The unconscious impact of caring for acutely disturbed patients: a perspective for supervision

This paper is concerned with the emotional experience of working with acutely disturbed patients. It examines how the disturbance of the patient unconsciously impacts upon the nurse. Using a model of the unconscious, based upon classical psychoanalytic theory, a psychodynamic approach to clinical supervision in a group setting is described. This supervision process was found to be helpful in the therapeutic process, identifying unconscious dynamics as well as alleviating some of the distress of the clinical work. Vignettes illustrating this process of psychodynamic group supervision are presented.