Between Us: A Psychotherapy Podcast
Episode 56: Reclaiming the Relational
Date: August 6, 2025
Host: John Totten
Guest: Roy Barsness
Co-Producer: Mason Neely
Overview
This episode of Between Us is a deep dive into the heart of relational psychotherapy, centering on the work and recent book of psychotherapist and supervisor Roy Barsness. Host John Totten and Barsness explore the evolution of relational theory, the importance of authentic presence and emotional openness in psychotherapy and supervision, and the radical, sometimes messy, co-creation at the center of meaningful therapeutic relationships. The conversation is infused with personal anecdotes, reflection on theoretical giants like Stephen Mitchell and Jessica Benjamin, and practical insights from Barsness’ new book, Psychodynamic Supervision Theory and Practices in a New Key. The focus is on reclaiming lost potentials—not retreating into the past, but using foundational relational theories to move the field forward.
Key Discussion Points and Insights
Revisiting the Roots of Relational Psychoanalysis (05:00-08:00)
- John Totten reflects on his theoretical allegiance to Stephen Mitchell and relational theory, noting a current backlash in the field toward more rigid, boundary-focused perspectives.
- Totten frames the episode as a journey: “I’m interested in revisiting the past to help me move forward.” (06:24)
- Mitchell's idea of constructive disintegration: Regression isn't just returning to primitive states, but can be an expansion—reclaiming lost potentials rather than a retreat.
The Emotional Realities of Therapy – Letting the Patient In (07:04-09:15)
- Roy Barsness discusses the deep emotional impact of having a patient share their positive therapeutic experience in public:
- “I probably wanted to be by his side and participating with, and not being a listener, but being a participant with them and sorting it all out together... We’re not outsiders, we’re inside, we’re co-participants, we’re creating and recreating a patient’s story as it infects us and impacts us.” (07:18)
- Barsness emphasizes allowing the patient to penetrate the therapist’s emotional life as integral to effective relational therapy.
Supervision in a New Key – The “Essential I” (09:13-17:04)
- Barsness describes the genesis of his new supervision model, built on therapists showing up authentically and affectively in supervision—not just “outside” the patient’s story:
- “Where are you? Where’s your fucking essential I?” (10:09)
- Redefines traditional supervision:
- The supervisee knows their patient best; supervision should help unlock that knowing, not impose the supervisor’s analysis.
- Barsness discovered a shift when, instead of focusing on patient behavior alone, he asked: “When you’re sitting with this patient, what are you feeling?”
- Authentic affective engagement becomes central—even when it elicits anger, boredom, erotic feelings, or discomfort.
Notable quote:
“Patients need to know we can be pierced, that we can feel, react and engage in multiple and complex affective states, including the negative, frightful states that are aroused... Too much therapy is conducted in the constant presence of each other's absence.”
– Roy Barsness (15:05)
Empathy vs. Authenticity (15:27-16:11)
- Barsness critiques contemporary, sanitized notions of empathy:
- “No, patients want from us a real response… even when we make mistakes, ... if we’re willing to stay in the fray, that’s when the work gets alive.”
Supervision as Co-Participation and Messiness (17:04-23:05)
- Barsness discusses the implications of embedded supervision—supervisors are in the process, sometimes getting caught in parallel processes or enactments.
- Example: A supervisor inadvertently acts out family roles from the patient’s history and is challenged in-session.
- The “third” (Jessica Benjamin): The co-created psychic space, the “in-between,” where transformational moments happen.
- Humility and radical openness are necessary; supervisors solicit honest feedback about their presence and impact.
Notable theoretical summary (on “the third”):
“The third is a position constituted through holding the tension of recognition between difference and sameness, taking the other to be a separate but equivalent center of initiative and consciousness, with whom nonetheless feelings and intentions can be shared.” (20:45, Benjamin via Totten)
The MAMAL Model for Supervision (23:05-34:40)
Barsness unveils his supervision model, its key components forming the acronym MAMAL:
M: Muse
- The case is not an object to dissect but a muse for all present—everyone is impacted, and everyone’s reaction is considered.
A: Affect
- “What is the affective states that are getting stirred?”—the first question is always about emotion.
M: Metabolization
- Transforming the felt affect into meaning, exploring personal and developmental resonances, not just intellectual insight.
A: Articulation
- Bringing genuine, lived affect into the therapeutic moment. “Can you really find yourself bringing yourself into a genuine kind of meeting with your patient?” (34:18)
L: Learning
- “What have we learned today?”—for self, for theory, for practice.
Key insight: The model shifts focus from the patient as object to a co-created subjectivity within supervision and therapy.
Example: Working with the “Annoying” Patient (35:08-41:03)
- Totten shares a clinical vignette about a patient who chronically disqualifies positive feedback.
- Totten’s spontaneous, “off-script” intervention (“She had to take a shit”) opens a playful, authentic space that shifts both his and the patient’s emotional stuckness.
- Barsness interprets this as metabolization in action—“something stuck here... it needed a laxative.”
- They discuss the importance of using mistakes or misreads as opportunities for joint meaning-making:
- “I’m allowed to get you wrong, but then you have to help me figure out why I thought of that.”
- “I get a read of you, but it’s only sort of a read. And the only way I can get a good read is if we read it together.” (41:16)
Therapist Presence, Self-Disclosure, and Ethics (43:29-48:18; 54:43-56:30)
- Barsness distinguishes personal self-disclosure from relational disclosure:
- “My whole work is about relational disclosure, not self disclosure... patients don’t really seem that interested in my personal self disclosure. And I’ve never seen it useful... what matters is how we show up, not what stories we tell.”
- The ethics of non-disclosure: Withholding is sometimes unethical if important relational dynamics remain unspoken, potentially harming the patient.
- “I made my patient very ill by my refusal to [disclose]... I think that’s unethical and we should be talking more about that.” (56:05)
Going “Home” and Belonging (48:41-54:40)
- As a coda, Mason Neely and John Totten reflect on revisiting literal and psychological “home,” drawing parallels to revisiting theoretical and professional roots in psychotherapy.
- The search for “our people” is ongoing, but true belonging may come from shared openness and creative searching rather than rigid identity or technical mastery.
- Radical openness is posed as the antidote to staid, technique-dominant training:
- “We have to be radically open to ourselves and radically open to our patient... the idea of being non-judgmental is nonsense—we are judgmental people. So what do we do with that judgment?” (54:43)
Notable Quotes & Key Moments
-
On relational impact:
“We’re not outsiders, we’re inside, we’re co-participants, we’re creating and recreating a patient’s story as it infects us and impacts us.”
(07:35, Roy Barsness) -
On patient need:
“They want to know they have an impact.”
(15:24, John Totten paraphrased—Roy agrees) -
On the limits of expertise:
“Quit being the expert... let that patient get inside of you as the supervisor.”
(42:41, Roy Barsness) -
On mistakes and repair:
“I’m allowed to get you wrong, but then you have to help me figure out why I thought of that.”
(41:26, John Totten referencing Barsness’ teaching) -
On radical openness:
“One of the problems we have in our trainings... is it’s so staid and technique dominant... I say this idea of being non-judgmental is nonsense... So what do we do with that judgment?”
(54:43, Roy Barsness)
Key Timestamps
- 05:00 Revisiting Stephen Mitchell and relational roots
- 07:04 Barsness on the emotional impact of a patient’s public compliments
- 09:13 Barsness introduces the “Essential I” and the centrality of therapist’s subjective presence
- 14:00-17:00 The paradigm shift: therapist affect, not just patient affect
- 20:00 Explaining “the third” (Jessica Benjamin) and co-created subjectivity
- 23:31-34:40 MAMAL supervision model explained
- 35:08-41:10 Clinical anecdote: working with stuckness and annoyance
- 43:12 Blurring the patient/supervisee distinction, the therapy-supervision parallel
- 54:43-56:30 Radical openness, the ethics of non-disclosure
- 56:30 Wrap up and mutual appreciation
Summary Takeaways
- Relational therapy and supervision require radical openness, humility, and a willingness to be affected—to be “pierced” by the other.
- Supervision is not about expertise or objectivity, but messy, authentic, co-created meaning and presence.
- Therapists and supervisors must pay attention to their own affect—what the patient or supervisee stirs in them; metabolize these responses, and bring them genuinely into the dialogue.
- Mistakes, misreads, and ruptures are not failures but fertile ground for new understanding—if processed together.
- Returning to foundational theories isn't nostalgia, but a creative means to move forward and expand what's possible in therapy.
This episode is essential listening for therapists, supervisors, and anyone interested in the relational depths and transformative potential of honest, emotionally alive psychotherapy.