268 Is it important for therapists or counsellors to make notes within the therapy session?

Hello everybody. Uh we're back with the therapy show episode number 268 >> with myself Simon Bailey and the wonderful Mr. Bob Cook. >> Hello to you all. Hello to you Simon. >> Um the subject today the title of the subject is is it important for therapists or counselors to make notes during the therapy session? What an interesting title. It >> is an interesting title. It it assumes so much, doesn't it? >> It assumes that we make notes. It assumes why do we make note? You know, the we have a purpose in making making notes. It assumes that we do it in the in the session rather than outside or both. There's lots of assumptions behind that. When Bob, when you thought of that title, what did you have in mind? >> I was thinking of many different things. One is ethical requirements. Okay. >> So, you're a member of the TA world. You're also a member of the UKCP like me. And if you're a member of the BACP or whatever regulating body you are, you are required to make notes for lots of different reasons. Um I've had the police call on me a few times for example and asked to my notes for clients and me too. >> Yeah. Yeah. So we have to keep notes. Um and it's ethical requirement in the UK CPE it's seven years >> or is it? Yeah. And the TA world is seven years. >> So um >> the question I I I was really alluding to though is do we make them in the session? >> Yeah. Oh, I'd realize that. I'm just trying build this up. Some people do. Some people do. So I run a a supervision certificate course with many other therapists like I've got one coming up with 40 therapists online and counselors and that questions often comes up and many many well I was surprised but therapists do keep notes in the session often and and counsel as well and when I've always asked them about that they they seem surprised I asked um and they said oh well I asked a client and I don't take any notes anyway just some themes and things I want to come back to and things like that analysts particularly did though they were behind the client's eye range so it's a different frame of reference alto together um but um I was surprised that that that many people uh nodded their head and said oh yeah I keep notes as well but I always have to check out Christ now why I found it surprising is because I don't keep notes in the session Um and I remember saying that back to and the person said, "Oh, I do keep notes." Oh, must have a wonderful memory then. And um I have a good emotional memory. >> Um and I've never really needed to keep notes. Um having said that, there are people that do. >> I don't know about yourself if you do or you don't or do I keep notes make notes during session? Well, I certainly do at the beginning. Oh, do you >> certainly when I'm taking when I'm when I'm interviewing clients at the beginning of the the very beginning of the the work? >> Do you mean the assessment or do you mean >> assessment and then when they're they're they're talking I'll make some notes. Yeah. Um >> that's the first session you're talking about >> the first session. Um, I will uh I have a notebook to to hand for later on if if there's something really really relevant like a quotation, >> I want to quote them on something or if I know that they're at the beginning of of a story and they mention something and I I know I want to come back to that at a later date and I'm not there's so much involved. I might make a note about an aid memoir to to to come back to that. >> Well, so that's interesting. So, do you tell the client that? Do you say something like, um, I just wanted to let you know that is it okay for me to not? >> Yeah. >> So, you'll get that permission. >> I get that permission. >> Yeah. >> And they all say yes today. >> Yes. Oh, yes. >> Because I was thinking of paranoid clients. >> Okay. >> Extremely paranoid clients and very disturbed clients. Um it's interesting because in the um placements we do here um they often have to record for um for their training and when you go for UKCP you often record because you need a transcript in terms of the evaluation and uh my experience when I talk to supervises about these they said oh it's okay until we have very paranoid clients and they don't want you to um you know record and they don't like you taking notes and um >> well so uh so that's a different ball game and then what do you do if somebody says no Simon I'd really yeah you know I don't know why you would be taking notes or some sort of paranoia transaction >> okay I've never had that >> you've never had somebody paranoia have you wor with many paranoids >> not to my knowledge not not to that level of paranoia but I've never had anybody object and say no please don't make any notes. >> That's really interesting because somebody who's paranoid paranoid with you don't have to have a disorder we could have say intense paranoid traits if you like their major issue is trust. So they're not going to trust you whatever you say. Um trust is their major issue. In fact I think most of the is about looking at trust. So it's interesting that no one's ever said anything to you about that. >> Okay. Yeah, it's interesting you bring up supervision because notes are important for supervision, aren't they? >> Uh, well, it depends who you are talking to because you know the question really isn't so much about making notes. So, if I've got supervises um, and I've got quite a few of them, they make supervision after the session, not in the session. >> Okay. Oh, yeah. Yeah. >> And so, yeah, of course, they would take notes to jog their memory. So we'll take it to supervision hopefully. But I think the question more I wanted to allude that is about in the session. >> Um is it interesting that you do at the beginning and perhaps if you just want to jot some quote down or something to jog your memory you come back to. I mean, I was always interesting I was surprised because people did answer the way you've answered um uh that they would take notes and some people said they would take notes religiously. >> Mhm. >> In the sessions and uh I found that interesting because it's something I never did. Um it's my experience that when counselors therapists are being trained they're discouraged from making notes during the session which seems to be >> in my training in my training. Yes. I don't know about listeners trainings like counseling trainings or whatever but I think I can imagine they probably would be discouraged >> for lots of reasons I can think of. >> Well it breaks it it breaks that connection doesn't it? Yeah, I mean I remember a colleague of mine uh who I really respected and is very well known now and uh trained with Pearls Fitz Pearls and if I've told you this story before please uh online I mean yeah and listeners bear with me but he said uh he was about 21 at the time and he's now about 85 and he said oh I did a f first year training with Fritz Pearls and I remember on the first day there was about 18 of us all with our notes and our pens and papers ready and Fritz came and he said for my training there'll be no no notes whatsoever I don't want any notes taken please put you all your um uh papers and pens so they all dutively then Richard said oh someone then asked dared to ask why and he said in apparent said in quite a stern voice apparently said well oh it's obvious isn't it it takes away contact >> from me and you. >> And so this training, I do not want you to take any notes because you've got out of contact for me. And and Richard used to say to me, "Oh, I I did do that, Bob, but you know, just think if I kept some notes of Fritz Pearl's wise stories or something like that, they're probably worth a fortune now." Okay. >> And I always remember his stories about that. And uh I'm not someone for notes because I'm not philosopher. mainly what you've just said about the connection, but also people got trust issues whether they tell you or not will probably fantasize about what you writing in those notes. >> So even if you said, "Oh, I'm just writing because I want to get some information at the beginning of the session or I'm just writing because of a quote." My fantasy is they might adapt to you and say, "Well, it's no problem." But I think they I can't check this fantasy out if I had to ask people. >> They're gonna be always wondering what you're writing. >> Okay. Yeah, that's possible. That's possible. >> Although they will there would be a there could be a problem in that if I do make a note, it's quickly and it's not particularly legible, >> right? I'm not there nose down writing. I might I will write something. And the other aspect is when I contract at the beginning of my the beginning of the work with the client I do explicitly say my notes are available to read if you want to read them. This I think this is a fundamental feature of TA >> and they probably won't believe you. >> Uh and how many have asked? >> Yeah. No, but I'm saying many many people and you don't have to we have difference of views on this. I think just wouldn't tell you. Well, maybe maybe you're right. >> And I think it might threaten and I hear it doesn't with you but or might take rel trust longer if they witness you taking notes. >> Mhm. >> Now some clients it might not bother them at all. And I know from talking to as I say different people that uh like you they've taken notes. Uh but I don't know whether that's to add the whole of the therapy or you said it was a just at the beginning. Well, I will take I will do note takingaking at the beginning and then as I said during the course of the work if they say something that's relevant or if I'm think if I have a thought to myself that okay we'll come back and we'll we'll we'll approach this again through the lens of a game or through the lens of something else then I might make a note on that. >> And and what and do you and what do you think clients think about that? Um, >> as I see you scribbling away. >> I I'm not I don't sit and >> I thought you draw you have an antidote or whatever you were >> you know. Yeah. >> What do you think their fantasies might be as they see you writing? >> I hope I I hope I'm I believe I'm as open as possible. But you're right. I'm not taking into account the client's fantasy. >> It's just interesting. I think that's why I wanted the title. I mean I I don't I don't think it's right and wrongs here. I think it's just a matter of difference and difference of style. I do think it break it can break the connection though. And I do think also people's fantasies are um another world. We don't know what they're thinking when they see a making a note. >> Um but that but I think they might wonder why. Well, not why they might wonder, oh is that person making a note about me? But they'll probably never say anything. So I don't know these are the some of the reasons why I think trainees are probably discouraged in training or certainly in my training anyway. >> No, I think that seems the case in most in most trainings in this country. >> But you're talking about those supervises and they're not from from from Britain. know from overseas and maybe they have a different number about I have about eight supervises in Croatia and Lubian and Si and I go and teach in both those places so I know it's not encouraged there >> oh okay >> so um but some people do so I was always interested in that and the from the frame particularly of the impact on clients Okay. What about making notes on the board using a whiteboard and making your notes and drawing diary? >> You remind me. You remind me of Eric Burn. Now, Eric Burn who is the originator of TA and he's he said this verbally, but he also wrote it down what I'm going to say now in a book called uh principles of group treatment in 1967. I actually think it's chapter 13 because I was always interested in these these uh what he said and in that chapter I think says you're not really a transaction analyst to go to the board at least three times in the session and what he meant by that I think was uh what I what we call nowadays educative TA >> mh >> where you might teach them say the parent adult child personality model or you might teach them game theory or he might depends on the client in a way. I he worked with quite a lot of disturbed people but he also worked with a lot of trainees. So you know it's a whole other question about educative therapy. Um but anyway I don't think I smile when he says you're not a TA therapist if you don't go to the board three times. I'm equally reminded of the person who I used to work with at one of the universities who said, "Oh, I don't I don't hold with those engineering diagrams that TA use." I think it's a it's a good co-creative space on which to put about kind of loops of behavior or ego states or relational patterns. >> I'm a great fan of educ what I call educative therapy. >> Not with people who intellectualize that. That's right. Well, uh, I think there's space for that. >> Oh, yeah. I'm not saying there's space, but I mean, what I mean by that, S is simply that >> I I tend to think that people intellectualize as a way of sort of going away from their emotions or they intellectualize in a way of inviting you into some sort of behavioral process of sabotaging themselves. I do think twice about it. >> But those those people, they need you. It's your way in, isn't it? It's your door in through the intellect. >> It may be. It may be. It could be. So, you might say, I think the way you're thinking about it, it sounds like you are. Is that if they're into thinking a lot and intellectualizing sounds like the way you just said that is that you're thinking about um perhaps going to cognition as a way to establish a relationship. >> Yeah. Exactly. >> Yeah. And that might be one way of thinking about this. Um, I just the same reason I don't give homework to clients who intellectualize or use cognition as a way to go away from feelings. I think about it anyway. I'm not saying I religiously wouldn't, but I definitely think about their sort of personality style and their script before I um yeah, sort of transactions or what I do next in therapy really. >> Okay. And the more I go along in therapy anyway is I think it's horses for courses. >> Meaning >> well some according to a person's script profile and where they come from you would do certain things and you wouldn't with certain other people. >> Absolutely. No. Yes. >> So so >> well not always. This is and I know you sounds like you feel astonished when you say that of course like that and I and it's not no no many many many people would have different way of thinking about this um yeah we were trained I think in a certain way of being you know you trained in in transaction analysis and the training is very relationally focused but if you were trained in CPT or you're trained in different as other aspects of therapy you may have a different thought process and also beginning therapists particularly to keep themselves secure in terms of security and uh secure and hoping that they get things right and not wrong. They often do what I call therapy by rote because they've learned a certain way to do things and they don't often move to from that until they get more experienced. Especially on treatment planning for example, you do this with somebody who's schizoid. You do this with somebody who's paranoid. You do this with somebody who's hysteric. You do this with somebody who's narcissistic. You do this with somebody who's borderline. And that's what you've learned in training. And they follow it almost. I'm not this is not a criticism. I think I think it's >> about learning from training. It's it's a way of the fear most beginning therapist cancers have. They don't want to get things wrong. They have a lot of anxiety about right and wrong. So they they often follow these treatment plans and what they've learned in training almost religiously. >> So that ability that we talked about the last podcast actually. >> Yeah. uh only often only comes with experience. >> Yeah, of course. I've got nothing wrong with and no objection to people following the rules and following the standard and then with experience adapting that and bringing in their own ideas and >> it's almost like a process not an event. You know, >> what a what a well said. >> Um I say that sentence. >> It's one of my favorite sentences. Is it >> it's a process? Another one of my favorite sentences is it's all gris to the mill, isn't it? And I think I often have these favorite slogans of mine and people who have followed my podcast or our podcasts over the years. Um, I often say these well-known little quotes of mine or and they're on my website as well. I love the one, you know, it's a process, not an event because I think you're right. Um, it's it's a more evolutionary Okay, I'll respond with one of my favorites. >> Oh, well, have you got have you got a favorite quote as well? >> I've got a favorite little saying that comes from a wonderful client. I learned from a wonderful client. The grass is always greener. >> True. >> Finish the sentence. >> No, where you water it. >> Oh, is that what he says? >> That's what she said. >> I use that a lot and people you know, with couples or with individuals and they people go, "Oh, yeah, right. I get that." And they take it away >> and they come back the next week and said, "That was a really powerful thing." You said, >> "Well, I think often the way I think I think symbolic symbolism and um almost like words which are transactions which appear to the left side of the brain are often often quite powerful and bypass cognition. So I agree with you. Um, terms of notes again, uh, another one of my supervis probably been in the counseling world sort of for 30 years and we talked about notes. Um, and he said, "Oh, I always kept quite a lot of notes, Bob." So I said, "Did you write them in the session?" "Oh, no, but I mean afterwards." I used to give myself 20 minutes writing notes. And I said to him, you know, I hardly ever wrote any notes. Even then, I might have some notes as supervision or terms of ethics. I kept some bits of notes, but I never really sort of did what you did after every cry half an hour having copious notes. But I wish I had because I know you're writing a book and what happened what on your sort of like what's happened in the therapy room for yourself over 40 years and you've got all these notes to go to. I haven't. So I'm quite envious. I said to I would have loved to I wish I'd made all these notes and then it it would have made writing my book a lot easier. >> So So but in terms of writing notes in the session uh no >> we have a don't we have a a professional obligation to keep notes a legal often in insurance companies? >> Yeah we have an ethical legal. >> Yeah. Yeah. All the time. I always kept some notes but not copious notes and even when I was the few times I've been asked by the police and recently actually um I my notes I gave them quite happily because they're so vague. >> Okay. >> They weren't very specific. I don't think they're any use to the police whatsoever because there was it was it was more in thematic themes that we did. you know, I always kept notes as vague as possible and um I never but this guy he wrote them copiously and now he's writing this book about you know his life and the as a therapist and he's got these copious notes to go back to um so you know that was interesting for me because my memory trying to remember you know what I've done for 39 years with clients yeah uh very very hard but no I I've always been interested about whether people write notes succeed in the therapy session and the impact it made on clients and impact it makes on therapists and um hence the title but I think you're right most trainings and it'd be interesting people put comments at the bottom of this podcast on whether they were discouraged or >> right but again it after training you one is reluctant to make notes one is reluctant to to go against the >> well my supervisor wasn't because he wanted he knew I think he knew in his head I I think he did it anyway because it was something he did religiously like a work ethic. But I think he must have always thought that he might write a book sometime. So perhaps he wrote copious notes. And I was always astonished how many people do sit down after class and send 20 minutes writing quite detailed intense notes. >> Yeah. >> Um because I never did and who's to say you know rights and wrongs in this. But I think the most important thing for me was the whole the conversation about what's the if you if you make notes in a session what's the impact or not on the client and their fantasies and how it might impact the working relationship. That was my >> that's your rationale for the question and my I come from the place of I think it's it's it it's discouraged and I don't think it I think it's it interrupts flow it interrupts the relationship but I'm not prescriptive about that. >> So if I if the cloud comes out with something that I need to hold and is coming out with lots of information, this happened the other day. I will make a note to remind myself that maybe before the end of the session or next session to revisit that subject. >> You write it in the session >> while that person is talking to me. >> And do you say anything to the client and you said >> and >> yeah, >> do you say anything to the client about what you're writing? >> I I said something um >> I was wonder if you do you might not. >> Is this okay? Um, but once I've asked that question, I don't ask it again. Vering towards you, but I don't mind something >> because mine's completely nil because I think it impacts on what the client's thinking and feeling. >> And even if you say it, they won't I don't believe they'll believe or they might not believe you. >> Okay. >> So, I for example, I had somebody in assessment today or was it the other day? um well I've had this several times. I was thinking of somebody who said they they think people don't like them and without contamination or whatever. And if you wrote something if I wrote something down stay with me I wrote something down and even if I said to her I think well I'm just want to write something down my fantasy is they might think oh well they don't like me and that reinforces it and they're just jotting that down. We don't what's happening up here. >> Okay. But when at that stage of the the session, I I'm not making the notes. I'm I'm thinking of an example the other day where you talk about the police, somebody will say, "I've been charged with something." Then I will make a note of what they've been charged with. Those factual points. >> Yeah. But you see, that's from your perception, Simon. I'm I I'm not saying don't do it. I'm saying the impact on the client is the one I'm interested in, not your perception. I understand why you're doing it. That must completely why you're doing it. >> I accept that. >> Mine my interest is the impact on the client of that. >> Do they feel validated? Do they feel >> I don't know. I have no idea. But I am interested. Um they could validate. They could feel they're special. But I'm interested on how it might affect or impact the client and the relationship with the therapist. >> Maybe there's some some further >> not from your perspect the therapist. >> I understand >> from the client the impact on the client. >> Yeah. >> Bilaterally in the relationship. >> Yeah. Um, from your perspective, I can understand what you're saying completely. And that's what I'm interested in this podcast that we don't know. It'd be really interesting to do some research on that. >> And it would be interesting if people would respond in the >> jot it down in the podcast and >> put it down what they think and feel about and what they think their clients may feel or not feel about knows they've been taking the session. M >> I know from a therapist perspective. I hear that from you. I understand. It's not that I'm thinking about. >> Yeah. Maybe I'm discounting the impact that it has on the >> Well, it'll have an impact one way or the other. >> Yeah. >> Validated maybe feeling special, feeling it's your job. >> Yeah. >> Feeling that all those things. Um and it might also have an adverse reaction. M so >> that's what was behind the >> no it's an interesting >> podcast I found that interesting >> in a supervisionary session that might be a bit different because I think that's different but I think that you know another thing I wanted to just talk about in this podcast is I this is my fantasy again I'm not talking about from your perspective and you why you're doing them Simon I'm I'm talking about what it may trigger and we may never know. >> Okay. Mhm. >> Because they'll have had a history, most clients have been defined, labeled. They probably have a history of internal negative critical uh dialogue. And I wonder if they just witness somebody for whatever reason, even if they're told writing something down, what that might trigger up for them. Okay. And it would be a great conversation and perhaps they have them regularly in training to have and see see what they of course or students have their own therapist >> and what the impact would be on them if their therapist was making notes for whatever reason. It'd be interesting. >> It was indeed. And on that note, Bob, I think we're going to finish there. We come to the end. >> Be interested in what the listeners think about that. >> I would like to know what other people think. >> Yeah. Yeah. >> Um, am I an outlier? I don't know. >> Oh, you're what? >> An outlier. Someone who's unusual. I don't make notes all the time, but I'm not going to prevent myself. >> Yeah. I'm not saying he's right or wrong, but I'm more >> and also um I know we've got to stop, but but but I hope people perhaps could leave something at the bottom because I'd be interested what people think. >> Okay, we will meet again uh next. >> I hope so, Simon. >> Sorry. >> I hope very much so. >> I do. Yeah, me too. Our next meeting, the subject of which will be When it's quiet in the therapy room, is anything actually happening? Well, the problem with this Simon is asking me right at the end. I I want to start talking about it and but the problem with that is I I don't want to take the thunder from the next podcast. So, I fortunately unfortunately or fortunately for the listeners, they are going to be left in the world of anticipation. But I hope you uh come on next week to listen to uh at least some of my thoughts and Simon's wise words. >> Thank you very much, Bob. Thank you very much everybody for listening and we'll be with you again in a week's time. >> Yeah. Yeah. >> Bye-bye. >> Bye-bye. Bye. [music] You've been listening to the Therapy Show Behind Closed Doors podcast. We hope you enjoyed the show. Don't forget to subscribe [music] and leave us a review. We'll be back next week with another episode.