 We demystify what goes on behind the therapy room door. Join us on this voyage of discovery and co-creative conversations. This is The Therapy Show, behind closed doors podcast with Bob Cook and Jackie Jones. Welcome back to episode 146. Can you believe it? No but I'm going to believe it. Well it's true because I've worked out all my figures and my numbers Bob. So what we're going to be talking about on this episode is the importance of observational skills in the therapy room, which I think is a fascinating subject. I might be the starter to which but I mean people aren't watching the, well maybe they are, but if you're just listening it's irrelevant isn't it really? Observational skills within the therapy room, yeah the importance of that. That's what I want to stress. And when I thought of this title, one of the reasons I thought it up is because it comes from the idea which has struck me over many decades is the importance in the training of counsellors counsellors and psychotherapists of observational skills and the diligence of that and what I think is that especially in the counselling world they teach observational skills at the beginning but as the counselling training goes on it often gets lost. Yeah. In the psychotherapy world often is similar. Now you and I trained in transactional analysis so I think there's a big difference because the major personality model of that particular modality transactional analysis is the parent adult child ego state model. Yeah. And what we're trained in for not just the first year but throughout the training is how to, how through the observation of behavioral observation sorry, through observation that we can detect what ego state the person is actually coming from in front of us. So we did a lot of work on spotting or practicing spotting or behavioral observation of gestures, tone of voice, many non-verbal signals so that we can work out or at least have a hunch hypothesis of what ego state that person is coming from. So there's quite a bit of training in non-verbal signals and behavioral observation which I think is very useful when you work with clients. Absolutely. I found it completely fascinating when I was doing my training and I became really aware of my own behaviour as well which was really interesting that certain little things that I did that I was like oh I haven't noticed that before. And did you go further than that and think oh that determines what ego state I'm in? Absolutely. I used to do a lot of this. I used to do a lot of these sort of things which I think are quite parental. People listening can't see you so. Yeah well touching one finger with the other or I would do you know yeah but there's this number one is this and number two is that and number three and I would like yeah it was just really parental. I remember in training when I was training people observational skills or non-verbal signals I get people to act out certain ways so stand up and put your hands on your hips and you know indicate your finger at the next person and then what ego state might that come from when you watch that type of a non-verbal process. It's really interesting because changing your posture changes your mindset as well you know to me and it does put you in a different place like you were saying then stand up and put your hands on your hips it does change the way that you think about things it's really powerful. And for psychotherapist counsellors it's a really important skill to bear in mind I think throughout the whole of their training and then to use when they start seeing clients because you know let's go back where I said T8 trainees become T8 therapists but they start seeing clients in their second or third years on placements. Yeah and we teach people to you know through three or four or five of the first sessions to evaluate through non-verbal expressions how long they might stay in one part of the self by parent ego state adult ego state child ego state and what that actually means yeah especially in terms of communication I had a couple in well I you know I do a lot of assessments and I'm just thinking of a couple that came in for an assessment and then I sent them on to a couple's therapist but this is in general what I'm talking about but it reminded me this couple I saw that when couples in general pick people who fit into what I'm going to call interlocking scripts yes other words life plans which somehow lock in with the other person's life plan and the other thing in a relationship in transaction analysis terms you get people who put a lot of energy in parental transactions which then hook people into child transactions yes so so one thing I should evaluate and think about was as I'm talking to this couple which of the two people spend more of their times coming from their parent ego state and which of the other you know which other person comes from their child ego state and is that representative of how they talk to each other yeah and I think what you were saying then about is that representative I think that's a really valid point when we're in the early stages of therapy yeah you know it's highly likely that they're going to come into the therapy room in their child ego state on the first couple of sessions because it's new it's different they're going to be anxious they don't know who we are so they're not going to come in in their adults or I suppose they might come in in the parents I'm not sure I think you know that in general we can make a sort of overall sweeping sentence here that they might come in or at least spend a lot of their energy in their younger self or their child ego state when they come to therapy for all the reason you've just said yeah that doesn't take away that they might come in from their parent ego state I'll spend quite a lot of time in their parent ego state or at least the parent part of the child ego state yes yeah for example when they first come to therapy and it's really important to think about that because it will then determine how you then address the person in therapy yeah because what we're talking about here is like non-verbal communication it's it's gestures and tone of voice and you know all those sort of things that yeah they often go under the radar it's not necessarily the words that they're using it's it's everything else the body language and everything that goes along with it that's fine so for example as you know Jackie I was one of my first I went to reality TV programs and one of my favorite reality TV programs is a program called the traitors oh yeah I've been watching that you probably watched up on cast up and it's just been on but if you if you watch that one of the sort of important parts of that program is that when they banish who they think is a traitor or a faithful man the 17 year old however many of them ran this big banishing table and they have to vote who they think is a traitor or who they think is a faithful now the way they start working these things out often is through the non-verbal behavior of the people they spend their time with so for example what you hear a phrase lots I used to anyway when I listen to it is oh their behavior has changed since they were on the train coming to the castle now their behavior is completely different yeah or their voice has changed or this has happened or they started to express emotions and they used to be like that yeah they must mean xxxx and there's a lot of evaluation of non-verbal behaviors for them to make their hunch decision who they're going to banish and it's really interesting when you watch them sit around that table not only about why they're banishing people but the non-verbal signals of the actual people around the banishing table absolutely most of these reality tv programs if you watch them and watch them they're non-verbal behaviors it is so interesting I do find it interesting just just you know people watching generally when I'm out and about and you're seeing people and you're watching them and I can remember when I was doing my training I'm not sure whether it was you that said it but watching soap operas is quite good to me just for the learning the you know non-verbal clues turn the volume down and see what you can pick up from people not soap operas they're nearly always in parent or child yeah yeah and there's always a drama triangle going on somewhere yeah yeah adult isn't adult isn't often there no no very important for clients I mean you know the world of a soap operas the world of dramas the world of tragedies the worlds of traumas are the worlds that we move in with clients yeah and then non-verbal signals determine where they're coming from when they're community taken not only with you but the stories they tell and the traumas they've processed in their histories and that's so important then in how we then tune with the person and how do we then talk to the person yeah I can remember having a conversation during my training about this that we I can remember it distinctly there was one particular client that I I know I was in my parent ego state an awful lot with them because they were in their child ego state an awful lot and I was questioning that it's not right and and whoever it was I spoke to said that sometimes we need to do that in order to re-parent them and teach them appropriately so we step into it and then appropriately step out of it at some point in the therapy which kind of made sense to me when it was explained yeah you're completely right and if we talk about TA again and I'll just pass people whether modalities or uh counselors listening but I just want to talk about a bit of theory called driver theory in TA yeah in TA they they have this piece of theory to talk about when people are under stress uh they move into what's called driver behavior which then drives their like their behavior and there's five of them clusters of them hurry up please me be perfect be strong whatever the other one was I can't try hard try hard but each one of them will have a collection of non-verbal signals yeah which shows that they've moved into that place so let's say be strong so if you if you're observing somebody and thinking about non-verbal signals for somebody who's moved into a being strong place there'll be a set of behaviors to go with that and it's the same with those drivers and if you look out for that then you can have some indication of what's what's driving their personality and what they're defending against yeah because underneath the driver behavior is of course the unmet needs so the driver behavior becomes the coping mechanism with regards to the unmet needs I think this is why I love transactional analysis so much is that everything's kind of interwoven with each other that you know to me the the way that we hide our behavior or the things that drive our behavior when we're stressed or overwhelmed or or anxious or anything is you know it links in with the parent the adult and the child that link then links in with the you know the script and it's just all interconnected it's fascinating yeah and in ta today when buying student Van George which is a really good textbook around most of the ta concepts they talk about drive driver behaviors or the five driver behaviors we just talked about there in terms of personality types you know please please others please me try hard be perfect etc and I then talk about the behaviors the none the observable non-verbal behaviors that go with those particular drivers that we look out for to make our hunch diagnosis of where they're coming from and what they're defending against so it's very useful I think the step is to think about the non-verbal signals which will can lead you to think what are the personality that they then coming from and what are they defending against and they usually defending against unmet needs so being strong is a coping mechanism yeah yeah perfect is a coping mechanism trying hard is a coping mechanism and they're all coping mechanisms even though we call them drivers in ta against the thirds of the younger self yeah absolutely and I think one of the things that I learned quite early on was telling somebody to not be strong doesn't really help it's probably the worst thing that you can do because it's a survival mechanism it's what's keeping them afloat so to speak so to say don't do that is is not going to help them and they won't know what to do instead anyway absolutely yeah yeah but the first part's really important what you've just said is if they go against that but they won't know what to do but if they did of course they'll probably drown yeah I don't know if you can see behind me I've literally got a picture of the drowning man up there oh yeah I literally talk about that all the time with my clients it's my go-to you know me in a diagram yeah you look diagrams but I think it's a very important driver sorry diagram there because if if we do confront the coping mechanisms or the defend you know too soon then you know it's like cutting through it's like cutting the defense mechanisms too soon person then drowns in a way yeah yeah I think that's when they become overwhelmed and sometimes they'll disappear from therapy and won't come back because yeah the other thing that I think kind of links into observational skills is noticing changes in behavior in the therapy room as well maybe you know red flags that what they're saying doesn't actually it's not conducive with the body language that they're showing or or things oh absolutely so the non-verbal signals or their behaviors is completely opposite yeah what you're saying is a really important thing and which will tell you such a lot and the next important thing is when do you confront that yeah one of my favorite questions that I've I've noted I don't know whether the it's been happening a lot with my clients lately is that I've been asking them the question what would I see if you were angry with me wow I can't remember the last time a client got angry with me and I'm not sure whether that's because I've not been doing a good enough job in challenging them or what so I've actually been asking them what would I see I would I know if if I upset you or if I made you angry in a therapy session asked a question because depending on their personality type I will determine the answer absolutely you might be afraid of conflict yeah like withdrawal other people might go into some pleasing baby other people might share a shadow part of themselves or whatever so it's a really good question but it really opens up conversations around you know appropriate emotions and if anger is an okay emotion to have and you know how we deal with anger or aggression and things so yeah the other thing I was thinking with the verbal signals is in the world of intersubjectivity that's a big word comes from the psychodynamic world it simply means what happens between the two subjects and so we say the therapist is one subject the client is the subject and there's an interspace between the two of them so it's more into subjectivity yeah as we get closer to the therapist or get closer to the client what happens in the space between them is the theory around intersubjectivity and often I think when the therapist and the the client are in that intersubjective space the non-verbal signals often become more intense yeah uh and so silence might happen for example yes what happens non-verbally in the silence you know so I think for most people who like the world of intersubjectivity or may even read books on intersubjectivity I think the evaluation of the non-verbal signals which happen in the space between the therapist and client outside verbal content is very important yeah and go on I was just going to say that links in for me with transference and counter transference as well because when you said silence then silence means a lot to me because of my past and my upbringing it usually meant that there was trouble brewing I don't like silence I'll try and fill silence with something so if a client was quiet in that space that would trigger a lot of thoughts in me which is interesting yeah and the next question would be your question for a therapist I wonder what you're thinking then yeah the other world world is really important around non-verbal signals and behavioral observation is the connection between the body feelings thinking in other words how do the body and the mind go together and if you think about it verbal content or you know let's say the externalization of the self through verbal content is really a manifestation of what's happening internally yes following me so external so verbal content through externalization is a manifestation of what's happening internally otherwise what then could be played out through verbality or it might be played out through somatic processes doesn't always have to be played out through the verbal world yeah can be played out through the somatic area in other words headaches yes or tense stomachs it's a bowel center we could go on couldn't we yes yeah yeah absolutely often I would argue that that those somatic processes could you know actually be repressed emotions yeah which don't get expressed in the external world perhaps through verbal content or through emotion yeah and it's through the observable manifestations of how the person holds their body or the tenseness in their different parts of their body or the agitation in their body might really indicate a way in for the therapist to ask the questions and no just observe that you feel quite agitated you for example you're right leg has been jiggling energy as we speak yeah what could be happening there if you found your own voice yeah I think that's a really valid point and I think a lot of us now have kind of lost the connection we have with our body and our mind they're kind of quite separated in a lot of us now that we don't see the connection with the mental and the physical like you were saying about headaches or you know irritable bowel syndrome you know all those sorts of things they're all interconnected absolutely absolutely that that's really really important to use or to think about how the person's holding their body what could they be saying but they're not saying yeah actually saying in their behavior do you think there's a there's a possibility that they're not even aware of it themselves oh nearly always not yeah so the fact that we broached that subject or it's a topic of conversation within the therapy room can be a really light bulb moment for some clients yeah look I hundred percent agree and it's something I always did as a therapist but and I want to pass on a tip here and for people who might say oh I go and confront the person who's I don't showing agitation or whatever it is yes I think that is part of the duty of the therapist to help a person be aware of what's happening perhaps at a body level which actually doesn't come out in verbal content but I also think you need to think about the possibility of shame absolutely in this process as well yeah absolutely it's how you confront I mean a really good podcast which we've never done is the use of confrontation in psychotherapy because it's how you confront it's how when you confront which is the really big questions in psychotherapy if you're going to say to somebody you know what I've been noticing that you're fairly agitated or you know I've been noticing that you your fists is quite clenched when you talk about XXX how come that is you know and the problem is if you need to think about when you say it you need to think about how you say it because you'll never know unless you ask that the person might feel shamed might feel interrogated then they go underground and you'll never their peace going to be much harder yeah but the opposite side of that if you do make that connection with them and the client feels seen and heard and noticed that's a massive plus so if it is handled correctly it really does build the therapeutic relationship if it's handled correctly yeah which I hope I did you know when I was making these confidations which are often divved between the somatic defences and the you know the poses I'm talking about then you are helping somebody being aware of when they're in script yeah and if you can help a person do that that's what I call real therapy absolutely yeah so when it's done correctly it's very important closest is for psychotherapists to think about yeah to help person determine change because unless they're aware of things it's much harder for them to change isn't it so absolutely yeah first place how could they ever change it yeah yeah can we help the person do it which is the crucial question yeah what an amazing conversation this has been Bob I've loved it yeah and I think anybody listening will know that if somebody confronts them at a time when they're not perhaps expecting it or time when they feel stressed or you know they might move into shame so quickly and defend so quickly that might take months for the therapist to actually reach them again yeah I'm a real fan of helping the person being aware of what might be happening in their internal world and their body yeah because it will help the person be aware what what or how they might be sabotaging change yes yeah and it like you said Bobby it all starts with awareness and and once we're aware of it then we have a choice we can make a decision whether we want to continue doing it or not absolutely yeah I mean Fitz Poles who was the originator of Gestalt Psychotherapy in the early 1950s he was of Gestalt Psychotherapy in many ways is centered around the whole idea of cure is mainly through a person being aware and the interruptions to contact and the interruptions to awareness are is how they sabotage themselves actually changing yeah I love that phrase as well the interruption to contact I think that's a lovely way of putting it and that can happen like that in a therapy room yeah and in many ways it has to happen yeah that's the defence against you know the therapist is actually working how the therapist then deals with the process so the person doesn't feel shamed or belittled or put down or humiliated there's a whole other story yeah and I'd like to think as the relationship builds between the client and the therapist that the client feels able to actually verbalize and say what's actually going on for them and that they do feel shamed or something yeah one has been I've been a supervisor for a very long time and I teach people and I teach supervisees to think about behavioural observation in the world of helping their own clients so in other words I ask them to bring their client into supervision and describe and paint a picture of that client and to paint that picture of that client in week one or two and then in week seven and eight and then in the last session and tell me the difference in that painting yeah and then it always what's wonderful inside you will get from that I'll let me paint a very quick picture what I mean so somebody comes in said oh this is ex they come into the room they sit down on the sofa we have a glass of water and then we start therapy so then I say okay tell me what were they wearing when they came into the room what was your impact what was the first impact you had of them when you went into therapy room where did they sit did they sit on the sofa did they sit on a chair did they sit on the floor did you offer them water were there the people that asked for a cup of tea did they have a rain mac on tell me how they were sitting so I'll get this whole picture now right let's move to the sixth session now tell me how they are where they actually sitting now how are they sitting oh and as you get the picture then they say oh they've taken off their coat now they're sitting in a different part of the sofa and you know what they are much more relaxed yeah oh now tell me about the ninth session which was the last time it's all where are they sitting now oh they've got their feet up now they don't have their raincoat on anymore and all these things signify relaxation yeah safety security so a lot's happened yeah absolutely a table observation from the first session to the last session which can aid supervision and treatment direction yeah would you point that out would you mention that to them that's the idea of doing it yeah yeah yeah I was good I think that's an amazing opportunity within the therapy room well I meant I meant I'm the supervisor this is the supervisors that's probably might be stuck or got some things they want to discuss about how to work with the clients so they bring the client into the supervision room and I usually supervisory and just the way I've done with you in many ways how what did you do then to help and be more relaxed what happened between xxx so they get some ideas on how to develop their own skills as a therapist to aid security safety and relaxation yeah like a therapy room that's a supervisory function as a therapist I think I much yes I could teach them to say I was really interested that you you seem to have changed in behavior do you see me in it so the way is a therapist yeah yeah absolutely yeah I was wanting to do on this podcast to talk about the importance of therapist evaluation of behavioral processes and script signals as a signification of where a therapist might go in therapy and what might have changed yeah yeah because observational skills and you know noticing non-verbal communication and all that sort of stuff is a really good way of giving and receiving feedback as well yeah in the therapy process do you know what I mean on how you're doing if somebody's kind of got their arms folded and the legs crossed and aren't really engaged it's a real big feedback but actually I'm not connecting with this client yeah and if you've got a good enough relation with the client you might say yeah you know I've just said this to you and I realize you've got your hands crossed or whatever you've just said okay how about you uncross you know your arms uncross your legs or most perhaps open stance and see how you feel when I say the same thing to you yeah and see if there's a difference yeah because one is a much more defended way than why another way is a much more vulnerable way and of course you might feel you want to defend against your vulnerability just for an experiment yeah see I like that just just as an experiment let's just go and see yeah yeah and usually I might do this around strokes and TA in other words the giving and taking of positive compliments if you like yeah a stroke is a positive unit of recognition so if you say to somebody oh you did that really well but now how they receive that because they may have had a history of people never giving them strokes so they might not believe you when you say it if you ask them to experiment that from a more open position rather than a defended position which you've reserved you often see magnificent differences though the client then becomes more aware what part of the self they're operating for what an amazing topic Bob it is interesting though isn't it absolutely I can talk about it for ages because it is something that really interests me but unfortunately we need to end yeah it's much better my behaviour will probably wouldn't get more slumped of relief or ending or I'll be you know more vibrant with passion and or I feel disappointed and slumped because I didn't have the chance to even continue more talking about it I don't know but you are right we have to end we have to all good things come to an end Bob including this episode so what we'll be talking about next time is taking new routes in therapy oh gosh I look forward to that me too okay until next time Bob see you then bye bye you've been listening to the therapy show behind closed doors podcast we hope you enjoyed the show don't forget to subscribe and leave us a review we'll be back next week with another episode