Tuesday, October 20, 2009

Small talk therapy

OLJ in the last post mentioned that at times she seems to engage in small talk in therapy that can last up to 20 minutes. This I found interesting as I, as a therapist, can also spend the first period of time in a session in apparent small talk. It got me thinking about why I do that, or what am I doing in the small talk that is going to end up being of benefit to the client.


Whilst I am engaging in small talk with a client, there is a lot of ‘other’ talk going on inside my head. In this way it is quite different when I do small talk in a normal social situation where there is not the same cognitive calculations going on inside my head.


Upon reflection, I think I use small talk therapy in a variety of ways. As OLJ says sometimes the small talk can lead to ‘hard’ talk. I would say that at times I am doing the same in small talk. It buys me time where I can assess the client’s current mood and allows me time to plan a strategy to follow for that session. As they talk I am constantly looking for a therapeutic angle where I can make a small switch of direction or make a connection they may not be aware of to their life script. Once done then the small talk becomes hard talk and sometimes clients will say things like, “How did we end up here”, or “I didn’t expect to be doing this today”.


It is also a good opportunity to give positive strokes to the client which builds the relational and then that can always lead into work on the client’s stroke filter. It is also a time where I might slip in some self disclosure which again helps build the relational with the client.


As I think about it, it is also a good way to take a psychological history from the client and do cross checking at the same time. I have always said that there are certain similarities between a therapist interview of a client and the police interview of a suspect. They seek some of the same goals but for different motives.


Positive strokes? These three women seem to have

a distinct dislike for each other


I worry myself at times how I never believe anything anyone tells me anymore, at least with client’s that is. Now don’t take that the wrong way. I am not saying that client’s are a group of pathological liars, but having been in the therapy business for 30 years I know how well people lie to themselves regularly. If they are lying to self about some thing and I ask a question then they are going to lie to me about it. In addition, at times I am asking people very personal questions and they may choose not to be fully candid in their answer with me at that juncture. There is nothing wrong with that and if I was in their shoes I would probably do the same.


In police interviews they can ask suspects the same question three times in three different ways. When doing small talk at times I am doing the same. Not to catch them out but to be able to identify incongruencies and bring them to the client’s attention.


Therapist: Did you go out on the weekend?

Client: Yes we went to a restaurant called ‘x’.

T: I know that one, they have great fish there

C: Oh do they, for my meal I had.....


I am now going to get all sorts of information about this persons eating. In my initial history taking with the client I may have asked about their diet and eating. I am just about to find out how consistent or inconsistent that information was. The client may be quite skinny and report eating a high fat meal or they may be over weight and report ordering just a salad. This is the other kind of information I may pick up.


Therapist: Were you there with family?

Client: Yes, my mother and sister......


I am now going to get all sorts of information about the client’s family dynamics and will be able to compare it with previous information the client has given me. I am also going to get lots of information about their social life which is important in any mental status examination.


I definitely use small talk for such psychological history taking and to cross check information.


Sometimes I just forget stuff about the client and small talk allows me to remember it without the client realising I had forgotten. I am sitting looking at a client and I can’t remember if her mother is dead or alive, if she has a father or brothers and sisters so I might say, “Have you caught up with any family lately?”. As I get a little bit of information a whole heap of information can comes rushing back as I recall it. Its like I just need that little prompt and then I remember lots of stuff about the client. So in this sense small talk therapy is like me reading my notes on the client that I should have done more diligently before they arrived


Well there you have it! I just discovered that I know all this stuff that I never knew I knew. Thanks OLJ.


Graffiti







28 comments:

  1. Thats interesting how you use that seemingly frivolous conversation to get info about broader issues.
    I send to be more likely to go silent than do small talk. I had a therapist call me out once on not being into small talk. It's not that I'm unable to do it. I do small talk just fine in the real world. But I do it feeling I need to fulfill a social obligation. In therapy I don't feel like I have to do that so I don't usually.
    I do do it sometimes tho especially when I have something tough I want to talk about am I'm trying to get there just by saying anything even unrelated stuff, but usually it leads to me not talking about the thing and then feeling awful about a wasted session.

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  2. Hi Lee,
    The use of small talk to avoid a topic. Sounds like a good tactic.
    I think silence is OK and if you don't want small talk then don't do it

    All the best

    Tony

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  3. What on earth gives you the impression that the 3 ladies don't like eachother? They're simply posing for the photo.

    Do you always read more into things that is necessary or observed?

    I'm currently on my last dash to the finish line on an assignment. I'm on a long shot... hope i finish the race!

    Small talk huh? That's pretty big small talk you is talking about.

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  4. Roses it is sooo obvious that those three women can't stand each other.
    Just look at them

    Tony

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  5. What? I see, competition perhaps. Some insecurities. Is this photo from Holland or something? Do you know these people? Actually it looks as though they are doing a spacific pose - like one is purity (which actually looks more like, pick me! Pick me!), one is surity (just try and miss my wears) and one is duty (just ask and your wish is my command). But dislike? Well that may be true but i need to see more to come to that conclusion. Honestly, i think they're posing for a specific scene like "see no evil, hear no evil and speak no evil" type thing.

    Maybe after I learn some stuff i'll beable to see the way you see it. But right now - it doesn't look as though the girls are being 'real' at all - just posing for a shot.

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  6. After reading back my most recent comment about the girls, it appears that you're small talk is indeed quite loaded! Cheeky!

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  7. It appears to me Tony, that on Blogsteam, i'm to do some 'goodbye' work.

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  8. The two women on either side are jealous of the one in the middle because she has big boobs.

    I appreciate your honesty in saying that you don't believe what your clients tell you, and that you forget things that they have told you.

    I bet they never forget anything you tell them about yourself!

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  9. Tony -
    I've been swamped at work with no time to comment. I will dash off one now.

    Wow - I feel honored to be the impetus for such a post. Interesting post - interesting to see things from both chairs. As I was reading your post about how you *use* small talk in therapy to recount things or to assess mental status, I was trying to relate the same to my therapist (as I am sure other patients are also doing).

    I laughed at your comment about trying to use small talk to lead to a switch in direction to point something out to your client. At times, I will tell my therapist not to overanalyze something I tell her as part of my "small talk".

    Start quote - It is also a good opportunity to give positive strokes to the client which builds the relational and then that can always lead into work on the client’s stroke filter. It is also a time where I might slip in some self disclosure which again helps build the relational with the client. End quote

    At first, I thought this came off as narcissistic - and perhaps it is to some point. Is "stroke filter" a technical term? Makes me wonder if when therapists say something that seems to single out a patient - like mine this week mentioned our connection and how we would likely be friends if we met in different circumstances - if that is honest or just being said to "build the relationship".

    Perhaps I'll ask her - although that will further expose my vulnerable side.

    Anyway - thanks for the thought invoking post. I also want to ask you (not having done any outside reading on the subject yet) - is the "child ego" you refer to in your posts equivalent to "inner child"?

    Take care,
    OLJ (oops - almost signed my real name - it's amazing what we divulge when we are "anonymous".)

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  10. Hi Roses,
    at the moiment i am on the other side of the planetand the internet connection is bad so i dont know if this will post but i will try later if it does not.

    they look competitive to me

    yes time to say goodbye to the old Stream my friend

    Tony

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  11. Hi Harriet and OLJ

    will respond later as I am in a rush to my workshops

    Tony

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  12. Yes - thought so. I hope you're having a doosie of a time over there... some where.

    Not saying good bye to blogstream! Its the only blog place that I have ever had. Why would i leave it now?

    I hope you're connection becomes more stable over time.

    Gosh! I hope you're having a fun time! Cheers...

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  13. P.S.
    Don't worry about this blog while you're gone! Get about and see something different, go somewhere new and smile at as many new faces that you possibly can! Becareful of the water and when you find some good water... drink lots when ever you can. But not while you're traveling distances or you'll be stopping to wee every few minutes.

    Oh for goodness sake - smile much...

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  14. Hello Harriet,
    To me those three women look like they are not on each others christmas card lists at all.

    I do forget things about clients.I have quite a good memory but not enough to remmeber them all.

    Its not so much that I disbelieve my clients I would see it as more that they are being human like me and all the others on the planet. We can stretch the truth for various reasons.

    I am enjoying my trip at the moment and will get back on here and speak with OLJ and others soon. I am off to Dalmatia today

    Regards

    Tony

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  15. So... did you get yourself one of those 101 spotted puppies?

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  16. I need to look at a map - I've never even *heard* of Dalmatia. Geography was never my strong suit.

    Hope your conference went well.

    OLJ

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  17. Miss you not blogging Graffiti.

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  18. My husband doesn't like to fly. His first flying experience was earlier this year. Even the most experienced fliers who were with him on that flight, exclaimed to have never been on such a dreadful flight.

    We drove to Sydney yesterday. I hope on your flight back that you're getting some rest inbetween the 'stuff' that may go on. And - I hope you left your self some time away from work to get back here... in other ways too (jet lag is it?).

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  19. Hello OLJ

    Dalmatia is in Croatia. It was a super spot that I have got lots of phtotographs that will soon be on my Facebook

    Tony

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  20. Hi Kahless,
    I am back tomorrow and might do a blog or two.

    Been and done the European thing for the last few weeks

    Graffiti

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  21. Hello Roses,

    Back in good old OZ tomorrow

    see you then

    Graffiti

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  22. Its Guy Fawkes day Roses.
    Happy guy Fawkes day

    Tony

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  23. Hello OLJ,
    back to your comment on Oct 23rd which I never addressed.

    I suppose if a therapist used small talk time to talk about self a lot then that could be narcissistic. Me having some of the narcissistic personality type characteristics myself maybe that is what I am doing!

    But I don’t think so as at times people have said I am introverted when it comes to talking about myself.

    Yes the term ‘stroke filter’ is a technical term in Transactional Analysis.

    You raise an interesting point (maybe another post on this one!) about how a therapist can single a client out as you put it. Raising the question of honesty or is it being said because its good for therapy. Depends on the therapist I suppose.

    The Child ego state is one of the three ego states of the personality that one finds in the theory of Transactional Analysis. In some ways it would be similar to what is sometimes called the inner child but it is much more complex than just that.

    Tony

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  24. Tony -
    I think I hit reply in my email box instead of posting it. Not sure if this made its way to you.

    Tony -
    Thanks for reply. I really need to read some more about TA. Although perhaps self serving - I find all this very interesting - if I were younger I would consider going back to school for formal training. Maybe after I retire.... which is still a few years in the offing.

    Oh - and thanks for the geography answer. Is your facebook page public - (to view the Dalmatia pictures). Although that would be complicated - you would know my real name. Not that I mind that, but I don't particularly want it tied to my blog at this point.

    OLJ

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  25. Hello OLJ

    No my Face book is not public so you would need to ask to be my friend and then yes I would know you rname. But there are lots of pictures there. I will put a few here as well.

    Tony

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  26. Well - maybe I will friend you. No reason that name has to cross over to here. I only get on facebook once every few weeks. I suspect there are a gazillion Tony Whites.

    OLJ

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  27. Well there are not that many of us OLJ and I can't ask you to be friend as I am sure you are not on FB as OLJ!

    Tony

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