 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 the next episode of The Therapy Show behind closed doors with myself Jackie Jones and the wonderful Mr Bob Cook. And if you're watching this on YouTube, you'll notice that Bob's in a different setting. He's moved position. And if you're not watching it on YouTube, go and have a look. So what we're going to be talking about on this episode, Bob, is what I've learned from my clients, which over the years that you've been doing this, I would imagine you've learned a lot from your clients. I've learned a lot. Yes, I am in a new room. I mean, one of my rooms downstairs, actually, it's the major room where the TV is. And behind me, people on YouTube, I'm really talking to and people who aren't on YouTube can always go and rush and look at it. But behind me is some of my favourite things and pictures are one of my favourite yachts on the left hand corner. And it's a much brighter room, which is really why I've moved downstairs. That's what we like. A bit of sunshine and a bit of brightness. Yeah, yeah. OK, yes, it's a great title. I mean, I know I choose these titles, but I do particularly like this title. So I was thinking about that. I've learned so much, but I'm going to start with, I think I've learned over the many, many, many years, and it continually amazes me how resilient people are, how resilient people are and how much they want to get better. Yeah, you took the words right out of my mouth that I was going to say if there's one thing that I've took from all of my clients is their resilience. Yeah. So the second one, people might say that seems strange when I say they want to get better. I mean, I always know that, of course, but the real determination that my clients want to achieve in terms of having an enhanced, different quality of life is really, really not only amazing, but very privileging to be part of. Yeah. It's interesting that you said that. I was talking with a client this morning about something, and it kind of makes sense that people come to therapy because they want to make a change and they want to move on in their life, but moving on can cause grief and loss. So it's not always an easy decision to make. It's easier to just stick with the familiar, even if it's uncomfortable and painful. Yes, it is. It takes a lot of courage to come to therapy. Yeah, yeah. And it takes even more courage, really, to stay with it in therapy, if that makes sense. Yeah, absolutely. So coming to therapy in the first place is pretty amazing. Staying in therapy and often going to the challenging, maybe darker places that they inhabit or visit when they're in script, particularly, takes a lot of resilience and courage. Yeah. It's interesting because I went to therapy last week. I get eight free therapy sessions through Millen for my cancer diagnosis. Oh, yeah. And it was very strange. That's all I can say. It was strange. Was it useful? I'm reserving judgment on that. Especially when your especially when your speaker on a podcast goes out to lots of people. Oh, that does above me. I'm quite open to show you things. It was person-centred. It was different to what I maybe would have chose if I was paying for it, put it that way. Yeah. And I think person-centred has its place and also it's very different from any of the psychodynamic models or transaction analysis from that point of view, which I know well. I'm just not sure what my therapist would have learnt from me in that session. But yeah, it's interesting looking at it from a different point of view from kind of being the therapist and sitting in the opposite side in a therapist situation. Yeah. So resilience, courage, real determination to get better. Those are things I'm often left with or I've learned if you like. Yeah. On a much more categorical level, of course, I've learned things like things that I did wrong in therapy. Yeah. Usually because they tell me. Yeah. I mean, or they don't get better, of course, and leave. And that's really important that we can learn how to be in different ways if need be. Yeah. And it's the class that usually tell us that. Yeah. Yeah. I think that's something that I put down. Maybe not necessarily what I learn from clients, but my clients encourage me to keep learning. Oh, good. Tell me a little bit more about that. That's a good one. I'm always evolving as a therapist just because I did my training, you know what I mean? And qualifying in 2016 or whatever. It's like that's not it done and dusted and just keep doing the same stuff over and over again. I'm passionate about evolving and learning continually as a therapist. Yeah. And you learn more from your clients than anywhere else. Yeah. Absolutely. Like you said, what works and what doesn't work, you know what I mean? What resonates with people and working out if putting things one way doesn't work rather than just keep saying the same thing over and over. I need to find a different way of getting this across to them. Yeah. Yeah. So they teach you that really, don't they? Yeah. Yeah. And then with the help of supervision, you can perhaps decode what they're teaching you. Yeah. Yeah. I think it's a journey. Everything's a journey all the time. Yeah. It's never an event. No. Unfortunately. It's not, it's not, you know, you do your training and that's it. You just keep doing the same stuff over and over again. I think each client as an individual, you learn something from them because they all come with unique life experience. Yeah. You can kind of categorize people as anxious or depressed or do you know what I mean? Vulnerable, whatever it is, but they're all unique in their own way. That's certainly right. So perhaps that's another thing I've learned is how similar and different people are. Yeah. Because even, you're right, even though they're saying, often they're saying presentation, maybe saying patterns, maybe saying connections, but they are of course, or their stories as well, uniquely different. Yeah. And maybe they've also taught me whether that's the same as what I've learned from them is not to, well, to be aware of stereotyping people. Do you know what I mean? I was thinking when you were talking then about the age of my clients, do you know what I mean? If they're older than me or younger than me, sometimes I have preconceived ideas on how old they are, how they're going to present in the therapy room. And the reality is it's never what I expect. That's true, because people are different, young, old, different. Even though they may have similar stories, their experiences are always different. Yeah. I couldn't agree more. And as well as learning in terms of mistakes and things that I could do differently and the things I've just said, I'll also learn what I've done well. If I take time out to just stop and congratulate myself, or even both of us congratulate each other, but if I take time out to recognize what works well, it's as important as it's what doesn't work well if you like. Yeah. Do you actually ask clients for reviews? No. Never. Have I? Oh, in terms of your nose, not something I do per rote, by the way. I've done it in terms of the therapeutic treatment. In other words, in a sense of the unmet need of mutuality in the building of a therapeutic relationship, in the process where a person needs to feel empowered, when a person needs to experience that the significant other is personally human and can make mistakes. Okay. So I've done it within the therapy treatment, but I haven't done it in terms of a supervision exercise or something like that. Okay. Because some sort of modalities, I'm thinking of CBT, they do like a form to fill out, you know, as in a number of one to 10, where are you now? And then in six weeks time to redo it again, so that there's kind of a progression. Yeah. But that's the client focus, isn't it? Yeah. They don't get the piece of purpose saying, you know, how did you go on with your therapist and did the therapist XXX and how was the therapist when you left and have one to 10 in that way? Yeah. But if it's gone off, then you can kind of assume from that that you've done a good job. Oh, you were thinking of it that way around. Well, it's interesting. That is one way to look at it, actually, what you just said. I don't necessarily think that's true, by the way. I'm not particularly a fan of what we call Core 9 or ID9 or all these different often computer focused generated processes you're talking about. And not necessarily because somebody puts themselves of nine when they went out and seven when they came in is a measure of success. Actually, not me either. It's not something I do. Yeah. No, but I'm saying it because quite often, quite often people think it is really. I mean, at one level you could you can't put that into the computing and generate it all together and get figures. And I think in some ways it's very useful. Don't get me wrong. And some clients will adapt to you. Some clients will make behavioral changes. However, they're not really changed at a fundamental level. Yeah. They could 10 in the level of adaptation, if you like. Yeah. Nothing's really changed. So one level is very useful. Another level, it isn't always the case. Yeah. I think this is the thing with psychotherapy that always interests me is there's so many layers to everything. Do you know what I mean? Filling out a simple tick form isn't necessarily a good judge of anything. It can be whether you got caught in traffic on the way there and you're not in a good state of mind when you walk into, do you know what I mean? It's sunny outside and you're feeling a bit better. The rules for me. And I'm saying it because when I started my therapy, I had to fill one out and I can distinctly remember thinking I'm going to have to fill another one of these out in eight weeks time. So I don't want to put too high a mark because I'm going to have to make sure that it's going up. And that was where my logic was. Do you know what I mean? So I'll just go for the middle ground on everything. And I didn't really put much thought into it at all. So the actual statistics that they get from it are irrelevant. They usually serve the purpose for the people who pay the money to the organisation in the first place. In other words, they need some levels of behavioural change or some levels of behavioural outcomes that have been reached to show the organisation that change has happened so they can get the funding. That's why usually they're there. Yeah. And many I can think of some organisations who won't get the funding if those sort of reviews, if you like, haven't been completed and fed into a computer. That's number one. And secondly, if the therapist, how can I put it? Review keeps going down all those things which show XXX. It's useful for the supervisor to look at the organisation to look at. But it's not always the case. So for example, a therapist that needs to perhaps confront for lots of different reasons could get very low score. Yeah, absolutely. These review forms are all around measures of success and failure. And then the organisation or whatever it is can be given some money. But again, that's subjective, isn't it? I thought you were talking about something else, which is to ask the client, well, how have we gone? Have I been what you thought I would be in this session? Have I exceeded or de-exceeded your expectations? Yeah. Within the transference or within what I asked, how I answered earlier on in terms of the need for mutuality, the need for strokes from a significant other, there's many reasons why I might ask somebody this in therapy. Because it's interesting when you think about it, because most businesses, because I'm in private practice, so I kind of run my own business, do ask for feedback. That's right. It's one of those things that I don't really ask for because how do you ask somebody for feedback? When you're in private practice, you're not beholden to needing any money from anywhere. You might do say for your own interest on how you've gone or haven't gone, but actually, I think it's a false picture usually. Many of my clients have to go through what is an idealised phase with their therapist, which is me, and that might last from two weeks to 15 weeks. Now all the time we're going through that phase, I'll get tens anyway. I might start doing it in the first few weeks. In the idealised phase, which is a normal term of development, talking about. Of course, when they hit the transference and you drop from idealised, I'll get minus nor for 10 weeks in the long-term developmental relational work I'm talking about. In the more shorter work, and maybe for beginning therapists, then these types of questionnaires or reviews can be useful in terms of a supervisor looking at what works and what doesn't work. I understand them, but I think they have their limitations as well. Have you got any tales from the therapy room where you've learned something that's kind of stayed with you? Yeah, I've got one here. I mentioned a book. It's a really, really well-known book. It came out in 1989, I think. So when I started trained to be a therapist in 1985, it was top of the book list. So it must have been in 87, actually, it's a long time ago, but it's from a very well-known British psychoanalyst. I think he's dead now, but pardon me. I went to see him and he was pretty elderly-learned, so I'm assuming something that could well be like. His name's Patrick Casement, and he wrote a book called Learning from the Patient. And then very creatively, as that was a massive hit, he wrote another book called More Learnings from the Patient, which I thought was very creative second title. Absolutely. That book is great because it goes through a lot of these clients and talks about what he learns in the therapeutic process from each of these clients. So it's a very good book, and I said it was very, very popular. The first particularly learnings from a patient, Patrick Casement. I'll just mention that because it's a really good book. Yeah. In terms of myself, did you say tales from the actual? It's sort of a client that you can remember that really opened your eyes and maybe changed the way that you look at things. Well, isn't any of you always... I'm particularly a client. I think, like I said when I started, resilience and courage are people who want to get better. I've always amazed me to their sense of capacity to stay in the process. So in an evolutionary process that I've gone on in the many, many years, that's never ceased to amaze me. Now, as I started to specialize in different areas, I was thinking of things like some of the more disordered people in terms of things like multiple personality, which is now disassociative, identity disorder. And I've always been amazed, I think around even though people can present quite ill, if they stay in the therapeutic process and they believe in it, they often can enhance their lives in ways which I would never have thought. Or go and learn to live their life with more healthy coping mechanisms. It's all about whether somebody's willing to invest in themselves, really. Not just monetary, but also time-wise. It's not a quick fix. I think nowadays a lot of us want to just go and get a tablet for everything to sort out the symptoms, either to numb it down, or to get rid of the symptoms altogether, rather than putting the groundwork in. Yes, that's probably why I'm struggling to find a particular path, because so many clients who I've thought might leave after a certain amount of time, because the challenges we're going to be so daunting in many ways in my head, have stayed the test of time longer than I thought, gone the extra mile. And that always amazes me. And it's taught me about the resilience of the human condition, and also about hope. So hope can be a very negative word and positive word, because people can hope and hope and hope and never do anything. But also, hope can be a very liberating word. What about yourself? Have you got specific cases that you can think of in this process that you're talking about? Because I've talked quite generally, I think, rather than I'd have to reflect and think, a particular client that has particularly taught me something differently, there's so many of them in different ways. Now, I can think of one particular client, I'm thinking, because they were very late in my clinical life, and particularly disturbed. And I wondered, and this, you see, this has happened to quite a few clients. You see, this is why FCO Center on this person anyway. And she was somebody who really did have very little protection about herself. And she was also quite split and fragmented. So you could say she was different people at different times, somebody who was quite paranoid, somebody who had a lot of her life had suicidal ideation and had tried to kill herself and came to my office in a very disturbed state. And what amazed me, and this amazed me quite a lot of people, is though they can be very disturbed and know they're disturbed, and life is very difficult for them. In their workplace, they function very highly. It's not until they get to their emotional life, where the disturbance shows itself at its highest. So I used to be quite amazed at that. And she taught me, and so many other people have as well, that people can function very well in an adult place. However, when they are in personal relationships or social relationships, which may demand they go to their younger self, or their younger self is triggered off in the relationships by different things, they lead a very unhappy life. It's really interesting that because I can think of a couple of clients where they're the same, do you know what I mean? That in the outside world and in the work environment, they've got quite high-powered jobs and function very well in that job. Yeah. So going back, yes, that's right. So going back to this client again, what I learned off her was that, I suppose, if I stayed in the relationship with her and was on her side and didn't frighten myself, and stayed in the relational process I'm talking about, dealt with the developmental deficits, then things turned out really well. So after the two things, I suppose I'm not for this particular client, not to scare myself so much, if somebody tells me really what could be potentially dangerous situations. Yeah. And secondly, that she taught me to recognise that I did a pretty good job. I love that. I love the first bit of that, Bob, because I think that's something that a lot of us, me included, can fall into is that we overthink things and, you know what I mean, catastrophise and can just eat quite easily, scare ourselves. Yeah. It's easy. Yeah, absolutely. Quite often they're projecting their own scare onto the therapist, that I mean this case. Yeah. They're projecting their own fear for narration or they could hurt someone else onto the therapist. Yeah. And it's not the therapist, but they often take it on as if it is, and then they scare themselves. For me, and I'm not sure whether this will resonate with the listeners or they'll agree with this, but I quite liked hearing you say that, Bob, because in my mind, you are above all of that. So it's kind of showing a human side to you when you're saying it's important, and I recognise not to scare myself when some of these very damaged clients come. So it's kind of humanised you a little bit for me. Thank you. Thank you. You're welcome. And that doesn't take away the necessity for safeguarding. Yes. I just want to say that. I know I'm pretty experienced and this is one of my later clients anyway. So I've been around a long time, but Bert or Stoke and I still took her to my supervisor. Yeah. And we did talk through it in safeguarding ways. And I remember talking to her about and requesting that she does certain things, keep herself safe. So I don't want the viewers to hear that the safeguarding goes out the window simply because you're not scaring yourself. Because it's very important to use a supervisor. Even if you've been around 20, 30, 40 years as a therapist, you still need a supervisor for these very reasons actually. Yeah, absolutely. Because when you're in the relationship, it's hard to look at it from an outside point of view. It's always easier for somebody else to do that. I think one of the things that I've learned from a lot of my clients is to keep it simple. I think sometimes we can try to intellectualise everything and you kind of lose the meaning or it becomes too in depth rather than just keeping it simple. Well, simple is more in this occasion. Yeah. And it's a very important thing you've just said that because it's very common as well what you're talking about there. The therapist too, especially as they get more and more experienced and they read and read more books. And especially if they have an intellectual tendency and especially if their ego takes control to do all the things you've just talked about there. And so to keep things more on the ground if you like. Yeah. And more simple is a very good thing, I think. Yeah. I think that's what I've learned. You know what I mean? That if I do keep it simple, I seem to make a better therapeutic relationship with them rather than yeah, talking at them with all these big long words and everything. And using real life examples or you know, things that they can understand, especially in the early stages when they come in the nervous and they don't even know how to be in a therapy room sometime. You know, what am I supposed to do when I'm here? What's you know, what do we do and things like that? So yeah, I just try to keep it simple. Good. Another thing I've learned very deeply, took a long time to learn it. Well, I don't know how long but anyway, that it's okay to love your clients. That took me quite a long time usually because I remember in the early days supervisors would say, oh well, I'll start talking to me about my own sexual feelings maybe or you know, looking at my kind of transfers or talk about you can't touch clients or many other things. And I was made to feel the wrong for loving my clients or lax or actually in some way saying that to a kind and showing my heart to clients. I remember thinking, well, I'm really wrong if I do this or at least this seemed from a supervision perspective that I was the one who was ashamed for doing that. So but I eventually started to learn and from my clients really that it was so important for them to explicitly hear from me that I cared about them. And they used to tell me in different ways how important because for many of them, they never had that from a significant person in their life. So it was a developmental deficit that really needed correcting if you want to put but for me personally to start to give myself permission to explicitly tell clients I love them or care for them was something that only did I I think I think it was my clients which really showed me the importance of that process. Yeah, I'm just thinking now whether I actually I'd like to think I show them in my behavior that I care for them. But I'm not sure I actually, you know, verbalize that and say it to them. Yeah, I think there's with being an ex foster care. I think there's always a fear for me of it being misinterpreted or that's what I'm saying something. Yeah. That's exactly what I'm saying. Especially if you take it to especially when I took it to supervision. Yeah. I felt quite ashamed. I used the word shame because I did. But I had to work through it. And I think probably in my career, if somebody asked me what's the most important development in terms of helping clients get through really difficult times, it would be by allowed myself to explicitly love my clients, which is a lovely thing to do and also difficult at the same time. Yeah, it was very difficult. And of course, I wanted to do it again. It was a chain supervisors largely because of it. Yeah. It was frowned upon about, oh, well, what does that mean? And is this that the other one? Yeah, I understand all the perhaps necessary debate, discussion, talk or whatever you like. But the bottom level is most of my clients, not if not all of them, but certainly most of them anyway. Their troubles were usually, well, what was the bottom of their troubles was that they hadn't received loves from significant other people or allowed themselves to even believe they were worthy of love for another person. Yeah. I can definitely see the therapeutic value in doing it. Absolutely. Yeah. And I like what you said in the beginning. You said you like to think by sort of showing loving actions and care. Yeah. No, and that's probably too. Sometimes I thought it was more important to explicitly say backed up by actions. Yeah. What that means, even an educated discussion if you wanted to put it that way. Yeah. Yeah. Because love, you know, even just having that discussion in a therapy session about what does love mean to you? Because, you know, the idea of love can mean so many different things to different people. Well, we did a podcast, I don't know how long ago, I think it was only about four or five sessions ago, talking about love and hate with therapy room. Yeah. So go back and listen to that if you've not already listened to it. Yeah. So I've learned a lot. I do think perhaps the biggest, actually, to be able to allow myself to show my heart and a lot of those commissions came from my own clients. Yeah. Yeah. Now, beginning as a beginning therapist, I was far removed from that. And I didn't even think about it, I think. Yeah. I think overriding for me. And again, it's come from experience and, you know, the confidence and all that sort of stuff is that I've learned from my clients that it's okay to be me and I'm enough as a therapist. Yeah. Great. Yeah. That's a good one. Rather than pretending to be something that I'm not, you know, and I think that again comes full circle to the keep it simple because that's who I am. I'm not an academic, you know, to be, but I seem to resonate with my clients and we do good work together. Yeah. Well, that's a great quality to have. Yeah. And I wouldn't change it for anything. Good. And I expect your clients wouldn't change you for anything either. Hopefully not because they keep coming back. So what we're going to be talking about next time, Bob, which kind of follows on from this quite well, I think, is how to prepare for your first client. You know, I'll have to think about this for the next one. I'll have to actually, I won't in some ways. I know my, I remember my first client as if it was yesterday. Okay. Until next time, Bob, hang on to that thought. Okay. 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.