Darren: Hello and welcome to Attach Together, the podcast where we explore all things attachment theory for counselors, psychotherapists and psychologists. Created by the team at Optima, providers of the level five and level seven diplomas in attachment-based psychotherapy. podcast is your space to deepen your understanding, ⁓ on your practice ⁓ stay connected to the heart of attachment-informed work. I'm Darren. a person-centred counsellor and an attachment-based psychotherapist in private practice. And joining me today is Oxley, the founder of Optima and tutor of the Level 5 and Level 7 diplomas. Jo is an experienced psychotherapist, counsellor, supervisor and tutor with over 35 years of teaching and tutoring experience. So whether you're newly qualified, whether you're training, whether you're fully qualified or simply passionate about attachment in the right place. So it's great to see you again. ⁓

Jo: Hi Darren, lovely to be with you again. Thank you for having me.

Darren: Absolutely welcome, it's great to have you back. So you created the courses at Optima, having trained directly with Linda Cundy. ⁓ chosen today to speak about theory of mind. Can maybe tell us what do we mean when we say theory of mind?

Jo: Yeah, it's a bit of a funny concept, isn't it? Theory of mind. And I think we learn to think about minds because someone first thought about ours. So we develop our theory of mind, if you like, on ⁓ our experience was with our caregivers or our caregiver. Attachment theory, as we know, was developed by John Bowlby and then that was kind of expanded by Mary Ainsworth. And we know, don't we, that attachment theory at the heart of it is about safety and proximity seeking, to survive, And it's also about emotional regulation through relationships and internal models that talked about last time about self and others, and also about how early relational experiences influence later relationships. So we know that attachment theory focuses on relational security and emotional development. But into this mix as well, we've got this theory of mind or ToM sometimes as it's referred to. Yeah, a bit of ToM we can think about attachment, if you like, as the soil. And theory of mind is one of the plants that grows in soil. And it really refers to the ability to understand

Darren: I like that.

Jo: that other people have their own thoughts, their feelings, intentions and beliefs. And what I mean by that is that, you know, that needs to develop because that gets modelled if that makes sense.

Darren: I think getting it, but I'd really like you to maybe expand a bit more for me. ⁓

Jo: Well, I've got a little granddaughter, well I've got three granddaughters, but I tend to have a little granny day on a Thursday with little Lara, who all of my tutors and most of my students hear about. So, ⁓ know, I might have been cooking or making biscuits or ⁓ crispy cakes or something with her in the morning as we do. ⁓ then, you know, granny gets a bit tired. ⁓ I might say to her, come on, you know, we've been cooking now for a little while. I need to sit down and a cup of tea. you come and do some drawing I'm a bit tired. And modelling that Lara gets learn that granny's got her own needs and wants in the world, if that makes to you. So she starts to learn that, that, you know, child is not the centre the universe, that other people... ⁓

Darren: Yeah, it does.

Jo: Yeah?

Darren: other people have needs, other people have their own mind their own desires ⁓ the world doesn't revolve around ⁓

Jo: And that's really important for lots of reasons. One of the reasons is children, as we know, are born narcissistic. They have to be because they have to, you know, solely focus on their own needs to survive. But what happens with, you know, the caregiver that is able to say, you know, right now I'm feeling this, you know, we've done that and this is why, and I'm explaining why I'm not going to play with you for half an hour because I'm tired and I need a cup of tea. that the child can start to internalize that other people, as I said, have their own thoughts, feelings, intentions and beliefs. you know, if that doesn't take place, then those mental states don't develop.

Darren: And if they don't develop, happens next? ⁓

Jo: Well, can imagine, can't you? a client in therapy comes and they only see their own point of view, they can only focus on what's in front of them, that ⁓ in would cause a lot of anxiety, wouldn't it? Because there's no perspective. ⁓ We're introspective rather than retrospective or looking outwards. And I think ⁓ theory mind really helps us to develop that social cognitive capacity to mind read in a reflective way, to make sense of in a reflective way.

Darren: I'm sat considering clients I've had in the room over the and I'm beginning ⁓ piece together the who ⁓ have been unable to consider the and the of others, ⁓ even a different mind is so stuck in their worldview and in themselves.

Jo: Yeah. I think that does give us stuckness doesn't it? But I it's, you know, there's of no fault, it's a developmental stage that didn't take place. And so something that we can start to do with clients is start to ⁓ evolve that of mind, if you like. There's some really research by Simon Baron

Darren: No.

Jo: and he does a great experiment, I think it's a three year old, she might be three and a half, maybe four. And ⁓ shows little girl a packet of and he says her, what ⁓ you imagine ⁓ in this of Smarties? And course she said of course she's gonna say sweets. ⁓ And then he says, ⁓ we have a look? And he takes the top off ⁓ and out come these pencils. and the little girl is momentarily puzzled, but then she realizes there are pencils. And then she watches him put them back in the box and he puts the lid on and he puts them back in the basket and he says to her, so your little friend Tommy's gonna come in in a minute, what do think he's going to think is in the smarties box? And I can't quite remember her actual answer now, but it's not what you think it would be. So she's not quite got there fully. but she's thinking that it's definitely not sweeties, that going to come in. And it's really interesting to see that theory of mind develop when we start to pose these questions to children. This ⁓ is in front of you, but what do you imagine? Can you what somebody else going to be thinking in their mind, ⁓ if that makes to you? ⁓

Darren: Yeah and I love that example that video is ever so funny isn't it. really considers her answer and gives the wrong one ⁓ bless ⁓ but really trying hard she really wants ⁓ to in be able have that theory in mind but it's just quite clicking into for her. Would that be around the age where this would start developing Jo? ⁓

Jo: Yeah. Yeah, I think it's about three, but after the age of three, yeah, when that theory of mind can start to develop and children can start to take into account, you know, other people's feelings. think, you know, becomes something can happen at that point because we can start to say, you know, well, you feel sad when you can't have something. How do you think so and so feels when they can't have something? And again, it's developing that theory of mind.

Darren: Yeah.

Jo: you know, imagining how someone else might feel.

Darren: And I'm then wondering those people who ⁓ ⁓ that theory of mind, what might have played out for them in their childhoods.

Jo: Yeah, so if we think about theory of mind also informing how we can connect, know, this is quite intertwined, isn't it? Because secure attachment tends to support or secure ⁓ tends to support the development of theory of mind. And a sensitive caregiver helps children learn to interpret emotions and intentions. And also that, you know, that reflectiveness that we can reflect that we are feeling tired, you know, ⁓ sort creates a scaffolding for mentalisation. So what happens? Well, there's a great quote actually, cannot communicated to mother cannot be communicated to the self.

Darren: Interesting. ⁓

Jo: So we can think about theory of mind if you like as two minds connecting. Think if we connect, if I'm just getting both my hands and I'm bringing both my hands together and I'm connecting my hands with my fingers, that two minds connecting of theory of mind. ⁓ if that doesn't happen, then very difficult for me to connect ⁓ with else's mind and understand what they need.

Darren: So I've got an image in my mind, seeing your hands come together like that. There's many examples of this, there? Like a mother and baby head to head, eye contact, fully engaged, loving looks, warm, and so much communication, non-verbal, but it's all there, that love and that interconnection and that link, you can feel it. It's almost like a

Jo: Mm-hmm.

Darren: power between these two people that draws them together and creates something more ⁓ that's what I'm picturing as you're speaking about theory of mind in that ⁓ with the mother ⁓ then I guess the baby can turn around and look at other people and start to build a connection ⁓ them because they've got that skill developed ⁓ they've that grounding ⁓

Jo: Mm hmm. Mm hmm. Yeah. And it was interesting as you were talking, your hand was going backwards and forwards. what you were kind of ⁓ almost non-verbally ⁓ explaining to me your body was it really is a non-verbal backwards and forwards. And what interrupts that backwards and forwards often is anxiety.

Darren: Yeah, I noticed that. Mmm. Yes.

Jo: So if the child is anxious or the mother is anxious or the caregiver is anxious, then that can interrupt that backwards and forwards of that nonverbal communication. I guess then we start to think about theory of mind that relies heavily on the networks in the prefrontal cortex. Now, what do I mean by the prefrontal cortex? Well, Dan has this great model of the brain. It's called the hand brain model. So just going to invite all of our listeners make a fist and their thumb in with their fist and then sort of turn their hand around. So they're looking at the hand almost like if it was a puppet, it would be ⁓ almost, know, facing you. And the between the knuckles and ⁓ the bottom of the finger. ⁓ This is Dan Seagal talks about. This is this ⁓ prefrontal cortex area if you like. And this is where all our thinking is done. But what happens with anxiety is where all these neural pathways are all there, it's like a highway. But what inhibits their production, if you like, or how they ⁓ developed ⁓ anxiety, Cortisol inhibits how the brain develops. And then if we use our hand-brain model again, this is our prefrontal cortex, where all our thinking is doing between the knuckles and the. the sort of bottom of the top of the nail. When we feel anxiety, if you open your hand out now and make like an L with your thumb the thumb represents the amygdala if you like or the fear response system, you'll see now the thumb is far away from the knuckles and the fingers. So no connection to the thinking brain. I hope that you know, visually make sense if you're following along with me. And in order to be able to think things through, to be calm and to have theory of mind, prefrontal cortex has to be online. so that we can wonder about minds, so that we can hold multiple perspectives, so that we can imagine intentions and we can think things through and we can make sense of things. But we cannot do that while our thinking brain is offline. So in order to come back to our fist brain, if you like, we have to do something calm the nervous system, to calm what we call in ⁓ terms, ⁓ affect. And the way in therapy that we calm the affect that we can use lots of different methods. One of them could be mindfulness. ⁓ could use a visualization with clients to get their nervous system back into a state of thinking. Or we can use things like 7-11 ⁓ or breathing around the hand. So you breathe, if splay your hand now, you can breathe in, going up the thumb and out, ⁓ going the thumb and in. ⁓ up the forefinger and down, going down the forefinger and so on and so forth. And that also introduces another sense because whilst we're using a finger to connect and touch up and down our fingers, we're also using touch and feeling that sensation. So that changes the way the brain is responding. So when we count and we calm the nervous system down, we get that fist brain back online and we get that thinking brain back online. So theory of mind is essentially the finger staying online while the thumb is still present. It's thinking with emotion, not thinking instead of emotion, if that makes sense to you.

Darren: Makes absolute sense, And those... those tricks and those tools ⁓ the nervous system down. wow, they've done me so many favors over the years in different in different workplaces. But I wish knew them sooner in life because they would have really helped me earlier on. ⁓ I have to a good old chest ⁓ tap does wonders me. And I really like how often I notice as nervous system calms, ⁓ my body gives

Jo: Mmm.

Darren: me a signal that it's there so I sometimes get a yawn or my eye will twitch or something will happen whereby my body will tell me okay I'm relaxed most often it's a yawn and it's just the body just has it wants to be calm it doesn't want to be on alert

Jo: Hmm.

Darren: We just need to help it get there sometimes, don't we? I think we haven't had that model to us as a child, ⁓ going to be an effort for us to do it for ourselves in adulthood.

Jo: Absolutely, you know, when you're saying about the tapping, you know, if any of our listeners want to at the moment, just cross your arms as if you were going to cross your arms, but rather than tucking your hands in, just tap each shoulder you listen to me talking now. And sort of represents that tapping, that patting that we do with babies. And you can even just gently rock backwards and And that... you know, for me, I can feel it in my solar plexus straight away that I start to calm that my starts to leave my brain. brain back online and I can start to think more clearly. It was something that occurred to me a minute ago as well about, you know, the cortisol that we talk about and developing that theory of It can really helpful to counterbalance anxiety when can think things through. And what I mean, guess, by that is when we can to put another story that overlays the story.

Darren: you'd use that with your clients.

Jo: All the time, Once they're in a calm state, then might say to a client, ⁓ let's play with this. ⁓ Let's imagine we're on a stage and we've that the audience have made an opinion the play that's just gone on. Do you imagine that all of the audience have the same theory ⁓ what's gone on? Now I know when I'm watching something on telly with my ⁓ particularly we're watching some sort of plot-ish thing, I might say, ⁓ I think it's this, this and this. ⁓ And say, ⁓ really? What makes you feel that? ⁓ well, because this, this and this. No, I think it's this, this and this. And it's always a little bit of competition now as to whose theory of mind is going to be right. But that is exactly it, isn't it? ⁓ So with clients, when thinking about the stage situation, do you imagine that everybody is thinking that? What other thoughts could other people, what about the people in the balcony? They might have seen it from a different perspective because they're looking down on it. What other things could be on here? So we're encouraging that theory of mind. ⁓ yeah, yeah, because obviously if you're sitting right close to the stage, you can't see the person in the back row that's doing X, and Z, but from the balcony, they can see this. They've got a bird's eye view. And that's what we're doing, isn't it? We're developing that bird's eye view.

Darren: Mm-hmm. ⁓ all what we've discussed with regards ⁓ theory of mind and all us clients and counselors, everyone, ⁓ can just return back to where we started ⁓ with soil ⁓ and plant Because I'd really like to draw us back into that image because it ⁓ is just such a ⁓ representation of what we're ⁓

Jo: Yeah Yeah. So we were thinking about before as attachment being the soil. if that soil is fertile, i.e. ⁓ the ⁓ have been able to demonstrate that other people have their own thoughts, their own feelings, their own intentions and beliefs, then theory of mind is one of the plants that grows in that so that the ⁓ person can understand that their mental state may differ from somebody else's mental state and that behaviour is driven by internal mental experiences and they may differ from their own internal mental experiences.

Darren: Beautiful. Wow, when it all comes together, a kind of magic, isn't it? ⁓ a beautiful garden we're going to up with. If we have that ⁓ soil there, the plants are just going to blossom. ⁓

Jo: Absolutely. ⁓ absolutely and I think that's what makes working from an attachment lens so exciting.

Darren: to see where it goes and what we plant and what can grow. really like that Jo. I'm really pleased that we finished back on that image of the garden Before we finish this subject, about a takeaway? Is there anything you want us to remember from this?

Jo: I probably the thing to take away is that clients can only develop theory of mind ⁓ if got their fist brain online.

Darren: Absolutely. Thank you so much, Jo. continue chatting in just a minute. we have our dilemma to finish on Jo for this week.

Jo: Haha!

Darren: this one has been suggested and I ⁓ really like this. The client always late. We've all been What do we do?

Jo: Yes. Well, I think first of all, we have to put some theory of mind into this. we have to think about what is going on for the client. Why are they always late? And I guess there could be lots ⁓ ⁓ for this. The one that comes first my mind ⁓ is That's the first thing that comes to mind. It's hard enough to encourage anyone with an avoidant defense strategy to come into therapy because the last thing they want to do is feel their feelings. They have lots of theory of mind. very in their heads. They can think things through, et cetera, et cetera. But what they often struggle to do is to feel the feelings. And that's quite terrifying. So I guess we can understand it.

Darren: Absolutely.

Jo: from that perspective. what I would say is we want to invite that conversation, that it's okay, that it feels scary. ⁓ maybe for a short period of time at the beginning of the ⁓ you know, how can we make this feel a bit safer for you? How can we encourage you if 15 minutes, if you're a few counselling hours or an hour, ⁓ that feels too much or too intense, ⁓ would make it feel better for you? So that would be my first idea in terms of talking that through with a client. I mean, it could be just, know, we do our sessions on the hour and the local bus doesn't get in until 10 minutes past the hour. So we need to find out, we need to have a conversation. We need to develop that theory of mind for that client. So what's going on for them?

Darren: Yeah practicalities are easily overlooked sometimes. think that we quite understandably look at life through a lens ⁓ and what might playing out. Sometimes what's playing out childcare or buses or roadworks. absolutely. I remember I started the new therapeutic ones, ⁓ I was always late. And that's just because was busy.

Jo: Yeah.

Darren: and I'd over commit myself and it took me a few sessions to learn. No, actually, if I'm going to come here, I just need to leave quarter an hour earlier. is something that's a commitment and I need to be there for it. And it just, yeah, it was just very bad at managing my time. and I don't feel that I was avoiding the sessions so much as caught up in ⁓ rest of my life. ⁓ a busy foster carer who at the time also had a part-time job, ⁓ just felt run ragged and I quickly learned actually ⁓ the help of my therapist ⁓ the therapy space itself could be a bit of a rest ⁓ a bit of a break. ⁓ so by bringing the sessions, ⁓ just slowing them down ⁓ letting them just be a space rather

Jo: Yeah. Yeah. Yeah. Yeah.

Darren: to start with but just a space where I felt comfortable really me into therapy and I'm mindful of that experience with others now ⁓ when I'm the therapy room. ⁓ Don't have rush into therapy, ⁓ don't have start it in the first session, let's just have a chat and get to know each other, ⁓ get to the space. ⁓

Jo: Yeah. You're really talking there, aren't you, a bit like we were saying about getting the hand brain back or the fist brain back online. You know, that soothing, soft way into, yeah.

Darren: Yeah, ⁓ Mm-hmm. Yeah, absolutely. Thank you. I'm really pleased that we've had that discussion. I think I found it helpful. It's been quite, it's reminded me of the importance of just allowing the space to be what it needs to be for the client. So that's great. I think that probably brings us to the end of today's podcast. But before we finish, definitely want to thank Jo for joining us again. Thank you so much, Jo. and you'd like to learn more about the level five and level seven diplomas ⁓ attachment theory and attachment-based psychotherapy ⁓ can find full details at OptimaHealthServices.co.uk Our course is starting in September, don't they Jo? ⁓ And were looking at numbers earlier on, ⁓ they filling up

Jo: They do.

Darren: so if you are ⁓ please do look us up Thanks for listening A Touch ⁓ it's been great to have with us ⁓ and we'll see you time