.