 Welcome back to the next episode of The Therapy Show behind closed doors with Bob Cook and myself Jackie Jones. So what we're going to be talking about in this episode is what is cure for the therapist or the client? You need to explain this title to me, Bob. Are you thinking when the therapist thinks cure has happened? Is that the same as when the client thinks it or? Well, Eric Burnley originated transaction analysis. He died in 1970 of a double heart attack actually was the age of 60 on Mel Beach in California. If you'd have gone back in time 17 years ago or so and asked him what's cure in the therapy to process for you? He would say and this is because he believed in contractual theory. He would say when the clients achieved their contract. I believe he would have said that. Okay. And I think I've read that somewhere as well. That's certainly not true for me. No, by the way. Now, what you asked me in 2000, where we are in 22, I said very, very differently and different trainings may have different therapies may have different views on what cure actually is. So for me, cure is an ongoing process. It's a process not an event. And, you know, I'm 71, you know, I wanted my own therapy when I was 34. Now, I'm not therapy all the way through since then, but I've had a lot of therapy. And, you know, I'm sure that I still will probably, you know, to the day I think have script issues or issues that may appear under stress, which hasn't necessarily been resolved. And perhaps I live with that. I can function much, much better than I could before therapy. I able to stay in the here and now much better. My life's enhanced and I'm much, much happier. And occasionally I still find myself under stress and falling into places which perhaps I wished I could have got out quicker. So it's an ongoing process cure. Somebody comes in and says, okay, I'd like to be free of depression. That won't happen in one session. It won't happen in six sessions. It won't happen in ten sessions. It may never happen in 60 sessions. You might get to a stage where the depression has not been so intense, where you understand where the depression comes from, that you've got coping mechanisms which can handle the depression in a different way. And is that cure for people? It might well be. That might be all they actually need to enhance their life in a different way, where the depression is less intense, where they function in a different way. They can maintain relationships. And maybe that's cure. Yeah. Totally agree. Literally those are the things that I wrote down here before, you know, coming on to record this. I put awareness acceptance, ongoing learning development, better coping strategies. Yeah. Maybe that's cool. Yeah. You see, that's what I mean. What is cure really is in the person who uses the term. Yeah. You can read lots of academic articles. One of my mentors, Richard Erskine, who is the president of the International Integrative Psychotherapy, which I'm a clinician. He wrote an article. I didn't have time to read it just before I came online here on why cure is. So I'd have to go back and read it. But I'm sure he would have come to the same conclusion that the cure is a process. Yeah. Pardon me, Richard, if that's not what you said, but it's what I think anyway. Yeah. Because clients come with one thing in mind and, you know, life throws us a curve ball. And that might be, you know, I've had clients that I saw for four weeks and were fine. But then something happened and then they'll come back for another few weeks and then disappear and then come back again. Or there's other ones that stay consistently. You know, but life happens. We think we've got it sorted and then something else happens. And that's for us as well, as therapists. It's an ongoing process. Yeah, I think for most people, if they can stay in the here and now, according to their own age, 71 or whatever it is, and they're able to be able to be, have a sense of spontaneous, be spontaneous. They're able to have a more enhanced quality of life. For most people, that's not a bad place to be in. Yeah. Most of my clients will take that. Yeah. And then where you are right about curve ball is then some things may happen, which trigger off things in your life, which actually you haven't thought about for a long time and probably compartmentalized in a part of your psyche and suddenly you've regressed or gone to a younger place and you're far from a position of being in here and now where you can utilize resources in a different way. So one thing I have learned very solidly in therapy is that when somebody comes in to deal with one issue, as they start to deal with that, they often may go down the layers of the onion of the younger self. Many of the things appear. Yeah. So it was right in one way as you started to resolve the contract of what somebody's come in for. That's more segment we might call as core if you want to use that word. However, you usually have to re-contract many, many, many, many, many times again if you wanted to work in a TA way. Yeah. On contractual therapy at the top of the list. But as we work down the layers of the onion, we'll find many different levels of hurts and healing. And as I say, if a person can develop a new set of coping mechanisms, I mean, healthy ones, which enable you to stay in the here and now and not regress and able to, you know, access new healthy resources around you so your life has got a different quality of being. Is that cure? Yeah, definitely. I was having a conversation with an ex-client probably a couple of weeks ago. And, you know, for me, I think one of the good things about therapy is when the client becomes aware of changes in themselves that are kind of like a warning that things aren't going that well. But in order to have that awareness, we've really got to look at, you know, our scripted stuff and, you know, what we step into and what we step out of. I know for me now, you know, what signs there are for me when my mental health isn't the best. That's the first sign and I'm aware of it. And you touched on it early on when you said, you know, we still fall into our scripted stuff but we don't stay there as long. That could be seen as cure, couldn't it? Yeah, yeah. I know my script hasn't gone away and I know I'm not 100% completely out of it all the time, but I'm aware when I'm in it, which to me is a good thing. It's a marvellous thing. And nearly always people come with one thing they want to look at as all cure and inverted commas. And what they find is, find is that that process they've come with will nearly always lead onto other processes under that process. Somebody comes with anger issues. As you start to deal with the desensitisation of the anger issues, they then may come to a place of hopelessness or they may come to a place of existential crisis, which they never knew was there because the anger was hiding it. So as you deal with one issue, what may appear underneath, like dominoes, that the therapist then suddenly is finding themselves dealing with, which actually probably has more severe consequences than they thought of in the first place. And that's why the concept in TA of rackets is so important to think about. In other words, what a person comes with isn't always what the therapist ends up dealing with. I'd say it's quite a high percentage of the time that it's not what we end up dealing with. They're defence systems or they're unhealthy coping mechanisms. So many, many, many people come with anxiety. At one level, if we look at desensitising the anxiety, putting in new behavioural programmes, the person then starts to perhaps feel better because the anxiety has dropped or they're dealing with it in a different way. And then suddenly, six months later, they feel completely worthless, hopeless, and want to harm themselves. So it's like the anxiety, the depression, whatever it is, is simply the mask. It's like a plaster. If you just help somebody put a plaster over whatever the process is, at one level that may help for six months, but two things might happen, the plaster might fall off and then what's then X happens, or the person keeps picking at the plaster until the sore starts coming out underneath. Yeah. And I think for me, it is something that I do, talk with clients about in the early parts of therapy is that things might seem worse before they get better. Yeah. Yeah. Right. Yeah. I don't like to give them a sense of false hope. It's like we might go down some paths where you don't intend on going and your anxiety or stress or overwhelm might actually get worse before it gets better. Absolutely. And then there's the whole thing that Eric Byrne talks about with transferential cure. In other words, as you start resolving the transferential issues, then which we could sort of say is cure. So you project them to somebody X and then you've got the whole consequence of that as you start to resolve that. Then something else happens and you get down the onion until you get to the authentic self. Yeah. Then you work with the existential issues and maybe that's cure. Yeah. Have you ever, I don't know whether it's a thing or not. Would you ever say to a client that they're cured? Do you know what I mean? Is there a point as a therapist? I have never in 38 years said that sentence because I don't believe in that sentence. I believe that people can make massive strides in enhancing their quality of life. They can make massive strides in understanding themselves. They can make massive strides in healing the trauma. I don't see that necessarily cure. I may see that as transformational empowerment. I might see that as taking control of their life. I might see that in many other terminologies but I've never used the word cure because I don't see cure in a one-off process. Yeah. As an event that happens. I think I was thinking more about my perception of the client's ability to be okay in the world. Sometimes isn't the same as theirs and whether there's a point where a client starts to use therapy as a crutch rather than going out and experiencing the world where they are now. The fear of letting go of therapy kind of keeps them in it if that makes sense. That's why I think Bernman when he talked about transformational cure he said the work you see when the client can you know the client may or may not leave therapy but they have sort of internalized the therapist as the idolized person who helps them. They may leave therapy with the therapist in their head and they leave God forbid Jackie but they live and there's no disrespect. They then live their life as Jackie Jones rather than themselves. Is that going to be better maybe if the person was a very unhealthy traumatized alcoholic or whatever and they've got you in their heads and they're able to you know move to a more self-caring position. Maybe that's enough but in terms of real authentic cure that's another story. Yeah it's about the client maybe trusting themselves to be okay. Yeah I think that's a big one if they've had two three years of therapy with me or you or whoever the therapist is you know I think the therapist needs to deal with that whole process of what we're talking about here which is getting to the real self rather than what I think a lot of cancer therapists sort of do and I'm not this isn't a criticism particularly is they they may allow the client to leave thinking they're cured but actually they then end up you know with you or me in their heads rather than ever dealing with the authentic self. Yeah that's so easy to happen isn't it. Yeah oh definitely yeah and yeah it is it's it's I'm wondering how how we kind of get to the end of therapy I know you know there's a process to it and the ending shouldn't be abrupt and all this sort of thing but how do we know when it's the right time. Well for me I've said it earlier on when they can stay in the here and here and now in a stable consistent manner yeah and they're able to enhance the resources around them and have a sense of spontaneity able to have a sense of freedom of action able to function in a way which is healthy for them. That's often not bad but then they have to say goodbye to the therapist on the way. Yeah now that might be the hardest thing of all and unless they've done the work about loss and here and now loss because the therapist might represent the father never had or the mother never had or whatever you have a line lines you want to go down but I think a real trap if you let the person leave still in a transformational process. I was once on a board many many many years ago in America in California and we were evaluating therapists and there's four examiners and one of them had been in therapy with Eric Byrne. Wow and do you remember what I said Eric Byrne died in 1970 so I was on board about 1992 or whatever it was so he'd been dead 22, 23, 24 years but she was still in transcendental therapy clearly. Yeah now I'm not saying that was necessarily I'm not necessarily being critical there because you know she might need and I don't mean this in any negative way but she might need Eric Byrne in her head to help her structure herself to help herself in terms of you know self-care to maybe she still needs that but is that sure that's another story isn't it? Yeah it is I'm just thinking you know I've had clients in the past that say you know after they've been with me that they'll often say what would Jackie say? Yeah there we are that's it that's necessarily a bad thing but is it indication that a person's never really dealt with their real self? Yeah I don't know but it's an interesting way of thinking about it. It is yeah yeah something I've never really thought about before. Maybe sometimes it's a bargain with the clients and the therapists that's the best they can get to yeah I believe they need to say goodbye to their therapist but it's that's another process because then you are going to deal with the existential self yeah and endings and goodbyes are you know can be quite traumatic in themselves for some people and most people yeah you take nine out of ten people off the street talk about endings yeah and in different ways they often have great stories about losses, griefs, grievance, endings, birth stories we could go on. Yeah yeah and I suppose it depends you know what the client thinks about as far as cure and endings you know it's one of them I'll put off the cure because I don't want the ending I don't know yeah. Well yeah so when you talk you know many people one of their criticisms of and I understand this of long-term relational therapists or therapy is over dependency. I understand this because you know this is what we're talking about here in many ways. Now I remember one of my mentors saying we'll change the word dependency to dependability, consistency, predictable things they need all the time and as they work through all these issues they'll be able to have a far more independent and interdependent life. Yeah certainly I believe it's true and I think there still is a lot of work to be done about to get to that position and one of them is it's to say goodbye to the therapist which may take a year on itself by the way for six months. Yeah it's a minefield you know every stage and every level you know they're coming into it sometimes I kind of think about it I'm not sure whether it was said to me at some point that it's kind of like you know how we are when we give birth to a child there's a process to it we need to prepare them for the outside world and give them all the skills and the knowledge that they need so that you know when they turn 18 and they fly the nest they've got everything that they need to survive in the world and I kind of see therapy in a similar way. Yeah now we I went and did our institute low cost clinics and you know where people can have therapy they haven't got that you know much money or economic officers or students at a lower price so they can afford the therapy yeah however you know the institute maintains that bursaries and things like that so it's 26 weeks so they get six months now talk to a lot of these people who've had the 26 placements and they'll say how helpful it was yeah through but it and you know they go a long way with verbs in those six months and often very very useful but in most cases it's not cure no most cases it's the beginning yeah but it's helped them understand themselves more it's helped them perhaps not fall into the pit so quickly yes yeah let's have more healthy healthy coping mechanisms and maybe later in life they can take therapy up again yeah so help them help them for that moment but is that cure not from where I'm sitting but it is a great help to some people yeah and like you say it's an introduction into the world of therapy and you know when you were saying that because I went through that process as part of the training we were working the lower cost clients and everything but there's something different about knowing that there's an ending to it from the beginning yeah yeah it feels different yeah there's a beginning middle and an end yeah problem often is and it's a problem but I do the assessments a lot and I make sure they know that and still you know you know it's not an easy process as well um and sometimes we you know they carry on the journey of therapy with different therapist of course you know a bit more money or that they end and come back at a later date all these different things yeah so but we've helped their lives and so they never be able to afford the therapy yeah 50 or 60 pounds an hour so it's an introduction and we may help them have more healthy coping mechanisms talk for the first time be listened to by a considered predictable healthy other person for the first time so it's an introduction yeah maybe from some aspects some people might say that I don't think it is I think it's the beginning of a journey yeah but a useful one definitely yeah and you know I would imagine that people get a great deal from it particularly you know having been through that process as a trainee myself is you are really keen as a trainee you know you you're you're giving it 110 percent for every session that you're doing it so they you know they got a good deal they do they do I mean they don't know anything else but they can have a good deal I think yeah yeah but cure I'm not for sure cure is a process not an event in my book yeah it's kind of like when you're saying that you know some people listening might think well what's the point in going to therapy if there's no cure at the end of it but I'm kind of related to Maslow's hierarchy of needs you know we start off at the bottom and we work up and then self-actualisation is right at the top I don't think we ever get to that because if we do then what else is there yeah well in TA it would be script free but I don't follow that either no well knowing when you're in it and when you're not to me is is good enough yeah it's good enough yeah yeah so so that that top pinnacle of cure or self-actualisation or the perfect human being or whatever I don't think there is such a thing Bob apart from you maybe you're pretty close no no no certainly I certainly agree with you anybody who sets themselves themselves up to be perfect is always setting themselves up to fail yeah so it's not fun being perfect is it it's a failing position yeah so it's a script position doesn't exist there's only one way to go and that's done well I think this you know I just think a lot of the clients again who come from this whole families or society which doing doing doing perfection in the whole thing you know we're talking about and then of course they realise that just being with the clients is so hard in itself so they realise that's what I mean setting themselves up so cure is a process there's no doubt about it if I had to write an article today that's the position I would come from I know I won't talk about different levels of cure transferential cure social cure I haven't gone into too much because you know I prefer talking in a different style in these podcasts but you can go to academic articles but in the end even with this different levels of cure I still think their process is yeah I don't think they're events no I agree so Bob thank you so much I have no idea what we're doing on the next one no but did you say or you perhaps you didn't say that this podcast is the 50th this is the 50th yes I'm glad I remember do you usually remind me I do at the beginning I had a milestone of 50 I thought and the new today's was the 50th so I and you didn't say what interesting enough you did not say at the beginning this is the fifth and I would say if we weren't over these podcasts we would find out that usually you say this is the 47th this is the 48th this is the second but it's so interesting that this podcast you didn't put a number on it I don't know what that's about but I do know it is the 50th well maybe it's a milestone maybe it's because it's a milestone and I didn't want to reach it 50 50s a big it's a milestone Bob so I think we've done well and I hope the listeners have enjoyed them as well I think for me the milestone was 52 because then that's a full year that we've done it I think we've still got two more to go and then we celebrate well on the 52nd then I will remind you and if you don't say this is the 52nd podcast I will say see something else we need to think about Bob about that we should think about it in this podcast or not is are we going to once we go to 52 are we going to start season two and start from one again or are we just going to keep going we're just going to carry on right all these seasons is an American process these are the decisions we need to make though Bob the multi-level they're all processes in the end I was just about to say it's a process we'll just keep going with it right until the next one Bob thank you so much heading off to 52 that's what I'm going to remind you speak soon yeah 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