beginnercountertransferencetransferencesupervisiondependent personality disorderpsychodynamictherapeutic relationship
A PMHNP providing psychotherapy to a 30-year-old man with dependent personality disorder notices that she has begun dreading their sessions. She realizes she feels irritated and trapped when the patient calls between sessions seeking reassurance, and she has started giving brief, dismissive responses. In supervision, she recognizes that the patient's excessive dependency is evoking a reaction in her that mirrors how others in his life respond, eventually rejecting him and confirming his belief that he is a burden. The supervisor helps her identify this pattern as a therapeutic phenomenon that, if understood rather than acted upon, can provide valuable clinical information about the patient's relational world.