Tim Talks: Behavioral Health is a fast-paced podcast featuring candid, 10-minute conversations with leaders across the behavioral health field.
Hosted by Timothy Zercher, CEO of A-Train Marketing, each episode dives into what’s actually working in marketing, practice growth, and leadership — with a sharp focus on ethics, sustainability, and smart strategy.
Designed for behavioral health providers, practice owners, and executive leaders, Tim Talks delivers real insight from real operators shaping the future of care.
Dr. Susan Swim – Executive Director, Now I See a Person Institute
•Tim Zercher•Season 2•Episode 21
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What changes when mental health care sees the person before the diagnosis?
On this episode of Tim Talks: Behavioral Health, Tim Zercher sits down with Dr. Susan Swim, Executive Director of the Now I See a Person Institute, along with Christina and Ashley, for a conversation about human connection, dignity, trauma, and alternative approaches to mental health care.
Dr. Swim reflects on more than four decades in the field and why her work has increasingly focused on moving beyond labels and pathology toward Collaborative-Dialogical Practices. The conversation explores what can happen when practitioners listen to each person’s individual story, allow clients to help lead the conversation, and approach healing through relationship rather than a predetermined path.
Christina shares how her own difficult experience seeking mental health care led her to question who traditional systems and processes are really designed to serve. Ashley discusses the role empathy, human connection, nature, and physical environments can play in a person’s experience of care.
Together, they explore a different question for behavioral health leaders and practitioners: What becomes possible when we stop defining people by a diagnosis and start meeting them as individuals?
Timothy Zercher
Dr. Susan, thank you so much for joining us. We really appreciate you taking time to join us and share some of your experience.
SPEAKER_02
Well, I just want to let you know that we're all very excited to be here. I did invite a couple of our faculty members to be with us today. And um let them introduce themselves at the end of this in order to kind of streamline this a little bit.
Timothy Zercher
First question is you spent decades in this space of forming dialogue and forming different approaches to mental health care. What first drew you into the space and what's kind of kept you committed over so many years?
SPEAKER_02
Thinking about the question of what drew me into this is that this was kind of the space that I was educated in in the late 70s and early 80s. And so it was a time that a lot of us were exploring alternative ways of describing why people were having problems or why they were having challenges. And so I think that there were a lot of people, if you study a lot of people that are my age, they were there before the introduction of SSRIs. We were there before the ESM came out with the biopsychosocial model. And so before those things, most people healed. Most people found wellness. I think I was researching this yesterday that we have from the time I was first practicing or studying in graduate school, there's 500% more providers and treatment than there was at that point.
Timothy Zercher
Yeah, yeah. And I think that's obviously then there's the reason of why you've stayed committed, right? That the problem has not gone away. If anything, it's gotten worse. And and therefore your investment has continued. I sense a recurring theme in your work, and that's that moving beyond labels and diagnosis towards real human connection and dignity. What experiences led you to challenge the more traditional health mental health frameworks, if you wouldn't mind?
SPEAKER_02
You know, I always when I hear the word kind of challenges, I think. Well, I didn't really mean to challenge because I'm not really a rabble route, like rules and like to kind of follow those rules. But as time went on, we could see that things were happening in a way that really didn't make sense to us. So, for example, I kind of the analogy I was thinking about was a broken leg. So let's just say that we have a broken leg on Friday and we go and see somebody on Monday, we see a different practitioner that next Wednesday, and that next Wednesday, that practitioner says, This is due to a biological problem. This is due to a deficiency. And so before this, most symptoms were due to trauma. And so you would see so much the trauma being overlooked, and that people became worse because they were being medicated. I think you've had other people on your show before talking about the medicalization of mental health. And so it was really something that you just saw this kind of pyramid falling apart and more and more people needing services, more and more people thinking they couldn't get well or that there was fear.
Timothy Zercher
Absolutely. Absolutely. So I want to ask more about that, right? You've worked with many individuals who, I guess, another way to say that have kind of lost hope after years of traditional system care that they're going to be better, that they're going to feel better. What have some of those experiences taught you about what truly drives healing and recovery for individuals suffering from trauma or complex sets of diagnoses?
SPEAKER_02
So we talk now about humanizing ourselves for the epic. And we do a lot of conferences on that, a lot of writing. And so, how we as practitioners can we be able to so that we go in when we talk to somebody, the lenses that we have are the lenses what every person is saying, not the lenses of what other people have said. And when you start talking to people, each person has their own narrative, and that narrative might change throughout the time that you're talking with them. And so people are brilliant. You know, we don't see people as being broken or to the lenses of pathology. And so we really allow the client to be the expert and to lead us in the conversation, and we accompany them on these conversations. So all everything itself tailored to that client.
Timothy Zercher
I like that. I like that. So there's not some kind of single path to healing, right? It depends on the client. It depends on what how they envision their healing journey. I love that. I love that. So, Christina, I want to turn to you now and learn a little bit about your approach because I know it's it's similar. And I think you kind of came to the same approach in a different way.
SPEAKER_01
Yeah. So I came to this ideology after COVID. So there were a series of pretty horrific events that happened to me during the pandemic, which began with the death of a close friend and was followed by more deaths of young people. And then just a really difficult time during the pandemic, lots of things I lived through during that time. And I reached out for mental health care and pretty much everything that could have stereotypically, institutionally gone wrong, I guess, as we might think that things could go wrong, did go wrong. And I very much felt managed. I came to realize that my experiences there were not unique. I felt dismissed, judged, like my problems were either hypothetical, self-generated, or eventually as if I was fundamentally broken. I was waitlisted for nearly two years. And a big part of that time was they were struggling to find a diagnosis for me. And I thought about that and I thought, this is ridiculous. Like I needed help yesterday. I needed help over a year ago. Why is this taking so long? And I thought, why is this important to helping people? And that made me think more about the models with which we deliver care under. And I started asking myself in each step of the process, who is this for? It's not for the client, it's not for the patient, it's not for me. And that made me think about how I wanted to shape my practice. I got in touch with, well, I was looking for other models of care. I found out about collaborative dialogic practices and also about narrative therapy. And that's how I got in touch with Dr. Swim and her work.
Timothy Zercher
That's awesome. That's awesome. Thank you. Thank you. I mean, I'm sorry to hear that that was your experience, but I think it's a unfortunately common experience, right? That the weightless and failed diagnosis and feeling managed, I think happens a lot in the institution. And I love that well, all three of you are working to combat that kind of standard process. So, Ashley, if you wouldn't mind, I want to turn to you and I want to hear a little bit about your approach and the process that you're studying as well.
SPEAKER_03
Hi, yeah, thank you. Right. So I've been in a wellness coach here now, AC person, for like two years and some change. And I've actually known the institution for a very long time, like since middle school. But I'm personally really interested in seeing how people transform and you have this like really deep level of empathy with them and human connection, and specifically also when you give them beautiful spaces and beautiful experiences, and seeing how that helps their life unfold in a manner that is harmonious and beautiful. And like what role does nature play into this? And what role does like we write a lot about how beautiful spaces create this sense of healing and magic. And like I said, that I've known the institution since I was like what like 14. So I s I actually got to know him and Dr. Simb is still on a ranch. And you know, connecting with the horses and connecting like receiving care and understanding care in that ranch setting just flipped the whole mental health system on its head. And I think that was something profound.
Timothy Zercher
Absolutely. Yeah, I think it's I think it's really interesting. I don't think people often understand, especially within the industry, the impact that our environment has on our own mental health. I I think it's very cool that is what you're focusing on. That's where you're pushing your service to your clients. Well, Dr. Swim, would you like to say any anything to add to add as we wrap up?
SPEAKER_02
So one of the things is that the reasons why I invited both Ashley and Christina today is that they had their own diagnosis at one point in time, whether they were young or maybe a little bit older. And these were things that they were able to transform from. And so what we have found is that when people quit being defined by a diagnosis and they're defined by what stuff they want to be defined by. And so I think both Ash and Christina are wonderful examples of how people can transform and they leave behind those diagnoses. They don't have to be worried that diagnoses are going to come back because they don't see them as something legitimate in their life. And I think that a lot of people come to that understanding. I was reading something yesterday on the Clancy case. And I think that you have that's why there's a huge flash about medications, is because it's almost bringing together the voices of these women. We're hoping that our voices can raise awareness of some of that. It was meant to be accompanied with people, wasn't meant that we've wanted to diagnose you and then treat you as a diagnosis nor everyone else is like off the line.
Timothy Zercher
Absolutely. Absolutely. Well, thank you so much. I really appreciate all three of you taking time to join us and sharing your perspective. I think it's an important perspective that more people need to understand and need to adopt. So thank you so much.