In 2002, Dr Susan Swim, after three decades as a professor, author, theorist, international educator, researcher, and supervisor in the field of marriage and family therapy, moved to California from Texas and started a position on the faculty of Loma Linda University. Previously, she had always worked in a bubble of social constructionism. All of her colleagues were postmodern theorists, educators, and clinicians passionate about healing underserved populations without using “deficiency” models to describe people and how they suffer in terms of disorders. In today’s mental health fields unfortunately people are described through labels such as DSM (Link to DSM means). One colleague put it well when he described DSM diagnosis and treatment plans as “hate language.” “For this is the language one would use to describe people they not only did not believe but also disliked”. And when people are seen as merely the sum of their illness, symptoms, maladaptive behaviors, and triggers, they will remain imprisoned in these labels.

My heart sank, realizing I had moved to a foreign land where hate language abounded to describe human suffering. For me, marriage and family therapy still held the revolutionary potential of moving from focusing on individual pathology to focusing on relationships and the conversations within relationships that lead to trauma.

Sadly, what Dr Swim found in her new home state was an abyss of pathology and deficiency thinking in both academics and clinical practice. She remembers talking with Lynn Hoffman, a keynote speaker at the annual American Association for Marriage and Family Therapy conference who, after surveying the agenda, asked me what was wrong with California. Here we were, at a national conference on therapy using the lens of relationships, not individual pathology. Unfortunately, every seminar at the conference pointed to something wrong in the individual and then proposed a theory and treatment plan that could make that individual as normal as possible so they could survive their diagnosis.

But then, in 2007, I received an email from a colleague that talked about doing therapy with horses. That gave me an idea, and at the urging of my international colleagues, I decided to open a postmodern institute where I could practice therapy, teach, do research, and supervise clinicians as I had previously done for decades in Texas. Dr Swim had also grown up with horses and her strong connections with her family and community came with horses. So, Dr Swim brought all her current master’s level students and a handful of PhDs from the university to a horse ranch in Chatsworth, California, and they created the Now I See A Person Institute (NISAPI): Healing Underserved Populations Using Community Engagement: A Collaborative Recovery Model (CEACRM).

The name as well as the philosophy of our new nonprofit emerged from the experiences of one of her young students. Dr Swim had told her during a practicum session, “I hate my client,” and Dr Swim was surprised she felt safe enough to use those words. She recalled the words of collaborative therapy pioneers Harry Goolishian and Tom Anderson, who said, “When we do not like our clients, it has to do with us as a therapist, and not a client, we were holding prejudice to our clients….”

In the next practicum session, Dr Swim asked the student how things were going with this client that she did not like. And she said, “The client I hated is now my most beloved.” Dr Swim replied, “Let’s get this on tape.” For the next hour and a half, the class learned about this student’s journey. During her interview, she kept repeating that for the first time in 10 sessions, she had left the treatment plans, diagnosis, and progress notes outside the door and walked in with an open heart. And for the first time, she saw a “person” in front of her. She did not see the treatment plan, which was hers, not the client’s, and she could understand the pain and suffering that the client was going through.

It is amazing what happens when the therapist and client both see each other as people. A collaborative relationship evolves wherein the client takes charge – sometimes for the first time in their treatment and their lives. 

We are a not for profit organization giving people along with their families and community an opportunity for a safe space to work collaboratively and find meaningful ways to heal. We especially have success with those clients who unfortunately have lengthy histories of trauma, and past experiences with hospitalizations, therapies, and psychiatric interventions which did not aid. At NISAPI all clients are seen with their families, communities of support (including social workers, lawyers or others who can aid in healing. All learn to see themselves as people and not a diagnosis that may have labeled or limited them in the past. Our clients report in our decades of research that what we do is treat them as a person and the key to our success is our staff of genuine, caring therapists where each client and family member or support system receives a team effort, where all voices are heard and honored, and our equine co-therapists who are petted and embraced by those suffering when sharing their stories of trauma find their symptoms dissipating—it is not sitting on a couch therapy, our environment of normalcy, nature and nurturance, and NISAPI theoretical orientation of CEACRM leads to long lasting change (Meyers, Priest, Mikawa, Zilifyan, &Swim, 2017, Swim, Stephan, Abramovitch & Stone, 2017, Swim, Abramovitch & Stone, 2018, Abramovitch, Wilson & Kadler 2021, Swim, 2021).  We also provide an opportunity for clinicians and trainees to learn about CEACRM and the meaningful outcomes that can result for people as well as engaging and learning alongside our International colleagues .