Frontiers of Psychotherapist Development

At the Bleeding Edge of Development, Reaping Benefit for Our Clients.

Tag: practice

What are the Perennial Pillars for Psychotherapists?

For songwriters, the perennial pillar is song craft. It is not technical mastery.

A songwriter knows that technical agility at an instrument is not going help him create a better song. It’s easier to identify and work at improving techniques. It’s much harder to improve on their ability to engage with listeners through their songs.

At the time of this writing, in 2017, we commemorate three critically acclaimed albums.  


Perrenial Albums

If there are any three records you’d need to hear in your lifetime, it’s these.


Half a century ago, The Beatles released Sgt Pepper’s Lonely Heart’s Club Band. 30 years ago, U2 brought us the follow-up album from The Unforgettable Fire, Joshua Tree. And 20 year ago, Radiohead released Ok Computer. Modern music has never been the same since.

Sgt Pepper would never have had the chance to grow if the Beatles did not take the time away from touring.

The Irish boys from U2 narrowed the focus based on the American landscape in the making of Joshua Tree. Because they made that decision, the album reflected their evolving social consciousness of their time. The album become a timeless piece of art.

Radiohead’s Ok Computer, was spawned from the band’s disillusionment with a relentless touring schedule, resulting in their lives becoming a tour-bus race at the speed of light from one concert venue to the next. They had enough. A break was needed. 

(As an aside: It is significant to note that none of these records were the artists’ first albums.)

Consider three lessons we can draw from these landmark albums:


1. Take the Risk and Push Your Limits,

2. Get a Guide, and

3. Study the Process, Not the Outcome.


Continue reading

The Pursuit of Excellence is Not the Pursuit of Perfection

the pursuit of perfection vs the pursuit of excellence

“An expert is a person who has made all the mistakes that can be made in a very narrow field.”

-Niels Bohr, Danish physicist and Nobel Prize winner.

The pursuit of getting better at our craft in therapy requires us to make fine distinctions. One of them is to make the distinction between  the pursuit of excellence vs. the pursuit of perfection.

The pursuit of perfection has no room for mistakes. Failing = Failure. The pursuit of excellence treats errors and blunders as grist for the mill. It is where the ordinary magic of growth happens. Failing ≠ Failure.

The pursuit of perfection is rigid, exacting, clinical and cold. The pursuit of excellence is flexible, warm and humanistic in the emotionally charged interpersonal encounter of two persons coming together to co-create a better life for one party. In turn, the giver is moved to be a better person in return as well.

The pursuit of perfection is self-centered. The pursuit of excellance is others-centered. It uses the self in service of the other. It doesn’t use the other to enlarge the self.

The pursuit of perfection sees therapy as a performance. As if held within the judging gaze of another, it’s ego is at stake, thus it confines to it’s comfort zone. The pursuit of excellance seeks to re-form the status quo, seeking to reach beyond our comfort zone.

The pursuit of perfection suffers chronic anxiety. The pursuit of excellence embraces uncertainty, and accepts the uncontrollable force of life circumstances. It treats the turn of each event as teachable moments for the inner life. Its antidote to worry is to believe that the most perfect thing to do is to embrace imperfection.

The pursuit of perfection wears a fixed mindset hat. The pursuit of excellence wears a  growth mindset hat, which promotes receptivity in learning, and learning to take feedback seriously and not personally.

Finally, and perhaps most importantly, the pursuit of perfection thinks it is pursuing excellence.

May we make room for the pursuit of excellence in the new year ahead!

– Daryl Chow, Ph.D.

*imperfect image above hand drawn with Paper & Pencil  on iOS device

#3. Clinical Practice vs. Deliberate Practice: Why Your Years of Experience Doesn’t Get You Better


In times of change, learners inherit the Earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists. 

– American moral and social philosopher, Eric Hoffer (1973, p. 22)


Question: Would you hire this guy? Imagine an NBA basketball player decides that he doesn’t need training outside of competitions, because he has gotten so good at his game, and all he needs to do is continue play more game. If you own an NBA team and it’s drafting day, would you invest in this guy? Probably not. You won’t bet your money on the “Learned”, but you would do so for the “Learners”.

Many mental health professionals, counsellors, psychologists, psychiatrists, nurses, social workers, and marriage and family therapists alike, spend hundreds of hours clocking in our practicum years in order to be accredited and/or licensed to practice. Not to be confused, the word “practice” here means, well, work. It is not practice per say. It is the real deal. We end up falsely believing that since we have spend all that time in practice during our educational years, we are well equipped for the real work, that is, clinical practice. Thank goodness not everyone falls into this “Learned” group. Others whole heartedly believe that learning is lifelong. These are the “Learners”. But both “Learned” and “Learners” group have to deal with the same professional development issue: What keeps me at sharp at my skills in helping people?

It is crucial to make a distinction between work, and work that targets at getting us better at what we do. Therapists often confused that they worked hard to improve at their craft when they find themselves experiencing “flow” states during sessions. Clearly, when we are engaged in the therapeutic encounter, we strive to be fully present, attuning and relating to the emerging emotions and unfolding lived experience of this person who is in front of me seeking help and counsel. We get taken by this process, sharing a specific aim to ameliorate the person’s suffering. Continue reading

#1. Therapy Learnings: A Memorable Practice


Memory is the mother of all wisdom.- Aeschylus


There are many lessons I’ve learned that I’ve forgotten. Some times, my memory is like an old bookshelf, stock-piled with endless stories, references, and guidebooks, but shelved in such randomness that there is no quick-way to find a particular book.

If I can’t recall an important lesson, what good is it that I’ve have experienced it, but not able to recall it?

About two years ago, this geriatric problem confronted me. I was in my group private practice in Western Australia (SPOT), and I was seeing a young adult male, Jonah, who was depressed over the past two months. After the first two initial sessions, even though I felt that we had a good working rapport – along with his scores on the Session Rating Scale (SRS) indicated good engagement levels, I was daunted by the fact I still didn’t seem to get a sense of who he was. It was this paradox of communicating with him, but not knowing him. At that moment, I didn’t know what more to ask in order for me to get a sense of who he is, and how he was experiencing himself. It was an odd feeling, because I didn’t often run into such a situation relating with a person, what more after a few sessions. Aside from reflecting my disconnect with him, I didn’t know what else to do at that point.

My drive home left me thinking about Jonah. I ruminated, closed to bashing myself (with soft pillows) for not being able to get deeper with this pleasant and friendly client in my therapy office. Then my mind wandered. I felt like listening to the Beatles (Perhaps I wanted some Help!). Sgt Pepper was near at hand. I hit that last track.

It was “A Day in The Life”… That’s it! I’ve learned this before. Several years back, during my post-graduate training, I read Irvin Yalom’s wonderful book, The Gift of Therapy. One of the golden nugget that struck me then was about Asking for a blow-by-blow account of a person’s daily activities. How could I have forgotten this?

At the start of the next session, , that was what I did. I requested for him to share with me the details of what he did the day before, almost an hour-by-hour account. In between his part-time work at the supermarket and swimming training, he was ferried about by his mother. Why was this important? He felt he was not in control of his life, and he also felt bad if he was to tell him mum to back off a little, especially since she has been divorced and alone. Further discussions revealed that he also longed for connection with his mates, but has been plagued with a sense of inferiority (e.g., working in a low paying job, no car).

This session with Jonah struck home on two fronts. The first was that we were able to progress further on improving his life situation. He ended up sitting his mother down and having a talk about needing to move along in his life. The second was for me. I was confronted with the fact that my retrieval memory was like my old bookshelf, messy and disorganised. I needed to get organised.

Since then, on friday afternoons before I pack my bag and head home, I gather my thoughts and spend 3-5 mins, typing out my TherapyLearnings for the week.

Here’s How:

At the end of every typical work week, look at your work calendar to recall all of the clients that you’ve met. Pick one of the cases that strike you the most in that week. Write down one thing that you want to remember about your experience. This could be a lesson that you’ve learned from interacting with that client, a feedback that was given to you, even a mistake that you felt you’ve made? (Did you know that more effective therapists are more likely to elicit negative feedback than less effective counterparts? More on that).


1. You develop your own learnings, bespoke from your own clinical experiences.
2. In a month, you will have 4 learnings. In a year, you will have 48 such gems in your pocket! (well, probably less that 48. I highly encourage holidays).
3. The act of writing it out helps with the consolidation process of the memory, as well as aiding future retrieval. Be forewarned of this pitfall: “Since it’s so important, I will be able to recall it.” For a busy professional, things easily slip us by, and we miss making a pit-stop at the memory bank.

Suggested Format:

You can choose to do this on a notebook that you dedicate to your own TherapyLearnings, or you can choose to do this on apps for portable devices (e.g., tablets, smartphones). Free note taking apps like Evernote and Simplenote are available, and it syncs on multiple devices. Although I use Evernote premium for my web-clippings and other more advanced note-taking, I use Simplenote for my TherapyLearnings. As the name alludes, it is no-frills. Just create a tag therapylearnings for each of your weekly notes. A bonus feature about this is that you can share and collaborate each note with your colleagues in your TherapyLearning Group (more on this below).

Date: ________

Title: A succinct and catchy title helps e.g., A Day in a Life

Learnings: A one-sentence summary of this therapy learnings

Example: Provide a brief snippet of the case that led to this learning, in order to make it more alive and personalised for your future recall.

Keep each TherapyLearning to a maximum of 140 words. Constrains are helpful. For busy professionals, time is a luxury. By self-imposing a word limit (the 140 word limit was borrowed from Twitter), it helps to get the mind to pack a punch, keeps it focused, and makes it doable on a regular basis.

TherapyLearnings Group: I recommend doing this on any individual basis. Complementarily, a TherapyLearnings group can be formed to sharpen this weekly nuggets. A small group size of 4-5 is beneficial. It would typically take 45-60mins for each to share. One tidbit for someone can also be an impactful vicarious learning for the other. Resist the temptation of going into the group without first noting your therapylearnings down. This helps to keep the phenomena of group-think at bay. Walter Lippmann’s quipped, “where all think alike, no one thinks very much.”


Recall -> Pick one -> Write

Psychotherapy is one of the few professions that practice actually means the real thing. Our task is to predispose ourselves to learn from our ongoing clinical practice. In order to learn, we must develop the ability to have a retrievable memory. This is the hallmark of a memorial life. This is worth remembering.