A Response to “Thinking About Our Work: Supervision”

Abstract

A Response to “Thinking About Our Work: Supervision” J. Scott Rutan1 issn 0362-4021 © 2015 Eastern Group Psychotherapy Society group, Vol. 39, No. 1, Spring 2015 53 1 Private practice. Correspondence should be addressed to J. Scott Rutan, PhD, 71 Waban Hill Road, Chestnut Hill, MA 02467. E-mail: scottrutan@scottrutan.com. In his article, Dr. Stone focuses on supervision of group therapy, with specific emphasis on setting clear goals. I applaud Dr. Stone for calling our attention to the need to be thoughtful about teaching and practicing the art of supervision, which is the foundation of our work. It is often overlooked, such that Anne Alonso (1985) termed it the “Quiet Profession.” I will comment on supervision from a somewhat broader perspective, not focusing exclusively on the supervision of group therapy. Ours is an apprenticeship trade. We learn under the watchful eyes of our supervisors. Fundamentally, supervision is the loaning of experience to neophyte therapists. Venturing into the world of emotional healing can be daunting when we begin. There are powerful emotions—eruptions of old countertransferences, the seduction of projective identifications, receiving sexual and angry transferences. These can be bewildering and frightening to new therapists. In group therapy, the swirl of emotions is only intensified. A supervisor should have specific goals in mind, and they differ according to the level of experience of the supervisee. These may or may not match the goals of the neophyte therapist, though, as Moga and Cabaniss (2014) state, they need to be made clear to the supervisee. An initial supervisory goal is to help the supervisee become able to bear strong affect without having to act. Affect, certainly in the psychodynamic tradition, is a main avenue of change, and it is imperative that therapists become comfortable with a wide range of emotions and a wide level of intensity of those emotions. For example, some young therapists are made very anxious when their patients express sexual feelings toward them. A supervisor can helpfully point out that most feelings 54 rutan in therapy are often addressed to “Dear Occupant,” meaning that they are transference feelings invited by the role of the therapist. Another early goal is to help the supervisee understand and use theory to guide in technique. Early in the process, this will likely be helping the supervisee use the supervisor’s preferred theory. It is hoped that in later stages, the supervisor will help supervisees learn the theories that most naturally fit with them. In the psychodynamic tradition, helping the supervisee hear “process” and believe in the unconscious are two of the most important skills to impart. Then the task is to learn how to feed back to the patients what has been heard in a way that maximizes patient growth. The supervisory relationship is an intimate and complicated one. Supervisees are in a vulnerable position, often encountering painful aspects of their own personalities . In addition, most of the time, supervisor and supervisee work in the same setting and have multiple types of connections, including personal. The supervisor must be acutely aware of the boundaries of the supervisory relationship. Often the supervisory relationship is even more complicated, as when the supervisor is new in the role, or when there are personality conflicts, or when supervision occurs across professional disciplines. There are many types of supervision. There is supervision of specific modalities, for example, supervision of individual therapy, couple therapy, family therapy, or group therapy. There are different configurations for supervision. Much supervision of individual therapy occurs in dyadic settings, whereas often, supervision of group therapy occurs in groups. There are even peer supervisory groups (Kassan, 2010). Good supervision provides the supervisee with a cognitive frame by which to understand the patient, an ability to elicit and allow the full emotions of the patient, an ability to value the patient no matter how distasteful his or her defenses might be, a keen sense of professional ethics, the ability to “hear” the unconscious themes in each hour, and, finally, an ability to maintain a professional boundary that protects both patient and therapist. REFERENCES Alonso, A. (1985). The quiet profession: Supervisors of psychotherapy. New York: Macmillan. Kassan, L. D. (2010). Peer supervision groups: How they work...