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The dilemma of training in psychoanalysis and in psychotherapy is that the professional activity is essentially private and, in order
to remain maximally effective (and acceptable), must needs remain so, while the training actively geared to the acquisition of the requisite professional skill and experience (leading to public recognition and certification) involves the public interest and is at least partly public in character. The technique evolved, largely in the fields of psychoanalysis and of social work, to cope with this dilemma, has been that of individual supervision, in which the therapist in training meets regularly with the designated supervisor in order to go over the therapeutic transactions after the fact (but not too long after the fact) in as much detail as he can reconstruct, subject to all the fallibility, the selective distortions, and the emotional “blind spots” that limit the accuracy and the adequacy of such retrospective memory tasks.
That the system somehow works, however imperfectly, is attested to by the way clinical skills are apparently satisfactorily transmitted via this modern-day version of the medieval guild master-apprentice relationship to successive and widening generations of clinical trainees, with concomitant widening areas of applicability to the emotionally ill and malfunctioning.
The system, though, clearly has inherent limitations: it does not give the professional activity (the therapy) anything like the visible character that surgical training has, for example, with the operations of the novices carried out under the watchful eyes of their mentors with all the enhanced opportunity for accurate (consensual) perception, for forestalling, for immediate correction, etc.; the investment of time and energy in the supervision process is extreme and often clearly disproportionate to the knowledge and skill that accrue; the possibilities of mischief, witting or unwitting, are high in a system so dependent on the maximum of candor