 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. Okay, welcome back to the next episode of The Therapy Show behind closed doors with myself Jackie Jones and Mr Bob Cook. And this is episode 116, Bob, by my reckoning. Oh, good. I just took my glasses off when you introduced me there. I'm not sure why I did that. But anyway, 100 and what? Do you say 16? 116. Oh, we're climbing up the, uh, climbing up the panel or whatever. We are. We are. And I think when, well, last time when I looked on how many, I think we'd had something like 35,000 listens or downloads of this podcast or whatever since we started, which is amazing. Good. We average about 240, 250 every seven days. Yeah. Oh, the first seven days, anyway, that's picked the tails off. And we've got listeners on YouTube. So we've got listens on there and we've also got them on, I think, and we used to do it on Anker, but Anker's been took over by Spotify now. Oh my God. So I can't get in any more through Anker. So, well, you can. It's just that it's Spotify that's doing it. It's all very complicated. But yeah. So, so you can either watch us or you can listen to us. But I think it's, you know, we've done good at this, Bob. We've been doing it for 116 episodes now, all through the pandemic and everything. So the topic of this session is tissues and tea. Tissues. Which I love the title, Bob. I picked this one because a friend of mine, oh, I don't know how many moons ago it was, a Gestalt psychotherapy said that they just written an article on the use of tissues with the psychotherapy group. And that tickled my fancy. And I never got to ask him what he meant by that. And also, I never read the article. But I know what I think he means right. And I haven't read the article so, but I do like the title. And what I mean by it is different views on how to be with clients in the therapeutic room. So if we talk to psychoanalysts, for example, let's say psychoanalysts. And there are people who are into interpretation. They may be Freudian, Jungian. There could be some of the later psychoanalysts they've influenced by. They don't have to be working necessarily with couches anymore. But they very much into interpretation and self-awareness is the important curative factor. Whereas if we look people, say, from the disciplines I got trained in, relationship is the curative factor. And we could look at behavioralists. We could look at CBT. We could look at many of the holistic therapies as well. And they may have different focuses. But if you ask the psychoanalyst about tissues and tea or the use of tissues and tea in the psychotherapy room, they would probably say immediately, tea, tea, we don't give it out of tea. My gosh. They come at on the hour and they leave 15 minutes after that. And if they're going to want us to take care of their needs, then they need to go to different type of therapy. Because once we start making tea for them, we could be encouraging infantilization. And actually what's really important for us is that we encourage self-agency rather than infantilization. So making a cup of tea for their clients would be, I think theoretically anyway, I'm not saying all psychoanalysts to this point, but theoretically, have a seat. It's funny, isn't it? Because I can't imagine doing therapy any other way than the way that I was taught and the way that I do it, which, you know, having a cup or a drink, I don't think you can see it. But behind my chair there, there's always a jug of water and sunglasses so that they can have water if they want it, or they can have tea or coffee. It's part of the course. And that's because you were trained holistically. Yeah. It's because, oh, well, rather than me making assumptions, yeah, rather than me making assumptions, what's the thinking behind offering clients a cup of tea? Again, I'm assuming you mean when they come through the door? Yes. Yeah. Yeah. Not in the middle of the therapeutic process. No. No. It's a welcome. I always welcome them in and ask them how they are and say, would you like a drink, tea, coffee, water, anything? Okay. So what is the thinking behind that if there is any? For me, it's to put them at ease and it's to start building up that relationship with them. Oh. So, you know, the thinking behind it for you is to twofold. One, to make them, you know, at ease. Yeah. They might have, I don't know, they might have walked to your office. They might have come across town. They may have come through the rain. They may have had a stressful day. Yeah. So making a cup of tea would be, you know, making up the ease from your frame of reference. What was the second thing you said? Building up the relationship. Yes. Yeah. Yeah. I think they go together those two things, don't they? Helping them ease, taking care, building up the relationship. They sort of all go in the same ballpark. Yes. Okay. It's interesting because for 38 years, I did the same thing. Probably from the same frame of reference. However, no, I didn't ever change it because I ended up seeing people clinically at when I was four years ago now, when I was 69. I don't think I ever changed that habit, if you like. However, I run a lot of supervision groups and I meet a lot of supervisors from other disciplines. Yeah. As well as, you know, psychoanalysts I've just talked about. And when we talk about how do you meet your clients, for example, you've got variation of responses. One of the most common is when they go up to the therapy room, there might be glasses of water on the table. But there certainly isn't tea. They certainly don't make tea for them. You get some people who follow psychoanalytical view, which I'm calling the psychoanalytical view, maybe that's unfair. But the theory is, by making tea for them, you aren't encouraging self agency. And secondly, they might be doing that to pleasing you. And I think that was probably the favorite response for all of them. I had a discussion with one group of therapists about this. And they said, oh, no, we never could cup of tea. We do actually leave some water for them. But you know, have you ever asked your clients about this? So anyway, after that, I decided to ask, I was running a psychotherapy group. And I made a cup of, oh, no, I said him, they went and made our cup of tea. And I was talking about this, and she said, oh, well, I think, you know, when you made me cup of tea, I might just adapt to you, rather than think what I actually want. Interesting. Which is an interesting answer. And it follows that psychoanalytical view of maybe unconsciously or out of my awareness, supporting adaptation, or at its worst, infantilization, rather than promoting self agency. Yeah. Same with tissues, getting onto tissues. So I think the article is completely about that, what I've just said. By providing, I think the article was more about, you know, if there's a box of tissues in the room, do you actually pass the tissue box to the client? Or do you encourage the client to move for the tissue box themselves? Thinking behind that would be around empowerment and self agency, rather adaptation to the therapist who might think that the client wants to have a tissue. This is all very deep and meaningful stuff, Bob. On the surface, you know what I mean? For some of the listeners, they might think, what does it matter whether you pass them a tissue or they go to get it themselves? But there's so many layers to this. And, you know, I was talking with one of my clients this week, and it's kind of like, you know, the conversation that goes on between two people, we say something and we put it out there and the other person picks it up. And in the middle, it can be misunderstood from what our intention is to what they actually receive at the other end. And I think that with the tissues is one of those situations. Well, it could be. We asked one way of looking it, but I think philosophically, we are talking about very important. Absolutely. Philosophical values, which is why you meant when you said it may appear XXX with clients of therapists, and you know, what are we actually talking about? But I actually think that philosophically, they're very different positions. Yes, one is what I wouldn't pass a tissue to my client or even make a cup of tea because I'm encouraging self agency, not adaptation. On the other end of the spectrum is where you and I, me particularly for 40 or 30 odd years, probably sounds like you and many of my colleagues, by the way, offered tea and coffee out of what you've just said, not self care, modeling self care, courtesy, building up the relationship. So you've got two different, almost philosophical ways of thinking. Yeah. And I think they're important. I don't think they're, I think at one level, I think it's like, how can I explain, it's going down the union level. So one level, because say, well, doesn't really matter, does it? On another level, I think that both sides of the polarity would have been very, maybe very indignant about the other side of the polarity. Yeah. And I can understand what you're saying, you know, if you're doing relational psychotherapy, then the relationship is important. Whereas if you've been, you know, analytical or whatever, but that seems really clinical to me. Well, I think if you are promoting a self agency, that means promoting people being in their adult in the hearing and not adapting to the therapist or being younger or regressing or infantilizing, then there's a huge discussion around, well, they need to decide for themselves, whether they, whether or they do or don't want tissues and psychotherapy. They want, they need to decide for themselves, whether they make a cup of tea or not. Yeah. What have a parent figure inverted commas might perceive it that way in the discussion, making decisions for them, just like their own history. Yeah. I'm trying to think of the situation, how it would play out in my therapy room, if I didn't offer, whether they would say, you know, can I have a cup of tea, please? And I'm not sure any of my clients would actually say that. I don't know. That might be me making assumptions, but I don't know whether that's the British way, you know, to mean that we need to be offering or something. I'm not sure. Now that's an interest in bringing cultural scripts and cultural thinking. It's a really interesting deviation in the discussion. Yeah. I know, I certainly wouldn't. If I was going, you know, in the many years that I've been in therapy, I don't think I would say that to my therapist. Well, what wouldn't you say to that? I wouldn't ask them for, I might ask for a glass of water, but I certainly wouldn't go down the tea or coffee route. I don't know why there's a difference in that. But to me, asking for water is a lot more acceptable than asking somebody for a cup of tea or coffee. I don't know. Well, it's important, isn't it? Because if you think of the projection onto the therapist as maybe a significant other person. Now, you can go both ways with that. As I said, in the encouragement of developing self-agency, then it's up to the mind if they make themselves a cup of tea or a drink of water at the house, because that would be like from an adult frame out of courtesy. They might ask that, but if there's just a, you know, a kitchen there, they might go make it themselves. On the other side, which is again where I come from and you come from, building the relationship and even, let's put it another way around, even under the guise of what we could call a reparative relationship. So you and I have done a podcast on reparenting on reparative relationships and working developmentally, then making a cup of tea for them or passing them a tissue when they've never had a parent that might have accounted for them can be deemed very therapeutic. Absolutely. I can remember many, many years ago, must be 30 years ago, maybe. I was working in a school in Stafford. It was one for behavioural difficulties, kids that had been excluded or, you know, they had issues and things like that. And one of them had absconded, they'd run away and we found him and brought him in. And the first thing that we did, we always did whenever one of the kids had a kick off or they had a, you know, a meltdown or whatever it was, was we'd make toast and tea. They had tea and toast. We'd sit them down in the kitchen and this big dining table and we'd just sit with them but we'd give them tea and toast. And it was very therapeutic just doing that for them. Taking account of them. Absolutely. So there is something, you know, nurturing and like you said, psychological and everything about food and drink as in, you know, giving somebody sustenance or whatever. I don't know, but it meant a lot to those kids. Yeah, because it represents safety. Yeah. It represents security at a very deep level in terms of survival processes. So I understand that. And that's why I said if you work in a developmental relational way, then I understand very much the discussion around making tea, passing tissues around, coming from a nurturing place, you know, encouraging a reparative experience is all in my therapeutic lens. Yeah. It's interesting though, isn't it, that from a Netherlands, you know, that may be seen as a regressive fantasisation, disempowerment. Yeah. And I can see that as you're talking about it. Yeah. That's interesting though, isn't it? Absolutely. I think it really is. And I think there are two different positions. Now, as you said, way back at the early progress, I think there's middle grounds, the shades of grey on the continuum. Doesn't have to be one end of the polarity or the other. Could be many therapeutic approaches which would take different positions up on the continuum. Yeah. You know, I was just thinking when we were talking, actually, would I change my position on this, what we're talking about now? Yeah. The decades I was a therapist, because I didn't change it. Even though I have thought about what we're discussing many times and I think that I've always been a therapist that's thought developmentally. I've always been a therapist that's thought about new reparative experiences. And certainly with the relational turn of the 1990s, when most research said that the relationship is the core for a curative experience, they are all those both as principles, if you like, fell into one place for me. So I probably would never have changed what I actually did. I would still, and in fact, I ran a therapy group. I run three therapy groups. And each group is three, Monday, Tuesday, Wednesday, Wednesday, Thursday and Friday. I used to do three a year at the Manchester Institute. And I won, I, you know, I ran one recently. And I passed, oh, when I passed the actual psychotherapy, sorry, the tissues over to the client, I thought, because I knew somewhere in my head, this title was going to come up. And as I did it, it flashed in my brain, and I still continued to do it. Because I believe we, by taking account of our clients, by presenting that type of approach, we made, we are, and certainly for this person who had years of neglect in a history, providing a different reparative experience. Yeah. And I know I've mentioned this in the past in one or two podcasts that we've done. I can remember, and I think it was on the, one of the therapy marathons that I attended that you did. One of the first things that you used to do when I was sitting on the couch, which you would, you would literally consciously get the box of tissues and put them in between me and you. And I used to think that was really crafty of you. And what is Bob doing is playing with messing with me idea. But part of me felt like you were giving me permission to be emotional because showing emotions is something that I always found quite difficult. So it was kind of like you were just opening the door and saying, it's absolutely fine if you do, there's the tissues. Yes. And I do think that way. I think in terms of therapeutic permissions. Well, that was how it felt for me. Yeah. I did think you were very clever doing it, by the way. In fact, I did that the same in this therapy intensive that I was thinking about. Recently, I put the two boxes of tissues, three, two in the middle room and one next to the two men. So it's interesting that we can look at it in lots of different ways. The messages that, you know, are given out by a simple act in the therapy room, whether that's offering tea or tissues or where the person sits, all sorts of things. It's all permissions and and court and seeing whatever else that goes on in the therapy room. Yeah. When I first started off, very long time ago, in 1985, with my first client, I remember my first client well. And I remember being so anxious and thinking about, oh, how shall I have the therapeutic room? Should I have some cushions? And how should the cushions be? What colour should they be? Should they be far apart? Should I have a, what colour work should I have? Should it be a nurturing environment? Should the chairs be a long way away from each other? But one thing that did shape all that I did, besides the super my supervisors thinking, was to provide a nurturing environment. Yeah. Now, this is way before the whole advent of what I'll call relationship psychotherapy for the sake of clinical theory. This was, I think because I wanted to provide a environment which showed that I cared and taken the count of the person that came through the door. Yeah. If somebody has said to me, after that first session of the supervisor, no, that's fine. But what about self agency impairment and all those other things? Because I was such an impressionable, naive therapist, would I have changed my thinking to a completely different approach? I don't know. But my supervisor came from a school that I came from, which is transaction analysis, and was very much into providing a nurturing experience or a power tip experience that clients might never have had. Yeah. Because this is where I work. This is my therapy room for anybody that's watching. And I've got red throes on my chair. There's splashes of red on my chair, which you've seen there's not a good colour to have in a therapy room. I didn't know that. But that's my personality. Do you know what I mean? He's quite dull and muted, apart from bits of red that I've got in there. And do you know the red on the therapeutic lexicon is supposed to represent anger? Anger and danger and all the bad things. You do know. Whether that's me pushing a few buttons with the client in the room, consciously or subconsciously, I don't know. But I like a bit of red in there. Well, I'm a Manchester City supporter. And perhaps I should have light blue, but I never have done. But things have just said that. But again, psycho dramatists, people from different schools of thought may say, Oh, well, we need to have a completely blank space. Yeah. Because once we start having different colours, we'd have different pictures, we have this on the wall, then two or three things happening. The client then can distract themselves by projecting XXX onto the wall. And they can move away from what they need to be doing, which is a psychoanalysis or the psychotherapist's work or interpretation, whatever it is, because they're projecting goodness knows what or could get triggered off by all these different objects and pictures and fellows. So people, psychotherapists, I think, according to where they trained, where discipline they trained in, whether it be humanistic or psychoanalytical, for example, will have different ways and methods of working in the therapy room. Yeah, it's a really interesting topic. As a title, tissues and tea in the therapy room or whatever, it doesn't sound that much. But like you said, looking at it from lots of different perspective and lots of different angles, it's a really in depth topic. Yeah, and I think it represents the training, the different ways that people have been trained, the different polarities, like a dynamic, whether it's psychoanalytical, whether it's psychosynthesis, whether it's transactional analysis, whether it's relational psychotherapy. Many of these different polarities have different ways of working and different methods. Yeah, and is there also part of it or personality plays in it as well? Well, it's an interesting one, isn't it? Because I think yes or no. If you've been trained very much around what I'm going to call a psychoanalytical frame or object relations frame or different types of therapists on that side of it, then you may be trained around not going down the road of maybe what could be seen as infantilization or lack of self-agency and param and all the things I talked about. But if you're on the humanistic side or perhaps the relational side, that will determine. Now the question, does your personality, I'll tell you what I think happens more. I think that your personality might determine which type of therapeutic discipline you follow. Yeah, yeah, I would agree with that. Yeah. So yeah, I would never follow professionally a discipline, which is about interpretation, which is about what I would see as a one-up, one-down place. Yeah, me too. I would never have gone down that way. No. I'm much more attracted to a real individual, it's a relational style of psychotherapy. Yeah, and underneath all of this, I'm a people pleaser and I like to make people cups of tea and coffee. That's on another level. But the issue, the thing about that as a psychotherapist, that if you're a people pleaser, you can run down the trap, or chaps might be a strong word anyway, or encourage unconsciously or even consciously, the client adapting to the people-pleasing part of you rather than deciding what they want for themselves. Yeah, yeah, I agree. Yeah. But I mean, it's useful to just be able to say that off the back, but I think it's important, as well as just saying that, we can also think about what that means clinically. Yeah, which that's one of the things that I think in the therapy process, we do need to think everything from a clinical perspective. And like I said, the messages that we're giving out, it's whether they're being picked up at the other side with the same meaning or whether they get lost in translation. That's very, very important, isn't it? Yeah. Because I think I come from the view. From the moment I open the door to the clients, to the moment, or whether the clients get buzzed in themselves, which is another story, the moment they leave, we're always modelling things to them. Yeah. And from that framework reference, they will always pick them up. How much they integrate in that, and how much they digest all that is perhaps another story, considering whether they have an antisocial frame of reference, whether they have a narcissistic frame of reference, whether they have a schizoid frame of reference, or append how much they take on board, or they throw out if you like. Yeah. Yeah. I don't want that tissue. I'm going to throw it back to you. Yeah. Oh, you always make me a cup of tea. They come from an antisocial frame of reference, then it's interesting how much they will digest or adapt according to the therapy process, isn't it? Yeah. Yeah. And it's about being aware of all of this stuff too. Yeah. I remember, when was it? Two years ago, a client who had been in therapy with me for over 10 years knocked on my door and said she wanted to run this book by me, and my name was in it. And she wanted to do that at a courtesy, etc., etc. And then the discussion, that was very nice, but one of the things in the discussion I was sharing this podcast was, we were talking about what she remembered as so significant about the 10 years of psychotherapy. Now, at one level, I expected her to say all these, or some of these wonderful interventions I made, or some of these magnificent pieces of therapy we did, or some of really deep, regressive work we did. Did she say any of that? No. Narcissistic, because I was most disappointed because she's, no, was the answer. She didn't. You know what she did say? She said, what I took away most of all, Bob, was your kindness to me. Aww. Yeah. But in the ballpark of what we're talking here, and relationship psychotherapy, and taking account of a client. Yeah. I think it's very important. Absolutely. She said, I felt very moved, but you know, it made me think, gosh, I didn't think she was going to say, I thought she was talking about one of this wonderful pieces of work we actually did, which I remember. Yeah. Last thing I remembered was what she actually came out with, but on reflection, what a lovely thing to say. And that's it. When we're looking at things, you know, on the different levels, without you showing that kindness and her receiving it, and making that relationship with you, would that empowering life transforming work ever have took place? Probably not. Yeah. Certainly. So it's food for thought. I think what we model down and the way we are as such a profound effects on our clients that often, I don't, I think reflect on that enough. Yeah. Another good podcast, Bob. Thank you so much. I enjoyed talking about that. Thank you. So what we're going to cover on the next one is falling in love with your clients in the therapy process. Another one of my titles. Another one of your titles. I'm really interested in this and what we mean by falling in love with. So until next time, Bob, take care. See you soon. 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.