To mark passing the milestone of conducting 4,000 therapy sessions, here are a few of the things I’ve learnt…
1. The presenting problem is rarely the problem.
2. Transference and counter-transference can happen before any talking begins.
3. The ideal fee is “What you can afford + £5-£10”. If it stings just a bit then it helps.
4. I almost never correctly guess how long someone will stay.
5. ‘Bad’ sessions invariably lead to useful places.
6. Things can go very slow but then change very fast.
7. There is no such thing as mind-reading.
8. Everything means something.
9. The word “Why?” is a much more useful question than I assumed.
10. The more I get to know somebody, the less predictable they become.
11. A breakdown is often a breakthrough.
12. Nothing is intrinsically traumatic.
13. There is no league table of pain.
14. It’s not the thing, it’s the response to the thing.
15. Anger is as important as sadness.
16. When people cry, sadness is frequently not the reason.
17. I am rarely bored by a client, and if I am that is usually incredibly interesting.
18. After tissues, my second most useful therapeutic prop is Post-Its.
19. There is no such thing as an impartial view.
20. The people in our lives are a pointer to our needs at the time we met them.
21. I have a small number of analogies which I use recurrently (relating to trees, spotlights, movies, mountain climbing and Banbury).
22. My occasional “Oh Boy” when someone says something extraordinary is, I recently discovered, an accidental imitation of Fred Flintstone.
23. There are few if any clients I have ever seen from whom I haven’t learnt something about myself.
24. Nothing encourages humility more than periodically hearing something and thinking “I have no idea what to do with this”.
25. My talent for running sessions exactly to time deserted me as soon as I qualified.
26. My favourite ever question to a client was, when they said rhetorically, “I mean, what the fuck?” was “Yes. So what is the fuck?”
27. I spend lots of time hearing about significant others in clients’ lives and yet have never once imagined what they look like.
28. I have conducted sessions in which the client spoke almost entirely uninterrupted for almost the whole session, and others where neither of us has spoken hardly at all.
29. I’ve noticed how often I unconsciously imitate clients’ speech patterns.
30. Most clients have no interest in what I’m doing with them, they care only about whether it’s helping. That’s as it should be.
31. Staying in the present moment can be achieved with attention to three things: “Breath/Bum/Feet”.
32. Almost every body part has at some point been the focus of sessions with one client or another. But not knees.
33. Someone’s relationship with sex often parallels their relationship with everything else.
34. Someone’s career is often a pointer to their way of engaging with the world.
35. We often unconsciously conspire to create the exact circumstances we most fear.
36. People are typically the most afraid of something which could never happen or something which already has.
37. The best way to end a therapeutic relationship is to work out what a client normally does with endings and then do something different.
38. Zoom saved the psychotherapy industry.
39. Freud was right about pretty much everything.
40. Being a psychotherapist is the best job in the world.