 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. We're up to 143, Bob now. Oh gosh, heading towards Bellamy. I don't know how many years we've been doing, but we'll soon be heading up to 150. Yeah, it's not so far off that we're going, yeah, that's it. It'll be nearly three years. Shocking. And the episode that we're doing today is the importance of continuity and predictability in the therapy process. I often say this when I start these podcasts, what a wonderful title. And I'm saying it again, but then what happens in my head, I think, well, as I thought most of these topics up, I must be pretty narcissistic. It's very true though, Bob. They are wonderful titles. At the same time, my wife listening would say I am pretty narcissistic. But anyway, let's go on to this. Continuity and predictability. Yes. Yeah. Well, without them, Jackie, I don't think effective psychotherapy will happen. Say more, Bob. Well, you know, with continuity and predictability, they're the cornerstones of a safe, secure, protective psychotherapy. And without continuity, predictability, without safety, without security, effective therapy will not happen. See, it's really interesting you're saying that because in the last episode, if people haven't listened to it, go back and listen to it. But we were talking about science therapy. We can't predict how it will go. No, I didn't mean predictability in the sense of what's going to happen in the next session. I didn't mean that type of predictability. I meant the predictability for the client that they know that the client's done, sorry, the therapist is going to turn up. The therapist is going to be late. Right. So we're talking about the actual structure of a session. Yeah. And that we're the same person, week in, week out, and that sort of thing. Yeah. Yeah. And that type of predictability leads to a stable other. Absolutely. Yeah. If there's security and all that stuff. Yeah. Yeah. It's quite often for the client, they've had an unpredictable history in the sense that their caretakers or significant other people have not been a stable other at all. Yeah. There's something about this in my early days that I can remember I felt quite uncomfortable with because I wasn't very good at having firm boundaries. I was a people pleaser. I still am to a certain extent, but I needed to learn to be more, I want to say strict, but maybe that's the wrong word. You know, if somebody turned up late and tried to extend the time that I would say, you know, without being very blunt, you know, times up and keeping firm boundaries as a predictable therapist, I found quite difficult in the early stages. Yeah. And while you're talking, I'm sure you've got trained this way, the essentiality of that. Yeah. Absolutely. Oh, yeah, because nearly all the clients, I'm not saying nearly, but the majority of the clients you'll meet and I will meet and a lot of the therapists listening will meet have been reared on boundaries which are unstable and unpredictable. Yeah. And therefore the client growing up doesn't know, didn't know where they were. Yeah. Didn't know what to expect. Yeah. There's no stability in the whole process. Yeah. So structured firm boundaries are really important in the development of a healthy upbringing. Yeah. And some clients will challenge that. Of course. Well, that's what adolescence is about. I mean, so, you know, the problem is when somebody walks in and said they've never had an adolescence. Now, when somebody says that, you know there's been problems because that means they've adapted and complied such a sense they've lost sense of themselves. Yeah. And the therapy then is usually about helping them have a later adolescence where they can say no. Yeah. Where they can do, you know, develop a sense of autonomy where they can develop and know who they are and create an identity and ownership of that identity rather than adapting the caretaker or parents or significant others, few of what that identity should be. Yeah. So we need to be quite robust and resilient in the therapy room then, if we're going to be challenged by adolescence in there. Yeah. You see, I think it's very important. But just get back to what you said. I think even though you may have felt, and this might have come from your fostering background and being a, you know, foster parent and everything, even if you felt, you know, unkind, strict or whatever it was when you were keeping these boundaries, I would say to you back to you, that's essential healthy parenting, even if you felt X. Yes. Yeah. See, I don't think it's being strict. I think it's being the healthy, firm parent, helping creating predictability, continuity and structure. That is so important for psychological health. Yes. Yeah. Even if they don't always appreciate it at the time. When you see people we've seen usually come from a place where they haven't had that. So, you know, they don't appreciate it because they haven't had it. But once they start, you know, understanding the importance of boundaries and predictability and stability and everything else that goes with that, you have a different process. Yeah. Yeah. But if you think of, think developmentally, therapists will work with the younger self, you know, many different 3, 4, 5, 6, they might work 9, 10, 11. If we're going to adolescence, usually you probably have done the younger work before you get to the adolescence, but you might do the adolescent tour more, what a relationship needs to get down to the younger self. Usually, though, you go to the younger self and work backwards. But I know many therapists who are wonderful at working with the younger child at 3, 4, 5, 6, 7, but are so wonderful at working at the adolescence stage. I know many people as well are wonderful working at the adolescence stage, but aren't so perhaps wonderful working with the real younger infant. Now, if you find a therapist that can do both, you're onto a winner. Yeah. I was much better working with people, the younger infant. I wasn't so, I thought it was not bad, but I don't think I had the same type of effectiveness perhaps working with adolescents. And that's mainly because of the terrible, my own history. As you were saying that, I was thinking, what would I say? And I think I'm probably the opposite. I think I probably work better with somebody in their adolescence than younger. I can connect with it better. I'm the reverse. It doesn't mean you couldn't do both. It doesn't mean I couldn't do both, but I know that I can connect and perhaps work more effectively if I want to use that language. I think it might be more potent language with the younger, trauma and high self and perhaps the adolescence self. That could be, I haven't done enough work with the trauma of my adolescent self. There could be many reasons, but I know it will be to do with my history. Yeah. Yeah. And I think we've got to respect that in ourselves as well that we prefer to work in certain ways with certain people. That's okay. Yeah. My daughter who always swore growing up, she would never be a psychotherapist. I mean, she used to say, well, you know, I was brought up by two psychotherapists, so I'm not going to be doing that. And she went off to university to study in film. Interestingly enough, she decided she wanted to do that. And now she went on to another university and studied, you know, what was it called? I can't remember the title, in the air, mental health. What does she do now? She is a mentor working with adolescents and adolescents with behavioral problems in schools. And she will talk to me how much she loves working with adolescents and particularly adolescents that have had, you know, I don't know, negative behavioral problems if you want to put it that way. Yeah. Now I know that I would not be effective with that population at all. So that's really interesting, isn't it? That she, if you think of my script, think of her script, then that I'm the parent of her and she's passionately, passionately now involved in working with adolescents and helping them develop a much more healthy sense of being rather than those negatives. But she's no interest in working with the younger tool to herself. Yeah. There's a story in there somewhere, Bob. Yeah, too much for the podcast. And I'll think about it later myself. But it's interesting. Yeah, absolutely, absolutely. Yeah, I think I like it because it's challenging. I feel like I can be challenging in the therapy room. You know, if they're not being what I think is authentic, I can challenge them on it, and they'll come back with something and it opens up a whole area of discussion. If I had to guess the difference, that you had a more secure parent in your history than me, probably. Now, if I look at Jessica, I think I did a good job, Jessica, and she's got a secure parent and able to be able to set the boundaries in a healthy way with an adolescent from a mother and from me. In my history, I didn't have that type of secure parent I gave to my own daughter. Yeah, absolutely. But I potentially look at it another way that I didn't feel like I had the emotional connection to my parent when I was younger. Okay, okay. So it's that emotional empathic side of me potentially that isn't the best that I think you might need when you're working with the younger self. Yeah, with the adolescent, they're a bit more robust. I think it's courses for courses. It's really interesting. Yeah. But I do know continuity, predictability leads to a stable other, and that's for a healthy process and healthy psychotherapy. That's what our clients need. They don't need a therapist that they see as unpredictable. Yeah, won't be there for them. Yes, in your supporting other. And one, they sit and they don't need a therapist they see as unstable. Yeah, that's absolutely certain. If those if they see their therapist is unstable, letting them down hasn't got a sense of continue continuity when things get tough. They'll actually be repeating history. And if I was a supervisor, I will tell that client to leave their therapist. Oh, but basically, I'll tell the therapist to have their own therapy first. But what I'm really saying is the client needs another type of therapist because for a healthy process and effective psychotherapy, you need to depend on the therapist. You need to see them there in a healthy, continuing way. You need to have a sense of the client's predictable and on their side. Yeah, as you will repeat history. Yeah, yeah. Yeah. And again, that's supposed to eat what the client sees as being predictable. You know, and what they want from us. And that goes back, I think, to the relationship that you have with the client, which is paramount to everything. Absolutely. But and if you're going to make that relationship secure and safe, as much as you can, you need to be there for them. Yeah, you need to be predictable in that caring, kind attitude that's supported of whether someone is on their side. And that promotes what we're talking and promotes the safe harbour. Yeah. In the relationship. Yeah, yeah. They can literally come and tell you anything and everything. And there's no fear of judgment or repercussions or anything like that. Yeah. They feel held as a sense of containment. Yes. That's why these additions for therapists are so important. The therapy to foster. Yeah. Yeah. That's a wonderful space. Well, that's why I hope we do. Yeah. Yeah, me too. I've had people say, you know, friends and relatives, I suppose, say to me, is this what he's like in therapy? And I might know this is nothing like what he's like. This is not me being a therapist. Yeah. People, unless people have been to therapy, I think they assume what it's like. But I don't think there's any other space like the therapy room outside of the therapy room. Not in the sense of the developmental work that we do and the dealing with deficits and repetitive trauma. I agree. Yeah. Yeah. Because I'm not very predictable or, you know, good at continuity outside of the therapy room, I don't think, in my personal life. Yeah. I think as a therapist, we need to carry through certain attitudes and certain ways of thinking. All the things we're thinking about here is in the service of creating an environment that they didn't have or couldn't even dream of having. So you'll get a reparative process going on. Yeah. Yeah. So, Bob, that was another good session. Yeah. I enjoyed it. And I know I've got a couple of weeks off now because I'm going away on holiday and I was just thinking predictability and continuity. One thing that is in another sense of predictability is I do enjoy my holidays and it leads on what we talk most of all about, which is self care for the therapist. Yes. Which is vitally important. Very important to model. Yeah. I'm actually going away for the first time ever on a retreat in a couple of weeks, actually. Yeah. In fact, I need to check up on the dates. I'll talk to you about retreats. Yeah. You know, I've been on many, many, many, many, many, many retreats for the last 12 years. And in fact, the retreat I go to twice a year is ending in March next year after 12 years. So I'll happily talk to you about retreats. Talk about continuity and predictability. Minds in Anglesey, Bob. That's where I'm going for mine. Well, I was born in Wales. I was born in Brecon. Yeah. Yeah. One place I've been to a lot is the Brecon Beacons and Canaveral and many different places a lot in Wales and Port Madduck. And the retreat, one of the retreats was always seven miles from Port Madduck. So Wales is in my heart. I lived in Wales for two years. Both my kids are fluent in Wales, not me. So what we're going to be doing over the next couple of podcasts, Bob, which I have absolutely no idea what the contents of either one of these are. There's a surprise. Well, I can get a list of loads. I mean, one of the things I was talking about, again, was about sequences of psychotherapy and how there's a beginning of that. And actually, I've got a marvelous book up here called Sequences of Psychotherapy and the sequences that therapists tend to follow through for an effective psychotherapy. I mean, that's an interesting podcast. I can think of a lot of, but I know you've got a lot of these titles. Well, I've got written down in my little book that I have is the Pinocchio effect and the Cinderella effect. Right. So my other one can go later because both of those are fabulous. I have no idea what that is all about, Bob. So I will learn something now. I'm presuming the Pinocchio. Well, I don't know. No, I have no idea. I'll just be guessing. Okay. Well, I'll see you in the next podcast. Okay, don't, Bob. Thank you and enjoy your holiday. Thank you. 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.