Joost A.M. Meerloo, M.D.: “Some Psychological Processes in Supervision of Therapists”

Abstract

THEODORE SHAPIRO M.D.* Meerloo's 1952 commentary on the psychological processes in supervision provides a practical working frame for teaching dynamic psychotherapy. The brief paper alerts us to the pitfalls of controlling our supervisees versus teaching them while offering homey recommendations that include catch-phrases such as guidance. He notes that his approach revives old way of learning and teaching medicine, i.e., learning by precept. Curiously, the piece is both modern and dated as evidenced by the didactic tone and recommendations about empathy as well as the assumption that teaching psychotherapy is a feature of medical education. The former seems modern, the latter an unlikely assumption for our next generation, as physicians are being taught other forms of therapy in most areas of the U.S. The contrast Meerloo makes between the technical present in 1952 and the humane personal aspects of meeting with a patient remain current concerns. Indeed, in usual psychiatric curriculum planning we contrast knowledge and skill learning. At the same time we contrast blind spots to dumb spots, a distinction that has been attributed to so many that I dare not use a citation because it is bound to offend someone. At any rate, the blind spot must be analyzed for its unconscious dimensions; the dumb spot, by contrast, may be removed by education. Since Meerloo's paper, using the psychoanalytic frame, there have been multiple commentaries and one book, Becoming a Psychoanalyst: A Study of Psychoanalytic Supervision by Robert Wallerstein,1 in 1981 and more recently, in 1993, a paper by Szecsody, Kachele and Dreyer,2 among others, that address the supervisory process. Szecsody described four ambiguities in supervision: 1. The candidate must be good enough in his openness to learn. 2. The supervised candidate must now consider his/her role as real as well as fantasied transference object. 3. Parallel process between patient and analyst and analyst and supervisor must be considered. 4. The triangular situation established is central in any dialogue between two of the parties. In addition, the COPE Study Group of the American Psychoanalytic Association described three styles of supervision: (1) didactic, (2) collegial, and (3) Socratic. Each has its pitfalls. Turning to formal empirical research on psychotherapy, we find that supervision now takes the shape of formal training. The therapist is taught to adhere to a specific procedure, for there is no possibility of studying any therapy without reviewing and judging the therapist's reliability and adherence to a manual designed to deliver a specific treatment. …