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Internal supervision, according to Casement is “What I was thinking in the session and how I arrived at each intervention”. With a large number of apposite vignettes one is skilfully drawn into the world of the therapist, behind the scenes as it were, in his interaction with the patient. The reader is able to savour the intimacy, the concern, the lapses, the warts and all of the clinical interaction.
Many vital areas of psychotherapy and psychoanalysis that are difficult to know about, let alone write honestly about, are investigated in this book. There are interesting chapters on containment and analytic holding under pressure as well as an important appendix on confidentiality. He takes a broad clutch of references and often utilises, side by side, concepts of Winnicott and Bion.
Generally this is a book about countertransference phenomena. In 1919 Ferenczi wrote “If the psycho-analyst has learnt painfully to appreciate the countertransference symptoms and achieved the control of everything in his actions and speech, and also in his feelings, that might give occasion for any complications, he is threatened with the danger of falling into another extreme and of becoming too abrupt and repellent towards the patient; this would retard the appearance of the transference, the pre-conditon of every successful psycho-analysis, or make it altogether impossible. This second phase can be characterised as a phase of resistance against the counter-transference. Too great an anxiety in this respect is not the right attitude for the doctor, and this is only after overcoming this stage that one perhaps reaches the third, namely, that of the control of a counter-transference.”
“Only when this has been achieved, when, one is therefore certain that the guard set for the purpose signals immediately whenever one's feelings towards the patient tend to overstep the right limits in either a positive or negative sense only then can the doctor “let himself go” during the treatment as psycho-