Episode 4: Twinning Isn't Always Winning

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 therapy, Noor unconsciously communicates her grief. Andrew initially struggles to recognise this as to do so involves him in accepting loss himself. Andrew is helped by his unconscious, which reveals itself in the session both through an enactment of a jet lagged state, and an understanding of what the words jet lag signify. Thus, an understanding of both the music and the the words of the session, as it developed in supervision, allowed a paradigm shift  from intellectual defence to emotional engagement.

17 Aug 23min

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 Rachael to be mean and partake of the jouissance of revenge. By unpacking her own unconscious with Gill, it becomes clear to Rach that her countertransference wish is a clue to the patient's fear, which is preventing her from surrendering into the patient position.

13 Jul 23min

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 affects when words are off limit and the patient wishes to screen off pain and to avoid facing into the void. Questions are raised about the perils of going along with the patient's wish not to speak the unspeakable as well the dangers of not doing so.  All the while, the affective registration of Rob's screened off trauma persists at somatic and affective levels in Andew as an embodiment of Rob's traumatic memories. The power of this is barely tolerable and Andrew feels doomed if he does speak and doomed if he doesn’t, but in the supervision he explores the possibility of a third way and finds a way out of the binary.

15 Jun 29min

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 is incumbent on them to bracket them. They also agree it is fair to question the patient about the consequences of their new found comfort with problematic actions and to explore if the comfort is authentic or defensive. However, Andrew and Gill also accept that they may be defending themselves against accepting the patient's comfort with a lack of empathy for those in his ambit. They are left with the question 'Whose defensiveness is it anyway?'.

11 Mai 25min

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 pleasures and perils that they engender.At the end of the session, Rachael and Gill concluded that whatever side we finally land on in the resolution of inner conflict, it is essential to own the outcome and to stay authentic and transparent.

16 Apr 28min

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 these dynamics. He moves from a wish to confront binaries and from an appeal to both/and thinking to understanding the feelings underpinning either/or thinking, projection, and othering.Andrew comes to see how his own responses have been subverted by this extremely pressuring dynamic and returns to the capacity to go meta to himself and to the transference/counter-transference matrix

2 Mar 24min

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 constructing and applying lists of red flags. Rachael tries to shift the agenda to fostering agency,  but to no avail.  In supervision, Gill asks a series of questions which leads Rachael to her own conclusion that her own narcissism constellated around the “need to know”. A common dynamic in therapists is implicated in this therapeutic impasse.

2 Feb 25min

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 speaks of her engagement in this practice as a means of regulating her affect. Rachael comes to understand that her reaction to Petra’s request was connected to wanting not to judge Petra’s engagement in human suspension and also wanting not to turn a blind eye to the trauma that could be "implicated” in Petra’s activity. Thus, Rachael comes to understand her own reaction as pointing to the need to integrate both the positives and the problems involved in Petra’s chosen mode of mastery and self soothing and to engage with both traumatophilia and traumatophobia (Saketopoulou, 2023).

22 Des 202425min