Developing Meaning

#25: A Past Year Review Has Consequences (I Quit My Job and Started a Clinic - Yikes!)

• Dirk Winter

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In this New Year’s episode, I explore the very real consequences of last year’s Past Year Review. Most notably, I decided to retire from a beloved community mental health clinic and launch Park West Integrative Psychiatry — sparked by a desire for creativity, continued learning, and a growing belief in integrative trauma-informed approaches such as EMDR, Internal Family Systems, ketamine-assisted therapy, hypnosis, and breath-based practices.

This episode reflects on how intentionally examining meaning and purpose can lead to significant life changes — changes that invite both opportunity and risk, excitement and fear.

To close the episode, I share a recording of my retirement speech from the clinic, which turns into an unexpected sing-along and a fitting ritual for marking the end of one chapter and the beginning of another.

Chapters

0:13 — Nerves and a Big Career Pivot
 0:52 — Last Year’s Review and 2025 Intentions
 1:46 — Leaving a Beloved Community Clinic
 2:46 — Why Change Now, and What’s Next
 3:09 — New Directions in Trauma Treatment and Psychiatry
 4:05 — Building Park West Integrative Psychiatry
 5:02 — Fear, Complexity, and Finding Balance
 6:00 — A Cautious Note on Year-End Reviews
 6:20 — Reflections on Podcast Growth
 7:06 — Upcoming Group Therapies and Retreats
 7:54 — Yellowstone Lessons and Old Friends
 8:40 — Gratitude, Global Listeners, and What’s Next
 9:11 — Retirement Speech and Sing-Along

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Theme music by The Thrashing Skumz.
 Developing Meaning is produced by Consilient Mind LLC.


Dirk:

Hello. Welcome back, Meeting Seekers. It's 2026 and I am feeling nervous. I have a major career change happening. I will tell you about that in a second. This episode I would pair with the past year review that I just reposted. So if you are having fish for dinner, I might pair that with a Chardonnay or Pinot Grigio. And if you're listening to this episode, I might pair that with the past year review episode that I just reposted. Episode 24. In that episode, one year ago, I did a past year review in which I reviewed my photos, journals, bank accounts from 2024, and then set plans and intentions going into 25. My intentions for 25 were beginner's mind, questioning assumptions, and conciliance. And that led me to quit my job and start a clinic that is based on those principles. This is a scary transition. I am leaving a job that I love, that is the longest job that I have ever had. I started out of residency working at a community mental health clinic that is part of Columbia and New York State, where I get a faculty appointment. I get to train residents and I get to work with a really interesting population of people with severe bipolar disorder, schizophrenia, and psychotic disorders, a lot of trauma. It is a low-income Spanish-speaking population. And the clinicians that work with me are really smart, really kind. It has been my professional home for a long time. I am a loyal soldier with a boss that I really like, working on projects that I think are meaningful. I have job security, I'm part of the union, I have benefits. Why would I leave that? Well, I turned 55 and I hit an age where I could leave and take my health insurance. And I feel like I have hit a plateau in my work and my learning. And if you've been listening to this podcast, you know that I have been exploring new tools and feel like mental health is moving really fast, and there's all kinds of exciting new tools that we can use to do things differently, do things better, get people a more meaningful life faster, heal pathology faster than before. I'm talking about tools like memory reprogramming through EMDR, eye movement desensitization and reprocessing, using ketamine and psychedelics, using internal family systems, the knowledge that our mind is multiple minds and can be approached using a systems approach that can be really intuitive and healing. And this allows us, this and other techniques allow us to make changes much faster and more efficiently and not get as stuck as before. So I want to put my money where my mouth is and really explore. Can I bring together a group of healers? Can I create a community of healers that explores these new tools and puts them together? And so I wanted to call this clinic Concilient Mind, after the Eo Wilson book Conciliance, in which he talks about a new era of bringing multiple areas of knowledge together and finding concilience overlap coming together between ancient wisdom, modern science, and different healing approaches. New York State didn't let me call my clinic that for reasons that are not so interesting. I'm not going to talk about that now. So our clinic is called ParkWest Integrative Psychiatry. You can find us on the web and follow our progress. I've hired a really great nurse practitioner, and I am learning how to run a business, which is a whole new, different set of skills and problems. Accounting, figuring out how to be profitable, figuring out how to negotiate contracts. I'm getting a pit in my stomach because a big, a lot of parts of me are saying, What, Dirk? What are you doing? You had a comfortable home and you're leaping into this unknown, risky new thing. You want simplicity, nature, quiet, less. You want to simplify. And here what you're doing is you're adding and making things in many ways more complicated. So that voice is happening in my head. So I'm going to take you along through this transition. I'm nervous. I do not know how this is going to play out. I'm going to interview some fascinating people who have built their own clinics. And I want to learn not just how you build a clinic that works well for a community and for employees, but how to create balance and a nice life that's sustainable. So I'm going to put a content warning on my recommendation of doing a past year review. This process could lead you to make major changes and they might not turn out so great. I do not know how this is going to turn out. Some nights I don't sleep great and I worry. So I do want to reflect back a bit more on this past year. I feel like the podcast has grown in interesting ways. I love the episodes that we put out. Ridge House on Adoption, Margaret Connolly on treating legacy burdens, and then Bo on how to run retreats in nature. Mike Mandel. I'm really taking in his perspective as a hypnotist of how it is helpful to have three models of the mind at once so that you don't get locked into any one perspective. I talked to some really fascinating people last year, and I also set up some really fascinating learning experiences, uh week-long ketamine group therapy, IFS group therapy with Ted Riskin in Asheville, North Carolina. That's going to become a podcast episode. Another group therapy episode with uh Chris Burris doing healing circles at his home in Asheville, North Carolina. Have a group of IFS therapists and embody, personify our internal world, have different people represent our internal parts, and then use that as a healing experience. That is going to be a podcast episode that's coming up this year. I had an amazing experience in nature, going out into Yellowstone Park, into the backcountry with my oldest child, with uh Knowles, uh National Outdoor Leadership School, learning how to hike with a 40-pound pack, purify water from streams, poop in cat holes that I dig. All of those things grew out of my past year review from last year. And I also prioritized connecting with some old friends, in particular, a friend of mine who had been stuck in Iran in a very difficult situation and used stoicism to heal himself in that context. And that will become potentially a podcast episode. So that's where I am now, beginning of 2026. I so appreciate you having you along. This podcast is growing. We're in 82 countries now. Thank you for listening. I wish you a meaningful and meaning-filled 2026. Stay tuned for our next episode with Dr. Patricia Gerbarg, co-creator of Breath Body, Mind. That's going to be a great episode. Sign up for our Substack newsletter. And I'm going to send you out with my retirement speech that I gave at Audubon Clinic a few days ago. So happy New Year's, everybody. Uh, warning, this is going to lead into a little sing-along. Be careful about those year-end reviews, everyone. See you next time. Peace. All right. So I just wanted to say a few words. Um, and I'm really happy to be here with all of you. Um and I love that my retirement party is to mine. Oh crap. Because honestly, I really feel like it's a celebration for the whole clinic. Um, also, there's gonna be a sing-along at the end of this song, uh, short speech. So what my beer's singing voices. Um I'm not gonna telegraph it, but you're gonna know what to do. Just be ready. And Claire, Claire is gonna sing a song. Um so, for people who don't know me, I was born in Germany. I grew up in Amherst Mass after I was eight. I went to Columbia as an undergraduate, then did a PhD in Boston, and then tried to be a mushroom field biologist in Puerto Rico. Then went back to Boston, uh where I worked as an MHGA at the Cambridge Hospital, and that's where I met through my wife. And then I went to medical school in Minnesota and eventually found my way back to Columbia, did my adult and child psychiatry training, and have been at Audubon ever since. So, all that to say is that I am kind of a restless soul. I like new places, new ideas, new adventures. And yet, since finishing my child training in 2012, I've been here at Audubon, which makes this the longest that I've ever stayed anywhere in my whole life. And that's because this is a really special place. Audubon was founded to provide free care to this community, and somehow over the years, it has managed to attract the kindest, smartest, and most committed people. I honestly don't know another place that combines uh people who are so kind and uh smart. This spirit has been here as long as I've been here, uh, and it's clearly alive in the newer generation of social workers and staff, which makes me really incredibly hopeful. Um, so I've spent afternoons in private practice dealing with Upper West Side problems. Uh and Audubon has been such a nice contrast. Uh, the patients and the staff here are just so warm. I remember so many days walking in and feeling like I almost get an ovation when I walk in the door. Oh, it's Dr. Winter. I learned how to get off the phone with patients who continuously say, I love you, I love you. And praying for me, so many prayers. I've tasted to call me Dr. Willie or just Willie. Window, Window, Dr. Window, Dr. Window. Um I also want to thank um Laura Clark. I'm not wearing my glasses now, but um uh and the leadership here. And we you know, we've made it through the pandemic together. Uh, and I truly can't imagine having a better boss or a better team of colleagues to work with. Um, at some point, though, my restlessness caught up with me again, and I made the mistake of following Drew Ramsay on Instagram. Who, as some of you know, is an Ottoman alum, now living in Montana, hiking, riding horses, writing books, and constantly doing and posting amazing things. I do not recommend following his Insta. Dangerous. Um, and during the pandemic, I went down a whole rabbit hole of integrative trauma treatments. Uh I trained in EMDR, IFS, hypnosis, breath body mind, pedamine assistive therapy. And I realized I wanted to build something new. Uh, take what I learned here uh into a new chapter and build an integrative trauma clinic. Uh it's a scary jump. Leaving this warm cocoon is not easy. I actually delayed my retirement once already because I got anxious about leaving. So clearly, change is not always easy for me. Part of me wants to say, April fools, everybody, I'm not leaving. But maybe if I delay again until April, I can do that. But um I also want to thank my wife and kids. Thank you for supporting me through this slightly terrifying transitional phase of life. But it feels like this chapter is coming to an end in another one. It's a big beginning. And when I look back, I feel like I've lived a full professional life. I've learned and experienced along so many great people. I really did try to do what I felt right, even when it wasn't the easiest path. And I tried to take each step with care and attention. And now go ahead. Just uh and now the end is near, and so I face the final curtain. I friend I say it clear. I'll state my pace, which I'm certain I've lived a life that's full. I've traveled each and every highway, and more, much more than this, uh, I did it the Audubon way. So I'm gonna have French try to keep us somewhat in tune and on pace. So let's all sing along. But I changed uh my way to Audubon or Washington Heights way. And now it is near and so I face the final curtain. I'll stay clear. I'll take my kids of which I like that ball, much more than this, I did you What are we got to do? Let's side through without exception on plant each land, careful step along the highway.