In just a few short weeks my home will be filled with the sounds of my newborn infant daughter, which in itself is ironic given that the term “infant” is from the latin “infans,” which means, essentially, “incapable of speech.” Nonetheless, gurgles and coos and neh’s and wah’s will be heard, in a language all their own, and I am, in short, excited. As of late my mind drifts to all kinds of places, most of which are probably a bit romantic, but sweet nonetheless – a pint-sized ball of curls and swaddling clothes asleep on my chest; flirtatious smiles capable of melting even the hardest heart; barely-there kisses; tender touches from tiny hands that humble the spirit and wet the eyes.

Perhaps not surprisingly, a gentle stirring in my soul beckons me to appreciate life a bit more just now. My sense is that this is some of that proverbial, “you just don’t understand till you’re a parent” business the old folks used to talk about.

All of this fanciful revering has lead to a good bit of more serious contemplation as well, which I’m told is quite normal by my book, “The Expectant Father” by Armin A. Brott. And I suppose it does make sense – all of this talk of new life helps one to realize his own will one day end. When I look up from my daydreaming I find nearly-teenaged nieces and nephews and aging parents caretaking for aging grandparents. And the circle of life seems to be leaving increasingly deep impressions like crop circles on the green fields of my experience.

Genesis 3:19:
“…until you return to the ground,
since from it you were taken;
for dust you are
and to dust you will return.”

Book of Common Prayer (p.485, Burial Rite 1):
“In sure and certain hope of the resurrection to eternal life through our Lord Jesus Christ, we commend to Almighty God our brother Ryan, and we commit his body to the ground; earth to earth; ashes to ashes, dust to dust.”

The underlying message here isn’t just written in the ancient texts or in the ritual processions of the religious. It is a common thread woven into the tapestry of nearly everything I see.

My wife and some friends and I recently saw the movie, “The Time Traveler’s Wife,” in which Eric Bana plays a man with a rare genetic anomaly that causes him to live his life shifting back and forth through time, appearing at this moment or that. He has, of course, fallen in love, and is therefore cursed to watch himself as a young man who doesn’t yet know the woman who he’ll marry, and then again as an old man who dies in her arms, and the arms of his daughter.

Even the last Simpsons episode I watched depicted Homer and Grandpa on a jaunt to Ireland to live it up as part of one of Grandpa’s bucket list wishes. And the fact that I can use the term “bucket list” and you know what it means only reinforces my point.

And music is certainly no place to look for an escape either. Imogen Heap laments the passage of time in one of my favorite songs, “Hide and Seek.” The imagery practically creates itself out of thin air right before you: “hide and seek/trains and sewing machines/all those years/they were here first/oily marks appear on walls/where pleasure moments hung before/ the takeover, the sweeping insensitivity of this still life.”

But that’s just it – life isn’t still, though it is most desperately insensitive. The seconds and minutes and hours and days and months and years keep passing me by whether or not I protest. And all the while, the sirens’ song is heard with increasing clarity:

You are mortal. You will die.

I am mortal. I will die.

What’s a boy – er, man to do?

I guess haven’t quite figured out the answer yet. But, seeing as how the passing of time, and even my own death is not at all unlike the inevitable forced assimilation by the Borg, I have begun to develop the attitude, “resistance is futile” (yes, that was a Star Trek reference). So, I might as well enjoy the passing of time rather than spend my years trying to escape it. But to do so, I must conceptualize death as something other than a forever haunting, scythe-wielding, hooded Skeletor.

In 63 B.C., Seneca (Lucius Annaeus) wrote, “You will die not because you are sick, but because you are alive. That end still awaits you when you have been cured. In getting well again you may be escaping some ill health, but not death.”

It is as simple as that. To be alive, and indeed to truly live, is to die. This is echoed in a hundred clichés about self-sacrifice and tales of all-for-one and one-for-allism, but I’ve always conceptualized it in such immediate terms. The soldier recklessly charging a hill, the death of the hero for God and country, that sort of thing.

But to go on living wisely (see the prayers of Thomas Aquinas), in light of my imminent death, as if that death is in fact the most real part of my life, is something much more confounding. It is much more gradual, much more difficult, much less glamorous. Yet, my experience thus far also suggests it may be much more meaningful.

Prior to this stage of life, I found myself in hearty agreement with and placed shoulder to shoulder among the ranks of my contemporaries who wonder at the self-centeredness ending possibilities of marriage, children, and family life, and, though we may not have said it, most any meaningful connection with other humans that asks us to exit our one act, one actor, often plotless tragedies. We could scarcely dream of committing to something we weren’t convinced would work or of bringing children into a world so cruel and unforgiving. Even now this line of thinking is provocative to me.

But part of what makes a tragedy a tragedy is that no matter what unfolds at its beginning and end, the main character, the hero, the one everybody likes, still ends up dying in the end. This is, in a word, tragic.

Likewise, whether they are extended, self-indulgent monologues or complex confluences of interactions that have ripped us from our infatuations with self, our lives will still end.

Perhaps if others are involved, if we have truly given ourselves to others, and ultimately, to God, something profoundly transformational occurs;

Perhaps we learn to laugh at ourselves.

Perhaps we learn to delight in seeing others preferred over ourselves.

Perhaps we learn to smell fresh lilies, to rub ocean-foamy sand between our toes, to take our coffee with chicory, to play hooky from business meetings to go on dates with our daughters, to love and be patient with our sons.

But my sense is that it for me, it will be profoundly difficult. That in this life of living I will experience more pain than ever before. More joy too, but still, much more pain. And that if my previous behavior is any indication, in response to that pain life will begin to take on a hazy gray quality when I’m seduced away from those to whom I’ve given myself because it just hurts too much.

But I dream that maybe I’ll hear my wife’s voice or hear my daughter’s singing, or I’ll just feel the gentle prompting of the Holy Spirit in my heart, and the yellows, and greens, and blues, and browns, and dashing violets and splashy oranges will come rushing in again and I will feel alive for the joy and the pain alike.

All of this will be subtle, however, which is what makes it real life and not some technicolor dream movie. And I will need God’s help to be sensitive to the changing tides of myself and my world. But when I am most sensitive, if I am listening, a Voice will remind me…yes, yes! Life is worth the living.

And perhaps, when life is worth the living, my imminent and unavoidable death, my mortality, can only serve to remind me how fearfully, wonderfully alive I am.

I hope so.

rtn

**

–Man fully alive is the glory of God.–
St. Irenaeus of Lyons, 185AD, Against Heresies (Lib. 4, 20, 5-7; SC 100)

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Good to Great for Counseling Therapy Practices

I hear often the story of when a person buys a counseling practice, only to have the previous owner open a new practice down the street. Having a good reputation in the community, the therapist who sold his or her practice quickly attracts all the clients and referral sources from the business / counseling practice that was sold. This is a prime example of a leader who was building their name, not their practice.

Often I meet counselors who are building their name first, and building their business or counseling practice second.

Also, often I see CEOs / owners of counseling practice who—in addition to minding their business—are seeing lots of patients, writing books, or spending their time giving trainings, etc.
All of these behaviors need to end if one is going to be a level-five leader for their therapy business. As Michael Gerber in “The E-Myth” explains, one cannot work in the business and on the business. A leader has to work on the business.

2. First Who, Then What

Getting the right people on the team comes before vision, strategy, and tactics. Collins words it as getting the right people on the bus, and the wrong people off the bus.

Put your best people on your biggest opportunities, not the biggest problems.

Don’t waste time trying to “motivate people”. The right people are self-motivated but can be de-motivated.

Good to Great for Counseling Therapy Practices

This applies to the therapy practice fairly simply, but it is often overlooked. If you are running a therapy practice you need not only talented clinicians, but great marketers and public relations, great business operations, exceptional billing, extraordinary reception.

Our receptionist / scheduler at Thrive Counseling, Barbara, is a great example of having the right person on the Bus. She does her job with excellence, and it benefits the management, clinicians, and clients alike.

3. Confront the Brutal Facts (But Never Lose Faith in the Potential for Greatness)

• It is impossible to make good decisions without an honest confrontation of the brutal facts
• Create a culture wherein the truth can be heard
• Lead with questions, engage in dialogue not coercion and conduct
• Autopsies of the business without blame
• Remember that Charisma can be as much a liability as an asset because a strong personality often deters people from presenting the brutal facts

Good to Great for Counseling Therapy Practices

Take a long look at the problems your therapy practice is facing and fix them. You will always have issues—if you think you don’t, you’re either missing them, or you’re out of business.

Examples: Billing procedures, payroll, managing time off, managing office space, marketing costs, hiring procedures, client scheduling or rescheduling, etc.

4. The Hedgehog Concept

Organizations should only do what they 1) can be great at, 2) can make money at and
3) have a passion for doing.

The Hedgehog Concept is not a vision or strategy, but an understanding.
Good-to-Great companies set their goals and strategies based on understanding; others set their goals and strategies based on bravado.

Getting the Hedgehog Concept is an iterative process.
Hedgehog companies are simple creatures that know one big thing and stick to it. Other companies are more like foxes that know many things but lack consistency.

Good to Great for Counseling Therapy Practices

I see many therapy practices that provide ancillary services as a way to make ends meet, or because it seems like there is a quick profit to be made. I have been consulted several times by persons who have told me to also provide “Business Consulting” or trainings for corporations. True, there may be money there, but we currently don’t care enough about it to have a lot of passion for it, and I’m not sure we would be GREAT at it, the way we are great at saving marriages and helping people overcome anxiety.

In addition, the Book Focus (al Weis and Jack Trout) also promotes this concept, because a business can only be known in the marketplace for one thing. Sometimes what increases revenue on the short term, hurts the company brand in the long term. For example, if thrive became a place that provided Therapy and Energy Supplements, that might make money immediately, as some of our clients would probably purchase them. However, down the road, why would we want to dilute our brand, our message, and our mission? This would harm any counseling practice in the long run.

5. A Culture of Discipline

Sustained great results depend upon building a culture of disciplined people who take disciplined action within the three circles of the Hedgehog Concept.

A culture of discipline requires disciplined people who engage in disciplined thought and then take disciplined action.

The single most important form of discipline for sustained results is fanatical adherence to the Hedgehog Concept and the willingness to shun opportunities that fall outside the three circles.

The purpose of budgeting in a good-to-great company is not to decide how much each activity gets, but to decide which areas best fit within the Hedgehog Concept and should be fully funded and which should not be funded at all.

“Stop doing” lists are more important than “to do” lists.

Good to Great for Counseling Therapy Practices

Many therapy practice work on a fee-for-service model, where clinicians “come and go” and see a few, or many clients, depending on how much money they want to make.

In many industries this is known as having “hired guns.” The thing about hired guns is that they don’t care a lot (or any) about the company. There are present to do work and make money. They will not be committed, they will not tell others about how great the company is (unless they are telling another hired gun how great the pay is), and eventually they will move on to start a competing practice (this happened ALL THE TIME).

Instead, build a culture in your therapy practice where you invest in your clinicians, and you clinicians invest themselves in the growth and health of the practice. This starts with the hiring practice—I never hire clinicians who say they are “just looking to pick up some hours” or clinicians who eventually want to “end up with my own private practice.”

6. Technology Accelerators

Good-to-great organizations avoid technology fads but become pioneers in applying carefully selected technologies. Good-to-great organizations use technology as an accelerator of momentum, not a creator of it.

The key technology question is does it fit directly your Hedgehog concept? If yes, then becoming a pioneer in the technology makes sense. If no, you can settle for parity or ignore it entirely.

Good to Great for Counseling Therapy Practices

For therapy practices, the issue is rarely one where they are trying to overuse technology. Usually it is the opposite—that they fail to see how EHR (electronic health records), advances billing processes, online scheduling, and other technologies can make their practice run better for management, clinicians, and therapy patients.

7. The Flywheel and the Doom Loop

Good-to-great transformations look dramatic and revolutionary on the outside but actually are organic, cumulative processes on the inside. There is no single defining action, no grand program, no one lucky break or miracle moment.

Sustainable transformations follow a predictable pattern of buildup and breakthrough – like pushing on a giant, heavy flywheel.

Average organizations follow the “doom loop” pattern. They try to skip buildup and jump immediately to breakthrough. Then, with disappointing results, they lurch back and forth, failing to maintain a consistent direction.

Good to Great for Counseling Therapy Practices

In Jims Collins more recent book “How the Mighty Fall” he talk about how once the Flywheel gets going, businesses get bored of it—and begin to start pushing new flywheels. For therapy practices, my advice is to keep pushing the flywheel of providing great therapy to your target market—don’t get sidetracked with trying to start a CEU education company, or a DVD program, or a series of self-help books, or …the list goes on and on.

Turn your flywheel until you company is moving from good to great—then keep turning it some more!

NOTE: This post is a work in progress! If you find it helpful, excellent! If you find grammatical or syntax problems, stay tuned! I hope to refine it in the future. Today I’ll be working on my therapy practice in Cambridge, MA, Thrive Boston Counseling. (www.thriveboston.com).

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If your inbox is overflowing, if your work desk is buried under a wide pile of papers, if your house is a mess–I want you to know this:

Organization is a skill; it is not a personality trait. Anyone–with the training and practice–can drastically improve their organization skills.

I talk to my clients about this because often improving organization both decreases stress and increases peace of mind.

David Allen is author of a Book called “Getting Things Done,” where he describes his method for personal organization. It’s probably the best–and most practical–organizational method to date. The book is a dry read, and the audio-version isn’t a lot more interesting. However, the personal organizational system Mr. Allen promotes actually works.

Here is a wikipedia article about the “Getting Things Done” personal organization program:

http://en.wikipedia.org/wiki/Getting_Things_Done

JACKPOT: Here is a 45 minute presentation, about personal organization, staring David Allen, presented recently to staff at Google. This is actually the most interesting thing I have seen on the topic yet.

Are you looking to improve your organization, and get some peace of mind about your list of “to dos”?
If so, get a cup of coffee, relax and watch this presentation. It probably cost Google tens of thousands of dollars, and it’s yours for free.

Be well,

Dr. Anthony Centore

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