Let's Stop Calling Our Private Practice "Small"

The other day I had a client tell me she has a “small” private practice, and when I asked her what “small” meant, she said she was doing 15 weekly sessions, and had a total of 25 clients altogether. OK. When I do 15 sessions in a week, I consider that a pretty full week! It got me thinking about why we use the term “small private practice” so often, and it got me thinking about whether we are doing ourselves a disservice when we call what we do “small.” So that’s what today’s post is all about.

The effects of one “small” word

I once had a supervisor say to me “Melissa, when are you going to stop calling your private practice small?” This stopped me in my tracks. At the time, I was about two years into practice, and I was also doing full-time agency work, while I had a growing private practice three days a week (around 8-10 sessions or so).

I didn’t even realize that I was saying “small” or why I was saying it. But when I stopped saying it, it had an impact.

It wasn’t long after I stopped calling what I did “small,” that I realized the potential of my private practice and left my agency job to pursue private practice full-time.

Was that all because I stopped using that one “small” word? No, of course not, but still I believe it was a part of it.

By always calling my private practice small, in a way I was diminishing myself and all that I had accomplished. Essentially, I was saying “Don’t worry, I’m not taking up too much space over here.” When I just took out that one “small” word, and started saying “I have a private practice”, something inside me started to shift.

“Wow, cool, I’m a business owner, this belongs to me, and I made it myself.” How different does that feel, rather than shrinking away and calling this thing that I worked really hard for “small”?

The way we talk to ourselves matters, a lot.

Also, side note, thank goodness for good supervision, because I did not see that one!!

Why are so many of us using this term?

Maybe it’s just me, but I hear people saying it a lot. And I think the answer to why we do it is complex and layered. Here are some thoughts:

Cultural conditioning

Gender, race, ethnicity, religion, sexual orientation, and class all play a factor here. The cultural messages we have received about our right to take up space, and be heard, and to want more for ourselves, and to value ourselves lead us to qualify our successes when we speak about them.

I’ll speak from my own experience, just using the cultural lens of gender for example. As a cis woman, I know I have received messages my whole life not to take up too much space. Be small (not just figuratively, but also literally). And to not put myself out there unless I was perfect. Oh, and also that I’m never perfect, never enough, or doing enough. And that my opinions aren’t as important.

So it would make sense, with those messages playing in my head, I’d use the word “small” and not even realize I’m doing it. Similar to when we apologize and say “Oh I’m sorry”, when someone walks into us.

Imposter Syndrome (or Imposter Complex)

Imposter Syndrome tells us something like: “If I just say that I’m small, then no one will pay much attention to what I do, and realize that I actually don’t know what the eff I’m doing.” And then that becomes self-fulfilling. It leads us to shrink away, and not do the things that would allow us to step into our potential and our power, and that furthers our belief in our own “not good enough-ness”. Saying we are small, being small, and feeling small. And around and around.

Tanya Geisler, whose whole life work is around helping people with Imposter Syndrome (or Imposter Complex, as she puts it), calls this “Diminishment”, and I think she’s put the perfect language on the experience, so I’ll quote her here:

“Diminishment is about hiding out — dimming your light — to make others feel comfortable, and in doing so, convincing yourself that you're not actually worthy of shining anyway. Diminishment is the way in which we dial our brilliance and our message down. Take up less space. Avoid displaying actual confidence at all costs.”

There are lots of reasons why we “dial down our brilliance”, especially if, as mentioned above, we are a member of a group that has been culturally oppressed or marginalized, though Imposter Syndrome really knows no bounds, and pretty much everyone I’ve ever met who reaches a level of success (whatever that means for them) deals with it to some degree, at some point.

Family and Life Conditioning

Maybe we developed a coping style in our family of staying small. Maybe when we tried to be big, there were negative consequences. Maybe there is some trauma there. What does it mean to really put yourself out there? Maybe doing that has lead to hurt in some way. Small might feel safe.

Plain old practical math

In addition to these deeper themes, some people might simply saying it in reference to how much money they are making with the practice, in relative terms. Either relative to how much of their income comes from another job (so like private practice is 10% of their income, and their agency job is 90%). Or relative to how much they’d like to be making, now or in the future.

So in this case, fine, maybe it’s not harmful to the person saying it, but at the same time, it’s still just not a very descriptive term because it doesn’t tell the other person very much. Additionally, it could make another person feel bad about their business by comparison. “If so-and-so thinks their practice is small, what does that mean about me?”

So in conclusion, how about we all agree to just stop saying it?

Whether it’s for practical reasons, or reasons that are deeper, I think the word “small” is not helping us as a community of therapists running our own businesses. At the very least, it’s just not a very descriptive term. To help you, here’s a list of alternate things you can say about your practice, feel free to try any of them and let me know how it goes:

“My private practice is LIT!”

“I have a _____________ [insert positive adjective here, e.g. beautiful, bountiful, sparkly] private practice.”

“I run my own business”

“I own my own business”

“I love my job”

“I’m proud of what I’ve built”

Melissa KellyComment