March 21, 2025
Finding Purpose Through Advocacy and Mental Health, Featuring LCSW Andrew Chiodo
How do life’s biggest challenges shape the work we do?
For Andrew Chiodo, a Licensed Clinical Social Worker and Therapist, the path to helping others started with understanding himself. Growing up gay in a traditional Brooklyn neighborhood, he had to navigate a world that didn’t always accept him. Then, as the AIDS crisis devastated his community, he found himself on the frontlines—advocating, fighting, and supporting friends through unthinkable loss.
But through it all, Andrew discovered something powerful: his struggles weren’t just obstacles—they were shaping his purpose. His journey from activism to social work led him to a career of helping others find clarity, resilience, and healing.
In this episode of No Wrong Choices, we explore how Andrew turned personal adversity into a lifelong mission, what it takes to thrive as a therapist, and the lessons we can all take from his path.
If you’ve ever wondered how to turn life’s challenges into something meaningful, this is an episode you won’t want to miss.
Key Highlights:
- Navigating identity while growing up in a traditional Brooklyn family.
- The impact of the AIDS crisis and his role in LGBTQ+ advocacy.
- How activism led him to a career in mental health and social work.
- The mindset therapists use to support others while managing their own emotions.
- Practical advice for anyone considering a career in therapy or social work.
Listen now on your favorite podcast platform!
To discover more episodes or connect with us:
- website: https://www.nowrongchoices.com/
- instagram: https://www.instagram.com/nowrongchoicespod/
- LinkedIn: https://www.linkedin.com/company/no-wrong-choices-podcast/
- YouTube: https://www.youtube.com/@nowrongchoices
- Facebook: https://www.facebook.com/profile.php?id=100086704773105
Chapters
00:00 - Introduction to Andrew Chiodo
02:16 - Growing Up Different in Brooklyn
08:12 - Navigating the AIDS Crisis
16:21 - Finding Purpose in Social Work
27:04 - Building a Private Practice
35:07 - Modern Challenges in Therapy
44:28 - Media Portrayals of Therapy
49:39 - Career Advice and Final Thoughts
Transcript
WEBVTT
00:00:02.944 --> 00:00:06.471
Some struggles shape us, others define our purpose.
00:00:06.471 --> 00:00:15.483
Those are the themes we explore in this episode of no Wrong Choices, featuring the licensed clinical social worker and therapist, andrew Chiodo.
00:00:15.483 --> 00:00:17.286
Thank you so much for joining us.
00:00:17.286 --> 00:00:23.091
I'm Larry Samuel, soon to be joined by my collaborators Tushar Saxena and Larry Shea.
00:00:23.091 --> 00:00:30.913
Before we kick off, please be sure to support us by liking, following or subscribing to the show, wherever you get your podcasts.
00:00:30.913 --> 00:00:33.707
Now let's get started, andrew.
00:00:33.707 --> 00:00:34.911
Thank you so much for joining us.
00:00:35.320 --> 00:00:36.182
Pleasure, larry.
00:00:36.182 --> 00:00:43.060
It's a delight to be here with you and I'm happy to share the stories and the arc of the career.
00:00:43.401 --> 00:00:50.932
Why don't you set the stage for us and just tell us you know, in your own words, who is Andrew Chiodo and what do you do?
00:00:51.560 --> 00:01:26.671
So, as of today and since 08, 2008, I'm a psychotherapist, licensed clinical social worker in private practice in the Flatiron District, wherein I treat individuals, couples, families and adolescents for a variety of psychiatric disorders, ranging from depression and anxiety to ADHD, bulimia, gambling addictions and some alcohol and drug addictions.
00:01:26.671 --> 00:01:51.923
Um, that's been an outgrowth of many years of being in hospitals and what preceded that, which got me into the work, is a is a whole other story, um, which we can get to, but that's been the primary practice for 17 years privately.
00:01:51.983 --> 00:01:55.650
Got it All right, so let's begin at the beginning.
00:01:55.650 --> 00:02:00.503
You know, were you always a kid who wanted to help people?
00:02:00.503 --> 00:02:04.730
Did you feel that you were built to do do?
00:02:04.730 --> 00:02:06.513
Were you built to be a caretaker, so to speak?
00:02:21.087 --> 00:02:42.060
Well, I grew up in a sliver of Brooklyn called Diker Heights, which was, for better or worse in those days in the late 60s, early 70s, very protected by the mafia and very intense, and so it was very Catholic.
00:02:42.060 --> 00:02:44.588
We went to church every Sunday.
00:02:44.588 --> 00:02:57.306
It was very Catholic, we went to church every Sunday, and in my household the drill was there was Jesus Christ there was the Pope and there was Frank Sinatra, Not necessarily in that order.
00:02:57.306 --> 00:03:03.520
That was it.
00:03:03.540 --> 00:03:04.362
Like you know, you genuflected at.
00:03:04.402 --> 00:03:06.807
Francis, albert and you were good.
00:03:06.807 --> 00:03:18.972
So, but from a very early age I would say six or seven I understood that I was different, and by that I mean I understood that I had an attraction to men, but I couldn't, you know, it's not something you verbalize, it's unconscious.
00:03:18.972 --> 00:03:28.879
And so, as a result of that, you one, I started to sort of pull back because I understood it was dangerous.
00:03:28.879 --> 00:03:39.429
I don't know how I understood it, but I did, and I calibrated my movements, my behavior, to the environment, and so I was very sensitive.
00:03:39.429 --> 00:03:49.487
I was a really sensitive kid, but perceptive, and understood that if I make a wrong move or if I'm to something, I could get my ass kicked.
00:03:49.487 --> 00:03:55.980
And that happened on occasion, as it did to many other kids in the neighborhood.
00:03:55.980 --> 00:04:15.234
And so I understood how to navigate a neighborhood that was very complicated and very kind of intense, because our parents were raised by immigrants and they had one foot in the old world and one foot in the new world.
00:04:15.234 --> 00:04:27.634
They wanted us to assimilate, and so going to Catholic school from grades one through eight was intense and hard, and I understood that.
00:04:27.634 --> 00:04:33.512
When it came time to go to high school, my parents said do you want to go to Catholic school and I said no.
00:04:33.512 --> 00:04:46.593
So they put me in New Utrecht High School in Bensonhurst, brooklyn, where I quickly gravitated to the school's literary magazine and became the editor and started to dabble with writing and words.
00:04:47.940 --> 00:04:56.011
And I was a kid who was always had his head in a book or his face in a book, or I'd go to the bleaker street cinema in those days and watch foreign movies.
00:04:56.011 --> 00:04:59.300
And I wanted to meet guys at 15 or 16.
00:04:59.300 --> 00:05:11.088
And I knew it wasn't going to happen in Bay Ridge, brooklyn or Diker Heights, and so I ventured in.
00:05:11.088 --> 00:05:29.708
Beginning sophomore, junior year of high school, I was in the city every weekend, I was at museums and I wound up working in Red Hook in those days, which was very rough, and at a paper company, and met a fellow of mine, a friend, and he was about six years older.
00:05:29.708 --> 00:05:35.163
And soon enough in my late adolescence, like 16, 17, 18, I found myself in the.
00:05:35.163 --> 00:05:46.069
You know it was post stonewall, it was hedonistic, it was fluid, and I found myself at underground gay discos and studio 54.
00:05:46.069 --> 00:05:55.302
And I was doing all sorts of stuff that was I shouldn't have been doing, but I did it and it was an education and it was a lot of fun.
00:05:56.165 --> 00:06:11.922
I want to ask you just real quick I need to interject because that's such a huge part of the layers of the onion that are you basically, how did that affect you, kind of hiding that aspect of your life for your entire childhood and only letting it out in certain areas?
00:06:11.922 --> 00:06:17.060
I mean that must have had a profound effect on you in terms of how you navigated the world.
00:06:17.201 --> 00:06:37.226
I learned how to compartmentalize very quickly and to show parts of myself to some people and not to others, how to read a room very quickly, how to deflect with humor, how to please people so that they would not get too close to me, so that they would know.
00:06:37.226 --> 00:06:39.305
Now that was there.
00:06:39.305 --> 00:06:53.846
When I got to New York and started to really develop a community, I busted out and was, you know, ready, and so I met my first partner in 1983.
00:06:53.846 --> 00:06:56.932
And we were fortunate to have.
00:06:56.932 --> 00:07:08.625
We had a great setup on Perry Street in the village and we had a floor through brownstone and it was a good relationship and we we both were writers and I started writing fiction.
00:07:08.625 --> 00:07:25.372
Um, I wrote for a literary magazine called Christopher Street, which at that time was the literary magazine of the day for gay people, and also for the New York Native, which was a newspaper, and I did restaurant reviews and theater reviews.
00:07:25.531 --> 00:07:35.586
But at the same time that that was happening, there started to become rumors in the community that this strange gay cancer was happening and nobody knew anything.
00:07:35.586 --> 00:08:00.571
And Ronald Reagan had just been ushered into the White House along with the religious right and all of a sudden everything went from a big party to a big hangover and all of a sudden we found ourselves at the sides of our friends at hospital beds, at clinics.
00:08:00.571 --> 00:08:05.607
I was giving eulogies, and this is not an exaggeration.
00:08:05.607 --> 00:08:06.975
I think I was giving eulogies, and this is not an exaggeration.
00:08:06.975 --> 00:08:09.343
I think I was giving eulogies every quarter for somebody.
00:08:09.343 --> 00:08:25.672
So, like you know, four, five, six a year, and so all our friends, virtually all our friends, passed and, wow, we couldn't fathom what was happening.
00:08:26.451 --> 00:08:34.934
So we um mobilized and joined act up, which at that time was run by larry kramer of, who founded the gay men's health crisis.
00:08:34.934 --> 00:09:12.768
And so we did dyans and we did all sorts of stunts with the stock exchange, and we went to washington and we marched and we laid down in streets and I dealt with families who were throwing their kids out of their houses, and these kids didn't have men, didn't have anything anywhere to go, and we watched robust, healthy, 20-something and 30-something men architects, lawyers, doctors, designers robust guys in the prime of their life shrink to what looks like sort of what you see in the sorrow and the pity in concentration camps.
00:09:12.768 --> 00:09:15.974
And so it was a profound.
00:09:16.840 --> 00:09:24.846
The 80s were transformative in that way, and we were doing social work without knowing we were doing social work.
00:09:24.846 --> 00:09:25.928
You know, we just did it.
00:09:25.928 --> 00:09:43.465
We rolled up our sleeves, men and women, and got to work and by 1989, I decided you know I'm doing this and you know my writing wasn't making money and I figured I got it Meaning being an advocate and being a voice for being a voice, being an advocate.
00:09:43.485 --> 00:09:48.306
An advocate, you know, advocating for people in hospitals so that their partners could be at their sides.
00:09:48.306 --> 00:09:57.491
And the doctors were, some were great, some were not um, so we were doing a lot of social work and I decided I should just go do this.
00:09:57.491 --> 00:10:08.748
And so I went and got accepted into hunter college school of social work on 77th street and that was a great fit because it was very community organized.
00:10:08.748 --> 00:10:16.452
Um, it wasn't so clinical as it was grassroots, yeah, in its in terms of the program that you entered into.
00:10:16.813 --> 00:10:19.462
Yeah, the school program in terms and, and the school was very like.
00:10:19.462 --> 00:10:21.970
You couldn't say at hunter that you wanted to do private practice and I didn't want to do it at the time.
00:10:21.970 --> 00:10:25.922
But you couldn't say at Hunter that you wanted to do private practice and I didn't want to do it at the time.
00:10:25.922 --> 00:10:33.105
But you couldn't say that because then you would be like I don't know, looked not so well upon.
00:10:33.547 --> 00:10:36.496
So if you're ostracized, really yeah, not ostracized.
00:10:36.557 --> 00:11:00.302
But if you wanted to do community organizing and you want to do advocacy, it was very sort of strike oriented and very right up my alley, whereas NYU and Fordham were very clinical and great, but clinical, so graduated in 92 and found and then got a job at, luckily a plum job at Mount Sinai.
00:11:01.424 --> 00:11:03.389
Before we explore that, I'm curious.
00:11:03.389 --> 00:11:11.288
You went into the program and, with everything that you had gone through up until that point, what was your vision?
00:11:11.288 --> 00:11:27.018
Like you knew, you wanted to focus and do something, I guess more structured around what you were already doing, but did you have a vision for how you were going to make an impact on the other side of school for how you were going to make an impact on the other side of school.
00:11:27.038 --> 00:11:27.919
It's an interesting question.
00:11:27.919 --> 00:11:55.960
I don't know if at the time I had a strong vision, but I saw myself as advocating for the marginalized and the downtrodden I don't know what the right word is for people who didn't have a voice and felt very strongly and committed to this population.
00:11:55.960 --> 00:12:14.110
And that's where I segued into Sinai, where I worked with severely and persistently mentally ill patients who were underprivileged and very ill, and in that setting.
00:12:14.730 --> 00:12:18.961
I learned because it's a medical model setting in the hospital.
00:12:18.961 --> 00:12:25.370
We attended rounds, there was medication groups, there was a lot of you know.
00:12:25.370 --> 00:12:36.900
We dealt with very sick schizophrenics, bipolar patients, personality disordered patients every day, and so it was trial by fire in the trenches.
00:12:36.900 --> 00:12:40.105
I didn't know I was going to land there.
00:12:40.105 --> 00:12:43.630
When I was in school I had no idea I'd wind up in a psych program.
00:12:43.630 --> 00:12:52.688
But I did and I took to it and I learned a lot and I had a great mentor who was this woman.
00:12:52.688 --> 00:13:06.635
This woman, elaine Hobson was her name and she was all of five foot two and had hair down to her ankles and was bottomlessly compassionate and terrifyingly strong.
00:13:06.635 --> 00:13:09.687
And I wanted that.
00:13:09.687 --> 00:13:20.460
I wanted to inhabit that world, and so it was a great experience from 94 to 2000.
00:13:20.903 --> 00:13:30.394
I want to step back just a little bit and talk to you about and ask you about your career, getting into it, as to how your family reacted to it.
00:13:30.394 --> 00:13:39.732
And then I mean, maybe does that maybe coincide a bit with when did you come out to your parents about, about, about being gay?
00:13:39.732 --> 00:13:54.129
And then when you obviously you are treating those, as you say, who are on the marginalized, on the, on the, on the outs, not the, but the fringes of society, so to speak, at that point how did they accept your career choice?
00:13:55.279 --> 00:14:02.014
Well, they were really good, actually, about the writing as well as the as the social work.
00:14:02.014 --> 00:14:12.948
As the social work, they were high school graduates, middle class people who worked very hard to put their kids through school.
00:14:12.948 --> 00:14:14.010
They were it's a funny story.
00:14:14.010 --> 00:14:31.330
When I came out to my parents, they were confused and befuddled and the only thing they knew how to do was go to a priest and say you know, my son just came out to me and I don't know what to do.
00:14:31.330 --> 00:14:36.349
And I, they must've gotten a gay priest, because the priest said you know, do you love your son?
00:14:36.349 --> 00:14:38.543
And my mother and father said of course we love our son.
00:14:38.543 --> 00:14:40.470
And they said well then, that's all you need to know.
00:14:41.259 --> 00:14:42.162
Yep, that's a great answer.
00:14:42.162 --> 00:14:42.623
How old were?
00:14:42.623 --> 00:14:43.323
How old yeah?
00:14:43.625 --> 00:14:48.500
I was uh 22 okay and you were in school.
00:14:48.541 --> 00:14:49.523
You were in school at this point.
00:14:49.643 --> 00:14:54.400
I was in school at this point I was dating women, but not dating women.
00:14:54.400 --> 00:14:56.583
I had beards, I didn't have beards.
00:14:56.583 --> 00:15:00.128
Um, it was, it was again.
00:15:00.128 --> 00:15:06.754
It was all fluid but they in six months they were great, like they were.
00:15:06.754 --> 00:15:16.003
They were great and I was very fortunate because I watched kids come out in Brooklyn and they got the crap beat out of them by their parents.
00:15:16.023 --> 00:15:25.294
I mean I can imagine growing up in such an insular community hardcore Catholic as you say for them to be very cool about it is great.
00:15:26.037 --> 00:15:43.923
Yeah, I was very lucky and they were very impressed, if I can use that word, with my choice of career and what I was doing, because they were FDR Democrats and they believed in, you know, helping others and being there for people and they were Christian.
00:15:43.923 --> 00:15:47.596
You know they others and uh, being there for people, um, and they were Christian.
00:15:47.596 --> 00:15:50.950
You know, they were really Christian people in the best sense of that word.
00:15:50.950 --> 00:15:53.825
Um, so they were very supportive.
00:15:53.825 --> 00:16:10.855
Um, I have one older brother who was also very supportive, so fortunately, no complaints there and they were very welcoming of my partners and you know, and very just very humane about the whole thing.
00:16:11.100 --> 00:16:19.674
So I was very fortunate and that allowed me, I think, to feel good about what I was doing.
00:16:21.681 --> 00:16:27.664
So you know that's not always the case that a family supports, especially during that era and where you come from the background, etc.
00:16:27.664 --> 00:16:29.706
So that is a good thing.
00:16:29.706 --> 00:16:34.990
So you're at Hunter College for social work, and how long a program is that?
00:16:34.990 --> 00:16:38.514
How long are you going to be there?
00:16:38.514 --> 00:16:43.317
So were you thinking about private practice at that time?
00:16:43.317 --> 00:16:54.652
At that time you said you didn't really say that out loud, but is it in the back of your mind that you want to do private practice, or are you still just all about the community?
00:16:54.652 --> 00:16:55.662
And I'm just going to fall in line here for a minute.
00:16:55.662 --> 00:17:11.011
So it's a two-year program at Hunter College and you have two days of classwork and three days of internship and what I was doing was doing that and then I was supporting myself through from five to 12.
00:17:11.011 --> 00:17:13.429
I'd go to school five to 12.
00:17:13.429 --> 00:17:16.185
I was word processing, if you recall that term.
00:17:20.807 --> 00:17:21.458
I had a brother.
00:17:23.866 --> 00:17:25.230
I vividly remember that.
00:17:26.780 --> 00:17:44.108
I was working with high-end attorneys at law firms and just you know, sort of proofreading, word processing, getting out at midnight, going home or sometimes going to the Odeon for a burger and doing the same thing for two years.
00:17:44.108 --> 00:17:48.102
And so it was in the back of my mind that I wanted to do private practice.
00:17:48.102 --> 00:17:57.888
But I also knew that that was way down the line, because I knew I needed to get real training, because I really didn't know what I was doing.
00:17:57.888 --> 00:18:04.653
I knew how to, I knew how to care for people, I knew how to be empathic, but I didn't have tools in my toolkit yet.
00:18:04.653 --> 00:18:20.807
And it was only at Sinai when I learned how to do what we call psychodynamic therapy, cognitive behavioral therapy, dialectical behavioral therapy excuse me that.
00:18:20.807 --> 00:18:33.791
I started to feel like I could start to really treat people in a real way, and Sinai gave that to me in spades, like they were great.
00:18:33.791 --> 00:18:38.846
And still in 19,.
00:18:41.752 --> 00:18:49.040
In 2000, I was recruited by Cabrini Medical Center to run their psychiatric day treatment program.
00:18:49.040 --> 00:18:54.359
Ironically, it's the hospital where my father was born, so I had a certain affinity for it.
00:18:54.359 --> 00:19:03.265
Um, it was called Christopher Columbus Hospital in the twenties, um, and so I ran that program and during that time.
00:19:03.265 --> 00:19:05.991
That was very interesting because 9-11 happened.
00:19:05.991 --> 00:19:28.707
And you know I can tell you an anecdote that's funny and not funny about 9-11, because I was at that time I was supervising psychiatry residents, social work interns, non-clinical staff and clinical staff, because I was wearing a clinical hat and an administrative hat.
00:19:28.707 --> 00:19:37.131
I was responsible for all the clinicians as well as the audits from regulatory agencies that gave us our accreditation.
00:19:37.131 --> 00:19:53.851
So I sort of learned how to be a half a lawyer and a full-time clinician and I was supervising a social work intern on the morning of 9-11, at about 8.45, before anything had happened, and I didn't know.
00:19:54.432 --> 00:20:12.183
You know, in those days, right, we only got our news from radio or TV, and so I'm talking to the social work intern and reading her notes and we're talking and the policy at Cabrini was if a patient was going to be absent, they had to call me and they had to tell me why.
00:20:12.183 --> 00:20:18.150
Because I had to assess, you know, somebody's suicidal, is somebody not feeling well, blah, blah, blah.
00:20:18.150 --> 00:20:24.651
So a patient calls me and says, andrew, I'm not coming into work today because a plane has hit the World Trade Center.
00:20:24.651 --> 00:20:34.065
Says, andrew, I'm not coming into work today because a plane has hit the World Trade Center and I said OK, I'm going to call you back because I was in the middle of something.
00:20:34.065 --> 00:20:34.885
And I said are you OK?
00:20:34.905 --> 00:20:35.847
And she said yeah, I'm OK.
00:20:35.847 --> 00:20:36.429
I said OK, fine.
00:20:36.429 --> 00:20:54.494
So I turned to the intern and I say, and I relate what I just heard, and I say so you know, this is somebody who's not necessarily medication compliant and sometimes they can lapse into psychosis and sound like a psychotic episode.
00:20:54.494 --> 00:20:58.063
Yeah, the phone rings three minutes later.
00:20:58.063 --> 00:21:04.671
It's my boss and he says get up here right now we got a problem, right, yeah, bingo.
00:21:04.750 --> 00:21:31.530
So now we have to sort of contain 30 psych patients who are we're all traumatized right, all of us are traumatized and manage them, manage us, manage the staff and and figure out what to do, because we're all waiting for people to come in and sort of all hands on deck, nobody's coming in to the ER or anybody, as we know, right, you know.
00:21:31.530 --> 00:21:41.909
So that was kind of a moment at Cabrini that was very intense, a bookend to that which is nicer.
00:21:41.909 --> 00:21:48.067
Is that one of the things we did at Cabrini, wherein we had very many talented patients?
00:21:48.067 --> 00:22:03.928
They did artwork which we had framed and we turned the whole center into a gallery oh nice, it was really great and invited the hospital to come in and purchase and there was beautiful artwork and so people purchased.
00:22:03.928 --> 00:22:10.826
It was great PR for our program and I think the patients donated the monies to a 9-11 fund.
00:22:11.259 --> 00:22:14.025
Obviously, as you said, you wore two hats administrative and clinical.
00:22:14.025 --> 00:22:20.823
Was there ever a point in your career where you said I want to go one way or the other Because I mean these?
00:22:20.823 --> 00:22:30.949
You know, as a social worker, I think and you correct me if I'm wrong these really are only kind of the two paths you can go, and so many go the administrative route.
00:22:30.949 --> 00:22:33.092
What is the biggest difference?
00:22:33.092 --> 00:22:36.715
And then, in your case, what made you want to go one way or the other?
00:22:49.799 --> 00:23:19.269
Well, I liked both ways, because the clinical allowed me to be with people and to train and to be in the human section of it, and the administrative piece satisfied my closet OCD, which you know you have to dot your I's, cross your T's, make sure your chart notes are right, get your performance improvement numbers up, and so I was very I'm wired for that and so I really it was a welcome relief for me to step away from clinical stuff and focus in on charts.
00:23:19.269 --> 00:23:20.712
I know that sounds really dry.
00:23:23.079 --> 00:23:21.664
That's okay, it's you.
00:23:21.664 --> 00:23:22.267
It was really dry.
00:23:23.369 --> 00:23:28.147
That's okay, it's you.
00:23:28.147 --> 00:23:29.751
I'm the exact opposite.
00:23:29.751 --> 00:23:34.201
Detail does not exist in my universe.
00:23:34.221 --> 00:23:41.087
So it was a way I I guess it was a way I coped, but I felt I could master it, like I could get my arms around it.
00:23:41.087 --> 00:23:59.240
You can't always get your arms around people and their pathology, but you could around a chart note and we always got like the top not to toot my own horn, but we always got the top accreditation.
00:23:59.240 --> 00:24:00.001
We always came in with flying colors.
00:24:00.001 --> 00:24:01.163
My staff was always great and they were wonderful.
00:24:01.163 --> 00:24:18.336
So it was a really good to answer the question a really good combination that worked both from a human place and a I don't know paperwork place and kept me sane a little bit.
00:24:18.336 --> 00:24:23.928
But it meant going in on weekends and looking at charts and you know it was a lot of work.
00:24:24.648 --> 00:24:34.732
All right, so what is the biggest difference, then, between an administrative social worker and a clinical social worker, outside of the paperwork portion of it?
00:24:37.221 --> 00:24:44.269
So that's a good question, because in the hospital system, especially at North General, they wanted numbers.
00:24:44.269 --> 00:24:48.516
They wanted us to get patients in.
00:24:48.516 --> 00:24:50.246
They would double book patients.
00:24:50.246 --> 00:24:52.114
I didn't agree with this, but I did it.
00:24:52.114 --> 00:24:54.201
They would double book patients.
00:24:54.201 --> 00:24:59.297
They were all about getting the, getting the funds and the clinic.
00:24:59.297 --> 00:25:04.506
I had to really balance the clinicians because the clinicians were like, why are they double booking us?
00:25:04.506 --> 00:25:10.115
And inevitably when you double book somebody, the truth is only one person shows you right.
00:25:10.115 --> 00:25:17.282
You book one person, you don't get a client, you don't get money and so you don't make income, you don't make revenue that way.
00:25:17.282 --> 00:25:32.152
And so that's the biggest difference was trying to bridge the understanding that we needed to get financing and revenue and provide good clinical care and those things can be at odds with each other.
00:25:34.060 --> 00:25:42.694
And that was hard because sometimes two people would show up and somebody would have to wait.
00:25:42.694 --> 00:25:48.551
The clinician would be stressed Were they doing their best work, knowing they had somebody right outside waiting to come in.
00:25:48.551 --> 00:25:49.394
It was hard.
00:25:49.394 --> 00:26:11.132
That would be the biggest difference and hospitals have to do that and for better or worse and I'm not proud of this, but Cabrini and North General both and St Vincent's all went under no longer hospitals in New York City and they went under because they were not administratively managed well.
00:26:11.339 --> 00:26:22.027
So, Andrew, can you tell us when you made the decision that you were ready to go out on your own, so to speak, and start your own practice?
00:26:22.027 --> 00:26:23.628
And start your own practice.
00:26:23.648 --> 00:26:42.652
Sure, it was that was 08, 18 years after having worked in three hospitals, that I felt confident enough to pull the plug on institutions and plug in the plug on private therapy.
00:26:43.201 --> 00:26:44.065
And how do you do that?
00:26:44.065 --> 00:26:46.006
Do you hang a shingle?
00:26:46.006 --> 00:26:46.969
Do you place an ad?
00:26:46.969 --> 00:26:48.483
How do you get started?
00:26:48.785 --> 00:26:51.633
Well, it helped me that my boss quit.
00:26:51.633 --> 00:27:04.201
My boss at North General quit and I didn't want to work for anybody else, so I thought I'm out and I was already starting a private practice part-time in the evenings.
00:27:04.201 --> 00:27:10.468
And then I used my network from Sinai Cabrini, north General.
00:27:10.468 --> 00:27:30.261
I had a lot of psychiatrist friends, a lot of social worker friends, and I used that word of mouth and my network to build a practice which took me a good seven years.
00:27:30.261 --> 00:27:35.288
Before I was at 45 patients a week and now I'm at about 35, and that's a good number for me.
00:27:35.749 --> 00:27:41.500
So this question kind of goes without saying that everybody, this field isn't for everybody, right?
00:27:41.500 --> 00:27:44.170
It takes a very, I think, special person to be a therapist.
00:27:44.170 --> 00:27:54.307
But I have to ask this question, jokingly but not really jokingly how sick do you get of listening to people's problems all day long?
00:27:54.307 --> 00:27:56.511
Because that's not for everybody, right?
00:27:56.511 --> 00:28:03.828
It takes, like you said, some real empathy and some real care and some real understanding to, day after day, you have your own problems.
00:28:03.828 --> 00:28:06.900
You're dealing with somebody else's, that's that's a lot.
00:28:06.960 --> 00:28:14.971
Yeah, you know, I think in the beginning it's really, really, really hard because you're not, it's an untrained muscle.
00:28:14.971 --> 00:28:43.330
So if you think of it like going to the gym and working a certain muscle that gets stronger and stronger and stronger over the years, I can sit down now, now and um, and it's the rare occasion that I get a really boring patient, although I've had them and uh what qualifies as a boring question.
00:28:44.373 --> 00:28:45.634
Problems are rudimentary.
00:28:45.875 --> 00:28:46.536
Good question.
00:28:48.441 --> 00:29:13.873
People who are I have to do, I have to be delicate here, people who are repetitive and sort of bring in the same problem every week, every week, every week, without really listening, and you have to know when to intervene, really listen, and you have to know when to intervene so I can, someone can come into the office at a first meeting and usually nowadays I can see what the path is for them.
00:29:13.873 --> 00:29:21.665
But I'm not, I'm not going to say that I have to wait and I have to be patient and I have to know when to when are they?
00:29:21.806 --> 00:29:22.769
ready to hear this?
00:29:22.769 --> 00:29:29.208
You know, know, when are they ready to hear that they're acting like their mother, who they complained to me about for the last six months?
00:29:29.208 --> 00:29:43.425
I'd assume that's what, to me that that seems like the essence of the boring patient you know, and so it just requires and I think this is where karate and meditation helped me be very patient.
00:29:43.425 --> 00:29:49.275
It's the work, it's like anything.
00:29:49.275 --> 00:29:52.066
It's like you go to work and you're a lawyer.
00:29:52.125 --> 00:29:59.571
There are things about doing, being a lawyer that are not so interesting, but you have to do them and you learn how to do them.
00:29:59.571 --> 00:30:02.923
And how does one?
00:30:02.923 --> 00:30:05.990
How does a therapist separate his problems right?
00:30:05.990 --> 00:30:14.233
Because I've gone through parental deaths, deaths of friends, my own sort of personal challenges.
00:30:14.233 --> 00:30:33.201
How do I do that while I'm sitting in front of somebody who's also, you know, telling me their stuff, you know telling me their stuff.
00:30:33.201 --> 00:30:37.952
In a way, it's kind of easier to listen to somebody else and shelve your own problems and then come back to them later in the day.
00:30:37.952 --> 00:30:54.054
It really does prevent you from ruminating about your own worries because you have to pay attention, and so that was always harder in the first half of my career and much less hard in the second half.
00:30:55.500 --> 00:31:02.310
You know I'm wondering about the first part of your career as a young therapist.
00:31:02.310 --> 00:31:11.087
How do you get comfortable, meaning I imagine there's a lot of pressure on you to learn your craft.
00:31:11.087 --> 00:31:16.980
I mean, if you screw up, I mean I can't imagine what those consequences could potentially be Like.
00:31:16.980 --> 00:31:22.743
How do you get comfortable and what are those emotions early on?
00:31:23.464 --> 00:31:25.145
And what are those emotions early on?
00:31:25.145 --> 00:31:32.891
You have to be able to tolerate a lot, a lot, a lot of discomfort in the work.
00:31:32.891 --> 00:31:41.875
It's essential you can't take things personally and you have to be okay with screwing up and you have to own it.
00:31:41.875 --> 00:31:53.025
And I've screwed up and I've said to patients I'm sorry, that was the wrong thing to say, so I apologize.
00:31:53.025 --> 00:31:59.608
And if you do that, you're home free, because patients always know it's my experience at least, and especially with very sick patients they always know when you're lying or not telling them.
00:31:59.608 --> 00:32:00.791
They always know.
00:32:01.759 --> 00:32:08.054
Obviously, your clients unburden themselves with problems to you and you work through it.
00:32:08.054 --> 00:32:12.049
That's got to be a lot for any therapist, for you, for anybody else.
00:32:12.049 --> 00:32:14.688
So who do you speak to?
00:32:14.688 --> 00:32:17.127
Do therapists need therapists?
00:32:17.721 --> 00:32:22.550
In the beginning absolutely In the beginning I was seeing you have a number of different things.
00:32:22.550 --> 00:32:26.461
A I was blessed with a very good supervisor who I met weekly.
00:32:26.461 --> 00:32:29.326
B we had group supervision.
00:32:29.326 --> 00:32:32.232
C I had an outside group.
00:00:02.944 --> 00:00:06.471
00:00:06.471 --> 00:00:15.483
00:00:15.483 --> 00:00:17.286
00:00:17.286 --> 00:00:23.091
00:00:23.091 --> 00:00:30.913
00:00:30.913 --> 00:00:33.707
00:00:33.707 --> 00:00:34.911
00:00:35.320 --> 00:00:36.182
00:00:36.182 --> 00:00:43.060
00:00:43.401 --> 00:00:50.932
00:00:51.560 --> 00:01:26.671
00:01:26.671 --> 00:01:51.923
00:01:51.983 --> 00:01:55.650
00:01:55.650 --> 00:02:00.503
00:02:00.503 --> 00:02:04.730
00:02:04.730 --> 00:02:06.513
00:02:21.087 --> 00:02:42.060
00:02:42.060 --> 00:02:44.588
00:02:44.588 --> 00:02:57.306
00:02:57.306 --> 00:03:03.520
00:03:03.540 --> 00:03:04.362
00:03:04.402 --> 00:03:06.807
00:03:06.807 --> 00:03:18.972
00:03:18.972 --> 00:03:28.879
00:03:28.879 --> 00:03:39.429
00:03:39.429 --> 00:03:49.487
00:03:49.487 --> 00:03:55.980
00:03:55.980 --> 00:04:15.234
00:04:15.234 --> 00:04:27.634
00:04:27.634 --> 00:04:33.512
00:04:33.512 --> 00:04:46.593
00:04:47.940 --> 00:04:56.011
00:04:56.011 --> 00:04:59.300
00:04:59.300 --> 00:05:11.088
00:05:11.088 --> 00:05:29.708
00:05:29.708 --> 00:05:35.163
00:05:35.163 --> 00:05:46.069
00:05:46.069 --> 00:05:55.302
00:05:56.165 --> 00:06:11.922
00:06:11.922 --> 00:06:17.060
00:06:17.201 --> 00:06:37.226
00:06:37.226 --> 00:06:39.305
00:06:39.305 --> 00:06:53.846
00:06:53.846 --> 00:06:56.932
00:06:56.932 --> 00:07:08.625
00:07:08.625 --> 00:07:25.372
00:07:25.531 --> 00:07:35.586
00:07:35.586 --> 00:08:00.571
00:08:00.571 --> 00:08:05.607
00:08:05.607 --> 00:08:06.975
00:08:06.975 --> 00:08:09.343
00:08:09.343 --> 00:08:25.672
00:08:26.451 --> 00:08:34.934
00:08:34.934 --> 00:09:12.768
00:09:12.768 --> 00:09:15.974
00:09:16.840 --> 00:09:24.846
00:09:24.846 --> 00:09:25.928
00:09:25.928 --> 00:09:43.465
00:09:43.485 --> 00:09:48.306
00:09:48.306 --> 00:09:57.491
00:09:57.491 --> 00:10:08.748
00:10:08.748 --> 00:10:16.452
00:10:16.813 --> 00:10:19.462
00:10:19.462 --> 00:10:21.970
00:10:21.970 --> 00:10:25.922
00:10:25.922 --> 00:10:33.105
00:10:33.547 --> 00:10:36.496
00:10:36.557 --> 00:11:00.302
00:11:01.424 --> 00:11:03.389
00:11:03.389 --> 00:11:11.288
00:11:11.288 --> 00:11:27.018
00:11:27.038 --> 00:11:27.919
00:11:27.919 --> 00:11:55.960
00:11:55.960 --> 00:12:14.110
00:12:14.730 --> 00:12:18.961
00:12:18.961 --> 00:12:25.370
00:12:25.370 --> 00:12:36.900
00:12:36.900 --> 00:12:40.105
00:12:40.105 --> 00:12:43.630
00:12:43.630 --> 00:12:52.688
00:12:52.688 --> 00:13:06.635
00:13:06.635 --> 00:13:09.687
00:13:09.687 --> 00:13:20.460
00:13:20.903 --> 00:13:30.394
00:13:30.394 --> 00:13:39.732
00:13:39.732 --> 00:13:54.129
00:13:55.279 --> 00:14:02.014
00:14:02.014 --> 00:14:12.948
00:14:12.948 --> 00:14:14.010
00:14:14.010 --> 00:14:31.330
00:14:31.330 --> 00:14:36.349
00:14:36.349 --> 00:14:38.543
00:14:38.543 --> 00:14:40.470
00:14:41.259 --> 00:14:42.162
00:14:42.162 --> 00:14:42.623
00:14:42.623 --> 00:14:43.323
00:14:43.625 --> 00:14:48.500
00:14:48.541 --> 00:14:49.523
00:14:49.643 --> 00:14:54.400
00:14:54.400 --> 00:14:56.583
00:14:56.583 --> 00:15:00.128
00:15:00.128 --> 00:15:06.754
00:15:06.754 --> 00:15:16.003
00:15:16.023 --> 00:15:25.294
00:15:26.037 --> 00:15:43.923
00:15:43.923 --> 00:15:47.596
00:15:47.596 --> 00:15:50.950
00:15:50.950 --> 00:15:53.825
00:15:53.825 --> 00:16:10.855
00:16:11.100 --> 00:16:19.674
00:16:21.681 --> 00:16:27.664
00:16:27.664 --> 00:16:29.706
00:16:29.706 --> 00:16:34.990
00:16:34.990 --> 00:16:38.514
00:16:38.514 --> 00:16:43.317
00:16:43.317 --> 00:16:54.652
00:16:54.652 --> 00:16:55.662
00:16:55.662 --> 00:17:11.011
00:17:11.011 --> 00:17:13.429
00:17:13.429 --> 00:17:16.185
00:17:20.807 --> 00:17:21.458
00:17:23.866 --> 00:17:25.230
00:17:26.780 --> 00:17:44.108
00:17:44.108 --> 00:17:48.102
00:17:48.102 --> 00:17:57.888
00:17:57.888 --> 00:18:04.653
00:18:04.653 --> 00:18:20.807
00:18:20.807 --> 00:18:33.791
00:18:33.791 --> 00:18:38.846
00:18:41.752 --> 00:18:49.040
00:18:49.040 --> 00:18:54.359
00:18:54.359 --> 00:19:03.265
00:19:03.265 --> 00:19:05.991
00:19:05.991 --> 00:19:28.707
00:19:28.707 --> 00:19:37.131
00:19:37.131 --> 00:19:53.851
00:19:54.432 --> 00:20:12.183
00:20:12.183 --> 00:20:18.150
00:20:18.150 --> 00:20:24.651
00:20:24.651 --> 00:20:34.065
00:20:34.065 --> 00:20:34.885
00:20:34.905 --> 00:20:35.847
00:20:35.847 --> 00:20:36.429
00:20:36.429 --> 00:20:54.494
00:20:54.494 --> 00:20:58.063
00:20:58.063 --> 00:21:04.671
00:21:04.750 --> 00:21:31.530
00:21:31.530 --> 00:21:41.909
00:21:41.909 --> 00:21:48.067
00:21:48.067 --> 00:22:03.928
00:22:03.928 --> 00:22:10.826
00:22:11.259 --> 00:22:14.025
00:22:14.025 --> 00:22:20.823
00:22:20.823 --> 00:22:30.949
00:22:30.949 --> 00:22:33.092
00:22:33.092 --> 00:22:36.715
00:22:49.799 --> 00:23:19.269
00:23:19.269 --> 00:23:20.712
00:23:23.079 --> 00:23:21.664
00:23:21.664 --> 00:23:22.267
00:23:23.369 --> 00:23:28.147
00:23:28.147 --> 00:23:29.751
00:23:29.751 --> 00:23:34.201
00:23:34.221 --> 00:23:41.087
00:23:41.087 --> 00:23:59.240
00:23:59.240 --> 00:24:00.001
00:24:00.001 --> 00:24:01.163
00:24:01.163 --> 00:24:18.336
00:24:18.336 --> 00:24:23.928
00:24:24.648 --> 00:24:34.732
00:24:37.221 --> 00:24:44.269
00:24:44.269 --> 00:24:48.516
00:24:48.516 --> 00:24:50.246
00:24:50.246 --> 00:24:52.114
00:24:52.114 --> 00:24:54.201
00:24:54.201 --> 00:24:59.297
00:24:59.297 --> 00:25:04.506
00:25:04.506 --> 00:25:10.115
00:25:10.115 --> 00:25:17.282
00:25:17.282 --> 00:25:32.152
00:25:34.060 --> 00:25:42.694
00:25:42.694 --> 00:25:48.551
00:25:48.551 --> 00:25:49.394
00:25:49.394 --> 00:26:11.132
00:26:11.339 --> 00:26:22.027
00:26:22.027 --> 00:26:23.628
00:26:23.648 --> 00:26:42.652
00:26:43.201 --> 00:26:44.065
00:26:44.065 --> 00:26:46.006
00:26:46.006 --> 00:26:46.969
00:26:46.969 --> 00:26:48.483
00:26:48.785 --> 00:26:51.633
00:26:51.633 --> 00:27:04.201
00:27:04.201 --> 00:27:10.468
00:27:10.468 --> 00:27:30.261
00:27:30.261 --> 00:27:35.288
00:27:35.749 --> 00:27:41.500
00:27:41.500 --> 00:27:44.170
00:27:44.170 --> 00:27:54.307
00:27:54.307 --> 00:27:56.511
00:27:56.511 --> 00:28:03.828
00:28:03.828 --> 00:28:06.900
00:28:06.960 --> 00:28:14.971
00:28:14.971 --> 00:28:43.330
00:28:44.373 --> 00:28:45.634
00:28:45.875 --> 00:28:46.536
00:28:48.441 --> 00:29:13.873
00:29:13.873 --> 00:29:21.665
00:29:21.806 --> 00:29:22.769
00:29:22.769 --> 00:29:29.208
00:29:29.208 --> 00:29:43.425
00:29:43.425 --> 00:29:49.275
00:29:49.275 --> 00:29:52.066
00:29:52.125 --> 00:29:59.571
00:29:59.571 --> 00:30:02.923
00:30:02.923 --> 00:30:05.990
00:30:05.990 --> 00:30:14.233
00:30:14.233 --> 00:30:33.201
00:30:33.201 --> 00:30:37.952
00:30:37.952 --> 00:30:54.054
00:30:55.500 --> 00:31:02.310
00:31:02.310 --> 00:31:11.087
00:31:11.087 --> 00:31:16.980
00:31:16.980 --> 00:31:22.743
00:31:23.464 --> 00:31:25.145
00:31:25.145 --> 00:31:32.891
00:31:32.891 --> 00:31:41.875
00:31:41.875 --> 00:31:53.025
00:31:53.025 --> 00:31:59.608
00:31:59.608 --> 00:32:00.791
00:32:01.759 --> 00:32:08.054
00:32:08.054 --> 00:32:12.049
00:32:12.049 --> 00:32:14.688
00:32:14.688 --> 00:32:17.127
00:32:17.721 --> 00:32:22.550
00:32:22.550 --> 00:32:26.461
00:32:26.461 --> 00:32:29.326
00:32:29.326 --> 00:32:32.232