Box 3.

Case Vignette - Example of Using Role-Playing During Supervision

Supervisor: So, I understood your patient “shuts down” and answers that she is not able to explain when you ask her about her thoughts and emotions, especially in the situations when you recognize that she criticizes herself. Therapist: Yeah, and I feel extremely helpless in these situations – as if there are no possibilities for intervening with this criticism. Supervisor: What do you think about trying to play it out? If I pretend I am here, and you are in your own role? Therapist: OK. So, Kate, when you go down the street and feel that other people look at you, can you describe more about what are your automatic thoughts at these moments? Supervisor (in the role of the patient): I cannot explain, and I cannot tell it. I do not know (looks away). Therapist: I see it is hard to talk about it. You do not have to tell it perfectly. Just try to describe. Supervisor (at the role of the patient): Looks away, do not talk. Therapist: Kate, let us try to talk about something else. Supervisor: Thank you for this great showing how it looks like! I could feel how difficult it is for you to be with this, and it seems like this part of her almost totally controls both of you. Let us try to change the roles! Therapist: OK. So, I am Kate now. Supervisor (therapist’s role): Kate, when you go down the street and feel that other people look at you, can you describe more about what are your automatic thoughts at these moments? Therapist (in the role of the patient): I cannot explain, and I cannot tell it. I do not know (looks away). Supervisor: Kate, I understand how hard it is to talk about it. Still, please, look at me! Therapist: Looks at the supervisor Supervisor: Great, thank you, it is so nice that you can see me and I can see you. I really feel how hard it is; it seems you feel like you are just forced to escape from me as if you are afraid. Can it be like that? Therapist: Yes … it is like … I know you will not criticize me, but it feels like you will. You will think I am crazy, totally ill, and do not deserve to be in this world. Supervisor: Sound so hard and painful. These words: do not deserve to be in this world – do they remind something from your past? Therapist: My grandmother. She told me often that I was spoiled like my mom and did not deserve to be in this house. Supervisor: I see … These were such horrible words … And it is something you expect from me somehow, and from other people … Like she continues to control you and me … Sound great; that you for this roleplay! What does it look like for you now? Therapist: Thank you, I got it! It was so important that you asked me as a Kate to look at you directly, without the possibility of avoiding the contact. You did not let grandmother control the space, and it will help me do it, also.