 but also in force breaks, and they're in force breaks by the therapist, by the therapist going on holiday. And that often evokes a morbid fear of abandonment, which lies within the troubled psyche of our clients. Or at least made it. Yeah, totally. And even just the time of year. 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 81 of The Therapy Show behind closed doors with myself, Jackie Jones and the ever-present, ever-epravescent Mr. Bob Cook. And what we're going to be talking about today, which is quite apt, is how to deal with holidays on this run-up to Christmas. Yeah, I'm dyslexic. So I can't even say the word you said about me in the description of it, but it sounded very delightful. Yes, I've just had the dentistry today. So, you know, an hour and a half in the actual dentist, you know, dentist chair while they're preparing for root canal work. So I have gone off the numbness of my, so I'll be able to speak. Good. Okay, so holidays just before, of course, holiday time. Yes. So... It can be quite a big deal and intensive time for a lot of people, can't it? It certainly is. And according to NTA terminology, according to how much adult they've got, even in terms of resilience and robustness will depend on how they may... I use the word in inverted commas, act out, it's a psychological term. And TA might be going to script. Yeah. When, you know, there's holiday time and the therapist goes on holiday and how they then interpret that. Now, having said that, which I can talk about in a minute, I also wanted to book contracts in this stage because your TA is very... A contractual theory is very, you know, pivotal. Yes, yes. So when you actually make the contract with your client at the beginning, in terms of a focus of what they want from the therapy, in the business contract, you will... I'm gonna speak for myself, but I'm gonna go out to you in a minute. We talk about holidays. Yes. So, for example, in contracts I made with my clients, I would talk about, you know, Christmas time, being off of Christmas time, you know, New Year, perhaps. And when I went on holiday. Yeah. So they would know how many holidays I have and they would be prepared for that at a certain level. And also, specifically the one after Christmas, we can prepare them for that. But at the early stages of third of course, there is a contractual process around holidays. Yeah. Is that the same with you? Yeah, yeah. And I think it's important as, you know, therapists and counsellors, that we take account of ourselves in that period, that, you know, we are entitled to have a holiday and to take a break. It's just about planning it. That's, you know, that's the important part. Yeah. Now I've just said that a bit about contracts and... Yeah. That in the contractual process, Clarence and I just know when the holidays are. Yeah. There is a process there at the beginning. I'll go on to the next bit. Now, about 12 years, maybe 15 years ago, a film came out which became a cult film. And it's not a cult film because of my name, because the actual film was called What About Bob. Wow. And I'm called Bob, you see. So it didn't become a cult film because of that. But what about Bob? It is a most wonderful film. It's a comedy. The most wonderful film. And Bill Murray from Groundhog fame. Yeah. Played the obsessive-compulsive, paranoid, schizophrenic, if you like, client. And Richard Dreyfuss played this narcissistic American psychotherapist. And it's good. And basically, how Bill Murray became, who played the client, became a patient of Richard Dreyfuss, who was the psychiatrist, psychotherapist over in America, was that the client, Bill Murray, was so disturbed that a lot of the psychiatrists had given up with him and they turned to the very narcissistic therapist and said, can you help? And of course, he's extremely narcissistic, this therapist, and believes in cure everybody. So he took on Bill Murray. Now, what the story, I don't want to tell you the end of the story because, you know, it was still a story, but basically over in America, of course, psychotherapists went on holiday the whole of August. They took the whole of August off, generally in America, you have a whole month off. And the client, I, Bill Murray, was told about this about three weeks before Richard Dreyfuss took him on. And of course, he went straight into paranoia and triggered his script and abandoned him phobic and his OCD came out much more and he felt abandoned by the therapist. So that was all going on. And then to cut to the next part of the film, because I don't want to destroy this film for you, he followed Richard Dreyfuss to his whole day home. And he invaded his therapist's home while he was having a vacation and all this is going on. And I'm not gonna tell you the end, but this is really important in terms of what we're talking about because clients have got a morbid fear of abandonment. Even though they were able, from their adult, understand the therapist has gone on holiday, can from child, inadvertent comments, act out because they felt abandoned. Yeah. And in this film, the extreme consequence was the client followed the therapist on holiday. And in fact, engaged in the family of the therapist and there's a lot more to the film. But it's a very funny film. Please go and watch it. I enjoy it. You can get it out on DVD. I'm sure it was 12, 15, 16 years ago. But we take the grain of truth about this is the more disturbed the client is, especially borderline clients in the vertebrate commerce who have a morbid fear of abandonment. They may well act out in the therapy, you know, in the holiday time. So the therapist needs to take this into consideration. And with the client, talk about the, you know, maybe the problems that might arise and what the two of them are going to do about it. Yeah. Which is a good idea because planning and preparing and talking about it and bringing it into awareness is really useful, I think. Yes, I'm very, very important. Yeah, yeah. I always did this with clients. I was always very conscious when I go on holiday, we may cause a rupture in the relationship to the therapist and clients. And I wanted to make sure that we could work around that if that happened. Yeah. Now, if the client is going away for a whole month, which I never did, by the way, it's a long time for a client to hold that, what we call object constancy. In other words, keep the therapist as a good enough object in terms of safety and security, a month's a long time. It is, talking about a constant object, I have known of, and it's not something I've done myself, but I have known the therapist to give the client something as a constant object. Do you know what I mean? Before there is a break, whether that's a holiday or whatever it is, what are your thoughts on that? I've done it myself. And I've also received it. When I was in therapy myself many decades ago, my therapist went on holiday and gave me one of a... How can I explain this? One of her rings, I think it was, in terms of providing a bridge in that relationship. So, and also as I was a therapist myself, I might give some sort of constant object or something from my house to provide that transformational experience. So, if the client was having difficulties and they're resilient or holding the adult place and they were moving to child and feeling abandoned or whatever it is, they could look at the transitionary object or be able to hopefully it would provide a bridge to hold the therapist in an okay position. I just, like I said, it's not something that I do personally, but I know that there are quite a few therapists that do do that. Yeah, they might give them many things like a favourite cushion of theirs. Yeah. Give them a picture, might give them... I often, which is very common, to give a sort of, you know, I was thinking of the sort of gemstones. Yes, yeah. Crystals or something like that. Yeah. The client can take them out and they're very tactile. Yeah. They can feel it. And they can remember the therapist's words or it will help them. Yeah. Therapeutic presence, even though the therapist is away. Yeah. Because it's interesting. I think one of the things that I've experienced, you know, around holidays is that if the client is going on holiday, they seem to be okay with it. But if I go away for a week, then that kind of brings up all the attachment issues of abandonment and everything, but not when they're going away. It's when I go away. Yeah. Which I find quite interesting. Oh, but you've got the magical powers. In other words, you're the secure object. Yeah. Yeah. And in transference terms, you're often the mother, the important sister, maybe even the father. You're the secure person. So in transference terms, it's pretty straight, it's pretty logical that way around. Not the other way around. Because the therapy is with the idealised other, which is you in this place. So if you go away, that might bring out or trigger certainly, which is an attachment, times where they feel neglected or abandoned by their mother, father, or significant other people. And that's, in transference terms, that's who you are. Yeah. Yeah. I just find it quite interesting that the way the way that a weaker part can be viewed through different lenses, if that makes sense. Whether it's them going away on holiday or whether it's them being abandoned by you, but it's just looking at it from a different perspective. But the length of time and the being a part is exactly the same in both situations, but it's how they perceive it. Yeah, but if you're going away, you're more likely to stay an adult. You're not going to be triggered really because the therapist hasn't gone away. Therapist, you're choosing to go away and you know the therapist is going to be there when you come back. Yeah. It's very different from a therapist leaving. Yeah. Because the therapist has not chosen the therapist to go. Yeah. Yeah, I understand what you're saying, but it's just how it's perceived, looking at it from a different perspective. You know, seven days is seven days. The length of time is the same. But one has much more impact on the client than the other one. Yeah. You're correct. And I think if we look at it in terms of ego states then psychologically, perhaps you can see it differently because in terms of ego states, the client goes to the child. Yes. Yourself, if they get left. Yeah, yeah. Or if they perceive it that way, as you said. Yeah. We say we'll do, like you said, they don't have a say in it. It's not a decision that they're making to be left. It's a decision made by the therapist. And yeah. So we brought the subject of transfers up. So usually when a therapist chooses to go away, they will know that it might provoke a transferential process. Mm-hmm. And if it provokes a transferential process and you'll know by the script of the client or the history of the client, then by definition the child will move, sorry, the client will move to the child ego state. Yeah. If they move to the child ego state, which is the younger self, that's usually where the trauma is. Or where they felt abandoned or traumatized. So in terms of ego states and transfers, then the clinical treatment makes sense. Yeah. The real key to this is preparation. Yeah. And the therapist preparing with the client for this process. And also utilising transformational objects or in a sense consistency, whatever we want to look at it. So that if it's too long or the client feels that they are likely to act out in some way, they've got some sort of bridge in terms of a constant object to remind themselves that the therapist has gone away and it's going to come back again. Yeah. See coming back is the bit. So if the person moves to a younger self, especially if they're quite disturbed, they can lose sight that the therapist might come back because the history usually or might be one where they were left or neglected or abandoned, traumatized, but significantly, they didn't come back. Yeah. So they find it harder to hold in their heads the idea that the therapist is going to come back. Yeah. Or if they did come back, everything had changed when they came back. You know, it's that continuation. And that first session after you've had a break can be very different to what it was before you went away. Absolutely. And there's a famous book written by Paul Patterson. And I think the other person knows Margaret Atwood, their attachment therapist. And they wrote a book called Separation of the Young. I think it was 1954 or something like that. Don't swear me on the action. You know, you came out, but their attachment therapist and there's a lot of photographs, black-and-white photographs in this book. And one of them is of the mother taking their young child, who's seven, to hospital. And the young child was going to hospital for some reason, which was going to be about a week. Yeah. So walking into hospital, they were holding hands. Yeah? Yeah. Okay? Yeah. She went to fetch her daughter and they came out again. They weren't holding hands. So you're perfectly correct. Even though the mother went back after a week or whatever it is to collect the child, the child had unfelt by the sense of this picture able to trust the mother enough to be able to attach to her again. Wow. So when the therapist comes back, the therapist needs to understand that things like you've just psychologically, pups have changed and that the client will need to talk about the process to be able to attach back to any sense of secure attachment, hopefully, that the person had before in the therapeutic process. Yeah. Now, if the therapist doesn't understand that, they don't understand the attachment process and ruptures in the attachment process. They might well be caused by a holiday and Christmas is coming up. Yeah. If they don't understand that process and don't give credence to that process, they're much more likely to cause ruptures in the therapeutic process, which will become much harder to get back to where they were before. Yeah. Yeah. Because ruptures in our past, however they show up, do you know what I mean? It might be quite a normal process that a family is going through where one of the parents has to go away, whether it's through work or illness or whatever it is. You know, and the family gets over it, but inside of us somewhere, there's always gonna be that little niggle that they're gonna leave me. So it can unearth an awful lot of hidden trauma that the client isn't even aware of? Absolutely. And for most of us, yourselves, me, you know, yourself and most people, they haven't had the traumatic history of what I would call cumulative neglect. Yeah. Yeah. And we have a sense of resilience to be able to cope with a week's break or two weeks break. But the more fragile the adult or the resilience in the client, and the more they've had a history of cumulative neglect and trauma. Yeah. Then a therapist going away for two weeks or a week means a completely different process to what I'm talking about. Yeah. You know, you and me are talking about. Yeah. And will by definition of both things. Yeah. A therapist needs to, I say it again, really needs to understand attachment theory or at least understand some sense of what might be laid out or recreation of history for the client by the therapist taking Christmas off or something. Yeah. Yeah. It needs to be really talked through psychologically, I think. Yeah. And again, you know, it is up to the therapist and the client to talk through certain things. Again, you know, I have in the past, if I've taken time off contracted that maybe we could have a 10 minute telephone conversation during the week. Good. Just to touch base or, you know, not that it's a free for all and they can follow me at any point but it's contracted a time and a date for either a text message or a quick five minute phone call. Yes. You know, so there are ways around this as long as it's contracted and it's agreed beforehand. I think that's the key to a lot of this. Absolutely. And with disturbed clients, especially the so-called borderline clients, they will attempt to push that boundary. Yeah. Yeah. Completely. Yeah. Suddenly caught up in a particularly difficult situation. So, but on the whole, you're correct. Yeah. I think it's a contractual process that can be worked out beforehand. Yeah. Yeah. So there are things that we can do, you know, that's gonna make it less of a rupture in the therapeutic relationship than, you know, just going away for a week or two. You know, and like I said at the beginning, you know, the downside to that is that we are entitled to have a break and a holiday. We have a duty of care to the client, obviously, but we also need to, you know, the self-care and us recharging our own batteries and having time away too. Absolutely. And we, in terms of this duty of care to the client framework, we need to think clinically about what us going away may evoke. Yeah. Urson script. In my experience, nine times out of 10, coming back after Christmas and I'd always take two weeks off. Yeah. Was never the same. In other words, what I mean by that, whether it's in the business or in a group, clients had to attach back to me. Yeah. To be able to do work they needed to do. And usually the first, individually the first hour back or this group usually two hours was taken up, not just talking about a holiday, but you know, working through a process of getting back to some semblance of attachment with the client and the client with the therapist. Yeah. I'm being mindful of that. And, you know, I don't want to say scheduling that first session in, but having a process to go through in that first session in order that you can get back in the relationship. I think it's really important rather than just coming back in as acting as if everything's fine. And we're just going to carry on where we left off type of thing. That's right. Or ignoring the psychological significance. Yeah. You know, and I think therapists that do that will pay the price and also clients will. Yeah. They'll be, you know, because in the therapist says, oh, I don't know why that client left. I mean, we're doing such good work. I know Christmas came up, but, you know, I don't understand, you know, I came back after Christmas and three or four weeks later, the client handed their notice in. Yeah. Or decided they wanted to leave. And I thought we'd get on fire. They really don't understand what happened. And I think that therapist doesn't or hasn't been given enough emphasis on, you know, attachment theory or at least an understanding of that. Yeah. Which could evoke the process of termination with the client terminating therapy. Yeah. See, I often when I'm working with clients or whatever, I kind of put myself into a similar situation in my upbringing and how I felt and connect with that, which kind of makes me a bit more empathic towards the client. And I can remember it when, you know, at school, particularly, you know, primary school, the end of the term, so at the beginning of the Christmas holidays, everything was stripped out of the classroom. You know, all the old displays on the wall, you took everything home after that first term, so your little drawers were all empty and you went back to this bare box. And I can remember feeling really strange going back into that classroom because it wasn't like this in a classroom that I'd left just before Christmas, if that makes sense. No, a very good analogy. I mean, for many clients who had very difficult histories, when the therapist has gone away and comes back in January in this case, it's almost like the world has changed. Yeah, yeah. Or could be like that. Yeah, and potentially that's how it feels. You know, you want the same, yeah. Yeah. So it's really important preparation here. Yeah. Sometimes they need to know that they've been in your thoughts as well, which can be quite impactful for them, that you haven't just closed the door and not thought anything about them or your practice at all in the week or two that you've been gone. Yeah, so you might, like you said, arrange time to send them a text or... Yeah. This all has to be done within contractual process. Yes, really important, yeah, yeah. Because like you said, some clients will see a, you know, a gaping in the rules and, you know, yeah, it wouldn't be helpful for the relationship. It could be open to interpretation. Yeah. One way, so following up from your suggestion, when the therapist comes back, so when the therapist comes back in January after this Christmas break, I don't know if you're suggesting this, but I'll go with the way you're talking. Are you saying that one idea would be for the therapist to talk about what's happened for themselves at Christmas and talk about what they did and put in the process, say, you know, I was thinking about you and I know Christmas is an unbucketed time for you and you were in my thoughts and I'm glad I'm back now so we can talk about, you know, what Christmas did bring up for you. Yeah, totally. And that's what I would do, yeah. Not just deny Christmas never happened? No, no, because it did. And I think, you know, it's an opportunity as well to, I don't want to say reparent, but, you know, role model how we can have a break and not see each other and come back and be okay with that and that I, you know, being consistent. And if I say I'm coming back, I'm going to come back and, you know, just model a different behavior to a client. No, I think that's really important what you've just said there. The modelling of different behavior from the person's history. Yeah, because, you know, the festivities and Christmas is going to happen every year and, you know, the summer period is going to happen every year and there are going to be times where there might be a rupture in relationships and trusting the other person when they say, I will be back, is really important. It's very important, I think, as well as preparation, it's really important for the therapist to think developmentally. Yeah. And making cries about how Christmas was for their clients at a different, younger time. Yeah. Because a lot of clients actually express back they don't enjoy Christmas. And when you say, well, how can we go into a Christmas? They talk about their history. Yeah. And how Christmas perhaps was such a dreadful time for them. Maybe they have parents who always argued or maybe they had parents which didn't like to be at home with each other. Maybe they had parents who would get drunk on Christmas. Maybe they had parents who actually hadn't got enough money to ever give them presents. Perhaps they had parents which went off themselves to expect their clients in the house. Yeah. Maybe Christmas is a very traumatic time and I think that needs to be all talked about because we must not assume that Christmas is an okay time for somebody. Particularly from their history. 100%. And I think statistically, I think the likelihood is that a lot more people will find it stressful and emotional and all those sorts of things rather than it being like the picture postcard or like it is in the films. I think the majority of us have experienced some distress or something around Christmas time. Yeah. The statistics will tell you that New Year's Eve is the time when there's more suicides. Secondly, Christmas. We know that Christmas will bring up a lot of things but also in forced breaks and they're in forced breaks by the therapist, by the therapist going on holiday. And that often evokes a morbid fear of abandonment which lies within the troubled psyche of our clients. Or at least made it. Yeah, totally. And even just the time of year, do you know what I mean? Statistic, I don't know whether it's just me or not but over the summer period when the days are longer and the sun is shining, I get a lot less people wanting therapy. Whereas as soon as the clocks go back and the nights are drawing in and everything else, I tend to get busier over the winter months. Yeah, definitely. So it does have a bearing on how we're feeling. Yeah. Yeah. So if we go back to holidays in the summer, for example, or in the Easter, for example, I know there's Christmas as well. I've got an added sense of implication there but you really usually what's underneath all this is the clients who's had a neglected history. Yeah. And ruptures in an important attachment system which gets a vote by the therapist going on holiday. Yeah. And that needs to be discussed, there needs to be a preparation, there needs to be contractual thinking and maybe the importance of transformational objects to bridge the gaps so the client can realize the therapist is coming back and can hold the focus. These sorts of ways of thinking developmentally, I think are really important when we think about holidays with clients. Yeah. And I know you've said, and I completely agree, it's contracted in the beginning to me that around bank holidays or whatever, there's gonna be holidays, but when we say talking about it and discussing it prior to it, it's not just a week before or remember, I'm not here next week, we're talking, dipping in and out throughout the year, touching on this if anything's coming up and a month before the planning and the preparation for having that week off. Yeah. I couldn't agree more. I remember clients that I took on board but I knew this from the beginning. It was a holiday, a summer holiday and the mother went off and she didn't come back. You know, she had an accident. And so the holidays, in the sense of what we're talking about now, with the therapist going away. Yeah. Would bring up so much. So if you can talk to the client way before and you know their history. Yeah. Then you can prepare ahead. Yeah. And for me as well, I always found it okay or I was comfortable with asking the client what it is that they needed or they felt they would need. You know, rather than making assumptions or me presuming, I can give them a crystal off my cupboard and they'll be absolutely fine. Do you know what I mean? Asking the client, you know, what is it that you feel like you would need from me during that week or is there anything that we can plan together that's going to make it easier for you or whatever it is? Yeah. And that shows that you're thinking about the client, you're taking account of their history and those things are so important, I think. Yeah. Yeah. Thank you. I think that's been really helpful for this time of year because, you know, we will want to have family time on our own with our own family. But, you know, there is always that relationship that we need to be mindful of in the work situation. Yeah. Yeah, and to be mindful of when we come back to our clients to inquire and take account of what they've been up to and what it's been like for them. Yeah. Not just assuming they've had a good old jolly time. Yeah. To think developmentally, yeah. Yeah. And I think, you know, I'm not sure whether it was the last podcast or the one before then about, you know, relational needs, you know, the need for the other to initiate. So for us to bring up that conversation and inquire about them and their life and how has it been for them? You know, that's a good starter for coming back into the therapeutic relationship and making that connection again. Yeah, absolutely. And also think about time. Yeah. In other words, it might take time for them to attach back again. Yeah. After the break. Yeah, yeah. It will be aided by the sort of process you've just talked about. Yeah. Just the client. And also, you know, what you touched on, be mindful of the fact that, you know, the disruption might be that much that the client doesn't come back. Well, you know, that's a very important one to think about and then what you do. Yeah. Next. Yes. Yeah. I mean, maybe that's another podcast, but it is an important one. Yeah. Time's just suddenly leave. And of course, they never suddenly just leave. No, no. If you think about it clinically enough, you will put in context, you'll get some understanding. Yes, yeah. And I think that is something, you know, I'm going to write that down, I think, because I think it is a good topic. You know, if a client leaves, what do we do? Do we make contact? And if so, how many and how? And, you know, yeah, absolutely. Another good part, you know, another good podcast off the back of this sometime would be about the use of transitional objects. Yeah. Yeah. But very important in the conversation which you've had about holidays. Yeah. So, thank you, Bob. And following on from, say again. Welcome. Yes. In terms of... In terms of the conversation we just had on me. Yes. But following on from this one, what we're going to be doing in the next one, I think it's quite apt, is we're going to be looking at attachment styles, which I know we've kind of touched on in this one. So, yeah, it might be useful to learn a little bit more about those. Absolutely, and it really follows off on this podcast. Yeah. This is the last podcast then of the year. It is, yeah. It's nearly New Year. It's nearly 2023. Well, I have enjoyed this year of podcast immensely. Me too. So thank you very much. Well, do you think we've aged a bit? Well, every day we age a bit, but do you think... Do you think in the last year we've aged a lot? Well, I think the podcast has... Podcasts have actually invigorated me. There's been lots of stresses throughout the year. So I think I've probably aged a bit more this year, but for other reasons, not because of the podcast. Yeah. And, you know, rounding 2022 up, I think it would be nice. You know, and I would just like to say thank you for everybody that's following us, whether that's on, you know, the podcast listening or whether it's watching the YouTube videos. And we do look at the comments and, you know, we do a bit of a thing before we come on about how many people have actually listened to it. And it does... It's nice to know that there's people out there that are listening to the podcast. And while you do that, we will keep making them. I agree to have a good Christmas. Yes. And, you know, new year, even if it comes. Yeah, good. Yeah. So until next time, Bob, thank you. Yeah, bye-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.