Toward a tripartite vision of supervision for psychoanalysis and psychoanalytic psychotherapies: alliance, transference-countertransference configuration, and real relationship

The psychoanalytic supervision relationship is examined as a tripartite phenomenon, comprised of the supervisory alliance, transference-countertransference configuration, and real relationship. While most supervisory analysts would readily acknowledge that a real (or personal) relationship element exists in analytic supervision, that facet of the supervision relationship has not routinely been incorporated into considerations of psychoanalytic supervision. In this vision of supervision, real relationship, supervisory alliance, and transference-countertransference configuration are presented as integral and complementary constructs that define psychoanalytic supervision. Each of those three components is examined briefly with regard to its beginnings, evolution, and contemporary status; each component is also considered from an empirical perspective. While we have a growing quantitative and qualitative research foundation that supports psychoanalytic practice, psychoanalytic supervision has largely been ignored as a subject and object of scientific study. Supervisory alliance, transference-countertransference configuration, and real relationship are explored as research ready variables. Some clinical hypotheses--eminently testable and worthy of investigation--are proposed with regard to each component of the model, and some ideas--albeit tentative and preliminary--about how to initiate such inquiries are offered.     

How does psychoanalytic supervision work? A brief communication

In this brief communication, we offer one perspective – the contextual psychoanalytic supervision model (CPSM) – on how psychoanalytic supervision works. The CPSM, a supervisory extrapolation of Wampold’s contextual psychotherapy relationship model, accentuates four psychoanalytic supervisor–supervisee relationship variables as crucial and change inducing: the learning alliance bond, supervisor–supervisee real relationship, creating supervision expectations/providing an expectation-consistent form of supervision, and the supervisee’s engagement in facilitative educational actions. The CPSM is presented in hopes of stimulating further discussion about what makes psychoanalytic supervision work.     

Psychoanalytic supervision in the new millennium: On pressing needs and impressing possibilities

Having now completed its first century, psychoanalytic supervision has been and continues to be regarded as the cornerstone of psychoanalytic education; it is the primary means by which (1) psychoanalytic ideology becomes translated into practical product, and (2) budding analytic practitioners develop and grow in their therapeutic skills and professional identity. The supreme significance of supervision in contributing to the “making” of the competent psychoanalytic practitioner now seems a widely accepted given, even axiomatic. But as its second century gets underway, what have we learned from psychoanalytic supervision's first 100 years? What are its most pressing needs and, in turn, impressing possibilities at this time? And what needs to most change if psychoanalytic supervision is to most profitably advance in the years and decades ahead? In this paper, I would like to consider those questions, giving focus to five needs that seem to most require attention now: (1) making the practice of psychoanalytic treatment an increasingly competency-based, concretized learning affair; (2) enhancing the efficacy of supervisors through competency-based practice and training in psychoanalytic supervision; (3) more effectively incorporating existing technology and emerging technological advances into supervision and using them to enhance the psychoanalytic learning process; (4) better attending to matters of difference and diversity, and striving to seamlessly integrate them into the conceptualization and conduct of the psychoanalytic supervision experience; and (5) vigorously researching the psychoanalytic supervision process and working to establish an evidence base for supervisory practice.     

Convergence,commonality, and context in psychoanalytic supervision

ABSTRACT

What are the binding commonalities that demark and define any and all psychoanalytic supervision perspectives? What do we all do as psychoanalytic supervisors that practically matters? Furthermore, might there be a unifying model that anchors those binding commonalities together into a supervision meaning-making, explanatory framework? In this two-part paper, I take up those questions. In Part I, based on a century-spanning literature review, I identify 50 (non-exhaustive) common Support and Learning factors that appear present across the panoply of psychoanalytic supervision perspectives. Relational, educational, and interventional, these 50 factors reflect the very stuff of which psychoanalytic supervision is made. In Part II, I present and elaborate upon the Contextual Psychoanalytic Supervision Relationship Model (CPSRM) – a theoretically-grounded model that anchors and contextualizes those common Support and Learning factors. Because common factors can be seen as nothing more than atheoretical amalgamation (i.e., lists of desirable characteristics endlessly strung together), the CPSRM is proposed as a theoretically-based antidote. A supervisory extrapolation of Wampold’s contextual psychotherapy relationship model, the CPSRM accentuates relational connection, expectations/goals, and educational action as preeminently supervisee change inducing and learner affecting.     

Supervision Is a Relationship Too: A Contemporary Approach to Psychoanalytic Supervision

This paper discusses clinical cases presented by Comins and Eliot within a paradigm of psychoanalytic supervisory work based on relational theory. Here, in making the medium of supervision more symmetrical with the message of contemporary psychoanalytic ideas about structure of mind health, pathology, and treatment, the relationship between the supervisor and supervisee is considered to contain crucial supervisory data to be delineated and discussed by both members of the dyad. The supervisory relationship is described using three dimensions: power and authority, the data held to be relevant for supervisory conversations, and the mode of the supervisor's participation in the supervisory process.     

The competent psychoanalytic supervisor: Some thoughts about supervision competences for accountable practice and training

What are the competences required to satisfactorily practice effective or “good enough” psychoanalytic supervision? In this paper, I would like to consider that question. Over the past approximate 15-year period, increasing attention has been directed toward more specifically identifying and defining the components of competent psychoanalytic practice. But any parallel attention toward identifying and defining the components of competent psychoanalytic supervision practice has, in comparison, been sorely limited if not virtually absent. If we are to best practice competent psychoanalytic supervision and best train future psychoanalytic supervisors for competent practice, effort needs to be made to concretely delineate the competences that are requisite for such practice. In what follows, I present and adapt six broad-based families of internationally relevant supervision competence areas for use in psychoanalytic supervision: (1) knowledge about/understanding of psychoanalytic supervision models, methods, and intervention; (2) knowledge about/skill in attending to matters of ethical, legal, and professional concern; (3) knowledge about/skill in managing psychoanalytic supervision relationship processes; (4) knowledge about/skill in conducting psychoanalytic supervisory assessment and evaluation; (5) knowledge about/skill in fostering attention to difference and diversity; and (6) openness to/utilization of a self-reflective, self-assessment stance in psychoanalytic supervision. Although by no means an exhaustive list, 30 supervision competences (five per family) are proposed as significant for guiding competent psychoanalytic supervision practice and supervisor training, and a brief explanatory comment is offered in support of each broad-based family of competences.     

The peer supervisory group for psychoanalytic therapists

The recent interest in peer supervisory groups for psychoanalytic therapists raises important questions regarding both psychoanalytic training and group process. The present paper explores these issues and suggests that there exists a continuum from case-centered peer supervisory groups to process-centered peer supervisory groups. Transference and countertransference and the recognition of parallel processes in psychotherapy supervision are examined in their relation to the supervisory group experience. The authors suggest that the model a therapist employs regarding the role of countertransference will most likely influence the kind of peer supervisory group that s/he will choose. Further, there are specific techniques, as well as experiences, which may foster alteration of the group's psychic organization. Illustrative case examples are provided throughout.     

Supervision and Analysis at a Crossroad: The Development of the Analytic Therapist: Discussion of Papers by Joan Sarnat and Emanuel Berman

This discussion of papers by Sarnat and Berman on psychoanalytic supervision explores the complex nature of the contemporary psychoanalytic supervisory relationship. It considers how developments in psychoanalytic theory and practice, reflecting relational, intersubjective, attachment, and field theory influences over the past 30 years, have changed the ways in which many analysts practice and theorize supervision. Contemporary supervisors attend not just to the patient being presented, or to the therapeutic dyad, but to the supervisory relationship itself as part of the clinical/supervisory frame of reference. Similarities and differences between therapy and supervision are considered.     

Mein Konzept der Supervision

The reflections on supervision presented in this paper were written against the background of a psychoanalytic training. The paper describes what – in the author's view – characterizes a patient in psychoanalytic psychotherapy, a psychoanalytic therapist, and a supervisor. In addition, the author reports on his personal experiences which he has made with supervision in the course of his activity as a psychoanalyst in the roles of supervised and supervisor. In this context, he presents some actual memories from supervisory experiences with M. Balint, H. Argelander and F. Morgenthaler.     

The Evolving Nature of Psychoanalytic Supervision: From Pedagogical to Andragogical Perspective

In what primary ways has psychoanalytic supervision evolved over the course of its 100-year plus history? In this paper, I address that question by: (1) sketching out some of the historical differences that have been identified as characterizing the patient-centered, supervisee-centered, and relational-centered supervision perspectives; (2) placing those three perspectives within an adult education framework; and (3) considering their pedagogical (youth-focused) versus andragogical (adult-focused) nature. Based on this examination, I propose the following. Due to the infusion of interpersonal/intersubjective views into the body psychoanalytic, (1) the “maturing” of vision in psychoanalytic supervision (i.e., the movement from a youth-focused to an adult-focused approach to supervision) was made possible; (2) a shift from a supervisory “one-person model times two” to a triadic conceptualization was actuated; (3) traditional perspective on power and authority in supervision was upended; and (4) a more egalitarian, empowering, co-participative approach to supervision emerged and now endures. Attending to the six core principles of adult learning is presented as one primary way in which that “maturing” of vision is most evident in the contemporary practice of psychoanalytic supervision.     

Disruption and Working Through in the Supervisory Process: A Vignette From Supervision of a Psychoanalytic Candidate

This paper describes the author’s supervision of a psychoanalytic candidate, including the development and resolution of impasse in both the supervised analysis and the supervisory relationship. When the author became aware of the degree to which her own anxieties and defenses were implicated, she sought consultation, after which both supervision and analysis moved forward. As supervision continued, work on supervisee’s and supervisor’s interlocking anxieties and defenses, and understanding of their impact on the supervised analysis, deepened. The author concludes that exploring supervisory disruptions allows both members of the supervisory dyad to come to grips with conflicts that subtly distort their work and facilitates a deepening of the supervised analysis.     

On psychoanalytic supervision

The author provides both a theoretical context for, and clinical illustrations of, the way in which he thinks and works as a psychoanalytic supervisor. The analytic supervisory experience is conceived of as a form of 'guided dreaming'. In the supervisory relationship, the supervisor helps the analyst to dream (to do conscious and unconscious psychological work with) aspects of the analytic relationship that the analyst is unable to dream or is only partially able to dream. It is the task of the supervisory pair to 'dream up' the patient, that is, to create a 'fi ction' that is true to the supervisee's emotional experience with the analysand. To carry out this work, the supervisor must provide a frame that ensures the supervisee's freedom to think and dream and be alive to what is occurring in the analytic and the supervisory relationship, as well as in the interplay between the two. In one of the clinical illustrations presented, the author illustrates his conception of the importance of the feeling on the part of supervisor and supervisee that (at least occasionally) they have 'time to waste'. Such a state of mind may provide an opportunity for a type of freely associative thinking that enhances the range and depth of what can be learned from the supervisory experience. In another clinical example, the author describes his own experience in supervision with Harold Searles, which contributed to his conception of the supervisory process.     

Dynamics of psychoanalytic supervision: a heuristic model

This paper presents a heuristic model for the dynamics of psychoanalytic supervision. It is not a manual for how to perform supervision, but a model for how to identify and think about the complex elements and forces influencing the supervisory process. The point of departure is that psychoanalysis is a composite craft in which seemingly contrary elements like strict rules and creative intuitions have their place and interact. Several aspects of supervision are discussed: aims, learning processes, teaching methods, relationship, emotional atmosphere and evaluation. Competence is given a pivotal place in the model. The main feature of the model is that these aspects of supervision are all seen as suspended in a field of dynamic tensions between phenomena in real or apparent opposition. One example of this is the tension in the supervisory relationship between supervisor as instructor acting as an authority for the candidate whilst being a mentor fostering autonomy in the candidate. It is argued that related kinds of dynamics characterize several aspects of psychoanalytic supervision and that these tensions are inherent in analytic work. In conclusion a key word picture of the model is presented.     

Better Identity Politics

Suchet's paper is an inspiring demonstration of the power of openness and vulnerability. It offers a clinically daring and theoretically far-reaching account of the transformation that can sometimes occur in the psychoanalytic relationship. My commentary focuses on two of the paper's major threads: the interplay of subjective experience, intersubjective space, and collective forces, and the ethical dimension of the psychoanalytic project. From the outset, the meeting between Ara and Suchet is not only a meeting of bodies and minds, but also a meeting of collective histories and politics. Suchet finds, and in her account powerfully demonstrates, that addressing her patient's trouble requires an exploration of how collective traumas and political narratives infuse the possibilities of intersubjective exchange and subjective meaning. In my commentary I trace and elaborate on the trajectory of this analytic process, contemplating the ways in which identities and identifications involve both familial and social attachments. I attempt to highlight Suchet's contribution to our understanding of how what happens, and is made meaningful, in the register of collective identification and experience, forms the very substance of subjective and intersubjective life, and should be therefore formulated as an intrinsic aspect of the analytic endeavour. Turning to Suchet's engagement with the philosophy of Emmanuel Levinas, I consider her drive to reach beyond the traditional boundaries of psychoanalytic discourse. Following the same drive, I add some ideas developed by Theodor Adorno, as means of illustrating the trouble and the potential for reconciliation inherent in the experience and politics of identity.     

The Beginnings of Psychoanalytic Supervision: The Crucial Role of Max Eitingon

Psychoanalytic supervision is moving well into its 2nd century of theory, practice, and (to a limited extent) research. In this paper, I take a look at the pioneering first efforts to define psychoanalytic supervision and its importance to the psychoanalytic education process. Max Eitingon, the “almost forgotten man” of psychoanalysis, looms large in any such consideration. His writings or organizational reports were seemingly the first psychoanalytic published material to address the following supervision issues: rationale, screening, notes, responsibility, supervisee learning/personality issues, and the extent and length of supervision itself. Although Eitingon never wrote formally on supervision, his pioneering work in the area has continued to echo across the decades and can still be seen reflected in contemporary supervision practice. I also recognize the role of Karen Horney—one of the founders of the Berlin Institute and Poliklinik, friend of Eitingon, and active, vital participant in Eitingon’s efforts—in contributing to and shaping the beginnings of psychoanalytic education.     

Love in the counter-transference: The uses of the therapist's excitement

SUMMARY

The psychoanalytic tradition has always had difficulty with the question of the therapist's sexual feelings toward the patient. This paper traces that difficulty: from Freud's original struggle to replace moralism with a psychoanalytic mode of understanding, to the more recent literature on countertransference which still seems particularly averse to the possibility of the therapist's sexual experience. By way of a discussion of a psychoanalytic psychotherapy, I argue for the sometimes central therapeutic role of the therapist's experiencing, and then containing, excitement.     

Parallel process and projective identification in psychoanalytic supervision

In the present paper I explore the notion of the parallel process, a controversial concept in psychoanalytic supervision. I suggest that the parallel process is essentially the operation of the defensive process of projective identification, which in some quarters is similarly viewed with skepticism and/or is mistakenly seen as primarily a malignant defense operating exclusively in severe character pathology (Kernberg, 1975; Mendelsohn, 2009). Further, I present several vignettes of psychoanalytic supervision where a series of parallel processes occurred, and I suggest that these parallel enactments are the result of the projective identifications which stimulated them. I agree with critical writers who say that simply suggesting the presence of a parallel process in the supervision adds no new information to the supervision, but I show how an exploration of the parallel enactments, which includes (1) exploring the patient-therapist dyadic dynamics, (2) a narrowly focused exploration of the dynamics of the therapist/presenter, and (3) and an exploration of the dynamics of the therapist-supervisor dyad, can enrich the treatment, as well as the supervision. Finally I suggest that while the projective identification that occurs in the supervisory dyad does not always lead to a parallel process, every parallel process is the result of projective identification(s). I further suggest that while every parallel process does not lead to an enactment via projective identification, enactments can only occur via the parallel process instigated by projective identification.     

Self and Talent—Treatment Considerations

The clinical pursuit of patients' experiences of talent, in their current life and in their developmental years, has broadened the clinical field considerably and provided more lanes and latitude in the “royal road to the unconscious.” Interest in patients' talents has been experienced as an invitation to bring in their created works, not just as a display of aesthetic interest but, much more importantly, as another pathway through which the analyst can access an understanding of the deepest and most meaningful levels of selfexperience. This article explores some of the meanings of talent for the self and suggests that there is a developmental line for the maturation of one's relationship to one's talent. I provide discussion that illustrates the coextensiveness of the inner experience of talent with the selfobject surround throughout growth and maturation. Finally, I provide illustrations of how talent can be experienced and how exploration of experiences of talent can play a quintessential role in psychoanalytic treatment.