Presence of the Therapist

by Mar 23, 20240 comments

Blog by Dawn Sather, RSW, RCC, RCC-S

‘It is a joy to be hidden, but a disaster not to be found.” D. W. Winnicott

Reflecting on the quote by psychoanalyst and pediatrician Donald W. Winnicott (2005), one could imagine you are a child playing a game of hide and seek. How quickly your delight and joy of hiding is lost when no one comes to find you. The game continues to be played, while you remain unfound.

We are social beings and as such, relationships are primary. Since the day we were born, we experience moments of union and separation with those we love. There is complexity in these oscillating rhythms in insecure and even in secure relationships. At times, when we are in union with the other, we can feel intruded upon and engulfed; and other times in separation we can feel neglected, rejected, and forgotten. Too little and too much contact can have us feeling equally alone and unfound. As therapists, how might we use this metaphor to disrupt a disaster in the therapy room?

The Bringing the Body into Practice (BBP) psychotherapy approach leans into theoretical and conceptual understandings of relational psychodynamic principles and practices. A BBP foundational pillar is the relational framework, often referred to as a two-person psychology. There is a principal acknowledgement that there are two full subjectivities who come together to creatively co-construct the intersubjective field. In the psychotherapy process, both the client and the therapist have an experience of themselves as individuals and as individuals together.

It is not so much what we know or what we do in therapy but how we are when we are with our clients. This does not mean we should dismiss the knowledges we have garnered from our professional development training. It is imperative that we continue to grow and develop, as theories inform our practice. What it does mean is once our training has been fully integrated and internalized, the knowledges become a bedrock to how we are. In a relational framework, our central focus is on being with so clients feel heard, seen, held, and ultimately found. In the space between, there is a continual co-constructive experience uncovering the ever-evolving, unfolding of Self in the present moment. Our intention is to offer our presence, as a holding container, to welcome those hidden parts of self to be known. Winnicott (2005) author of Playing and Reality writes,

Psychotherapy has to do with two people playing together. The corollary of this is where playing is not possible, then the work done by the therapist is directed towards bringing the patient from a state of not being able to play into a state of being able to play. p. 51

As therapists, we attune our embodied self and our internal state of mind, which includes our nervous system, sensation, thoughts, affects, and intuitions to create a holding space. Thoughts that may split our attention, or interfere with our ability to be fully present are bracketed off. We orient to the client’s history and hold memory traces in the forefront of our mind, to be called upon by our clinical intuition to facilitate a client experience of themselves. Our intent is to track the oscillations, the embodied push and pull of the field, while co-regulating injured and fragmented self-states. We aim create a relational holding space so the client may experience an embodied felt sense of themselves.

In order to cultivate presence in the holding environment, it is essential to have a certain degree of self-awareness. Are we aware of our self-knowledges, beliefs, values, abilities, aspirations and identity? Are we aware of our emotions, thoughts, attachments, conflicts, injuries, and dilemmas? Do we have a solid framework that defines our practice? Self awareness is not static but expands creatively throughout the lifespan. There are countless practices to deepen self-awareness. Centering, grounding, meditation, contemplation, reflection, and orienting to the inner and outer parts of ourselves may be a place to begin. There are times when we may struggle because our own material shows up in the therapy room unexpectedly. This is when we may need to seek additional support from a peer, a supervisor, or our own psychotherapist. We can only take people, as far as we have gone ourselves.

Fundamental to cultivating presence is deep listening. What are our clients showing us rather than telling us? In stillness, we listen with our eyes to their non-verbal communication, such as: eye contact, facial expression, posture, tension, and gesture not only in the other but also listening to what happens in us. We remain curious and open to the mystery of being with the other in a state of receptivity.

We listen with our ears to the client’s expression of language, sound, tone, vocalization, affect, content, and context. Simultaneously, we bare witness to the way the client communicates. Specifically, their linguistic output – prosody, timing, intensity, rhythm, lapses, themes, patterns, and coherence – which provides a window into their intrapsychic organization. What remains unconsciously hidden? Silences, pauses, and quiet moments are patiently held while listening with and attuning to our own inner experience. Grossmark (2018) writes, the field affords the emergence of unformulated non-represented meanings that cannot be articulated in language, but are lived through together (Joseph, 1985) and find form in this companioned experience. p. 98

We listen to and with our bodily sensations and our nervous system. Feeling into our tensions, strains, impulses, releases, temperature fluctuations that tells us something about what is happening in the intersubjective field. Our embodied self tracks the rhythm, timing, and pacing of the session while seeking opportunities of genuine connection through empathy, inquiry, disruption, and punctuation. Our focus is on being fully present to a shared experience of deep companioning engagement.

Let us return, full circle and imagine delighting in playing hide and seek. We use our creativity to find the best possible hiding spot, challenging the seeker to uncover where we are. The game plays on, and we remain hidden. Anticipation builds, and in our waiting, we harbour an unspoken wish, a hope that we will be found. How quickly our delight and joy return when we are. We need the Other to help us find our Self.


Grossmark, R. (2018). The unobtrusive relational analysis: explorations in psychoanalytic companioning. New York, NY: Routledge.

Winnicott, D. W. (2005). Playing and reality (2nd Edition). Routledge Classics. London & New New York: Routledge. Originally published in 1971, Tavistock Publications.

Dawn Sather, RSW, RCC, RCC-S is a private practice therapist in Victoria, BC. She currently works with Adults using a Somatic Attachment Psychotherapy Approach. Dawn has studied extensively, and continues to do so, in the field of: trauma, attachment/disrupted attachment, relational, and somatic attachment psychotherapy. All her trainings weave together to provide an integrative, attachment, relational, trauma-based approach to her practice.  Dawn can be found at