Three Associating: Adventures in Relational Psychoanalytic Supervision

In this episode, Rachael⁠ revisits the complex feelings that child sexual abuse evoke in both patient and therapist. Rachael discovers that her wish for magic powers has not disappeared and has reappeared in a different form. Beyond this, Rachael contacts both the magic and the terror of the therapeutic journey itself and the loneliness this sometimes produces in the therapist.

Both Gill and Rachael conclude that while trauma itself is to be regretted, the person that we emerge as in the wake of trauma is to be embraced as a crucial and valuable aspect of our autobiography.

In this episode, Andrew surprises himself by the degree to which his patient has led him into dissociating from his own inner subjectivity and into merging with the patient's agenda. This agenda, in turn, reflects the patient's merged state with his partner so that “two become one”.

Andrew is able to use supervision to take up a third position and to take a perspective which frees him to use his own thoughts, thereby helping the patient shape his own subjectivity independently of his partner.

In this episode, Rachael approaches the taboo of sexual attraction in therapy and its tendency to lead to dysregulation, involuntary self-disclosure, and shame. 

Rachael's feelings unduly amplify her self-consciousness, complicating the ongoing therapeutic task of understanding her and her patient's contribution to the co-construction of their relational field.

After engaging Rachael in a discussion of the reality/fantasy divide and the difference between voluntary and involuntary self disclosure, Gill invites a recourse to theory both as a stabilising force in the choppy waters of the embodied and as a way of retaining the boundaries of supervision versus therapy.

In this episode it becomes clear that Andrew and his patient Manuela are unconsciously co-constructing a dynamic in which Manuela is under pressure to be cultured and cool in order to maintain Andrew's admiration, while Andrew is under pressure to take up a lesser position. As the supervision unfolds, Andrew becomes aware of how his envy is at the heart of this dynamic and how he is projecting certain longings onto Manuela. He becomes aware this leads to both an underplaying of Manuela’s limits and vulnerabilities and the overplaying of his own and keeps her stuck in a relational impasse. In the session, Andrew moves to a more balanced perception of Manuela’s plight and a greater recognition of his own contribution to her relational dynamic.

Rachael comes to realise that feeling provoked by the patient’s apparent self-centredness in enactments that occur in the waiting room and in the session has led to a wish to be provocative in return. She first enjoys then tussles with revenge fantasies. By talking through these fantasies and owning their pleasure, she recognises their meaning, and this opens up multiple perspectives.