 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, who is in a different place. It's bringing back lots of memories for me that Bob. In the training room, the big training room at the Manchester Institute for Psychotherapy. So that's where you did your first training, wasn't it? And that was my view because I used to sit on the couch underneath the window and I used to look out at that very view Bob. Wow, wow, it's very busy and short at the moment. Believeably. So that must trigger back memories for you. Lots of happy memories. Four years of virtually every weekend, not every weekend, but one weekend a month for four years in that room. Absolutely. So the topic of this one, which is quite interesting, having just said all of that, is life after therapy moving on and letting go. Well, a very apt title as we're ending 2023 moving on to 2024. Absolutely. So we couldn't get a better title. I mean, it's a specific title, a generic title. So when we think of therapy, psychotherapy, and the sequences of psychotherapy, you know, we have the first stage, which is getting to know the client and building up a working relationship. Yeah, they can trust you and feel safe and secure. I always think developmentally, so I think about safety and security. Absolutely. Yeah. In terms of relational needs. So that first stage can take quite a long time, especially if a person is slightly paranoid or they have trust issues or whatever we're talking about here. Yeah. Well, it certainly takes a long time. And in that time, a TA therapist, that'd be interesting, your thoughts on this, but a TA therapist will be doing things like a script analysis, looking at injunctions, counter injunctions, early life decisions, how they're played out today, and how those decisions may stop the person achieving what they want. So that will be in that stage. Also what will be in that stage is contracting treatment contracts, overall contracts, etc, etc. Then you have a sort of middle secret. Well, middle, we'll say middle sequence of psychotherapy, where people have got to trust you and start to do, have a good relationship with you and start to do what I would call the yeah, let's say middle phase of psychotherapy, they start looking at the behavioral issues. Yeah, the babies that need changing so their script can be different. Then we move on to the next stage, which we could say the latter stage of the middle stage, which is how to, well, basically looking at the emotional changes underneath the behavior changes. And then we move after that to the next stage, which is integrate those new emotional and cognitive decisions with the new behaviors. The final stage, which is particularly pointing to this particular podcast, is termination and endings. So we're going to just concentrate briefly on termination and endings. And of course, letting go and renewing ourselves and moving on. Yeah, a bit like a cycle of most life processes in a way. So the big question is around clients endings. And more often than not, it needs to be a co-created decision. Absolutely. About endings. And when they, not only when they want to end, but also whether the ending actually is an adapted ending, or whether the therapist thinks that there's more work to do, or whether the therapist's major confrontation might be, well, actually, by ending too soon, you're not doing the real therapy that you need to do. Yeah, there's a lot of questions the therapist needs to consider in the co-created decision about endings. Yeah. And there's also, endings as in not having weekly therapy. But for me, a lot of clients will, they don't want a definite ending that I'm never going to come back and see you again. Sometimes they'll go to a monthly, or it's important that they know that the door's always open. And even if they decide that now's the right time, and we co-create an ending, they can come back at any point. Because life happens. Yeah, she, well, I think you're talking about what is often called in the trade maintenance contracts. Yeah. Yeah. There's advantages and disadvantages that Jackie, I think. I mean, you're absolutely more saying above. I mean, you're absolutely right. Of course, life happens. And you're absolutely right that, you know, for the client to leave therapy with a therapist, which perhaps we've gone for at least a year, there's a sense of withdrawal, and maybe even a sense of lack of object consistency. Yeah. So we, the disadvantages of what you're saying, let's start with them, is that, you know, if they know they can come back, which I think is the best way forward, by the way. So I am in agreement with you. Yeah. And if they, they may actually stay in therapy for a very long time, in a place of dependency without actually full agency and doing a full goodbye, because they always know it's not really a goodbye. Yeah. I do, I do understand that. Yeah. Yeah. And that's a very important consideration in this. So the ending work never gets done, because they just keep on this never ending maintenance conference, this never ending maintenance contract. I'm thinking of clients that I've had that, you know, to me, and after maybe four years, we've had an ending where, you know, it's an agreeable one, and they've made the changes that they want to do. But then maybe there's been a bereavement or a breakup of a relationship, and they've chosen to come back at that point. Oh, that's different for a maintenance. So there's been a big gap, but then they come back because of a life event. You're talking about something different what I'm talking about. Many therapists have what I call a maintenance contract, where there might be three, four, five, maybe even less, perhaps built in, that they can come back. And I see the advantages of that in terms of helping people integrate behaviors and new scripts in their life. Yeah. The disadvantage of what I've just said. Now, you're talking about something very different, which is the permission or the, it will say a commission that the therapist gives to the client when they leave, that it's always okay to come back. Yes. An open door policy type of thing. Yeah. I think that's different for maintenance conference contract. Yeah, that happens a lot, doesn't it? Where clients may have life crisis. Yeah. Or you want to come back and continue some of the therapy they actually missed out on when they left. Actually, I don't know how often that happens. It happened quite a bit with me. It's just the danger with either of the ways we're looking at here is where clients, let's put it another way, where the therapist unconsciously you're out of their awareness, enables the client into still having a dependency relationship with them. Yeah. Yeah. And I think that is something that I'm conscious of in the therapy process anywhere that you become a crutch for them. You may become. Yes. Yeah. Yeah. You see, that's very necessary at certain stages in psychotherapy. However, it's a really important aspect to think about when we're talking about endings. Yeah. And it's kind of, you know, I know it's not the same, but along the lines of, you know, re-parenting, that we're there, we're nurturing, we're guiding, we're supporting, we're doing all of that stuff, but at some point we have to let them go. You see, that's such an interesting parallel at a developmental level you're talking about. Now, I'm 73 now. I'm not even going to be so rude to guess what your age is, but I am 73. So I was born in 1950. Yeah. In the 50s and 60s, it was very, very common for teenagers to leave home at 18, 19, 20. And actually, I remember thinking around 16 that it was very odd if people weren't married and having children by the age of 22, 23. Yeah. And not many people stayed at home in these sort of, you know, older ages I'm talking about. However, today in 2023, and for lots of different reasons behind, we've got a very different cycle and a very different society in what we're talking about here. And it's very common, very common for kids who are young adults to still be at home with their parents into their 30s. Yeah. Yeah. It's very common for lots of reasons. Yeah. Is it healthy? That's another interesting question. And I understand the parallel you're making completely, you know, and if we look at, I can just think of several people, by the way, who their kids who are now young adults are still home into their 30s or late 20s. And the question is, is it the parents or significant other people who are enabling this situation because of their own fear of loss, etc., etc. And I would argue there's a lot in the case I've just said, by the way. Yeah, but again, I think there's a lot of different reasons why it happens. Do you know what I mean? One of them would be codependency. Do you know what I mean? That codependent relationship with somebody, but it can also be practicality. Do you know what I mean? They go where they live their life and then they come back again because something happens or various things like that, which to me does mirror the therapy process. Yeah. Well, I mean, I think what you're talking about as well, in terms of practical things, is we now live in a generation of economic crisis when people haven't got that much money to get a house for the young child. There's cultural things as well. Some cultures. It's the dumb thing that the family all live together. Oh, and into the late 29, 30s, absolutely. So I'm not saying we don't understand all these things, but I also am saying it does parallel the therapeutic process. What we're talking about is where significant other people and parents, I think are part of an enabling process where children or young adults are kept dependent, not for the sake of themselves, but for the sake of the actual parents who don't want to leave home. Yeah. And I know I'm thinking of a couple of people particularly here. And if we do look at this as a parallel of what we're talking about with the therapists and clients here, it's the same, isn't it? Yeah. So those same considerations and some therapists who aren't aware of their own, say, processes around loss or whatever you want to look at this, they may out of awareness be part of a process where they keep the client infantilized and dependent on them. Yeah. And so leaving takes far longer than it should. Yes. Yeah. And I can relate to that. I up until partway through my psychotherapy training would openly admit to not being good with endings. Right. Do you know what I mean? When I finished my psychotherapy training, I can remember it being quite a pivotal moment for me as far as endings were concerned. And normally that would make me sad and feel a sense of loss and grief and all that sort of stuff. But there was some sort of a shift in me that, you know, in order to start something new and have a new beginning, we have to end something and we have to let it go. And that's okay. That's part of life. I couldn't agree more and a dilemma that I think therapists face is that many, many therapists, though they come into therapy to therapeutic change and to have a new script or integrate new healthy behaviors, right, find it extraordinarily hard, understandably so, to let go of a lot of these quite often unhealthy processes because those unhealthy processes are part of a dysfunctional identity. Absolutely. Let them go and change. Yeah. It's extraordinarily hard. Yeah. Yeah. Some clients, I think many clients actually wish to leave or go to leave there be far too early as a way of not dealing with the painful feelings they need to deal. Yes. That's why I said endings I think need to be a co-created process. Yes. The therapist brings into awareness what they may be thinking about things we've just talked about and the client can also talk about it as well. So one of my problems around, and I know you didn't mean in this way, so bear with me a moment, is a reparenting analogy. Isn't that I don't believe in a spot with parenting, by the way? It's not that I don't even believe in comparisons with a parenting process as with therapy. I'm not talking about those. That's another really podcast. But one of the issues is power dynamics. Yes. In other words, the client who still hasn't gone through the child developmental processes is still in a or can be in a sense of a dependent relationship with a therapist who may or may not even be aware of that. Yeah. So to get to an adult-adult co-created conversation around endings isn't always that easy. No. Yeah. And there can be a sense of abandonment, do you know what I mean? That if we bring the subject up that they feel that they've done something wrong or I don't know. Yeah. And for me, it's a long process that an ending isn't right. We're going to end and we end it in the next session. There's a process to the ending. Oh. A lot of, I think, valuable therapeutic stuff can take place in that process. Oh, absolutely. And people might need to practice endings. Yeah. Yeah. And the therapy room is a really good place for playing out different scenarios. Yeah. And of course with endings comes beginnings. Yes. So of course the client that is afraid of new beginnings or change may, a lot of things will come up around endings, just like you've just said. Yeah. Yeah. And needs to take quite a few sessions. Yeah. And again, for me, you know, talking about the re-parenting, I don't know, maybe it's my, you know, foster caring background or whatever, but there's something about the natural process of individuation and separation, do you know what I mean? When you've had that bond and that connection with somebody over what potentially could be a long period of time, you know, to separate out from them is a process in itself. Yeah. And what about if one of those two people, either therapist or client, actually doesn't want to separate and has a lot of investment in staying in this, let's put in inverted commas, co-dependent relationship. Absolutely. Yeah. And again, it's that awareness and bringing that into the therapy room and talking about that. Because, you know, we all bring our own background and our own experiences and everything. That's the whole point of having supervision and doing our own personal work so that we're aware of all that sort of stuff in the therapy room. So are you saying then, do you think it's in the main, the therapist's duty to initiate the endings? I think in the main, it's the therapist's duty to bring up the conversation of endings. What's the difference between those two things? I don't know. It just felt easier. What you said, I had a reaction to it. I'm not sure. I think because I said it in quite a sort of final way, perhaps. Yes. And you added a different slant, which is instead of duty, you added, it's the, you know, you didn't say duty, but the process to actually bring the subject up at least. Yeah. Yeah. Which again, I think probably says something about my opinion of endings. I've still maybe got work to do on my own opinion of endings. But yeah, I think, yes, sometimes clients have said to me, do you know what I mean? I want to go to monthly sessions as opposed to weekly sessions or something and they'll extend them and then we'll start to have the conversation about what you were saying. You know, if you're feeling able to go a month, then what's changing and what do we need to do about that? And is that that codependently relationship? They just don't want to let go completely just in case. Just in case the world collapses. Absolutely. Yeah. Or just in case I need you and you're not available, whatever. I think we both agreed that endings is or needs to be seen as an important, valuable part of the psychotherapy process. And we need to give it our attention and time so there's a healthy ending. Yes. And that's actually written in my contract with my clients at the beginning is that they don't, you know, end abruptly that we have a conversation about the endings rather than just stopping coming for that very reason. That's very positive, I think, that it's written into a contract. Yeah. For myself and for them really, do you know what I mean? That there's a process to it because, you know, I know we've spoke about co-creative, you know, relationships and all this sort of stuff, but my clients, I am invested in my clients and if they just disappear on me, that does have an impact on me personally as well as professionally. Well, be odd if it didn't, I agree. So there's another dimension to endings, which I hope is part of this podcast, which is celebrations. Yes. So do you make endings a celebratory process? I do. A very positive and a way of reflecting back over the changes and, you know, the things that they have achieved throughout the therapy process. Well, I think we could put this into the podcast because it's apt the time this podcast is going out and that is, I don't know how many people make New Year promises to themselves or New Year, what's it called? Resolutions. That's it. I do to a certain extent and I also, when we get to the end of the year, I reflect on whether I achieved them. Interesting. A lot of people do the resolutions, but they don't reflect back. They just make new ones for the following year. That's why I added it really. Yeah. And when I look back on whether I've achieved XXX, sometimes I have. Yeah. Sometimes I haven't, but I like to go a step further than that and look, well, what's stopping me achieving that resolution? So I remember last we go back to New Year. I don't know, 10 months or whatever it was, January the third or something. I remember making, oh, that's my wife's anniversary. So obviously it was on that date. But I made two or three resolutions and one of them was about weight that I would lose a stone. I think I have to go back and look at what the resolution was. I haven't done that. So I need to look at what's stopped me and how I can, if I want to have the similar resolution again, how I can change that. Another resolution I made was about holidays that I wanted to have as I hit 72, I was 72 then. I wanted to have my wife's 68. I wanted us to have, you know, at least a holiday every two months. So looking back on that, I've achieved that. Which is probably why you haven't lost the stone in white, Bob. Maybe the two are interlinks. Yeah, I think they're very interlinks. But when I, well, I think the, I think the exercise lack of, oh, but the important bit is that I look at the sabotage of it. Yes, absolutely. Yeah. I can have a different action or look at the psychological reasons behind it is the same with the holiday every two months. That was achieved. And when I look back at how come that was achieved, it was achieved because A, I had a lot of motivation to achieve it. Yeah. Yeah. B actually made a actual ritual out of this. In other words, I would always make, I would always make sure there was at least one holiday booked in, you know, but after I'd finished the other holiday. Yes. Yeah. Yeah. Thirdly, in terms of a psychological process, I started to allow myself to have permissions to enjoy myself and to dip into them my savings financially to allow myself to have the whole day. Hold on you, Bob. Yeah. So there's a process to it. Yeah. Yeah. And I think it's the same therapy. Yes. That's where I'm going with this. Yeah. Oh, and I will celebrate what I've achieved and look at how I can change the ones I didn't change. So I think, I think when we come to ending this with clients, we can use the same system. Yes. I think it's important with therapy as with, you know, new year's resolutions as well to kind of have accountability and a period of reflection rather than leaving it for the full 12 months, you know what I mean? To quarterly assess where you are and is it working or do I need to do anything and feedback and regular checkings is something that I do do with my clients in therapy. Every so often, I will check in and, you know, where are we and if the contract needs updating or the, you know, the work that we're going to do needs adapting or changing, then I will do that rather than just keeping on the same path all the time. So we're both really in on the page with this, aren't we? I think it's really good. Yeah. I don't, I didn't do it with myself as much, but I think having had my, you know, recent diagnosis, I'm a lot more conscious of the things that I want to achieve and I'm a lot more proactive in prioritising myself in that. Yeah. Right. I enjoyed this podcast. I think it's very me too. And I think again, the therapy room is a really good place for exploring and developing new routines for when people leave and maybe, you know, what would be the warning signs if things are starting to dip again? You know, for me, my script, I will fall back in it when I'm not in a very good place. So it's understanding the process and what the client can do about that. Just lots of awareness. Couldn't agree more. Yeah. So it's the end of 2023, Bob. So it's only left to say happy new year to all the listeners. Absolutely. The people who watch us on YouTube and to say a heartfelt thanks for your support, your listening over the last year. And I'm looking forward to another successful year podcast, Jackie, and also say thank you to yourself. Thank you to you, Bob. And here's to new beginnings in 2024. Yes. New beginnings, what can I say? Yeah. Okay, until next time, Bob, where we are going to be looking at, is there ever any reality in the therapy room? No, Jackie, that is honestly a wonderful podcast to start 2024 with. Yeah. Okay, until next time, Bob. Take care. Happy new year. 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.