Episode 23

Episode 23: Doubt Yourself And Do It Anyway

Self-Doubt Sucks, Doesn't It?

How often do you have an incredibly creative idea, something that excites you, only to convince yourself that it's not possible?

I get it. I've been there. Hell, I fucking live there more often than not. I'm not sure that self-doubt, insecurity, impostor syndrome, etc., ever go away. I am sure that they become less paralyzing though.

My coaching business, group practice, podcast, and entrepreneurial retreats, all have one thing in common.

  • Big Idea = Excitement!!!! HELL YES, THIS IS AMAZING.....AHHHHHHHH
  • Self Doubt = This is a great idea but not for you. This idea is better for people A, B, C,...
  • Bounce ideas off of colleagues, friends, and people I trust that are supportive
  • Decide to put the idea out to the world without an actual plan (Imperfect Action)
  • Make that shit happen!!!
  • Doubt Myself throughout the entirety of the process
  • Do IT ANYWAY!!!!

Put your idea out to the world, regardless of how scary and overwhelming it feels. You deserve to. Doubt Yourself And Do It Anyway!


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A Thanks to Our Sponsor!

I would also like to thank Embark EMR for sponsoring this episode.

Embark EMR is a superb software solution for solo practitioners, as well as group practices. Embark was designed by therapists to be simple and intuitive without all the extra stuff that you don't need so you don't feel like you're being nickel and dimed. Embark enables scheduling with automatic appointment reminders, a note organization system with multiple pre-built templates, and an automated invoice and superbill generation to make it easier on your clients.

There's even a patient portal where your clients can access notes, documents, and generate their own invoices and superbills. Embark EMR is setting a new precedent in EMR functionality and affordability. Embark’s simple one-tier system is $20 a month per therapist, and there are never any extra fees. Try Embark EMR today with a free trial at embarkemr.com.

You can also use code ATPP at checkout for 20% off an entire year of Embark.

Mentioned in this episode:

A Thanks to Our Sponsor, The Receptionist for iPad!

I would also like to thank The Receptionist for iPad for sponsoring this episode. As you prepare for the new year as a private practice owner, one area of your business where you might be able to level up your client experience is from the moment that they enter your office and check in with you. For many private practices, the client check-in process can be a bit awkward and confusing. Clients often enter into an empty waiting room. And chances are you're wrapping up a session with someone else, so there's no way of knowing when they arrive. With a visitor management system like The Receptionist for iPad, you can provide clients with a discreet and secure way to check in for their appointment while instantly being notified of their arrival. What's more, The Receptionist offers an iPad list check-in option where clients can scan a QR code to check in, which negates the need for you to buy an iPad and stand. Go to thereceptionist.com/privatepractice and sign up for a free 14-day trial. When you do, you'll get your first month free. And don't forget to ask about our iPad list check-in option.

Visit the website for The Receptionist for iPad here!


PATRICK CASALE: This episode of the All Things Private Practice Podcast is brought to you by Embark EMR. Embark is a superb software solution for the solo practitioner as well as group practices. Embark was designed by therapists to be simple and intuitive without all the extra stuff that you don't need, so you don't feel like you're being nickeled and dimed.

Embark enables scheduling with automatic appointment reminders, a note organization system with multiple pre-built templates, and an automatic invoice and superbill generation to make it easier on your clients. There's even a patient portal where your clients can access notes, documents, and generate their own invoices and superbills.

Embark EMR is setting a new precedent in EMR functionality and affordability. Embark’s simple one-tier system is $20 a month per therapist and are never any extra fees. Try Embark EMR today with a free trial at embarkemr.com. You can also use code ATPP for 20% off an entire year of Embark

Hey, everyone, this is Patrick with the All Things Private Practice Podcast. I am coming here today to talk a little bit about doing all the things. I've had a lot of you reach out to me recently and asked me to talk about, “How do you do so much? It looks like you've accomplished so much so quickly. Can you please teach me the secrets of your success?” And trust me, I wish I had that secret sauce or recipe. But I do want to talk about this a little bit because I think so often in the age of social media we have this misconception that like everything is easy on the outside looking in, and really glamorous, right?

ate practice business back in:

When I left, you know, I did a lot of the things I tell my coaching clients not to do. I took any fee from any person, I never was able to talk about money, I always felt very uncomfortable, couldn't enforce my policies, I had imposter syndrome all the time, constant fears of failure, and like, I'm not going to be a good business owner. That crossed my mind almost every single day. The phone would stop ringing, I would almost freak out, have a meltdown of like, clearly, I made the wrong choice. I just really struggled with a lot of that stuff.

And the more you grow into who you are as a small business owner or private practice clinician entrepreneur, the more you start to learn that you are really resilient in a lot of ways. And maybe that's because our stories shape our experiences. And for me, you know, some of you have heard me talk about a pretty significant history with gambling addiction, and some early childhood trauma stuff, and really just struggling with sense of self. And I know that as I work through that through my own therapy and having a good support system that really started to shift.

When I was in my private practice, I was doing my own therapy pretty consistently and talking a lot about the insecurities that were coming up for me, the imposter syndrome, the questioning and self-doubt that was happening all the time. And my therapist did a really good job of helping me reframe with like, “No, it's not, you know, that you're not a good therapist, maybe it's not a good fit, right? And that happens all the time in this profession, and in probably any helping profession where if it just isn't a good fit, the trust and rapport isn't there, for whatever reason. It's really hard to be invested in the process on either side of the couch, so to speak. The more you can work through a lot of your own stuff, the more you can, you know, come to terms with, it's not all about me, right? Like, it's just not.

nd once COVID hit in March of:

And by the summer of 2020, I was like, “Oh my God, I am burning myself out to no end and I don't think I can go at this capacity anymore.” And I had, had this dream of becoming a private practice coach and consultant for a long time, and imposter syndrome, insecurity, self-doubt, all the things kind of prevented me from launching that business. I kept telling myself nobody would pay me, I don't have anything to offer, other people do it better, other people do it in the same city, blah, blah, blah, blah, blah. You've probably heard me talk about this many times and are bored of hearing it.

And I just know that I started to put the pieces in place to become a private practice coach. I had lunch with one of my mentors from grad school one day, and she was like, “What are you talking about? Like, people are going to be drawn to your personality? And yes, other people exist, but you're going to do it differently.” And for me, I was like, “Oh, shit, yeah, okay. That makes a lot of sense and I am going to, you know, start to envision that this is the way my career is going to go.”

And so, I put it out to the world, and it was a risk, you know? Just a risk to say, I want to try to do this thing and I don't know if it's going to be successful, I want to just give it a go, and I want to see if I can make this a business that I really love to do. And I think that was a turning point for me. Because in the past, I would have convinced myself to not try, to ultimately say to myself that I needed to shrink back inside of myself, right? And that, that was a great idea, but it was a great idea for somebody else, and my own imposter syndrome definitely would have prevented me from moving forward.

But I decided in:

I gave away way too much of myself, way too much individual coaching, and priced it way too low. But it was a good experience for me to say, “Okay, this is something that can be done.” It was one step at a time, one very small step at a time that led to me creating the All Things Private Practice Facebook group that year, and I never thought it was going to turn into, you know, 5000 plus members at this point in time and growing every day, and a place where I've connected with a lot of close friends now who some of them help me moderate it, some of them are just very involved in my life, and we've never even met in person. So, this all came from taking a risk.

And that same year, I've been following a coach in the industry whose name is Ernesto Segismundo and he's in California. He has multiple businesses, a video production and filming business for therapists, which I've utilized a couple of times. He's a magician, in that regard, a coaching business, a group practice, and he hosts retreats both in Hawaii and throughout the United States.

And I saw him post something like, “Hey, I'm in Fishkill, New York.” Which is where I'm from, and I was like, “What the hell are you possibly doing in FishKill?” I didn't think much of it. We talked for like a minute, and I'm sure he was always getting bombarded by messages, so I didn't want to like make it anything more than just being like, “Why are you in Fishkill, New York?” A couple months goes by and he was mentioning, “Hey, I might go to Colorado, maybe host a small men's retreat out there.”

And I reached out and I was like, “Hey, I'd be interested in meeting and coming.” And he's like, “All right, yeah, I think we're going to make it happen.” And if you know Ernesto, most positive human being in the world, says yes to a lot of opportunities, and you know, at the time, I just was like, “Yeah, I will do it. Like, I will meet you in Colorado. Where do you want to go? When do you want to go? I'll book the plane tickets. I'll book the Airbnb.”

I don't think he expected me to do all of that. And once I did, he was like, “Oh, shit. Okay, I guess we're going to Estes Park, Colorado, and we're going to film your promotional video for your private practice business.” And I was like, “Oh, God.” That made me so uncomfortable to think like this could be out in the world in a bigger way. And I almost convinced myself not to go. I talked about it in therapy, like, “I don't know this person. How am I going to spend four or five days with them? What if it just doesn't go well?” All the things, right? Like, this person's way out of my league in terms of business building and creation? And I was really trying to convince myself to say no.

But for whatever reason, I saw it through and I think it was just again that mentality of, “I'm going to say yes to more things this year and take more risks.” And we hit it off pretty well. We went hiking every day, we ate some good food, we, you know, shared some laughs, we watched New Girl on repeat, because he had never seen it, and we filmed my promotional video. And I left thinking like, “Okay, that is something I wouldn't have ever done before. And I think that is going to lead to some growth in some way.” I didn't know-how.

And I started doing individual coaching with him, and you know, doing some other stuff, and started running free webinars and imposter syndrome, and just connecting with more and more people in the industry. And how I did that was just simply reaching out, like, “Hey, I've heard great things about you and I'd love to just meet you sometime over Zoom.”

Again, COVID created this new world of like internet and an online connection, and I met so many cool people that year. Like, people I never would have connected with, people I never would have met or had any sort of ongoing relationship with, some of whom have become some of my closest friends. Again, never have met any of them in person.

And that continued to lead to this building of momentum of like, oh my God, I'm surrounding myself with more and more people in this industry who are doing so many cool things outside of the therapy room that I never even knew were possible or things that I could even imagine doing. You know, I still felt very out of my league, still had a lot of imposter syndrome, and insecurity, and vulnerability around like, I don't really belong here. And I still don't think I do all the time, either even whatever people have said to me, it doesn't always fully land.

You know, I started to realize, okay, there are so many creative ways for us to use these skills that we have as therapists and clinicians because we are great at connection, we are great at being creative, we are really good at thinking outside the box. Think about how many times you've had to do that with clients, right? To get their needs met and support them, even though maybe you didn't have the resources at your agency job, but like, we figure out a way.

And saying yes in:

My virtual assistant, Kelsey, you know, same thing. I message her all the time, like, nobody's going to buy this coaching program. Like, who's going to sign up for a retreat in Ireland? Who's going to… you know, all of those self-doubt questions, that insecurity, that harsh inner criticism, that perfectionism, that imposter syndrome, all of that comes into play. And that is really painful to experience. But I think it's also a catalyst for me. I create in the pain. I am one of those people who is more creative when suffering and I just know that that is my process. And I've started to kind of appreciate it more and more comparatively to in the past where I probably would have shamed myself or why do I feel this way? You know, you have all these things to be grateful, like positive psychology reframe, which I am just not good at, and don't believe in entirely either. I just really struggle with that.

So, you know, I started to realize that I have all these superpowers, I have all this creativity, I have all these ways of thinking outside the box. But I am definitely not my best cheerleader and I need to surround myself with people who are able to support me, build me up, but also hold me accountable. Like, I don't want people in my corner who are just like rah, rah, rah all the time, because that's not how I am. And it just doesn't work for me, feels a bit disingenuous at times. So, I surrounded myself with people who I really enjoyed spending time with virtually and some of whom I've connected with in-person since that time.

oaching business in August of:

And when Ernesto and I were doing coaching together we talked a lot about this. And I had a hard time transitioning clients out because I had about 35 to 40 on my caseload. I was only seeing about 20 a week, I don't want anyone to think that I don't practice what I preach. But it was hard because you have to have a lot of difficult conversations with clients who you really care about. But I knew that if I couldn't free up time and energy, that I was never going to really be able to go full force into the coaching world and develop a reputation and just do the work that I was feeling really energized by at the time.

And a group practice for me, you know, felt like an ideal situation, because I could refer in, for the clients who wanted to stay in. I still gave alternative referrals. And I could make a little bit of money in that regard, offset some of the money I was making as a full time therapist to allow me to have space and energy to focus elsewhere.

And thankfully, one of my friends here in town was really pushing me to start the group, and he wanted to be like the guinea pig, so to speak, and I was like, “All right, if you wanted to do this, I have no idea what the fuck I'm doing. But I will do it. And you can kind of see how it goes. And let me know what you think.” And he filled up in a month, and I was like, “Oh, I could probably do this again, and again, and again.” Because that's just kind of my personality.

But ultimately, now I have 12 clinicians and a psychiatric provider, and an admin staff, who's one of my best friends, and it just feels good to employ good people, and provide all these services throughout North Carolina, but also just be able to pay them well because I know what it's like to feel the opposite, right? Taken advantage of, underappreciated, underpaid. I didn't start a good practice to get rich, I just started it to offset a little bit of financial stress, so I could focus my energy elsewhere.

So, group practice is in play, coaching business is in play, and I started thinking about a podcast that year, but I continued to convince myself that it could never be successful, who the hell would want to listen to me talk? I certainly don't want to listen to myself talk. But so many people told me like you have such a good podcast voice, you have a lot to speak about, you're very real, you're very authentic. I think a lot of people would get a lot out of this.

And I started to think like, maybe I'll just try it, right? And see where it goes. So, I kept pushing my VA like, “Hey, let's do it. Let's just do it.” And then I would come up with another idea in my neurodivergent brain where I'm like, “Yeah, this idea is more exciting. I'm going to pursue this.” And it kept getting pushed back.

me from that one step back in:

One story I'll tell you and as my brain diverts is that before I met Ernesto, I knew that he hosted the Not Your Typical Psychotherapist Summits throughout the country. And I remember looking at the lineup back in 2018 and thinking, “Wow, how cool would it be to be in a room or a conference with all of these people who are doing things differently, who are so creative, such just incredible human beings and entrepreneurs.”

And I very quickly convinced myself I couldn't afford the registration fee, which is very minimal, by the way, and I couldn't fly to California to do it, although I travel all the fucking time, and that I had no business being in the same room as these people. I had nothing in common, I had nothing to offer. I was a private practice therapist, and I had no ideas. And I convinced myself not to go, and I regret that.

However, I am actually speaking at the Not Your Typical Psychotherapist conference in Nashville in May of this year. And that was not something I foresaw four years ago. I didn't even see being able to be in the same room as these people.

It really can look on the outside, like these things just come naturally and fall into place, and you know, I'll name my privilege in this as a white man and as a cis white man, I get it. Like, life is easier for me in a lot of ways, but I'm also someone who has an addiction history and is a autistic human being. And these things have been really hard throughout life and it's taken a lot of work of interpersonally, and in relationships, and a lot of therapy, and a lot of pain, and a lot of, you know passive suicidality, some active suicidality back in the day, an immense amount of self-doubt, insecurity, vulnerability, imposter syndrome.

was the last time I gambled?:

I never foresaw sitting here talking to an audience of people who listen to me, and you know, reach out for advice, and support, and some of whom have become my closest friends. And, you know, having multiple businesses, how many businesses do I have right now? I mean, coaching and consulting for clinicians, and also entrepreneurs, retreats. I just held my first retreat in Ireland, and it was a unbelievable success. And it was just so surreal to combine my love and passion for travel and connecting human beings and pushing them outside of their comfort zones with experiences they may never have had with making money. Like, holy shit! That feels amazing and I cannot tell you how much self-doubt went into that process, and how often I messaged my friend, maybe Jennifer, AG, or my wife, or my VA, or anyone else that's been involved, you know, to say, like, “I don't think I can fucking do this.”

Like, I am hosting something in a different country during a pandemic, and then inevitably, without my knowing, potential World War, and people are paying me a good amount of money to be here, and are they actually going to think it was worth the money? Are they going to find this valuable? Because I cared so much about the outcome and the process, and it was really lovely. I mean, it far surpassed every expectation I could possibly imagine or have. And I'm actually doing another one next March, and it's going to be an annual thing, and it's already almost sold out.

We have two spots left, which is unreal to me. I just think it's so important to realize that all of this stuff is possible. But we have to take the risk, we have to take that first step, we have to put our stuff out to the world. And I really have bought into the motto that I keep using with my coaching clients and people in my circles, like doubt yourself and do it anyway because the self-doubt is always going to be there. And to some extent, it's completely normal and healthy to doubt yourself.

I always want to have humility. I don't want to feel like I am the expert in any way because I always want to grow, and learn, and I want to make mistakes because we learn from mistakes. But if we don't allow ourselves to just do it anyway, the big ideas, the passion projects, starting the private practice, I mean, all of the things that come with taking that leap of faith on yourself. I mean, not only is it so empowering and powerful, but it's freeing in a lot of ways and there are going to be bumps, and heartache, and constant questioning of your decisions, and all of that is so, so fucking normal. I cannot tell you how normal it is to have these experiences.

g to come to Ireland in March:

And we can easily fall into comparison traps of like, hey, you know, so and so is doing more than me, so and so is speaking at more conferences, selling more courses. But again, we don't know what happens on the other side of the coin, on the other side, when the computer screen goes off, when the social media posts aren't going up. That person may be just blood, sweat, and tears all in. And I bet they are because that's how I am with my businesses. Like, I care very much about the outcomes. I do this way less for public perception and I definitely don't do it for vanity or the perception of success. But I do it because I care about what I'm offering, and I think it's valuable. So, I might make a little bit less money in my group practice, because I pay my clinicians really well. And that doesn't matter to me.

And I might make less of my coaching business, because I pay my support staff really well. But I don't believe we build these empires or these successful businesses without our teammates, without our supports. So, I always want to bring the people with me who have helped build me up because I want to repay that favor, because that has been invaluable for me.

As someone who struggles with connection in general, I mean, I don't know the reasoning behind it, call it being an autistic human being, call it whatever you want, but that is how I can show my love and appreciation back to the people who have done the same for me. And I think it's been really important and inspiring to watch so many different clinicians become so successful outside of the therapy rooms. And that means a lot to me to watch this unfold, because we have to build each other up in this profession.

You know, as mental health clinicians, we do unbelievably important work that gets overlooked, and underappreciated, and certainly underpaid in a lot of ways. However, our skills are so transferable and applicable in so many different arenas. We need to be able to really acknowledge that, and not lose sight over that, and be able to put them in play if we no longer want to do 60 minute one-on-one therapy sessions. And it's really important to also know that saying yes, and taking risks, and kind of betting on yourself, and at least believing that you can try, that I can fail, and I can pivot, and I can bounce back because the way my brain works, I work outside of the box, very often, I figure out solutions, I get creative, and I tap into it as a superpower.

And as an autistic adult, I felt so shameful when I went through testing last year or six months ago and got my diagnosis as ASD, which I fucking hate that term. You know, it's pathologizing. But nevertheless, I understand why the testing exists. And I felt very ashamed and I felt very embarrassed. And then I started to realize, like, I'm so happy that this is the case, maybe it's lonely in a lot of ways, maybe it's painful, in a lot of ways, maybe it makes me feel so much more disconnection, but the people that I do have in my circle, I love them. And I can't always feel it, I can't always access it, but I at least know that they care about me. And I think that's the big shift. And I've also learned to embrace neurodivergence as a superpower, the creativity, sometimes the hyper focus, the ability to think outside the box, the ability to be really intuitive emotionally, and pick up on how people are, you know, feeling as a very empathetic person, you know, that double empathy situation, right? Like, I can be empathetic, and really, truly get how someone's experiencing life just by their energy.

But cognitively, I obviously have a very hard time of understanding what they're thinking. And I have a hard time picking up on social cues. I'm not great at that. That comes with the territory. However, all that to be said to kind of, again, highlight the fact that you can be struggling with some sort of neurodivergence, maybe you're struggling with a diagnosis, maybe you're struggling with a mood disorder, complex PTSD, which is also a part of neurodivergence. I mean, anything in the world. You could be struggling with addiction, you could be struggling with so many things, and you can still be capable of so many fucking things. You can still inspire so many people and when you're helping people in whichever way you decide to go in your journey that has a trickledown effect, that has a ripple effect, that impacts more than just someone in the room.

If you're a therapist, and you're doing one-on-one therapy, you helping someone heal, that then heals their relationships in most ways, that can then heal the family unit, that can then heal the community. I mean, all of this is so impactful and so powerful, and don't lose sight of that. But please know that it does take some risk. You have to be a little risk adverse for, you know, becoming a successful entrepreneur, in my opinion, and you have to step into the fear. Use the fear as a gas pedal, not a brake, doubt yourself and do it anyway.

And for those of you in my circle, who listen to my podcast, who participate in my Facebook groups, who say support me in other ways that, you know, are neither of those two outlets, I really appreciate all of you. And I couldn't do it without you. And I just know that we need people in our lives who get us, who see us, more importantly, and support us. But it's not an echo chamber. I want the people to tell me, I don't really like this, maybe you could tweak this, maybe you could revise this. And that's really important for me.

So, tap into your superpowers, don't beat yourself up if it's not building fast enough. Please don't try to do it all at once. Again, my journey did not start with where I'm at today. There are going to be a lot of exits off the throughway. And sometimes you're going to circle back around, sometimes you're going to make pit stops, sometimes the car is going to break down. But at the end of the day, having that friend with the tow truck or helping you change the tire, or the AAA card, like use your resource, and you know…

But, if you follow me, I'm a big Hobbit, Lord of the Rings fan fantasy kind of person who escapes into it. Sometimes it's been very useful for a lot of reasons. I like to think about it as like Gandalf prompting Bilbo to go on the adventure in The Hobbit. Like, Bilbo’s scared, he convinces himself he can't go, the quest is too dangerous. And then he thinks about it, and he's like, “You know what, I'm going to take the risk. I am going to go have these experiences because we don't grow in our hobbit holes, we don't grow in safety and stagnation, we grow when we push ourselves out of our comfort zones, and that does not come with being easy, or without heartache, or failure, or mistakes.”

So, I just hope that all of you that are listening still can really take that in. And you know, for all of you that have done coaching with me, I really appreciate you putting your trust in who I am and working together to create your businesses and your dreams. And for all of you who are coming to retreats or listening to the podcast, I mean the same things as well. And it means the world to be able to have people trust in what I can offer and bring to the table as someone who didn't believe I had anything to offer for so long.

So, do the work. Get into therapy, if you haven't been in, make sure that you are working on yourself and surrounding yourself with people who build you up and don't tear you down and take some risks. You know, you don't have to leap off the cliff. All you have to do is maybe step down slowly, maybe use a ladder, maybe do whatever makes you feel comfortable, but at least try. This life is too short and we don't know how much time we have left. And I just don't want that to come to an end without saying I at least tried as hard as I could.

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About the Podcast

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All Things Private Practice Podcast
Real, authentic conversations about the mental health side of small business ownership and private practice startup.

About your host

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Patrick Casale

Hi, I'm Patrick. I’m a neurodivergent entrepreneur and therapist who truly believes in the power of disclosure, vulnerability, and authenticity. It’s become more and more clear to me that people are either attracted or repelled by what we put out into the world, and we can’t “be everything for everyone.” Through a lot of trial and tribulation, a gambling addiction, and an Autism/ADHD diagnosis, I’ve learned that being your TRUE self is what draws people in and creates connection. I have tattoos related to Lord Of The Rings, Travel, and Anthony Bourdain. And I travel constantly. Becoming an entrepreneur and working through my fears (they still exist) have allowed me to do more of the things I love. That’s my goal for you with this podcast — to use fear as a gas pedal, not a brake, and to learn how to reclaim and own your voice so that you can create your own entrepreneurial journey.