Narcissistic Vulnerability in Psychoanalytic Psychotherapy Supervisees: Ego Ideals, Self-Exposure and Narcissistic Character Defenses

There are many reasons why psychotherapy supervisees are prone to narcissistic vulnerability, in which feelings of self-esteem are challenged. In the supervisory process, the supervisee reveals his clinical ability, basic intuition and personal feelings, creating a powerful experience of self-exposure. Ego ideals towards which he aspires, compound this basic vulnerability. These ideals are challenged by the dual nature of mastery involved in the task of becoming a psychoanalyst. As a therapist, the supervisee is required to perform as something of an authority - if he is not yet an expert, he must appear to know a good deal more than the patient who is seeking his help, displaying some degree of mastery. As a student, he is clearly less knowledgeable than his supervisor, and, in the supervisory relationship, he displays his mastery in a very different way. There he is, at once, the “knowing” therapist and the “unknowing” supervisee. This paper examines the role of ego ideals and self-exposure in the experience of the supervisee, and explores special problems that occur with supervisees who present with narcissistic character defenses. Case vignettes are used to illustrate these ideas and implications for supervisory interventions are explored.