Latest / Inside The Consulting Room - Understanding the Child Behind the Behaviour / From Inside The Consulting Room. Relationship first......

Transcript

From Inside The Consulting Room. Relationship first...... · Inside The Consulting Room - Understanding the Child Behind the Behaviour

• 0:00
  SPEAKER_00: Hello, this is Kim Lee Job, an adolescent psychotherapist.
• 0:03
  SPEAKER_00: Today sees the start of a new series entitled From Inside the Consulting Room.
• 0:12
  SPEAKER_00: This proved to be rather popular with many, many downloads.
• 0:18
  SPEAKER_00: And so I am going to do more with specific themes for each episode.
• 0:29
  SPEAKER_00: What I'm trying to do in producing these podcasts is not just to give people a look at what happens inside the room, so to speak, but more kind of educational example underpinned with some theory about the way in which child development, parenting, and the difficulties that families experience can be better understood.
• 0:59
  SPEAKER_00: Now much of my work is underpinned by fairly comprehensive theory, but I think putting that to one side, the single most important feature that I continue to return to is the notion of or the reality of relationship.
• 1:18
  SPEAKER_00: Many of the children who I work with have experienced significant damage in their relationships.
• 1:26
  SPEAKER_00: And so I suppose one of the privileged opportunities I have is to provide a very different kind of relationship in which it is possible for me to accept how the child is and who the child is within the context of the consulting room.
• 1:47
  SPEAKER_00: Now, I'll be giving quite a lot of examples of the different cases that I've worked with over the years.
• 1:54
  SPEAKER_00: And these are rich in some ways, but they of course signify the essence of the work.
• 2:03
  SPEAKER_00: They describe real children, real families with very real difficulties.
• 2:09
  SPEAKER_00: And in many, many cases things change.
• 2:14
  SPEAKER_00: But this isn't without working with parents as well, because quite often when parents come to see a therapist, they feel a sense of failure.
• 2:25
  SPEAKER_00: And the therapist becomes someone who is seen as the expert and you know maybe the fixer of the difficulties.
• 2:37
  SPEAKER_00: Well, in truth, we are clinicians, not magicians.
• 2:41
  SPEAKER_00: And what we like to do is to help parents to learn how there is a very great deal that they can do, and they simply need to be shown.
• 2:53
  SPEAKER_00: Not because there's something wrong with them, but we have to remember, and I've heard this so many times, you know, when children are born, they don't come with a manual, and that's absolutely right.
• 3:03
  SPEAKER_00: And so, as someone who has worked for a very, very long time with children, I'm in the fortunate position of having learned a good deal about what works and what doesn't.
• 3:19
  SPEAKER_00: And so this is what I try and introduce parents to.
• 3:23
  SPEAKER_00: I also pay attention to their mental health and the stresses and the very real difficulties that they may experience because I'm interested in the whole picture, as much as it's possible to gain that, and to try and create a situation in which when therapy finally finishes, my hope is that I won't see the child again, which is a bit of a double-edged sword.
• 3:52
  SPEAKER_00: But in truth, I want families to be better equipped, and my job is to try and make that possible.
• 4:01
  SPEAKER_00: And this depends on a number of factors, not least of which the preparedness of parents to engage.
• 4:08
  SPEAKER_00: Sometimes that's quite difficult, and sometimes they're living in situations where they are under constant pressure.
• 4:17
  SPEAKER_00: So, for example, where there are abusive relationships or there are legal proceedings in family law, when there is acrimony and opposition between the parents, where there may be other real life difficulties within the family.
• 4:37
  SPEAKER_00: Perhaps a family have a child who has significant physical health difficulties, and another who has developed emotional and psychological difficulties.
• 4:49
  SPEAKER_00: I mean, these are really difficult situations, and there are no off-the-shelf answers.
• 4:54
  SPEAKER_00: What we have to do is see each family as a constellation, or as we call it in our work, a system.
• 5:02
  SPEAKER_00: And we have to understand that system and try to work on building the existing strengths that are there in order to help people feel more confident about those bits that they can, with guidance, pay attention to and manage differently.
• 5:23
  SPEAKER_00: There is no people use the word judgment so easily these days, but I'm not here for that purpose.
• 5:33
  SPEAKER_00: I'm here to understand what it is that's happened, to try and make sense with parents of what's happened so that they can move forward healthily.
• 5:44
  SPEAKER_00: Very often parents will come with an anticipation of being judged or criticized.
• 5:51
  SPEAKER_00: So often I've heard people say, it's all my fault.
• 5:56
  SPEAKER_00: Or when we go through the history from conception through into pregnancy, labor and delivery, the neonatal period, the attachment formation period, all of these things probably, as they slip off my tongue, cause you to think, what's he talking about?
• 6:15
  SPEAKER_00: But as you can see, it's a very thorough look.
• 6:19
  SPEAKER_00: And quite often I will have parents who become very upset because they will recall the very early days, the difficulties that they experienced, and how for all kinds of reasons they couldn't be the parents that they wanted to be, because life just didn't pan out that way.
• 6:40
  SPEAKER_00: And the guilt that very often follows is something which I hear so frequently.
• 6:51
  SPEAKER_00: And the self-blame is potentially a kind of impediment.
• 6:58
  SPEAKER_00: And so for that reason, I I tend to hear parents anticipating that I will in some way confirm their worst fears, that they are bad parents and it's all their fault.
• 7:12
  SPEAKER_00: And in truth, that just isn't the case.
• 7:15
  SPEAKER_00: Because I say to them, look, you did the best you could, given all the circumstances, and okay, we can look back now when those circumstances are no longer there.
• 7:28
  SPEAKER_00: And yes, perhaps you would perhaps you would do it differently now, but had you been able to see how to do it differently then you probably almost definitely would.
• 7:39
  SPEAKER_00: But you're doing the right thing now.
• 7:41
  SPEAKER_00: You're paying the kind of attention that needs to be paid, and that's good.
• 7:47
  SPEAKER_00: We can we can progress from there.
• 7:50
  SPEAKER_00: The other thing that I'm keen to do is to help parents to understand that the problem or the difficulties, sometimes quite extreme, that the child is expressing through their behavior is a representation of what is happening inside the family.
• 8:10
  SPEAKER_00: So rather than seeing the problem child, what we see instead is a family who are struggling, which is a much more benevolent approach, and it certainly helps children.
• 8:21
  SPEAKER_00: This then makes it possible for parents to say, as a family, we need to get some help because things aren't working too well.
• 8:29
  SPEAKER_00: And that relieves children from the position of being constantly under the spotlight, you know, the kid that gets it wrong all the time, the kid that can't get it right, get it right, who upsets their parents, who, you know, and so it goes on and on.
• 8:45
  SPEAKER_00: So, in a sense, I think this kind of tone of trying to say, let when we're not here to criticize, we're not here to make judgments.
• 8:55
  SPEAKER_00: What we're here to do is to understand and make intelligent sense of what's happening, what has happened, but also what we can do.
• 9:06
  SPEAKER_00: And let's do that together.
• 9:08
  SPEAKER_00: And so this collaborative relational approach underpins my work and it, as I said, is born of many, many years of working with parents.
• 9:19
  SPEAKER_00: So my hope is that in listening to these from inside the consulting room podcasts, you will learn about the kinds of difficulties that I am offered to deal with, the way they've come together, the sense that's made of them, and how parents can be helped to understand differently and utilize the skills that they have.
• 9:46
  SPEAKER_00: And in truth, parents who come to me will almost always be open to that kind of approach.
• 9:56
  SPEAKER_00: I will be introducing some theory into this as well, and the reason I'm doing that is not because I want to teach you the particular theories.
• 10:07
  SPEAKER_00: What I'm trying to do is to provide a context that these are the sense that is made of this or these situations has an underpinning framework which is well recognised.
• 10:21
  SPEAKER_00: Now I'm trained in the psychoanalytic and psychodynamic modalities, which means that my I I don't work with using things like cognitive behavioral therapy or other particular types of symptom response related approaches.
• 10:42
  SPEAKER_00: My approach, like those who work in the same way, is much more forensic.
• 10:48
  SPEAKER_00: We we specialize in looking at the whole picture, the whole system, the history.
• 10:55
  SPEAKER_00: We consider a whole range of additional factors that may require further investigation or should at least be taken into account in terms of the whole clinical picture.
• 11:12
  SPEAKER_00: My work also inevitably brings me into contact with safeguarding, working with education, with schools, private and statutory, with GPs, the courts, police, and trying in different ways to work within and alongside my colleagues within the multi-agency network.
• 11:39
  SPEAKER_00: This is very time-consuming, but it's part of the work.
• 11:43
  SPEAKER_00: It tends to happen outside the session, as one can imagine.
• 11:48
  SPEAKER_00: But it's part of providing an intelligent, joined-up approach.
• 11:54
  SPEAKER_00: We don't just live in this or work in this kind of sanitized consulting room situation.
• 12:01
  SPEAKER_00: We we actually have to appear in court at times and give evidence.
• 12:07
  SPEAKER_00: We have to attend a variety of meetings and we have to write quite detailed reports, we have to advise courts, and there's all manner of things that we do, but it's all underpinned by the same kinds of principles.
• 12:22
  SPEAKER_00: And that is about trying to do what's right for children and families in a society where the services who we would normally rely upon are so stretched that families are desperate.
• 12:38
  SPEAKER_00: So some of this will inevitably find expression in the podcasts and a sort of glimpse inside the real world of pediatric mental health.
• 12:50
  SPEAKER_00: So I do hope that this is useful.
• 12:53
  SPEAKER_00: And also my hope is that if this is something, if these are podcasts which uh you you personally identify with, then I hope what is said is helpful.
• 13:06
  SPEAKER_00: And also, if there are people you think would benefit from hearing about these things, then please do just share them.
• 13:16
  SPEAKER_00: They're free, and I want to be able to speak to as many people as want to listen.
• 13:23
  SPEAKER_00: And judging by the rate of download, there are many people who do.
• 13:28
  SPEAKER_00: I should also say that the two of the books that are in pre-published state are concerned with both parenting and individual children.
• 13:42
  SPEAKER_00: And the first is called In Relationship, which is the psychological journey that parents undertake and travel through not without obstacles.
• 13:53
  SPEAKER_00: And the second is Small People, Big Lives, which is ten real cases of psychotherapy that are much more detailed than what I'm offering in this podcast.
• 14:04
  SPEAKER_00: My website, thechildren's consultancy.com, has some details about that.
• 14:09
  SPEAKER_00: And there is also a free parenting guide compendium, which you're very welcome to download if you wish.
• 14:19
  SPEAKER_00: These are overviews of particular aspects of childhood difficulty.
• 14:25
  SPEAKER_00: It's a compendium, and these are overview guides.
• 14:29
  SPEAKER_00: As you'll probably appreciate, to write them as full manuscripts would be rather time consuming.
• 14:37
  SPEAKER_00: That said, my hope is that they may very well point towards particular things that concern you, and also reassure you that some of the difficulties, many of them, are not new.
• 14:52
  SPEAKER_00: We as clinicians see them all the time.
• 14:54
  SPEAKER_00: They are known about further evidence that no, you're not getting it wrong.
• 14:59
  SPEAKER_00: You're just needing some help.
• 15:00
  SPEAKER_00: Anyway, thank you for listening, and I'll be back with episode one shortly.