[00:00:00] Bronwyn: Hey, mental workers, you're listening to the Mental Work podcast, I'm your host, Dr. Bronwyn Milkins, and today we are talking about how to make here and now comments in therapy sessions with confidence.

You may have had them called process comments or immediacy comments. Regardless, they're comments that we use to talk about what's happening in the present, the here and now with clients. And sometimes they're really difficult to know how to make and what to say. It's often something that's not taught to us formally in our programs, if they're, for example, cognitive behavior therapy heavy.

In this episode, we're going to delve into the practical strategies, the common pitfalls that. that we make when trying to make these comments and ways to build your confidence. By the end of this conversation, hopefully you'll have some insights into how to feel more prepared to make this sort of really valuable comment in therapy sessions. Here to help us out is our guest , Marie Vakakis. Hi Marie.

[00:00:50] Marie: Hello. Thanks for having me.

[00:00:52] Bronwyn: Such a delight to have you here as always. Marie, you are a mental health social worker. Just tell us a bit more about yourself and also tell us something good that's happened to you lately.

[00:01:02] Marie: Yes, I'm, um, the Director of The Therapy Hub and I have marivacacis.com.Au website. So through that, I have the, "This Complex Life" podcast and something good that's happened to me lately. I, um, cracked my iPhone and completely destroyed the back camera and the glorious, lovely sales assistant managed to find a way to get that replaced without costing me a cent.

[00:01:29] Bronwyn: Money win! Well done.

[00:01:31] Marie: Yeah, huge money win, but also I was just so annoyed at myself because it was such a oops thing. I mean, this, my poor phone, it's, it's dropped in all sorts of places and I've got one of those hard covers and everything and a weight like at the gym rolled off and landed, Oh, that's so unlucky. Yeah. Um, and so I was just going in to get a quote thinking I'm probably just gonna have to buy a new phone and I didn't and I could have hugged her. Like, it was just. So good, made me think, yeah, like Nikki from The Genius Bar. You're amazing. I love you.

Probably not listening to this yet. Cause you're not a therapist, but, um, thank you.

[00:02:13] Bronwyn: Did you have a Nokia 3310 or a similar model?

[00:02:17] Marie: Yes, I think I used to borrow, I used to share my mom's 3210 It was this beautiful purple one. And then I managed when I saved up money and I was allowed to, I've got a 3310

[00:02:26] Bronwyn: I remember at parties when I was a teenager, we used to throw each other's Nokias on the ground and they were indestructible. It was so good. I miss, I miss that.

[00:02:35] Marie: Yep. And now it's like you sneeze and it

breaks

[00:02:37] Bronwyn: Yeah, exactly. Well, Marie, thank you so much for being here as always. Let's talk about here and now comments. So what's your understanding of them? What would you say to someone who is like, Marie, what's a here and now comment?

[00:02:50] Marie: Yeah, when you posed the topic to me, I was like, I'm not sure what this is, but the stuff that we've talked about around that sort of relational work of what's happening between us in the room right now. And maybe that's that real observational like, I can see even as we talk about this, that you're getting a little bit distressed. Is that the kind of stuff you're talking about? Like that sort of talking out loud about what's happening what's happening in

[00:03:15] Bronwyn: Yeah, so I'm talking about either comments that you make that comment on the relationship between the two or just other stuff like observations. Um, as we talk about this topic, I noticed you're moving away. I guess that's a comment on the relationship as well. Maybe, like, the one you said before, you seem distracted at the moment. What's on your mind right now? So it's not necessarily a comment on the relationship. It's just an observation. So I'm talking about observations on what's happening in the room or comments that are between you and the client.

[00:03:45] Marie: Yeah, yeah, I think, I think that makes sense.

[00:03:48] Bronwyn: Yeah. And you mentioned that, like, maybe you weren't sure about it. Is this something like you've been trained in or is it something just intuitive to you that you're like, yeah, duh, of course we're going to make these kinds of comments.

[00:03:58] Marie: A bit of both, but I never heard it phrased that way. So we did it a lot in family therapy, where a lot of it is because you're observing interactional patterns and in couples therapy as well, you have to overt that, and so I never had a word for it, like you've said, so I learned it, but I never learned that wording for it.

So if someone said to me, just, you know, can you give me three examples of this? And I wouldn't have known what the definition was, but a lot of the work in relational work, when you're having multiple people in the room, that's where I learned that. And then I brought that into some of my individual sessions as well. And then notice that when I would go to therapy, the kinds of different therapeutic modalities that would do that.

So, someone very, maybe gestalt focused would do a lot of that. Someone maybe less um, relational and maybe focus more on a kind of a clinical moment. A background would have a different way of of sort of integrating that into their work. So I learned it And I do it quite intuitively now, but that's part of the training that I had in family and couples work mostly.

[00:05:04] Bronwyn: Yeah, that's really interesting. I wasn't exposed to this style like or technique early on in my training because it was quite CBT heavy. And so I was reflecting on this and I think the only type of here and now comments that I was encouraged to make in my CBT training was when, and in air quotes, resistance was occurring. And so that's when I would be like, um, I'm noticing that when I talk about this, you seem to be hesitant what's happening for you now.

But other than that, it was like coming in and here's the technique, here's the skill. And I feel like it was quite absent. And when I learned this, it really opened up a whole new dimension to my therapy. And I feel like I was able to do a lot more work and progress with clients. And I wanted to ask you, what value do you think these comments have in your therapy work?

[00:05:53] Marie: I think they're really, really beneficial And a lot of it is also, depending on what the client's coming for, I see it as a bit of a dress rehearsal of what's happening in life. And so if they are struggling with. with interpersonal relationships, um, with, you know, a child, a parent, a partner, a lot of what we, we do is I have that in the back of my mind that I get to role model some of the skills that I want them to do. And so being able to sit in some of my own, maybe discomfort, can be really helpful to. Bring that to their attention. So it's so powerful and it's with invitation.

And like I've spoken about in a podcast episode several months ago, just explain how you work and why, and then they know that that's okay. So when I do, um, couples therapy, like that's fresh on my mind at the moment, cause I've been working on my certification track and I have to show fidelity in a lot of the techniques. And when I talk about the four horsemen, I have to say, look, part of how I work is using this model. And that means when I see contempt, criticism, stonewalling or defensiveness, I'm going to pause the conversation and then I'm going to get you to try and do it again, differently.

So if you've said something, Bronwyn, that's critical to person X, I'll pause it, and then we're going to have a try with one of the antidotes. Because what I want you to do is to have a felt, lived experience of what this is like. And we'll stop as many times as we need to. And if I see, Marie, that you're getting, that you're stonewalling, we're going to stop and pause, and we're going to bring that to your attention, and we're going to do some grounding exercises, because this is what happens at home.

So I get so I get to call it here and now or they don't know. And especially in that when we're in that state of mind. That cognitive process goes offline. And so we need to kind of catch it as it's happening and help that person's, either nervous system, calm down, help their amygdala do its thing. Like really just calm it, regulate it, teach them, coach it in the moment with a real live example.

[00:08:10] Bronwyn: Can I get you to say in words what you would do, so let's just say I, Bronwyn, did something really defensive, "it's not me, it's her, she always does this", what would be the words that you use to stop me?

[00:08:22] Marie: I might say like, "Ooh, that sounds like it's really frustrating. Remember how we talked about those four horsemen. I know it's not what you intended, but that sounds a little bit critical and I'm just going to, I'll check in in a moment with you to see how", and I'll be pointing to the other partner with how it felt, but I just want to see, could we try phrasing that in a different way?

[00:08:43] Bronwyn: I like that. I'm wondering... I think you've already explained this, but one of the barriers I had to using process techniques at the start when I was using them was I, I felt like it would be weird to introduce this third perspective almost to my therapy sessions, which I hadn't done before because they had been so CBT heavy. So I thought that clients would be weirded out by them. But I think it comes to setting up the expectation. You make them right from the start or you say, this is what I'm going to do. Right?

[00:09:16] Marie: Yeah. Or you'd make a process comment about when I did that, you looked a little bit weirded out now.

[00:09:21] Bronwyn: Yeah. So true. Yeah.

[00:09:24] Marie: What's going on? Because you get to bring yourself into the room. So you don't have to be stern and flat and boring and unanimous. If you work like that, that's fine. Like use humor. Like I would use humor. I might do a raised eyebrow. I might have a sassy look if I'm working with someone who that feels like the right connection. So you might be like, look, I just, I noticed that I did something that... we haven't really done before and I noticed that your face changed. What's going on? Like, can I just check in with you?

So you can do it in whatever way feels natural, but you've got to have that, you know, um, manage some of that anxiety for yourself and not be like, is what I did okay? Is it okay? It's Being like at a place of curiosity, like, Ooh, what happened there? Yeah. Okay. I felt it. That was a bit awkward. What was awkward about it? And then they might be like, I've never seen that side of you, or that just caught me off guard. Like, come at it with some curiosity and vulnerability and humility and be like, yeah, sometimes we try stuff and it goes really well. And other times, not so well...

[00:10:34] Bronwyn: Okay.

[00:10:34] Marie: ...and that's okay.

[00:10:35] Bronwyn: I've got two other barriers for you, which come from my own anxieties, but I think they're shared as well, but because I use these comments so frequently now, so this is old beliefs, but they were really impairing for me before I started this way of behaving in my therapy sessions.

So barrier number two was, for example, a process comment might be like, as you shared that story, I felt my chest tighten. Do you notice any physical sensations in your body? And to me, by saying I felt my chest tighten, I was like, self disclosure, like, how could I? Oh my God, I can't believe I'm doing that. And I was really anxious about even just that minor self disclosure, which I'm, I'm past now. But what would, what would you say to someone who is like, who's having that reaction?

[00:11:19] Marie: would never occurred to me as being, um, inappropriate self disclosure especially if you're trying to teach somatic awareness. Like even CBT, really, how can you understand the, the emotions, feelings bit without some sort of somatic awareness? So I think a self disclosure might be like, maybe here's the list of all the unhelpful thoughts that I had, but just saying like, oh, I noticed something in me. Right now, that's part of that teaching, right? of us could benefit from having more awareness and moments of pause to be able to pause and notice that for themselves. That will help them so much in their relationship, in their parenting, in communication with their boss, in whatever friendships, to be able to be like, oh, this sensation... I have it I notice it, maybe I can sit with it and name it and then we can untangle it together. So I never, that would never have occurred to me as being self disclosure.

[00:12:21] Bronwyn: And I think I was conflating, um, what I now see as attunement and empathy with like inappropriate self disclosure. Um, because I think it's just made so heightened to us, like in early on in our training. Um, but now, like I, like you've shared, it's like, that's entirely appropriate and helpful to the therapeutic process.

[00:12:38] Marie: I think so, because you have to be human and you have to care. And I think about, look, I think it's tricky as different, um, generations of therapists come through. But if we think about like a more, vulnerable way of working in a more authentic, things are merging a lot more. And it's just in thinking, I think the difference is who's it benefiting.

And so if you're, if you saying that you think, oh, that's benefiting me. So they know that I'm distressed. Then maybe it's not helpful, but if it's, it's, benefiting our relationship and it's educational and it's process driven and it's, it could be the truth. Right?

Um, but maybe if it was like a sexual attraction, you might not say that unless you're working with someone who maybe is, um, conventionally very good looking and and maybe one of the things they're coming to you for is, I feel like people don't take me seriously because of my looks. And so maybe you might say, look, can I, can I share Um, some observations with you? When you say these things, this thought does cross my mind, or I can see how that might be interpreted that way. So you still could be very careful. You'd get supervision around those sorts of things, but it really depends on the function of it. And not, and not every time. Right. Because I can imagine the full narration of like, as you said that I just felt like yawning a little bit and like, Oh, I got really fidgety in my chair.

[00:14:09] Bronwyn: Yeah. And like, we're going to discuss some of the pitfalls in a sec, but one of them would be like, what's appropriate to share what's not. And the other barrier that I had was, and I think this depends on your orientation, but because I was CBT trained, I thought that if we talked about like the awkwardness that someone experienced or like, um, the hesitation, I'm like, that conversation will go for five, ten minutes. That will mean that I miss out on a skills thing.

[00:14:33] Marie: But that's just a bit, but that's a skill, And maybe that's where your, um, your new way of working. is, is, is changing how you conceptualize understanding feelings and sitting with them. That's a skill and that's a crucial skill Cause we don't want to intellectualize understanding of this. We want to felt understanding. So pausing it and reflecting on it. That is an experiential skill.

[00:14:59] Bronwyn: Yes. Yeah, and that's how I think of it now. I think it's so crucial. I love connecting with emotions, like it's one of the first things that I think about. I think about the relationship and the emotions and how are we going to connect with that today in a way that's helpful for this person.

[00:15:14] Marie: And that's the most non replicable bit of self help books, AI, chatbots, phone, um, help lines. Like Anyone can psycho ed themselves, anyone can learn, like, all the information you could possibly need is out there, free online.

Having that real life, in the moment, experiential connection, emotional attunement, and overting that, and sitting with it, and tolerating it, and the relationship being there. That is the biggest bit that we can do that can't be replicated yet by um, digital resources or other sort of media. So that's probably a more important skill

to cultivate.

[00:15:57] Bronwyn: I -think it'll be, yeah, definitely. It's already here, but it will be the future as well. It's, it's one of those unique aspects of therapy.

Okay, so we've got it through the don't be Bronwyn barriers. But let's talk about how we can, I guess, develop some confidence in making these comments and maybe some common mistakes.

But before I, like, let everybody, I guess, be a bit negative by pointing out mistakes, I just wanted to hear from you because I know you do supervision. What would you say to someone who's coming to you, maybe an early career therapist, and they've got a situation and they don't know how to make these comments, how would you recommend that they introduce these comments into into their practice?

[00:16:38] Marie: Part of it would be, I would do it with us.

[00:16:41] Bronwyn: Ah, that's so clever. Oh, you're smart!

[00:16:43] Marie: So I I would be like, cause that's a learning opportunity. So I would, I would be like, Oh, it sounds like even as you tell me, I see a little bit of anxiety pop up. Yeah. Okay. And then I might overt. Okay. Did you see what I did just there? That's that. That's how we do it. So I might role model it and just sprinkle it through through the conversations. And if we needed more intensive skill building on that, we might do some role plays. I might ask them to record a session and bring it in and we can kind of just look at that. Like. You're not going to record the session and be like, okay, so I need to get three of these in this session.

You tell your client, you get a consent form. Look, I'm doing some personal development and I don't know what's going to come up in our session. And if it hits on one of the things that I'm working with my supervisor. I will watch it with them and we can use it as a learning. Is it okay? So many people, and we've talked about recording before, they say yes. Um, and if they don't, that's okay too. That's another thing in that relationship that you've said, I've respected your boundary, that's awesome.

And so we will talk about that and maybe have a few, you know, I know when I first started, I liked script, so even just a few sentences, I could just be like, Oh, that felt... that I felt something in that, like, you might not pinpoint it yet, or you might not know that might be a gap for you. And that's normal. And okay, too, because like you've said, we didn't learn that explicitly. Most of the university courses are intellectualized. digest information, reproduce it, get assessed on it. So there might be some big blind spots in emotional intelligence and sitting with that sensory component of emotions for a lot of therapists out there. And so that's okay.

[00:18:31] Bronwyn: Yeah, it's so okay. And I think as well like during my first year, maybe the first year was when I just had a lot of anxiety during sessions. That was my predominant feeling. So it was hard to be attuned to clients because of my own anxiety covering up differences in my emotions. Um, so even being aware of that, I was able to make different here and now comments focusing on what's happening in the room.

And then later on when my anxiety reduced, then I was able to notice changes in myself and then communicate that. You, you, you start where you're at and you can't force yourself to go further than where you are. But you can try and help yourself and there's no shame in that.

[00:19:09] Marie: Yeah. And I'm very, um, more and more transparent with some of that stuff. Like I had a supervisee tell me the other day, I really was so happy. He's like, I really love that you just, you're so vulnerable. And I'm like, Oh, whoops. But I think it's, I overt some of the process stuff. So I might say like, even with a young person, they might tell me something like I had someone the other day and they, um, they recently got married and I was like waiting until the, uh, for 50 minutes was up.

I'm like, all right, your time's over. Can I please see some photos ? Because killing me the whole time. And he's like, yeah, of course. It's like, now that I'm a pain, like we, you know, made a joke of it, but I might say, look, and I started the session and he's like, Oh, I just had the wedding. Like look, a part of me really wants to like, dive into that, but that's about me. So let's just park that for a second. I'll try and contain my excitement. Let's focus on this.

So I might overt a part of me really wants to get into there. Or, um, you know, if I'm not feeling well, I might overt that too, because people are really attuned to my expression. And I don't want someone to think I'm bored because I'm sitting there with a strange look on my face because I have maybe really bad period pain. Or I did a leg session at the gym and I'm so uncomfortable in my chair, and they're thinking that I just can't wait to get out of there. So I might share some of those, like, you know, up front as well and just see how we can work in this relationship together.

[00:20:25] Bronwyn: Yes, yeah, definitely. I think that's so valuable. And I wanted to bring to you an example potentially of how we can apply this. Um, and that comes from a listener. So thank you for writing in. I really am appreciative and I'm so sorry this episode took a while to get out to you. But I still think it's valuable, nonetheless.

So they wrote in to me saying, I'm a mental health clinician with goals to be a clinical psychologist one day. I struggle with a client of mine who gives me a little and seems to want me to ask more questions of them, but then they repeat that they're a private person. And I picked up on this correspondence because I thought it'd be perfect for this episode. I thought we could use here and now comments for this. Do you have any thoughts or, or ideas?

[00:21:08] Marie: I could be really helpful for someone because they don't have to share too much personal information. It is very much here and now. So it might be like when you ask a question, could be saying, I noticed that you paused for quite a while there. And I want to check in what happened. Um, be room to, uh, overt that you're going to try something new as well. being like, look, I've thought about how we work together and I want to try a couple of different things. Would that be okay? You're happy to experiment with me and then get that permission as well. in mind all these other tools of maybe, um, language barriers, neurodivergence, different, um, processing styles, so it could be, um, maybe you have, I don't know, I'm just thinking, cause I, I like to work with, you might have two kind of, um, colored lollipop kind of, you know, like picture, like, um, one of those paddle pop sticks with like a colored circle. You might have like a yes, no kind of stick. and then it might be like, okay, so. I want you to tell me if it's, maybe put the thing up, if it's a, yes, you're happy to talk about it, you just need more time, or if this is a no go, like... so maybe you get to do some work with them around, do you actually struggle to understand what's private, what's personal and private work worth, what you can share?

Is there a difficulty with disclosure? Is there a difficulty with trust? Are they scared they're going to say or do the wrong thing? So you could start with, um, prompt cards or different ways to generate conversation and just be like, okay, let's try and see where you're getting stuck because you don't want to be working harder than the client.

And

Marie's audio deteriorates too much after this point.

[00:22:45] Marie: you also want to be flexible in your approach and be and be creative with it. So, we don't want them to think that they failed at therapy. also maybe saying, I don't know if I'm actually the best person for this. Would something like art therapy be better? Or maybe what about if we walked and talked, would that make it easier? What do you, what are you worried about, you, know, that we might get wrong? So.

I think it's a combination of both. those things. it's hard to do a process conversation if they're not saying anything.

[00:23:19] Bronwyn: yeah, exactly. And I think like, I really like your ideas. And I think one of the things that makes this tricky is because let's say that the person, uh, like, maybe they've had an experience that they really don't want to share yet. It's early in therapy. And it's like, there is a trust thing or just I'm not ready to talk about that.

How would we Could we use a process comment to work out which of those explanations is true? I was thinking like, when I said x, what showed up for you just just then when I said that? Um, I'm wondering if it was related to, like, Oh, like a bit of apprehension, like, Oh, I don't really want to go there. Could you tell me more about that?

What do you think?

[00:24:06] Marie: Yeah, I think that's great. It's hard because this doesn't feel, this is not like a textbook skill. You really have to use, it's the art and science. You really have to use some more of your intuition and that human attunement and attachment. And so if that feels suitable, then yeah. Or it could be that you wait a little bit longer and be like, Oh, I wonder if me asking you that question. I noticed your body change. Was that one of those that's not now basket or you might have to have like a visual container or maybe you say, how about you write it on a piece of paper? We put it in this box and I promise I won't open it until you're ready, but we know it's there like, you might have different tools and techniques to engage someone who's not ready.

Um, but Yeah, what you said sounds really great.

[00:24:54] Bronwyn: Okay, cool. Yeah, I think it's kind of just, yeah, exploring around it, asking questions, staying with it. Um, I just want to stay with that for now, like, I'm just interested. Um, but you obviously don't want to, like, go too much, and it's like, I think that's, I think that's a difficulty as well, actually. Maybe we could just talk about that for a sec.

It's like, I don't, I don't want to push someone into talking about something too much and harp on about it. Um, Yeah, if it's, if it's upsetting or like a no go topic, um, the way that I've addressed this in the past is when I notice that I'm really interested in something, I might actually say to the person like, I know I'm harping on about this a bit.

Is it okay if we continue to talk about it? Um, that's what I've said. But yeah, what if, what have you said in these similar situations?

[00:25:40] Marie: Yeah, I might say, look, I just want to check when you, when we ended last session, we talked about X, Y, Z, and today we're talking about this. I'm happy to but I just want to check. Is this what you wanted to spend today's session talking about

Um, or do we need to put a pin in it? Because especially with some of my um, ADHD clients, they could chat about any topic for a long time. And so it's just making sure I'm not wasting the session talking about something that's just excitable and just be like, look, can I just check? Do we want to do we want to go all in on this or? we did in the last session kind of with X, Y, Z, do we want to revisit that and just give them a bit of a chance to make that choice themselves?

[00:26:20] Bronwyn: Yeah. Um, just checking with your audio, um, do you sound normal to you?

[00:26:25] Marie: I do. Yeah.

Do you sound, not, not, do I not

[00:26:27] Bronwyn: Um, yeah, it's, it's like a bit robotic. I wondered if like one of your cords had like fallen out slightly.

[00:26:35] Marie: No.

[00:26:35] Bronwyn: Like your headphone jack or something.

[00:26:38] Marie: That shouldn't matter with the robot because it's not connected to the speaker in that way.

Any

[00:26:48] Bronwyn: it sounds fine on your end, that's fine

because it records separately. No, it was, it was fine. Like I say, it was, but then like for the past, like two or three minutes, it's been robot. Like, can you just say something?

[00:26:59] Marie: Um, does it sound any better?

[00:27:00] Bronwyn: it's

fine because it, nah, because it records separately.

Um, but, you know, that's fine. Okay, no, we'll just keep going. Um, okay. So, what are some common mistakes that you have seen therapists do when they're trying to use process comments, or maybe even drawing on your own experiences?

[00:27:22] Marie: It's hard because I wouldn't see it happen because it's not something that we get to experience really live that often. I can think back to when I was in my family therapy, like in the reflective practice groups. People would Be scared to interrupt.

And that can sometimes feel like, um, colluding

[00:27:44] Bronwyn: that's a big one.

[00:27:45] Marie: That can feel like colluding. Like, if someone like, imagine I did that spill earlier about the, um, the four horsemen, and then I didn't actually follow through with that. How's that going to make the other person feel if their partner is just kind of laying into them with all this criticism and they're like, I thought this was a safe place Marie was going to say, hey, stop.

And so there is the risk of. In that space, not, um, not creating safety because I didn't stick to that expectation

and doing too much can be frustrating and derailing. Like, I hate too much of it. Like, I've had a therapist who did a lot of it. I'm just like, I don't, I don't care about how it made you feel because I'm different to you than I am to other people. So can we just like. like. it, it almost felt too much because it's not what I wanted to work on or talk about. So I think it's being tactful and figuring out how do you meet the person where they're at and bring in little bits of that if that's relevant.

[00:28:49] Bronwyn: Yeah, back on the interrupting, such a good skill to learn. I remember not being able to do it early on in my career and now I do it really easily. And, but I feel like that's a really good skill, like an early skill to learn because it's like, I wanted to stop you. I think something important just happened right now.

Blah, blah, blah, blah, blah. Um, or just picking up on that or circling back to that. Um, it's a really good skill to learn how to interrupt and. I remember it being quite valuable because I got feedback early on in my career from clients being like, can you interrupt me? Otherwise I will go on forever and may not know how to do it.

I was like, crap, how do I do this? Um, so it's super valuable and you do help create that safety and I guess direction as well.

[00:29:30] Marie: Yeah,

tricky. Like these are all tricky skills and sometimes we can feel like oh my god, this person's going to know that this is the first time we've done this and they don't because they weren't in all your other sessions

[00:29:43] Bronwyn: it's so

true.

[00:29:45] Marie: and so it's just okay to just to give it a go and just sort of see

[00:29:54] Bronwyn: Yeah, um, and on your other point about overusing it, that was one of my pitfalls that I had written down, which was over emphasizing present moment observations. So, like, repeatedly commenting on minor physical movements or expressions. So, it's like, you just looked down, what was that about? You just looked up, what was that about?

It can get pretty tiresome.

[00:30:15] Marie: yeah, yeah, I think it can. But even again, like, if you interrupt and they have a funny look on their face, then you get to do it again, being like, oh, what just happened there? All right, cool. So that didn't land as well. Interesting.

[00:30:30] Bronwyn: Yeah. Mm. Okay. Do you want to hear my other pitfalls?

[00:30:34] Marie: Yeah.

[00:30:38] Bronwyn: Okay. So, and these are all potential pitfalls. So I think, um, one of them is over interpreting and I've, I'm still, I'm still interested in this. Like there's no absolutes here. It's like what could be a pitfall in one situation might be an asset in another, but over interpreting might be assuming a meaning behind the client's behavior, um, without exploring it with them.

So like you crossed your arms, so you must be angry. In psychodynamic, everything is meaningful. So, um, yeah, it's like you do pick up. There is no over interpretation in a way because it's all meaningful and all linked. But if you subscribe to a different therapeutic orientation, it can be over interpretation.

Sometimes like a cigar is just a cigar, you know, that kind of thing.

[00:31:21] Marie: Hmm.

[00:31:22] Bronwyn: Yeah. Um. Okay, another potential pitfall is projecting. So it's like confusing your own feelings or reactions with the client's experience. So assuming, for example, I feel tense right now, so you must feel uncomfortable with this topic. And that can lead, if the therapist is projecting, from moving on to a topic too quickly without checking in.

So I guess that's a downfall in not using the here and now comments.

[00:31:48] Marie: But both of those, what they have in common is assumption and not curiosity.

[00:31:54] Bronwyn: Yes, you're right. Yep.

[00:31:56] Marie: Because even like,

you know, what's that saying? Like, if you hear, um, hooves think horses, not zebras. Um, is that the right saying?

but

[00:32:07] Bronwyn: I'm

not, I'm not good at sayings

[00:32:11] Marie: but it's just be like, that's the, that's why it's being curious, curious and nonjudgmental and giving a generous assumption and sometimes that projection, a hundred

percent we do that because we would be uncomfortable.

And then if we're awkward about it, we make it uncomfortable to talk about.

So I think of some of the, episodes I've

done for this complex life talking around sex. And sexual health and parents talking to their kids about sex. If you're kind of being like, Oh, can we have this maybe awkward? because you're awkward about it, they're going to sense your awkwardness, but you being okay with it and talking about it, they might still be uncomfortable, but you've made it.

You've given them proof that it's okay to talk about. And so it's, it's kind of bi directional in that way. Like, this is why I get so angry when people be like, why do I need a therapist? Like my friends can do it for free. It's like, this is really hard

work and we're doing so much work to try and.

Get all of this stuff, um, done and, supportive and you know, the, the bio feedback and the atunement and the connection and make it valuable with towards the client's goals and maybe teaching them things. that didn't even know they need, but sticking on track and meeting their expectations.

Like, it's a lot of stuff.

And so I think if we can be curious and we can reflect and, you know, even just sort of the session rating scale, you can just hand that in at the end, or you can say, like, can I, can I check what's, what's this been like for you right now? Um, you know, having more of those transparent conversations, you'll get better at it and you'll practice and maybe practicing with your supervisors is a good place to start or kind of finding someone who works that way Or sending them an email and saying, oh, this is something I want to work on in our next session. Uh, is this something you'd do? So you can start building it in. There are so many of these skills that are learnable.

[00:34:04] Bronwyn: Yeah, definitely. I agree. It's something, yeah, you can practice and you can get better at and I think you're right. Like the thing binding these pitfalls that I was saying together was a lack of curiosity. Um, and I feel like that's really important because even this other pitfall that I have, which is be too vague, like sometimes you can make comments that are not tied to any behaviors.

The example that I had was saying. Something feels off right now without elaborating, but again, like, you know, in a situation that could be an entirely appropriate thing to say. Um, I, I don't know. What do you think of that one?

[00:34:40] Marie: Can you say that again? What do you mean?

[00:34:42] Bronwyn: So, okay. So if you make a comment like something feels off right now, but you're not linking it to like any behavior, you're not saying like, I noticed your tone of voice shift, something feels a bit off now. If you're just saying something feels off right now, do you think that'd be kind of hard for the client or is that okay?

[00:35:00] Marie: Um, it depends on the relationship because someone might really resonate with that. And someone else might find that a bit weird. I think without more context, I, it's hard to say. Um,

[00:35:12] Bronwyn: Um,

[00:35:13] Marie: cause yeah, like, I don't know if I would like that. Like, someone said to me, Oh, something feels a bit off right now. I, I don't know if I'd take it personally. Um, so I'm just trying to think as a client, I'd probably be more inclined to receive something like. I noticed a shift, or I noticed a change,

[00:35:33] Bronwyn: Yeah,

[00:35:34] Marie: than something feels off, because I think that might be a bit of a judgment. um, like the, you know, cigar thing that you were saying, like, just so maybe I'd be more inclined to be like, maybe it feels off to me, but I might ask it in a way that's like, I noticed a change.

between us.

[00:35:52] Bronwyn: Um, Yeah. And then letting them fill that in.

[00:35:58] Marie: Hmm.

[00:35:59] Bronwyn: Yeah. Okay. Cool. Okay. Um, moving on to, can you share any experiences where making a here and now comment was really helpful? Um, for a therapy session or direction. Um,

[00:36:21] Marie: Yeah,

I did have, um, a client who very flippantly, um, mentioned a disclosure of sexual assault and I was able to catch it and be like, you've just said something deeply painful and hurtful, but you brushed it off and said it with a laugh, and then she burst into tears and were able to unpack it. We didn't do trauma work in that session, but just noting That that maybe a part of her did want to talk about it, but also didn't want to talk about it. So it, was enough. It was significant, right? Like, I couldn't let that go, And then several months later when other things were worked on and we revisited that, and we've been doing some EMDR sessions. So I think sometimes it can be. Really helpful for someone to sit with that.

Um, oh, yeah, I have a habit of doing that. I talk about something really painful with a

smile or I dismiss, um, my own needs. So I had in my mind some of my hypotheses of what was happening for her and some of that was minimizing and not being feeling good enough. and so if you have that worldview, it might make sense that you would Um, minimize the impact of that kind of violation and I didn't want to let that go.

And so mentioning it and saying, we're not going to discuss it further now, but I just wanted to say that I noticed that you've done that. And that's, that's quite a concern. And so, yeah, it, it, it was hard cause

I think maybe a younger version, a baby therapist mode, or even just not so long ago me, maybe would have said, I don't want to upset her.

And so I wouldn't have brought it up because maybe I don't want to upset her, but that's not my job to not upset someone.

[00:38:17] Bronwyn: What

do you think

now?

[00:38:19] Marie: I think I'd handled that I think I handled that tactfully of, we're not going to go deep into it, but she's already upset because it's happened. And so I've made it okay to talk about.

I've seen it. I've named it. I've noticed it. I've parked it. And then we revisited that. And with permission, I was like, look, this. You mentioned this a few sessions ago, And I didn't want to blindside you with this but I think it's something that we could work on because I think it's still impacting you. Do you think? That's something we could put into our work together.

So we then sort of scheduled when she felt well enough to process that. So I think it was really helpful.

[00:39:11] Bronwyn: Mm. That's really cool. Nice work. Yeah. Um. Like, yeah, as you were talking, it triggered, like, it reminded me, um, like, the way that I use process comments here and now is sometimes to, um, help, I don't want to, I don't want to say compensate, but I don't know how else to put it, but like for me as a person, I really like laughing. And so sometimes like if clients have laughter as a defense, like I can laugh a lot with clients.

And if I don't keep it like in check, like we can not connect with emotions. And so one of the ways that I use process comments is like, if we're laughing about something, I might be like, and we're laughing about this. And I know we're having like a good time, but I wonder if there are other emotions that's going on here.

And then I'll let them kind of jump in so that we can actually get to somewhere else. Um, and that's to help them like with, if they're using humour as a defence, because I just like laughing. Um, but maybe it's also me using it as a defence, who knows? Um, so it's the way to, to help, help me help them in a way.

[00:40:18] Marie: Yeah. And that's really important because once you know that pattern, then you get to do what you need to do to be able to show up differently for that client. So if you need to check in with, Oh, am I laughing because it was genuinely funny or they laugh and so maybe you might not have felt the emotion first of. awkwardness or discomfort or I don't want to have this conversation. you might've just recognized the laughter and then you can reverse engineer, okay, what happened? Um, so maybe my dog's struggling to get up. Um, you might be able to then use that as a

you might be able to use that.

[00:40:58] Bronwyn: to get up on the

couch? Hahaha. Aww.

[00:41:05] Marie: like, a cartoon, like a road runner.

Um, all right. No, he's, He's fine. All right. It's rearranged. Um, You, just check in with

that because we're human, right? And I think so much of the work, this is why it's so important to have supervision.

It's not just a tick a box to use it well and to have that reflective practice and to have that insight. You get to talk about that and you don't have to do it all at once. It might be a learning curve that you, or a goal that you set around that and sort of being like, I want to recognize myself in the room, how I am. And I noticed that there are some topics that I shy away from talking about.

And then you might put in place what you need to feel more comfortable. So when we've talked about, sex therapy, for example, and you mentioned that, you know, those courses that you've done around exposure to the different sort of language you might come up because you don't want the first reaction you have in a session to be one of disgust or horror. So if you've got a topic that you find uncomfortable, you research a bit about it, you get some comfort so that when you talk about or ask about it, you can regulate and you can sit in that.

[00:42:17] Bronwyn: Yes. Yeah. Totally. I really like how you always give such a calm approach to learning things and you really emphasize that you can take it bit by bit and you can learn like these are not unattainable skills. These are simply things to practice and they might be difficult at the start, but we can approach it bit by bit and take it step by step.

Um, Marie. Okay. What do you hope listeners will take away from our conversation today?

[00:42:46] Marie: They're probably doing some of this without knowing, so now that they've got language for it, maybe notice that you've probably already done it and give it a go. If you haven't, see if you, where you might want to just kind of wiggle it into a conversation. See how, what you observe in a client that you work with, how you might put that into words. So you might want to have a couple, a couple kind of written down.

Um, but give it a go and see what happens.

[00:43:18] Bronwyn: Yeah, I agree. Um, I think one thing that I had when I was early on was I overestimated how severe like stuff ups were on my end or something didn't land perfectly. I was like, Oh, I've stuffed up the relationship forever. How terrible am I? Um, but now I know I feel like much more confident that it's like I can say something.

It might not land right. It's fine. Um, I don't know if that's helpful to anybody listening, but like you might be over it. Estimating how, uh, harmful or detrimental your, like, your attempts to try things out are, and clients are more resilient to that than we give them credit for sometimes. At least me.

[00:43:57] Marie: Yeah, don't underestimate just how much good stuff you can do by being a kind, calm, compassionate person. These are the skills you learn along the way

[00:44:07] Bronwyn: Yeah.

[00:44:08] Marie: and there's still a lot of value.

In being a kind person.

[00:44:14] Bronwyn: Mm. Yeah, and it's like, I feel like the foundations, like what I tell myself now is like, my foundation is that I'm trying to help. I'm trying to be a good presence here. I'm trying to be attuned and empathetic and kind and listening. Um, that's a really good basis for like me trying out other stuff on top.

I can always fall back on that. Um, yeah, that just gives me a little bit of confidence at least. I don't know if that's similar for you.

[00:44:40] Marie: Yeah. I think for me that what's helped me with my confidence is when I've done extra work on boundaries and I, um, it was fresh in my mind doing a sort of every year around the Christmas time, I do like a new podcast or a blog post or something about it because that seems to be a time where we really struggle with over scheduling and over committing and I remember putting into the one I did last year around. You can set a boundary Okay. and the other person can be disappointed. And that's okay,

And

that can be similar with clients as well, like we can do this thing. It might not have loved it, that might've felt a bit uncomfortable. And that's okay, too. Like we're, talking about tolerating emotions and we're working through things together and we're trying to create a relationship where they can say, actually, that wasn't quite what I wanted, or can we try a different approach?

So, you can build on some of those things relationally, and it's not all on the therapist to find this perfect way of communicating to meet that person's exact specific way of doing life. Um, we have to have some Kind of two way interactions in this.

[00:45:53] Bronwyn: Yep. Mm. Definitely. Okay. Marie, thank you so much for coming on. I always enjoy hearing, yeah, your, your great insights and great thoughts about topics like this and your relational, um, techniques and insights. It's really good. Um, so thank you very much. If listeners want to learn more about you or get in touch, where can they find you?

[00:46:15] Marie: Yeah. so check out the, this complex life podcast and, um, connect with me on, I think I'm more active on LinkedIn than anywhere else. and, all my workshops, training, supervision stuff is all on marievacacis.com.Au

[00:46:31] Bronwyn: Excellent. I will pop all those links in the show notes. And I really like this complex life. Even though I don't work with teenagers, I just like listening to you talk about stuff. It's really cool.

[00:46:42] Marie: Well, I'll, um, there'll be a series on couples therapy coming up. So that might be a little bit more interesting for you.

[00:46:51] Bronwyn: It's still interesting, but great. I'm very pleased to hear. As always, Mental Workers, thank you so much for listening to the podcast. If you enjoyed today's episodes, do listen to more episodes. I'll pop in a few links to Marie's episodes as well, if you like listening to Marie in particular. She's very cool.

Um, but I hope you take care and have a good one and catch you next time. Bye. And that's that. Cool.

Thanks very much.