Recently there has been an increasing interest in psychoanalytic supervision. The last two Pre-Congresses for training and supervising analysts sponsored by the IPA (in 1993 and 1995) have been on supervision and the Pre-Congress in Barcelona in 1997 will continue with this topic. Since 1991 there have been an increasing number of activities devoted to this topic at the meetings of The American Psychoanalytic Association, culminating this December in a major panel on “Supervision as an Intersubjective Process: Hearing from Candidates and Supervisors” chaired by Elizabeth Lloyd Mayer.
For the past five years, The Committee on Psychoanalytic Education (COPE) has sponsored three study groups and an ongoing workshop devoted to issues related to supervision. These were started in 1991–92 after COPE began to look at how institutes were (or were not) helping supervisors develop their supervisory skills. At the time we concluded that for the most part very little was being done on either the institute or national level to help supervisors conceptualize the supervisory process or develop their skills as supervisors. No guidelines for this had been formulated by the Board on Professional Standards, and little was being done in a formal way by the institutes. A few institutes had developed a mentoring system in which new supervisors were assigned to more senior consultants with whom they met to discuss problems they were encountering in their work with their first supervisees. Even fewer had ongoing peer groups where supervisors could consult and share experiences and questions with each other and with new supervisors. For the most part supervisors were left to learn by identification with their past supervisors and their own evolving trial-and-error experiences with candidates.
Recognizing the need to look more closely at how supervisors learn to do supervision and what we might do to improve this teaching process, COPE decided to form a Study Group on Supervision. At the time there was an ongoing COPE Study Group on Supervision that was about to end. This was essentially a self-selected group of experienced analytic supervisors, chaired by Stanley Goodman, who met twice yearly at the meetings of The American from 1981 to 1991 to share in depth their ideas, experiences, and changing perspectives on the supervisory process. (This group experience was described in News From COPE, Vol. 9, No. 1, Fall 1993.) The new group would be constituted differently and have a different purpose.
Under the guidance of Mort Reiser, then chair of COPE, and Marvin Margolis, then chair of BOPS—who was committed to opening the committees of BOPS to wider participation—the new study group was formed to reflect diversity of experience, geography, gender, institute training, and MD/PhD representation. Also, for the most part, analysts not already involved in other COPE study groups were invited in order to increase participation in the educational opportunities offered at the meetings.
The current COPE Study Group consists of ten supervisors at different levels of supervisory experience who have meet twice yearly for five years. Six months after it started, two discussion groups were formed with the same diverse makeup. In contrast to the earlier group of analysts, who already knew each other's work and psychoanalytic orientation quite well, these groups were made up of supervisors with different levels of analytic and supervisory experience, most of whom knew each other slightly, if at all. The participants were invited to meet together over a period of years to discuss supervisory processes and issues related to the teaching and learning of supervision. Membership in the groups was closed to allow the groups to develop cohesiveness and trust and lead to more complex, open discussions. The discussion groups were led or co-led by members of the first study group, with the thought that this group could use the material from the other groups, as well as its own, to study the group process of teaching and learning. At this point twenty different institutes are represented in these three groups, and twenty-eight supervisors are involved. To preserve confidentiality and encourage openness, no group has more than one supervisor from the same institute.
A review of the minutes, which are available from these three groups, reveals some interesting patterns. From the beginning there was tension in all the groups between the agenda that had been set by COPE—the study of how supervision is best taught and learned—and the groups' wishes to evolve spontaneously and work with each other to meet their own educational needs. By the sixth meeting of the initial COPE study group, the goal of exploring the group process in the other two groups as a way of studying this format for teaching and learning supervision was abandoned. It was clear that all three groups wished to proceed independently and with an open agenda, allowing discussion to develop more spontaneously. Thus, the study group and the two discussion groups became three independent study groups.
In one way or another, all the groups addressed:
the focus of the supervisor's attention—how much should be on teaching the dynamics of the patient and the evolving analytic process versus the educational task of uncovering resistances to learning as they occur in the candidate;
the complicated presence of the institute in the supervisory experience for both candidate and supervisor, realistically and in fantasy;
the impact of the evaluation process—how useful it is for supervisee, supervisor, and institute and what anxieties it stimulates in both those evaluating and those being evaluated. For example, if evaluations are shown to the candidate, are they written with this in mind, and how useful are they for an accurate assessment of candidate's readiness to progress to another case? Should supervisors be evaluated? Most agreed that supervisors learned much more about their candidates than they shared with progression committees. What was included in the actual evaluation was generally a compromise that included considerations of the candidate's needs and the supervisory alliance, institute needs, and anxiety about the assessment of the supervisor's performance by colleagues;
conflicts that can exist in the supervisor based on commitment to the development of the candidate, responsibility for the patient, alliance with the institute, investment in maintaining standards for the profession, and investment in being or becoming a good supervisor;
the difficulty in differentiating between blind spots, dumb spots, lack of analytic talent, and resistance to learning
in the candidate; and
problems associated with the supervision of an increasing number of candidates or graduates no longer in analysis.
It is interesting that as the groups began to coalesce, shorter illustrative vignettes were gradually replaced by more in-depth descriptions of supervisory difficulties. For example, one group discussed instances in which the supervisors felt they had “failed” in not functioning optimally with certain candidates. The group considered the complex nature of the interactions between supervisor and candidate that resulted in a disappointing teaching and learning experience for both. Supervisors want to be better supervisors. The experience of these three groups suggests that over time the study group format can provide a rich opportunity for supervisors to develop as they learn from each other in the process of group discussion and group consultation.
As word of the study groups spread, additional supervisors wished to participate. Unfortunately, we were told that lack of space prevented us from forming additional groups. This is something The American might want to reconsider. Meeting outside the political and professional constraints of local institute dynamics provides freedom that may move the group process more quickly than is typical on the local level. The vulnerability of exposure is lessened, the freedom to question long-accepted training practices and to consider alternatives is enhanced, the confidentiality of the candidate and supervisor are less apt to be compromised, and the discussion of the supervisory process is not complicated by extrasupervisory knowledge of the supervisor, analyst, or candidate, or of institute politics. In addition, the discussion is enriched by the inclusion of various theoretical perspectives, something which does not always happen at the institute level.
On the other hand, the successful experience of several study groups functioning on the institute level indicates that if local groups are able to deal with these potential difficulties and stay together long enough to permit an atmosphere of safety to develop, they offer advantages that the national groups do not have. For example, meeting more frequently allows for closer study of an evolving supervisory process, using ongoing supervisory notes; presentations by several supervisors working with the same candidate encourages consideration of the impact of different supervisory styles on learning and closer attention to the participation of the supervisor in the supervisory process; and addressing as a group the educational issues specific to a particular institute may have a more decisive impact on institute policies related to supervision and encourage more change than ideas that are brought back from national meetings.
In 1992 a workshop on supervision was started with the thought that ideas generated in the workshop could be taken back to the institutes for discussion and possible implementation. The workshop was initially open to representatives chosen by the institutes; eighteen representatives from fifteen institutes attended the first meeting. By the fourth meeting, the workshops were open to all analytic supervisors interested in participating, and approximately forty-five now attend. Because some institutes had indicated a wish to start supervisory groups on the local level, this was the focus of the first meeting. There were two presentations of institute supervisory groups; one had been functioning successfully for many years, the other had just started. Some attempts to start groups on the institute level had failed, so the discussion centered on the reasons for the success of these two groups and possible reasons for difficulties experienced elsewhere. Since then a number of institutes have successfully started new groups.
“The group format offers a unique opportunity for supervising analysts to benefit from the collective experience of colleagues struggling with similar complex educational issues.”
During the first meeting issues related to candidate evaluation were also discussed. It is noteworthy how strongly supervisors resist being evaluated by their supervisees and how reluctant many are to share their written evaluations with them. It would be interesting to know if those supervisors who participate in successful supervisory peer groups at the institute level have become more comfortable discussing their supervisory work, not only with their colleagues but also with their supervisees.
At the second and third workshops, discussion on these topics continued. For the third workshop we invited two supervisors from an institute that had tried unsuccessfully to address the question of supervisor evaluations by candidates to speak with us about their experiences over a fifteen-year period. In discussing what institutes might do to enhance the teaching and learning of supervision for both supervisors and supervisees, we recognized how rarely supervisors and supervisees meet to talk together about supervision as an educational experience. At the fourth meeting members of two institutes described recent educational retreats for faculty and candidates that included discussions of supervision; we hope that more institutes will consider including candidates in educational retreats of this kind.
The group decided that it wanted to hear more directly from candidates about their supervisory experiences, both positive and negative, so five senior candidates from different institutes were invited to attend the fifth workshop in 1994. This was a very exciting meeting. The candidates spoke openly and candidly, giving quite sophisticated and thoughtful presentations. The following is a very limited description of some of the points they emphasized.
The candidates stressed the importance of mutual respect with freedom to explore alternative ways of thinking about and responding to clinical material. They want to experience the supervisor not as an authority, but as a more knowledgeable and experienced senior colleague with empathy for their vulnerabilities as beginning analysts. They value being able to disagree without fearing attack or retaliation. They are sensitive to parallel process, especially as it occurs in the direction of candidate-supervisor to candidate-patient interactions. They appreciate supervisors who can comfortably link theoretical concepts with specific clinical material. They long for an atmosphere of safety and spontaneity in which they feel guided but not controlled. Candidates appreciate having supervisors with different orientations and different styles, even though this is more challenging, as they struggle to integrate the differences into their own styles.
The discussion that followed these presentations was so rich that we elected to continue the format for the next meeting, inviting the five candidates to return and
asking three more candidates to prepare comments for us. It is interesting that these three candidates focused in one way or another on the advantages or disadvantages of a close match in style between supervisor and supervisee. One candidate illustrated how her perceptions of how her supervisors' analytic orientations and styles differed from or resonated with her own had interdigitated with specific transferences to these supervisors and identifications with them to affect how much she was able to learn from each supervisory experience.
Another candidate described a situation in which he worked on the same case with two different supervisors with very different styles. The first supervisor's style more clearly matched his own. The tension between styles in the second supervision and his trial identification with a more confrontational style resulted in modification of some of his inhibitions and expansion of his analytic technique. Discussion focused on the supervisor's style as a pedagogic issue and the relationship with the supervisor as intrinsic to the learning process.
For the seventh workshop we invited two candidates and two supervisors from four institutes to present their thoughts about countertransference in supervision. Situations were described in which supervisory stalemates were addressed—resulting in movement both in supervision and in the work with the patient—or not addressed, resulting in decreased frequency of meeting or interruption of both the supervisory and analytic work.
Candidates are sensitive to a supervisor's discomfort with or disinterest in work with countertransference, and this may result in greater associative inhibition in the supervisee. (It was interesting that the topic for the meeting, “How Countertransference is Dealt with in Supervision,” was understood by the candidates to refer to the supervisor's countertransference to the candidate. The supervisors thought the topic referred to the candidate's countertransference to the patient.) Parallel process was described in all four presentations, illustrating that the two are closely related and that the most effective way to address the candidates' countertransference may lie in the supervisor first sharing in an appropriate way with the candidate his or her reactions to something in the interaction between them that was obstructing the supervisory work. With help from the candidate, transferences to the supervisor may be identified, paralleling the supervisee's countertransference to the patient. Perhaps it is only after the supervisor expresses what he or she is feeling toward the supervisee and they identify which supervisee transference is interfering with the learning process that the supervisee is freed, not only in the supervision but also in the analytic work, to explore more creatively what is occurring in the transference-countertransference paradigm with the patient. The supervisory work then becomes a model of how to deal with these problems, although it is appropriately limited in the depth to which transferences are defined and explored.
That this occurs in the course of supervision was no surprise to the group; how to deal most effectively with the phenomenon educationally needs further study. In general, the candidates who participated in the discussion agreed that if the exploration of countertransference in supervision is done sensitively and furthers an understanding of the patient and the analytic process, it is not threatening. An atmosphere of safety develops over time, so attention to countertransference as a part of supervision is generally easier for both participants later in supervision and in the candidate's development as an analyst.
As the workshops progress, there is increasing interest in interactive dimensions of the supervisory experience. Initially, the group focused on aspects of the supervisor's experience, then turned its attention to include candidate perspectives, and more recently began to address the impact of supervision on the candidate's analytic work. Because we wished to look more closely at the impact of a particular piece of supervisory work on the process of the analysis being supervised, we looked for supervisory pairs willing to explore this with us.
Interestingly, it was two senior supervising analysts, one in consultative supervision with the other, who first agreed to share their perspectives on their supervisory work.
At the last workshop, a supervisor and senior candidate vivdly described their experiences wtih each other during the fourth year on an ongoing supervision. Because this was a particularly valuable learning experience for the workshop participants, the same format has been planned for May. Interested supervisors and candidates are invited to attend.
Based on my experience with these three COPE study groups and the Workshop on Supervision over the past five years, I believe that the group format offers a unique opportunity for supervising analysts to benefit from the collective experiences of colleagues struggling with similar complex educational issues. This five-year experiment with study groups consisting of supervisors from all levels of experience has shown that this is one important way to learn how better to teach. I recommend that we make every effort to increase the number of groups at the national meetings so that more supervisors at all levels of experience can participate. Some groups should be structured to include candidates, because the study of this complex educational experience will be enriched by their continued input. We need their help so we can learn how to teach more effectively, and they need ours so they can learn how best to be taught. Groups on the national level and those on the institute level have different advantages and limitations; those of us who are involved in both feel that the experiences are complementary. Moving away from a more authoritarian approach to one that is more truly collegial on the national level will encourage the development of this in the educational structure of our institutes, to the advantage of the COPE Committee on Supervision.
Ellen Rowntree is chair of the Study Groups and Workshop Committee.