By Pauline Andrew

In July this year a much-loved client of mine died.  Yes, I did grow to love her over the 14 years we worked together.  Yes, 14 years.  And her death affected me profoundly.

Already some noses may be twitching and eyebrows raising.  I can hear whispers of boundaries and enmeshment.  That’s ok, I’ve got used to it.  When you work with someone who has Dissociative Identity Disorder (DID) you learn to seek out other counsellors who understand, and we huddle together for warmth.

I never knew I had the capacity to bear such a horrific story; I’d always seen myself as a sensitive soul who steered away from graphic details.  But in my work with M, I didn’t really have a choice.  I was her witness, her champion, her secure base, her friend who laughed at the same crazy stuff.

I was also a good-enough parent to the dozens of devastated inner children who shared the body with her, who had never before known tenderness or comfort, with no hidden agendas, no sexual content and nothing demanded in return.  It was life-changing.  Her courage and her determination to be ‘normal’ equally inspired and changed me.

So there I was, sometimes breaking the rules, often taking risks, sharing my soul and giving my heart... so who would supervise this work?  Who would hold me as I held my client?  Who would hear me through, without sucking in their cheeks with an “I’m not sure about this” frown?

Davys & Beddoe (2010) suggest that “The Supervisor must value exploration, tolerate uncertainty, accommodate difference and remain open and curious about possibility”.  And that’s exactly what I needed, and found.

Adah, my supervisor for the last six years of this work, was a blessing beyond measure to me.  When M died, she said, “Just come...”  I went to her house on Bank Holiday Monday in August, a month she doesn’t see clients or supervisees.  “This isn’t work,” she told me.  And she let me pour out all the feelings.  She didn’t even let me pay.  Like The Shepherd, she restored my soul.  She also understood that clients can win our hearts.  And in my sorrow, I felt held, comforted and loved by my supervisor.

Carl Rogers (1980) shared his feelings on this subject:

Brian Thorne (1991) picks up this point:  “I recognised instantly that to offer clients the kind of relationship characterised by the presence of the core conditions was, in practice, to love them.”

Ladany & Bradley (2010) suggest ten qualities that supervisors need:

1.       Integrity

2.       Courage

3.       Sense of humour

4.       Capacity for intimacy

5.       Sense of time

6.       Openness to self-inspection

7.       Responsibleness

8.       A non-threatening, non-authoritarian approach to supervision

9.       The capacity to be flexible, tolerant and open to various styles and levels of learning

10.   Confidence and professional assurance

Is it the ‘capacity for intimacy’ that comes closest to love?  Are we afraid to use the word itself in the context of any kind of therapeutic relationship?

Interestingly there is no mention of experience either in Ladany and Bradley’s list, nor of training or specialist knowledge.  Maybe that’s covered in ‘confidence and professional assurance’.  For me it was Adah’s specialist knowledge of Dissociative Identity Disorder (DID) that first took me to her door, and the knowledge that whatever I was facing, she’d heard worse.

Kindness in the supervisory relationship is, to my mind, crucial if we are to share our failings, our inadequacies and our weariness.  Above all, when working with issues such as complex PTSD, dissociative disorders, personality disorders and core attachment issues, we will need a secure base It has long seemed to me that ‘love’ in our work as psychoanalytical psychotherapists has been much neglected. I believe that most patients who present for analysis or psychotherapy feel themselves quite unlovable at some very deep level. My hypothesis inthis chapter is that until and unless there can be felt moments of love for the patient bythe therapist, the patient is not able to develop fully. I think it is only when a patient canarouse our deepest loving feelings (not empathy) that we can really hope for a truly positive outcome from our work.to run to when we feel we’re heading for melt down.

We may be the most educated, experienced professional in the world, but the message of 1 Corinthians 13 makes it clear that without love we aren’t up to much.  As The Message puts it, “If I speak with human eloquence and angelic ecstasy but don't love, I'm nothing but the creaking of a rusty gate.” 

And loving isn’t the same as sloppy sentimentalism or overlooking bad practice.  It sometimes has to be tough and make hard decisions, including fitness to practice and ethical or moral strictures.  But if the truth is truly spoken in love, then we’re in with a chance of a good outcome.

So, bearing all this in mind, how do I know, as a supervisor, if the love a supervisee claims to feel for her client is healthy... or maybe something different?

Many clients deep down feel quite unlovable.  The therapy room may present them with someone who accepts them non-judgementally for the first time in their life, and the feelings can be confusing.  They can feel like ‘love’.    Freud, Jung, Ferenczi and others were absorbed by erotic transference in the therapy room.  Ferenczi said, “It is the physician’s love that heals the patient”.  But you only have to watch the film “A Dangerous Method” to see how different their days were!

As a supervisor I need to listen with big ears.  Can I discern whether the love my supervisee claims to feel for her client is a genuine altruistic caring, or something more worrying?  Research undertaken by Pope & Tabachnick (1993) suggested that around 87% of therapists had been sexually attracted to at least one or their clients!

It is exactly in the supervision room that our feelings for our clients need to be explored in order to keep everyone safe.  If we are scared of being judged or misunderstood, the chances are we won’t raise the issues and that can lead to disastrous consequences.   Whether we call it countertransference or simply falling in love, it needs careful handling, not to shame, but to take the appropriate steps to protect both client and supervisee in what could be a time bomb waiting to explode.

If the counsellor suspects that there is idealising transference towards them which the client is mistaking for romantic love, this needs to be brought into the therapy room and explored openly.  In many cases it is the child within the client who is desperately seeking love and senses they have finally found ‘the one’ who can give it.

Once this has been recognised, it can hopefully lead to some deeper levels of insight and the relationship restored to a securer footing.  It is essential that all this is taken to supervision.  The parallel process is clear:  if the counsellor isn’t addressing it in supervision, the chances are s/he is not confronting it in the counselling room.

When I first began my training, supervisors were just really experienced therapists who drew on their years of working with clients.  They were the parent figures of the counselling world, and in the very early days, not many of us had (m)any qualifications at all.

In the 1920s newly qualified psychoanalysts were required to have supervision and the supervisor was a major authority figure.  The boundaries between supervision and therapy were more blurred, and if a supervisee dared to confess to difficulties in their practice, these were deemed to be indications of professional failure!  “Trained and experienced practitioners resisted the idea of supervision, considering it an insult and a suggestion of incompetence!”  (Davys & Beddoe, 2010)

We have a healthier attitude to and respect for supervision today; but there is still a need for professionalism and I am passionate about supervision training, especially in this complex and often litigious world.  Teaching supervision diploma students is one of the great joys in my life.  And underpinning all our knowledge and training I believe there is room to be loving.

I like the encouragement in 2 Peter 1:5-7 (TM):  Don’t lose a minute in building on what you’ve been given, complementing your basic faith with good character, spiritual understanding, alert discipline, passionate patience, reverent wonder, warm friendliness and generous love, each dimension fitting into and developing the others.”