On the strengthening and enlivening influence of being with patients and supervisees

Abstract

Analytic writers have studied existential anxiety or annihilation anxiety, emanating from traumatic disruptions to people’s sense of going-on-being, reminders of their finitude, and facing a chaotic reality, and suggested that they can endure this anxiety by being with and living through it together with another person. The literature suggests that to be with patients who experience such anxiety, therapists need to indulge “narcissistically” in their own memories and fantasies of similar experiences, and, in parallel to the patients, enter transient regressive states. Sometimes, however, therapists are faced with a chaotic analytic reality that arouses existential anxiety in themselves, and seek to share it with their supervisors who, by experiencing parallel regressive states, can identify with their supervisees and grasp their experiences. Supervisors who consistently fail to be with their supervisees at such moments and persist in offering them new constructions of therapeutic materials might strengthen the supervisees’ defensive operations and disrupt their development as therapists.

Key words:

• supervision
• being with
• chaotic reality
• regressive states
• existential anxiety

Additional information

Notes on contributors

Hanoch Yerushalmi

Hanoch Yerushalmi, PhD, is a clinical psychologist in Israel, professor emeritus at the Department of Community Mental Health, University of Haifa, Israel, a Consulting Editor for the journal Psychoanalytic Social Work, USA, and a member of the British Association for Psychoanalytic and Psychodynamic Supervision. He was formerly the Director of the Student Counseling Center director and a Senior Lecturer at the Hebrew University in Jerusalem. Professor Yerushalmi has served as a consultant to psychotherapy centers in Israel, the USA, and Central America, and published numerous articles on relational psychoanalytic therapy, supervision and therapists’ development, crisis and growth, and psychiatric rehabilitation.