Peplau's Ghost
Psychiatric-Mental Health Nurse Practitioners (PMHNP) discussing using psychotherapy within their practice. Four PMHNP program directors and a biostatistician from across the Unites States sharing their passion on how psychotherapy can help people with nearly all their emotional problems.
Peplau's Ghost
From Pill-Slinging to Soul-Healing: One Nurse's Journey
What if psychiatric mental health nurse practitioners could practice in a way that truly transforms lives instead of just managing symptoms? Dr. Brooke Finley joins us to share her remarkable journey from traditional nursing to psychoanalytic practice, revealing a path many NPs don't even know exists.
From her earliest days volunteering in healthcare at age 16, Dr. Finley found herself drawn to the profound human connections that emerge in moments of vulnerability. Despite being told that psychiatric nursing "wasn't real nursing," she persisted, eventually discovering psychoanalysis—a therapeutic approach that offered the depth she had been seeking. Through her own personal analysis and extensive professional training, she developed a practice model that places the therapeutic relationship at the center, rather than medication management.
Dr. Finley challenges the status quo with thought-provoking insights, suggesting that "probably 70% of people on drugs right now wouldn't need to be on them if they had good therapy." She dismantles common myths about private practice, revealing how therapist-focused care can be both financially sustainable and professionally fulfilling. Her work through the Finley Psychoanalytic Psychotherapy Fellowship aims to build bridges between nursing and psychoanalysis, creating pathways for NPs to incorporate these powerful therapeutic principles into their practice.
Most compellingly, Dr. Finley connects modern psychotherapy practice back to nursing's roots, reminding us that Hildegard Peplau envisioned psychiatric nurses as primarily therapists who would provide intensive clinical work with their patients. This historical perspective offers a powerful validation for NPs seeking deeper engagement with their patients. As Dr. Finley puts it, "You can only take patients as far as you've gone yourself"—a challenge to both personal and professional growth that resonates with the true spirit of nursing. Visit finleypsych.com to learn more about the fellowship or connect with Dr. Finley directly.
Dr. Brooke Finley (brooke@finleypsych.com)
Let’s Connect
Dr Dan Wesemann
Email: daniel-wesemann@uiowa.edu
Website: https://nursing.uiowa.edu/academics/dnp-programs/psych-mental-health-nurse-practitioner
LinkedIn: www.linkedin.com/in/daniel-wesemann
Dr Kate Melino
Email: Katerina.Melino@ucsf.edu
Dr Sean Convoy
Email: sc585@duke.edu
Dr Kendra Delany
Email: Kendra@empowered-heart.com
Dr Melissa Chapman
Email: mchapman@pdastats.com
Yeah, just my take on things. My answer to number two, I think we're recording.
Speaker 2:Welcome everybody back for another episode of Pep Lau's Ghost. I am really thrilled to have our next guest here, dr Brooke Finley. So excited to have her here, and every podcast I'm pretty much forgetting to introduce my guest. This time it is purposeful. It's because it's just Brooke and I and so that's going to be a great kind of little fireside chat just between the two of us, and so look forward to getting to know about her passion and her interest and the things that she does to really promote the role of psychotherapy within the psych mental health nurse practitioner role.
Speaker 2:So I'm so excited to introduce Dr Brooke Finley, who I understand is originally from Arizona but currently lives in New York. She has her own solo practice in New York in which she describes it as being very, almost fairytale, living out in this very nature-based environment that she lives in, which I hope to hear more about as we continue talking. Very impressive, she has both her PhD and DNP. She is triple certified as a psych mental health nurse practitioner, also specializing in addiction and also in I'm going to forget the last one APHN, which I always miss that certification.
Speaker 3:Advanced Practice Holistic Nurse Yep, all good Holistic nurse yeah, I don't know why.
Speaker 2:When I see it I think public health, but yeah, kind of totally off there. So, um, but the other very fascinating thing is that she runs the Finley psychoanalytic psychotherapy fellowship, um, which I again hopefully talk a bunch about today. Um, just had uh getting ready for my uh semester here we're getting into our first semester with our students getting into psychotherapy training and was promoting the fellowship as well. So maybe hear some people from Iowa to join your fellowship group. But let's get going. And again, thank you, dr Finley, for joining us. And I know, like I said, just read your website and a lot of good information there. But maybe beyond the website, you know what first got you interested in doing psychotherapy or just in psychotherapy in general.
Speaker 3:Sorry, yeah, no, no, that's. These are great questions and and thanks again for having me. It's such a delight to be here and I hope this can be enriching for every listener in their own way. You know, I got interested in psychotherapy in my undergraduate and that was just. I got a psychology minor, I did a bunch of gen eds in high school and was able to take more interesting classes and I got really interested, yeah, as like a 19 year old. So I was really interested right away because I was just curious how the mind can heal and what that would be like and what that looked like. So I guess I was really curious from a young age. But I was really interested in just how people think and how they work. Since a child, I mean, I was very interested. I have a huge passion actually for classical literature, literature. So I was reading like the Russian classics as a teenager. I was like interested in existentialism and absurdism and I had a really great AP English teacher from France who had us read all of the literary classics from France. So I was really blessed in that way to have her as a public school student. Um, I also got really interested in psychology and I don't you know the arizona public school system is not to be desired, but we had a two-year holocaust literature um section when I was in junior high and high school and we read a lot about people overcoming like massive psychic trauma and I was really curious about how they did that and and a lot of these people like I'm thinking like Victor Frankl and just how did they survive and how do they think about this. So that was what I think has got me interested. And then I you know there's professions around this right. So then I got really interested and when I was in nursing school I was.
Speaker 3:My psych rotation was by far the most interesting. I was so interested and I remember I think it was like early on my instructor's like you're going to be a psych nurse, I can tell. And I was like cool, I like these people and I'm like I think I'm in the right place. And it was so. It was such a bummer because we did a rotation where we had like a mock transition to practice where we'd work full, you know, 12-hour shifts at our West Western Nursing School and I said I know I'm going to be a psych nurse. I'm like for sure about this, I would like to do a psych rotation. They said that's not real nursing. That was what I heard and there was like there's no way you're ever going to do a psych rotation. So I did med search, which I learned a lot I'm not knocking it but I just felt like there was a disparity on how important psych is and just in general. So that was that kind of set my path.
Speaker 3:And then I started doing CBT courses, even as an RN, and started doing solution-focused trainings because I thought they were helpful when I was working as a psych nurse on an inpatient unit just doing crisis resolution, and I usually ran all of our behavioral codes because I just could stay calm in the eye of the storm and when the storm was passing through I could really kind of work those kind of difficult situations. So I started getting CBT training and ACT and did REBT and even MBSR you know mindfulness-based and I did a lot of meditation when I was younger and so I was very interested in all these therapies. But it seemed like all roads led back to Freud. So I was like where are all these ideas coming from? You know, and I, you know, I found out that Beck had analytic training, the guy who invented CBT and I was like where's all this CBT you know? And I, you know, I found out that Beck had analytic training the guy who invented CBT and I was like where's all this CBT you know going? And so I just started reading more Freud and I was on an inpatient unit and actually I was so lucky One of the attendings actually had psychoanalytic training and he had the best outcomes with patients, like by far.
Speaker 3:He prescribed really well, but he understood the patients deeply and I'd ask him questions and he like really understood the patients' minds and I was like, wow, this is so profound. And he's like, oh, you should go get analyzed. And I was like what's that? He's like you know you lay on the couch and like you talk about your mind. I'm like people still do that. And you know I'm in a Arizona's an analytic desert. You know there's very few analysts there. So I found like one of three analysts in my area. Thankfully I was so lucky to have that experience and I was just so lucky.
Speaker 3:So I started doing analytic work and that was really interesting to me and as a I had CBT in college and that was helpful to a point and had some psychodynamic work, but I found it really wasn't the depth that I was seeking. So I was seeking it intellectually, you know, as a professional, but also as a, you know, I think everyone should be in therapy if you're providing therapy, it's just kind of makes sense. Prevening therapy, it's just kind of makes sense. So, you know, it's good to have both angles, as the practitioner and the patient. And so I started doing, you know, analysis, and I guess it was eight years ago yeah, it seems like a long time ago. It was, I guess. But that was really what sold me. You know, I always felt like therapy was important. I mean, that was just never a question in my mind.
Speaker 3:And I think, you know, if there was an option, I unconsciously did this. This was so funny I laughed at myself when I applied for my first NP license. I accidentally applied as a CNS, because I really wanted the CNS. And I looked back in history and I was like I really wish I could have been a CNS because that was the original model. It was a psychotherapy model. Peplaw wanted inpatient therapists to be psych nurses who were not providing medication or doing hygiene. They were doing, you know, intensive observation and clinical work with their patients and yeah. So I accidentally applied for a CNS license because I knew I wanted to do more therapy and I felt so hungry.
Speaker 3:In grad school I'm like I only had such a brief intervention, you know, and you know there's so much variance in clinical experiences that I just really was hungry for therapy. Meds were kind of very secondary for me. So, yeah, I got really interested just to do more and so, you know, I knew it was going to have to be postgraduate, unfortunately grad school, even if you had a good purveyance of supervision. But the PEPFLAW model, I think, did graduate pretty competent psychodynamic therapists. But the model was totally different. You had didactic work. You didn't prescribe, you had your own supervision, you with like a one-on-one supervisor for your own therapy cases, you had your own analysis and you had group therapy. What a rich experience. And that was your focus for two to three years.
Speaker 3:That's not our case now, you know therapies. Therapies may be one unit, you know, and and that's I, you know that is the standard, which is unfortunate. So that kind of leads me into how I got to the fellowship. But I basically just started once I like there was someone warned me that psychoanalysis takes your finger and then it grabs your wrist and then it takes your elbow and then your whole arm and then it pulls you into a hole and you can never get out, and that was my experience. So I'm like totally in the hole.
Speaker 3:I'm probably like past the crust of the earth right now in the molten lava section, but I'm totally in it and I got so much more interested because it was really helpful and you know, I'll never forget. I mean I was doing therapeutic work with patients. Even in med management you can always make an interaction really therapeutic even if you have 15 minutes. But I got really interested in doing, you know, depth psychotherapy and with patients and I didn't even really have to find it. I think my patients felt something and they're like I want you to be my therapist. So I had patients asking me when I started getting more trainings and they're like can I just do meds and therapy with you? Like you're really helpful and like I really appreciate how we work together. So we had that therapeutic alliance which, as a nurse, you Like I really appreciate how we work together. So we had that therapeutic alliance which, as a nurse, you automatically know so important. But you know I had the skill set, I think, and the training to back it up. So you know, I started doing a lot of trainings.
Speaker 3:I started getting individual supervision, you know, psychoanalytic supervision, which is really different than maybe a physician looking over how you wrote your note or what you prescribed or something. That's totally different supervision. So I guess it just kind of yeah, it just kind of slowly dragged, dragged in, kind of got pulled in, but you know, it never felt like work and it's just been endlessly fascinating. It's one of those things where everything you learn about the world and about life kind of coalesces into helping you understand your patient, understand yourself at the same time. So it's just been a really fascinating journey. But I guess, to answer your question, summarize it, I've always been interested in people. I've always been fascinated by people. I've always wanted to understand what it means to be human, what are our experiences? Why are some people desperately miserable? Why are other people well-adjusted, adaptive, you know, and everything in between. So I was just really curious. I think that curiosity led me to psychoanalysis.
Speaker 2:Yeah, wow, thank you, brooke. I was thinking, you know, this is a true example of a lifelong learner, someone who even started in elementary school, kind of, and the great experiences that you've had. My wife and I continue to tell our kids, you know, life is a good teacher as long as you let it teach you. So you just kind of have to let it guide you. I mean, and it's impressive, impressive for me because you know you, you followed your heart, you followed your gut. Whatever you want to say, I mean you just you knew this was the direction you wanted to go. And then you had these real sentinel moments. You know the psychiatrist, who you know. You felt really kind of connected with people and had better outcomes.
Speaker 2:It just seemed like that's what you wanted to do and kind of these big questions continue to haunt you. I assume, I mean that's they haunt me for sure. They just continue to drive me to understand people. Like you said, why are some people really? They kind of get stuck and they, they really struggle to get out, where the other people, you can put them through the ringer and they just kind of seem to come out fresher on the other side. It's a, it is remarkable. So one of the questions I have, you know, which actually gets off top maybe you know the list of questions we typically ask, but very much you know. Thank you for explaining kind of that, that line, that and again, I know that's the way you explained. It is very linear, but I'm sure there's lots of kind of twists and turns as you go along. And so what are the twists and turns really? Cause you know how does, how do you get that addiction certification?
Speaker 2:You know the Karns and where where does that kind of fit into all this stuff?
Speaker 3:basically, yeah, yeah, no, that's such a great question. So when people think of addiction, I don't think they think of psychoanalysis, but they're actually completely connected. So I was working a lot with you know, and I guess this is another thing I should say psychoanalysis is not just for what we'd consider like neurotic people or like people with, like your typical, like high functioning anxiety, depression, like I have. I have supervisors who psychoanalyze people with schizophrenia and they stop having psychosis without medication. I mean there's, there's the work of bertram karen, um wilfred varecki does a lot of work with and like these are people who only treat psychotic patients. Period, that was, that was their bread and butter.
Speaker 3:My analyst treated, you know, psychotic patients in inner city Detroit who were, you know, on the homeless or had poverty. I mean they had to have social workers involved. You know Maslow's hierarchy is a real thing. But you know you can work analytically with just about anybody because it's a way of thinking, it's a way of being. You don't have to do quote analysis where they're laying on the couch. You know, four or five days a week, you can do analytic work with just about anybody. So I just want to be clear, like that, this is something you can do and you can do analytic work with people who have severe addiction, and there's actually I mean, I think the most helpful work that I have come across is there's two analysts that are kind of addiction experts in this area.
Speaker 3:There's Henry Crystal, and Henry Crystal is an amazing man. He survived the Holocaust and he only worked with people with severe addictions and he actually thought that addiction was a way to regulate intense emotions. Regulate intense emotions it actually was a way for people to have control and have consistency. And related this back to the subject of the addiction was actually the help or the consistent caregiver for this person. It was. They had a real relationship with their drug of choice, whatever it was, or processing gambling porn, whatever it was. So it was actually when I started reading that and understanding that and that coupled with my real clinical experience. You know, nothing that I really do is not come from my own experience working with patients, so I'm not just speaking from like a theory land or like an ivory tower, like I was. You know I still am in the trenches, but I was in the trenches for a long time, you know, and I was like how can I help people better? You know like I'm like what? What can I learn to really be more effective? So the work with Henry Crystal really was profound and when I started helping people who had severe addiction and it was like, actually, this is your way to have control and this is how you, and it was really about them understanding their feelings that was really what it was and using me as a person that they could rely on. Maybe for the first time they could rely on someone else to want to understand their feelings but help them, regulate them and find other ways. So there was a lot that you can do and Lance Dodes Henry Crystal's passed now, but Lance Dodes is a psychoanalyst in Boston and he has so many great books that are really easy actually some for patients but talks about addiction from an analytic viewpoint and I've had so much success. That's the thing is like I just it was so much better than like an AA or a 12 step because I'm like some people don't want that or even smart recovery it can work for some people. I'm not knocking it, but for the really difficult cases that are, like you know, someone's like on the cusp of, you know, dying or overdosing, like these were ways that I was really effective. So I do think you know that's how I got to that area and then my other certification with holistic health.
Speaker 3:You know I've always kind of been a hippie. You know just like I love nature. I grew up in nature, like my family. I come from a long line of people who homesteaded and farmed. You know, on both sides of my family you know back like we're talking like some generations ago, but there's always been a connection to nature. And when I started learning more about pharmaceuticals, I'm like these are just plant derivatives packaged up really nicely. And you know, when you start really laying out the history of nursing, you go into like the, you know the herbal healers in like 13th century England and you start to really learn about the history of plant medicine. And so I really just kind of connected those. And you know so many patients have side effects with meds I mean so many and it's like, okay, if I can give someone a really high dose of saffron and it's more effective than Prozac, I'm going to do that. And, by the way, this is a legitimate thing, you know, and that was great. And so you know I just started.
Speaker 3:You know a lot of people have lifestyle problems. You know it's like if you're not exercising and you're eating really highly processed food and you don't have people in your life that care about you and love you like anyone would be depressed in that situation, unless you're schizoid, you know, so like and that's your happy place, that's fine. But you know we have real deep needs because we're animals, you know, and Freud never was thinking that, oh, you're just a mind Like we have a bodily ego as in, like our body is how we interface and process with the world and what we make decisions on, you know, between our mind and our body and reality. So it's our center point and we know as nurses that we have to respect bodies. Right, there's some things that are really really physical and I think we come from a really great perspective, having such intimacy with the body that we really can understand how that interfaces with the mind and there's really no separation in my experience and the body can kind of be the unconscious, as in it remembers everything, it holds everything and that, I think, perspective from a nursing perspective, we bring so much actually to psychoanalysis and therapy because we have such an intimate knowledge of that process, such an intimate knowledge of people in regression right when they go into younger states.
Speaker 3:You know, I've had patients call me mommy. I'm, like you know, as a 19-year-old nursing student. They're screaming mommy, mommy, and I'm walking in the room, you know, and I'm like, okay, like that's the role I'm in right now, you know. Okay, like that's the role I'm in right now, you know. So we deal with people in very severe extreme states not to gift, I think, and we can bring a lot in our therapy with patients because we have that experience. And you know, I just think it all kind of coalesces nicely. So I just kind of followed my intuition and instincts and, you know, wanted to learn more and just have always been interested in learning more and um the lifelong learner.
Speaker 2:Yeah, Just following your following your heart.
Speaker 1:I love it, I love it.
Speaker 2:The next question I want to ask is you know and again I think this is a bit of a loaded question, of course, because if you ask me, I mean there's going to be tons of different thoughts that go through my head Um, but can you recall like the first time, like you had a real powerful experience doing psychotherapy? You know kind of thinking way back and kind of maybe towards the beginning of your career or maybe more more recent? I mean again, just maybe just kind of let that first memory and first you know success story kind of you wouldn't mind sharing that with us, and and maybe why that's so meaningful for you sharing that with us and maybe why that's so meaningful for you.
Speaker 3:Yeah, yeah, I mean I can tell you my first like therapy story, but I was like 16. Okay, I was a volunteer on a med surge unit because I was really interested in healthcare from a young age. I just thought what a beautiful way to help people. And you know, I was torn between being an English professor and a nurse, which are kind of odd things, but I was like I can read about people's lives or I can be a part of their story, and but I was 16 years old and this woman just got moved up from the emergency department and she had a broken femur and she I was just literally living with water. It wasn't anything major. I'm like I need water and she's sobbing. I mean like sobbing like very, very intense pain, and I just walked over to the bed and I just said what happened. You know, and I I don't see people sobbing on med search force, that much. I mean they're usually okay. So you know, stable ish and um, she just detailed that. I mean I'll make a long story short.
Speaker 3:There was domestic violence happening in the house and she got thrown downstairs and her femur broke.
Speaker 3:This is an older woman and and I'm like a pretty, I'm not like naive, but a little bit naive, you know, 16 year old and she just asked if she could hold my hand and she told me her story and time had flown by and actually I just I sat with her for an hour so you know, solid therapist hour held her hand and just like was a presence for her and I really felt what she was feeling and I was just, you know, being genuine and connecting with her and I was glad that she was there, you know, because she was out of this situation and, oh my gosh, I'll just never forget her. She stopped crying, you know, maybe about like 30 to 40 minutes in, and she just like she just really kept it with me and she said this is the nicest thing anyone's ever done for and I was like I'm going to be a nurse now. I was like done, I'm sold, I'm like this is the best job, and then you find out.
Speaker 2:I should be on a t-shirt or something. My gosh, that's amazing.
Speaker 3:But then you find out when you're a nurse you can't spend an hour with every patient. So that really hurt. I was like what? I can't do this. So that was really disappointing. Now porn now I get to do it now, but, um, it took a while. But yeah, that was my like first experience. I was like wow, a healing presence, like just being present, being there, being compassionate, being with somebody and allowing space for them to just experience what they're experiencing, and like that was like so powerful for me. So that's my first like nursing slash therapy story, I guess, but I love it. Yeah, no, that's, that's great.
Speaker 2:Yeah, again told you where you needed to go and and led you down that path, and that's awesome. I, you know one of the questions that come to mind because I hear this a bunch and you know I I try to stay off Facebook, but it's one of those things like it sucks me in as well. But you know there's a PMHNP Facebook page which is amazing and a lot of amazing people on that, but frequently hear a lot about people and it's just and maybe it just kind of hit me when you said it too about this idea that you spent this hour with this person and then you got into nursing and then discovered you can't spend an hour with people. I think that's what I hear a lot.
Speaker 2:You know people really struggling with this idea of you know finding the things in practice, what they want to do, versus kind of what a clinic tells them they have to do, right, I mean this you know pressure to prescribe, pressure to prescribe refill medications and things like that, which, again, I think a lot of people then do what you are doing. You know they get in their own practice and things like that. So can you share a little bit about that, like that? So can you share a little bit about that? You know the drive, or did you always know you kind of had to have your own practice, or you know kind of doing what you wanted to do, or did you try it another way and get kicked out, or what was the story there?
Speaker 3:Yeah, oh, I can tell you. This is like this is really clear to me. I remember this. I was like I had an existential crisis my first week of nursing school. They said what is your main priority? And I mean they're just being realistic, but they're like what is your main priority? When the patient comes in? I said to help them. They're like wrong to get them ready for discharge. And I was like I cried. I went home and I cried for like two hours. I'm like I made the wrong choice. You know, I was like no, and I'm like I'm just here to help people, which I think a lot of well-meaning nurses are. And I literally made up my mind the first week of nursing school. I'm like I have to be a nurse practitioner, but I'm like there's no way I'm going to be able to do what I wanted to.
Speaker 2:Isn't that the joke for med school when people ask that question? That's, I want to help people when they really kind of don't.
Speaker 3:But yeah, that's interesting. That's a good memory. Yeah, well, I shouted a bunch of doctors when I was in high school. My family's like you need to really make sure if you want to be a doctor, you want to be a nurse. And I was like, and the doctors were like running from room to room two minutes, weren't answering patients' questions. I was like sorry I got to go. I'm like I can't do this. I was like I need more time and I'm like, yeah, and I was just like this is not for me. So I really wanted more, more time and more care. So I guess, yeah, that's probably not sick, there's some wonderful physicians out there, but I really wanted the hands-on like, really wanted to be there for people in a different way. So, yeah, I made up my mind the first week of nursing school like nope, a nurse practitioner.
Speaker 3:And I was like this isn't gonna work, um, though, I love being a nurse, but you know you're so limited in a lot of ways. You know, just with there's just a lot of limitations you can you have such an impact, you have so much responsibility, but you you're kind of really limited, so I wanted a little bit more freedom. Um, yeah, so I'm sorry, let's see we were no, I think I derailed you.
Speaker 2:I apologize no, no, you're okay so, but we were talking about you know how you got into like a private practice and things like that.
Speaker 3:So, yeah, that's very easy to talk about, okay. Yeah, so I couldn't do the 15-minute med wheel. I was just like I have no idea who this person is. We don't even have any time to talk about things. And you know, I'd have patients come in and they're, even if I did an hour eval, this is like a blip. You know, I'm only getting certain things and there's a ton of stuff that's repressed, right. So I was like this isn't going to work for me. And yeah, I've pretty much like transitioned as quickly as I could into doing therapy plus meds and then actually now I don't even prescribe, I de-prescribe. So if people come in and they want to get off of medication, I'm all, all for that.
Speaker 3:I've had a lot of experience de-prescribing, even like serious drugs. I mean like like antipsychotics, immune stabilizers. But there has to there, you have to do it really safely. You have to know how to do it is not is not something you learn in school. So I've had a lot of experience with that. So I feel comfortable to do that.
Speaker 3:But I knew right away I was like this isn't going to work. And you know, I really wanted to understand people, Like once again, like I really wanted to help, I really wanted to understand. You know I think this is just my personal opinion probably 70% of the people on drugs right now probably wouldn't need to be on them if they had good therapy. And a lot of things are time limited too, so and maybe you know the other 30% maybe they wouldn't need to be on their whole life. You know so. And there are some people who definitely need medication because it's a public safety issue, like you know. So there's a lot of variance, but this is the thing Everything needs to be individualized to that person. And if you don't have enough time to really understand someone and I mean time, like I usually work with patients, you know I would.
Speaker 3:I mean some people just need a short period of help. You know, maybe with an issue I have a lot of people come to me that life transitions right, that's, and but they've never had a serious challenge, you know, with their ability to adapt to something. So I might see them for a few months, but I mostly treat people for years, and when you see someone for years, one to five times a week, I mean I know more about my patients than they probably know about themselves sometimes Like I could write a 200-page book about every single one of my patients because I know so much about them and I really care about them. And that's the thing is. You should never have more patients than you can care about. And if you can't care about your patients, what are you doing? Like, at least for me. And there are some people who don't want to talk to their patients. They just want to prescribe. That's fine, they can be prescribers, but that's not why I went into this.
Speaker 3:So I really I felt like private practice was the best way that I could really use my own talents and gifts in a way that I could help people. But also there's so much more freedom in private practice, like I could make my own schedule. That's really important. You know, I have a friend who's a therapist who's like a complete night owl. Like his circadian rhythm is like noon to 4 am and he literally works from like 1 to like 9 pm at night and that's his schedule and he loves it and he's happy. So I'm like everyone can make their own schedule that works with their body, that works with their lifestyle, and that's important because we need to show patients that you know, I mean, not everyone has the luxury of being a therapist and loving their job, but you know, people should see that you can have freedom, and psychoanalysis is really about freedom and choices and understanding. So we need to embody that.
Speaker 3:And I felt like when I was working for other people, I really couldn't provide the treatment that I wanted to in the way that I wanted to, and also I don't really think it's right for people to take my money, so I didn't want to work for somebody. I'm like this is ridiculous. Like you haven't been to these trainings, you're not with this patient. Why is someone else involved in this? So you know, I really wanted to change that. And there's this odd belief out there that if you stop prescribing, you're going to take a pay cut. I have never heard of that from any competent psychoanalytic psychotherapist yeah, that's a myth.
Speaker 3:Yeah, thank you for saying that, yeah I just because people make all these excuses, oh I can't do that. Or you know it's scary to open your practice for sure, and like, do it in a way that makes people say I had a part-time job while I transitioned to full-time private practice, so like, and I did that over like six months, so like you don't have to just jump right into things. I also think it's not a great idea to graduate and then just jump right into your own practice unless you're really sure that that's what you want to do. But you know it's good to learn. I didn't just jump right into private practice. I had a lot of time, you know, just working for other people, so I kind of learned what not to do and what to do. But yeah, you will make so much more because you're not paying for someone else's. You know just their I don't know just everything about it. Like it's just better to have your own control over your space, over your life, and I think it's just great.
Speaker 3:And you know I don't take insurance either, by the way, and a lot of therapists don't who are in private practice and you know are skilled. So I'm not saying that people who don't take insurance aren't skilled, but if you take insurance you'll be full forever. By the way, you have to deal with all the problems of taking insurance and I just don't think ethically anyone else needs to know what's happening in someone else's therapy. And it's like having like an audience for someone's extremely and I mean psychoanalysis. It's like everything's on the table. You know anything. It's whatever's on the person's mind and it can be, you know, very disturbing or embarrassing for them or shameful, like no one needs to know about that, especially not a corporation who I don't know what they're doing with their data. So you know I prefer to do private practice and not take insurance for that reason. But you know patients can get out-of-network reimbursement. There's no issues with that. But you know it is a complete myth that you will not make more money. But the problem is and this might be a question you've had on your mind but well, how do they become competent therapists? If you're not a competent therapist, you're not going to keep patients and that's just like. I mean I guess you could be an incompetent therapist and have patients stay with you for other reasons. But you know you've got to really know your stuff and you know I've done. I mean I've spent well over $100,000 on postgraduate training. That's okay, it's been worthwhile. Also, have your own practice so you can write it off as business expense. Okay, like there's so many reasons to have no practice, please do that.
Speaker 3:And I invented this fellowship because I wanted to show nurse practitioners there is another way to live, there's another way to be. You don't have to be a med management hamster wheel. You know you are just a pill slinger like and I'm not trying to be pejorative, but like I mean, that's what people say, this is how they feel. I don't feel like that at all. It's like a person of a trained professional who is offering an experience to someone that's life-changing and that feels great and I can sleep at night. So you know you really can have another way of being, you can have another way to practice and I truly think that nurse practitioners have so much to offer psychoanalysis and psychoanalysis has so much to offer nurse practitioners and I just think it's a beautiful partnership. And, like I said, nurses are primed with such a special experience of just being nurses that they can bring so much and I can tell you from my experience you know working just to change this, because when I first started getting interested in analytic training.
Speaker 3:I had to get a waiver because they weren't accepting nurse practitioners. Because they're like you guys want to do this. We've never had you here before, can you? And there was like maybe 10 in the whole US who had done any kind of analog training.
Speaker 3:I'm like so, I made it my like, my mission. I'm like, no, I'm going to pave the way for other people so they can do this, because it's kind of a. It's a flashback to the past, but it's been so long people don't remember. You know, peplau was 50s, 60s and then an NP role took over in the 80s. So a lot of people who are CNSs are in their 70s and 80s. They're retiring. There's a gap and so I'm trying to almost take us back, but take us forward in a way too.
Speaker 3:And you know I've had such a good reception. You know, and I've worked really hard on the national level. I lead the Advanced Practice and Nursing Committee at the American Psychoanalytic Association. We have scholarship funding now for nurse practitioners getting into training. We have a committee. We're working really hard just to pave ways. But there's so many more nurse practitioners interested in this way of working and I've been so proud of the fellows that I've had. They've gone on to do trainings at prestigious institutes. They feel respected, they feel really cared for, you know, and everyone's growing, you know, and there's individual characteristics, right. But as a whole I think nurse practitioners have a lot to offer and they're very welcomed now.
Speaker 3:But I think they were just like who are you? Why aren't more of you here? You could do therapy. That's under your license, you know. They just didn't know. And it's this big divide because these worlds don't converge, unfortunately very often, and part of that is because psychoanalysis is usually in you know people who are in private practice. They're not in the community centers and community spaces that nurses traditionally practice in. So I think there was a relational gap. I think there is an educational gap in some ways that we just don't learn this stuff very often it's not a huge part of our curriculum and people don't have psychoanalytic mentors anymore when they used to all the time with PEPWOW.
Speaker 3:So I'm trying to kind of be a bridge and the fellowship is a bridge and it's a constellation of, like all the years of training that I've done. I'm like what is important for your first year of learning about this so you can transform and practice to be a bit more analytic. It's not making you an analyst. You know, to be an analyst you need four plus years of intensive education, but there's so many ways to get analytic ideas into your practice that are incredibly helpful. And so this is, you know, a bridge program to help NPs get into this world, get, you know, cultured to it, because it's a totally different way of thinking, it's a different way of speaking. Right, there's a lot of unique terms and jargon and that can be intimidating for people. So really providing that transition for them and just to help them see that this is possible, and, gosh, it's such a better way of working, you know, because your patients really heal.
Speaker 3:It's not about symptom suppression. In psychoanalysis, the symptoms are the answers to what is the conflict inside the person. So why would we want to suppress them when they're the road marker to helping this person heal? So you know, really different way of thinking. But for me, I mean, and I tell my patients look, if there was an easier way, I would have done it already, because I care about you. But turns out there's not.
Speaker 3:So we're just going to have to do the hard work and do this kind of difficult, long work but it's really meaningful and it treats the whole person and it treats everything and you learn so much about yourself when you're really not just treating the patient. You're treating yourself at the same time Because you're learning and you're growing, especially when you're working with your own countertransference. You know what is coming up for you and the patient. I mean you're working with your own countertransference, you know what is coming up for you and the patient. I mean you get to explore your own edges and challenges, and so it's such a great experience for the provider, though it's incredibly difficult. So you know you have to be open to the challenge.
Speaker 3:It's not for everybody, you know. Not everybody is capable of being an analyst, interested in being an analyst or using analytic ideas, but it's such a wonderful way to practice for a lot of people and I think they're interested in you know the fellows. They really change. It's so much fun to see them change and just like they listen differently, they experience their patients differently and they're like whoa, it's like a whole new world opens up and that's really cool to see and that's been my experience. So it's, it's an honor, you know, to kind of escort people into this world and show them what it's about and they can take it from where they want to, but you know that's just been a really beautiful experience, yeah.
Speaker 2:Thank you, brooke, that's been amazing. Yeah, it's, it's. It reckons me no-transcript, but she was right, I mean. And just as you said too, I mean it's it's not for everybody and it's hard, it's. It's not easy work. It's not easy work. It's the only thing that I know where you have to actually go inward to really kind of you know do the work. It requires that you know that whatever a pint of blood or you know just kind of that payment to you know kind of entry fee into being able to care for people and to really kind of help people move along their journey and such. So thank you again. I think we're kind of help people move along their journey and such. So thank you again. I think we're kind of running up on time and so I mean I maybe kind of just last plug here, if anybody is interested in the fellowship, maybe gotten really inspired by this how would they do that? Where would they go?
Speaker 3:Yeah, great question. So it's all on my website. So it's just Fidley, which is my last name F-I-N-L-E-Y, psych, just as it's spelled com and you can find more about the fellowship there. I'm happy to answer any questions. You know I love relationships. I love making relationships with people. So if you're not even interested in the fellowship but you're just interested in psychoanalysis, please reach out to me. I'd love to connect with you and point you in an interesting direction. But I guess my last thing just to remind people is you can only take patients as far as you've gone yourself, and so that's the importance of doing this deep work is because you really get to offer people so much more and when you really do that deeper work yourself. But it's hard and you know we're all nurses here. I mean nurse in school. If it was easy, everyone would be a nurse. No-transcript.
Speaker 2:I love it. Thank you, that's a great way to end. Obviously flashes of Tom Hanks in my head. You know, talking about baseball, it was the hard is what makes it, you know, important and you you know it was the heart is what makes it, you know, important and you know it is it's kind of the only profession that I know it's. It's that is kind of the ethos of us, though. So again, thank you so much. Thank you all for listening to peplow's ghost. We will have another episode coming out soon and again I'll have contact information for Dr Brooke Finley here. So if you want to connect and make another relationship, that sounds great, so look forward to seeing it. Make sure everyone to like, subscribe, send comments. We love hearing from you, but we'll be back with another episode soon, take care.
Speaker 1:They feel it. Therefore, it's true, work hard until those thoughts are finally leaving, so you can be you. They feel it. Therefore, it's true, work hard until those thoughts are finally leaving so you can be you. God of discovery, identifying, challenging your beliefs, core beliefs, reframing your mind. Negative thoughts release. Let it go. These cognitive distortions decrease until they cease. Yeah, guided discovery, identifying, challenging your beliefs, core beliefs, reframing your mind. Negative thoughts release. Let it go. These cognitive distortions decrease until they cease.
