ABSTRACT
As I reflected on Orsoly Hunyady’s chapter, an image of two people swimming in the sea appeared in my mind. As therapists, we may make a conscious decision to remain on land and look out on the sea that affects our patients – shouting instructions to them from the shore. Alternatively, as illustrated in Hunyady’s chapter, one can dive into the water and navigate the waves with our patients. There are dangers and rewards in each approach. To remain on land may allow a therapist a broader view of what’s happening, and sometimes what’s coming; however, it may also leave a therapist removed and distant from the reality of the patient’s experience. In contrast, diving in may bring the therapist visceral knowledge of the patient’s experience, and affirm to the patient that the therapist is willing to be “in it with them.” But this knowledge may be gained at the cost of a broader perspective on the changing conditions at sea. Diving in also places the therapist in danger of drowning in the same vortex of intense emotion that threatens to swallow up the patient. In addition, the patient’s reactions may sometimes be unpredictable – clinging desperately, flailing, or, like Sally, choking the therapist out of transferential feelings of ambivalence at being saved. Diving into the sea with a patient is a riskier course of action but sometimes it may be the only way of saving another. It requires a strong swimmer, entailing both sensitivity to the patient’s response to the conditions in the water as well as attentiveness to the therapist’s own experience of the water. I know Orsoly well and I believe she would say that she does not know any other way to do this work than to dive in and swim as closely alongside her patients as possible. I also know that Orsoly is a very strong swimmer and the chapter provides a unique and valuable glimpse into what is involved in this kind of work.
