Three Associating: Adventures in Relational Psychoanalytic Supervision

In this episode, Andrew encounters a patient whose stated objective is to own her own competence and self assuredness and to be more like him. Andrew anticipates encountering a people pleaser and is surprised when he encounters a lack of it. The patient stonewalls him in particular moments  She resists his attempts to move closer by masking her anger and collapsing into tears and shutting him down...

In this episode, Rachael gets tangled up in her own anger and hostility towards her patient on behalf of the patient’s daughter. While trying to distance herself from the patient's enmeshment with the daughter she inadvertently gets enmeshed herself in the patient’s dynamic.  By more fully accessing her anger with the patient and realising that in her mind she has been treating the daughter ra...

In this episode, Andrew struggles with the question of therapy terminable and interminable. He faces an ethical dilemma as to whether continuing therapy with a particular patient who has made considerable gains would be in some way unethical. Andrew⁠ is thoughtful about the issue of fostering dependence which is an important issue to consider. However, he finds through supervision that he has unco...

In this episode, Rachael struggles with her own feelings about her therapy being cut across by a psychiatrist who seems to be opposed to long term therapy.  She feels activated especially as the patient has asked her to intervene and contact the psychiatrist.  In supervision, she engages with her frustration at the interference in her treatment and her therapeutic relationship and also her anger i...

In this episode, Andrew presents an unusual situation where a patient requires his partner to be present in his therapy not to work on couple dynamics, but as a benign observer.  Andrew finds himself unable to resist this demand both because Andrew is ideologically opposed to imposing his will on the patient and because he can’t in the moment think why the patient’s preference should be resisted. ...

In this episode, Rachael struggles with her impulse to be castrating when she encounters what she experiences as an impenetrable patient, a Citadel.  She is irked by the patient constantly batting away her interventions and seemingly needing to know better than her. In this episode, she and Gill discuss a stinging intervention that Rachael made. The problem was less the intervention itself than Ra...

In this episode, Rachael plumbs the mysteries of the erotic, both in the transference and the countertransference; mysterious because it occurs in liminal or transitional space as Winnicott would say. It is a space of illusion and disillusion where it is not clear what belongs to who. Both Rachael and her patient playfully enjoy the experience, while both in their own way bring in a third to dilut...

In his therapy with Noor, Andrew comes to realise that he is inadvertently co-constructing an avoidance of grieving and mourning. Through a careful unpacking of enactments in the room, Andrew comes to see how mini separations and losses within the therapy caused by sessions ending and holidays taken influence both the content and process of therapy. Through modifications in the pace and rhythms of...

In this episode, Rachael encounters the uncanny intelligence of the patient's unconscious. The patient, having criticised Rachael for her “messy” management of her clinical practice then adopts the same management style and surreptitiously benefits from it.  Feeling guilty, the patient has a dream revealing these dynamics but withholds her insights from Rachael. This produces a desire in Racha...

In this episode, Andrew finds himself embodying traumas the patient has experienced but has placed an explicit prohibition on articulating. During his therapy sessions with Rob, Andrew respects this prohibition. There is much else to speak about and the session feels lively. However, after every session Andrew feels strangely dead, reflecting a limit on his capacity to comfortably process powerful...

In this episode, Andrew presents us with an insoluble ethical dilemma. Is it desirable or even possible for therapists to remain neutral when the patient lives by a value system very discrepant from their own and seems to do so comfortably and credits the therapy for this outcome? Andrew and Gill agree that therapists are not neutral as they have their own moral compasses, even if they believe it...

In this rich episode, Rachael grapples with a variety of complex nuanced issues such as an unexpected ending and the feat of balancing the therapist's self interest with the patient’s interest in a number of domains, including payment. Also on the table were inner conflicts around masochism and self care and the potential risks and rewards of playfulness and creativity and the inherent pleasur...

In this episode, Andrew struggles with the power of splitting and projection as they close down thought, generate anger, and diminish compassion. He gets caught in these dynamics and struggles with his own reactivity as anger and defensive intellectualisation  masquerading as thinking emerge in the therapy space. Through supervision, Andrew realises the fear and existential threat that underpins t...

In this episode, Rachael works with a young woman who is desperate to find the right man and equally desperate to find a failsafe way to make a good choice. A prolific consumer of social media, she scours all the information about red flags that are meant to help someone spot a narcissist (e.g. lovebombing, gaslighting, self-centredness). She appeals to Rachael to assist in this endeavour of const...

In this episode, Rachael is conflicted about performance artist Petra's wish for Rachael to watch a video of Petra engaging in human suspension.  Rachael has an immediate countertransference feeling that she doesn’t want to be “implicated". Rachael does not understand this feeling as she is aware of the mastery involved in this activity and also Petra's pride in her ability. However, Petra also sp...

In this session, Andrew is confused by why Amber, an anorexic adolescent woman, is so silent in session when she chats easily with other team members. Andrew is sidetracked both by his anxiety about his position in the team and his anxiety that he is getting it wrong.  In supervision, Andrew comes to understand that his different treatment by Amber may signal something positive including  Amber's...

In this episode, Andrew finds himself conflicted. His talented young patient reflects a contemporary set of values and ideas that Andrew wishes to honour, but he has a nagging sense that Jaxx is running ahead of himself. He is caught between admiring Jaxx’s resilience and wondering about the cost. But Andrew is not sure if his worry reflects a more conservative world view in himself or real potent...

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 Racha...

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 u...

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...

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...

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.

In this episode, Rachael encounters a worthy adversary in the elegant and charismatic Iris. Beguiled by Iris charm and colourful stories Rachael can’t help feeling seduced.  However she also feels manipulated and is  irritated with herself and Iris.  Nevertheless she still feels the pull to captivation in the session. In the end, Rachael ⁠ realises that the most worthy adversary that she has is he...

In this episode, Andrew struggles to disrupt his patient's rigid self-control, ever mindful of a psychotic potential that could be unleashed given the patient's history of experiencing a psychotic episode. Andrew experiences both the seductions of a meeting of minds and the potential tyranny of his patient's mind that fears the body, its appetites, and affects.

In this episode, Rachael is provoked by a disrupted patient. Power struggles and challenges emerge in the room as Rachael struggles to think and not enact in the face of the patient's enactments.  Technical questions of courageous speech versus disruptive challenges are engaged as Rachael shows great integrity and courage in taking in the challenges of supervision to come to an expanded unders...