Three Common Clinical Dilemmas in Psychodynamic Supervision — And How to Approach Them
Therapeutic work asks us to listen on many levels at once — to our clients, to ourselves, and to the relationship unfolding between us. It’s no surprise that moments of uncertainty, emotional intensity, or “stuckness” arise. These are not signs that something has gone wrong; often, they are signals that something important is trying to be understood.
Supervision offers a space to gently unfold these moments, looking not just at what is happening with the client, but also at how the work is affecting you and how the therapeutic relationship is being shaped.
Here are three common dilemmas that frequently come into supervision, and ways of approaching them with curiosity and care.
“I Feel Stuck With This Client”
Feeling stuck can show up in many forms: sessions that feel flat, repetitive, confusing, or emotionally draining. You might notice boredom, irritation, helplessness, or a sense that nothing is moving.
In supervision, we begin by exploring the client’s world — what might be happening in their life or internal experience that could be contributing to this sense of impasse? But we also turn our attention to your experience in the room.
Questions supervision might explore include:
What do you find yourself feeling during or after sessions?
Do you feel pulled to do more, or to withdraw?
Does the stuckness belong only to the client, or is it something being shared between you?
Often, the therapist’s emotional responses are not accidental; they can offer clues about the client’s internal world and relational patterns. A feeling of deadness, for example, may echo a client’s own disconnection. A sense of pressure to “make something happen” may reflect a familiar dynamic in the client’s relationships.
Supervision becomes a place to think about these shared emotional experiences, helping you move from self-criticism (“I’m not doing this well”) to understanding (“Something important is being communicated here”).
“I’m Unsure About a Boundary Situation”
Boundary dilemmas can feel particularly exposing. Perhaps a client asks for extra contact, gives a gift, connects on social media, or shares something that stirs a strong wish in you to protect or rescue them.
Supervision certainly needs to consider ethical frameworks and professional responsibilities. But alongside these practical considerations, it can be just as important to explore the emotional and relational layers.
Together in supervision, we might ask:
What might this boundary pressure mean in the client’s relational history?
What feelings does this situation stir in you — guilt, anxiety, protectiveness, resentment?
How are you being positioned in the client’s inner world?
At the same time, supervision pays attention to how you are holding the therapeutic frame. Are you feeling confident and grounded in your role, or pulled off balance? These moments often touch on deeper themes of care, dependency, and separation.
By reflecting on both the structure of the therapy and the emotional meaning of the boundary challenge, supervision helps you respond thoughtfully rather than reactively — holding firm where needed, while staying emotionally attuned.
“I’m Carrying This Client Between Sessions”
Sometimes a client lingers in your mind long after the session has ended. You may find yourself worrying about them at night, replaying conversations, or feeling unusually responsible for their wellbeing.
Supervision offers space to explore this on several levels:
What is happening in the client’s life that may be contributing to this sense of urgency or concern?
What are you noticing in your own emotional and physical responses — anxiety, protectiveness, exhaustion?
Does this dynamic echo patterns in the client’s relationships, where others have felt overly responsible or overwhelmed?
It can also be important to notice what is happening in your professional role. Are you feeling stretched beyond your usual boundaries? Is it hard to step back into your own life after sessions?
These experiences often reflect powerful relational currents. Clients who have known neglect, instability, or emotional absence may evoke a deep wish in the therapist to “hold it all together” for them. Supervision helps you stay compassionate without becoming overburdened, allowing care to be shared and thought about rather than carried alone.
The Value of Thinking Together
Across all these dilemmas, one theme runs through: the work affects us, and those effects are meaningful. What happens in the therapy room does not stay neatly contained there — it lives in our thoughts, feelings, and bodies.
Supervision provides a reflective space to look at:
The client and their inner world
The therapeutic relationship between you
Your own emotional responses and professional role
By gently bringing these layers into awareness, supervision helps transform confusion into understanding, emotional weight into shared reflection, and self-doubt into growing confidence.
In this way, difficult moments in clinical work become not just challenges to manage, but opportunities for deeper insight and development — for both therapist and client.
If you’d like to speak to someone, please get in touch with me or try the below links to find the right therapist for you.
