Daimon Publishers

Jungian Perspectives on Clinical Supervision
by
Paul Kugler

Introduction

Introduction

In recent years the role of supervision in the training of psychologists, psychiatrists, social workers and psychoanalysts has taken on increasing importance. While the various training programs for psychotherapists range from behaviorism to depth psychology, and differ as to whether or not the therapist-in-training needs to undergo personal analysis, all programs require some form of supervision. Even though supervision has long been an essential part of the training of psychotherapists, remarkably little had been written on the subject until ten years ago. Our understanding of the supervisory process has had a slow evolution and, even today, there is limited formal training available for the would-be-supervisor.

The conception for this book developed out of several programs on supervision I organized while a member of the Training Committee for the Inter-Regional Society of Jungian Analysts. As we worked to develop continuing education programs for supervisors and training analysts, it became increasingly apparent that Jungians had published very little on supervision. This volume answers the need in Jungian psychology for more open discussion of the various facets of supervision in clinical practice, the training of analytic candidates and related fields. My primary objective in editing this book has been to provide a forum for discussion of the various practical and theoretical aspects of supervision. The papers included consist of nearly all the previously published material on supervision in the Jungian literature, supplemented by many new essays commissioned specifically for this book to provide a broad multi-theoretical perspective. The topics discussed will be of particular value to professionals using a Jungian-oriented approach to the supervision of analysis and psychotherapy in the fields of clinical psychology, psychiatry, social work, psychiatric nursing, religious counseling and spiritual direction.

Supervision involves a variety of important aspects which attempt to enhance the supervisee's work, elaborating technique, elucidating transference and countertransference issues, proposing direction and focus to the clinical inquiry, suggesting dynamic and archetypal formulations about the analytic process, and exploring repeated patterns of behavior, thought, and fantasy.

Some Questions of Supervision

Where the analyst needs the skills of an analyst, a supervisor needs the skills of both analyst and teacher. But what is supervision and how do we become supervising analysts? The distinguished American philosopher and educator, John Dewey, once noted that a question properly formulated is a question half answered. So, to begin this book on supervision, I would like to formulate a series of questions concerning the subject:

1. In supervision how do we approach supervisees just beginning to work analytically? How do we help them structure their understanding of the analytic process, delineate it, pace and work with the flow of psychic material, cultivate empathy, teach how to analytically inquire, to visualize what is being told by the analysand and to ask more reflective questions when a complex is constellated or when what is being discussed is not clear?

2. What are the different styles of supervision? There is, for example, the holding and confirming supervisor who sits in silence saying almost nothing, the pedagogical supervisor who teaches theory and technique, and who amplifies through mythological images and cross cultural parallels, the metatherapeutic supervisor who approaches supervision largely as an extension of the candidate's analysis, the Zen supervisor who continuously creates an atmosphere of creative disorganization, constantly calling into question the candidates unconscious assumptions and fantasies. And, there are, of course, many half breeds of these, as well as many other styles of supervision. How do we become more aware of our own unique approach to supervision and remain conscious of its shadow aspects?

3. How does typology influence the supervisor? Does a feeling type focus more on empathy, while a thinking type emphasizes insight and consciousness? Does the intuitive supervisor look to the capacity for imagination, while the sensation type values more engagement with reality? And how does the typology of the candidate impact on supervision?

4. What is it we are supervising? Is it the actual analysis of another person (the patient)? Is it the supervisee's behavior as therapist? Is it the fantasy image of the patient as separately imagined by supervisor and supervisee? How do we keep conscious of the limitations on what we can actually know of the "analysand" as we enter the complicated hall of mirrors known as supervision.

5. To what extent does the requirement that supervisors write evaluations affect the candidate's choice of supervisor and limit openness in the supervisory process? In what way might the institutional need for evaluations conflict with the candidate's need to be honest, open and exposed?

6. What role does countertransference play in supervision? How important is it for the supervisor to differentiate those reactions resulting from complexes in the candidate from reactions resulting from complexes in the patient or supervisor? Does the supervisor work with all three types of reactions or refer the therapist-induced reactions back to the personal analysis?

7. How does depth psychological supervision differ from other forms of therapeutic supervision?

8. Who has the ultimate responsibility for the case? Supervisee or supervisor?

These introductory questions are intended simply to begin the process of opening up for discussion some of the complicated issues associated with depth psychological supervision.

An Overview of the Book

The volume is divided into six sections: (1) Background, (2) Individual Supervision, (3) The Case Colloquium, (4) Assessing Progress in Supervision, (5) Phases in a Supervisor's Life, and (6) Supervision and Institutions.

Part One, "Background," consists of an "Introduction" by myself and "Historical Notes" by Mary Ann Mattoon. Presenting an account of the history of supervision in Jungian psychology, Mattoon interweaves her personal experience of training in Zurich with the larger history of the discipline. The evolution of supervision in analytical psychology is traced from Jung's early seminars and case discussions to the more formal requirements of "control analysis" as adopted at the various training institutes, providing the reader with a valuable genealogy and setting the historical context for the present volume.

Part II, "Individual Supervision," contains seven papers ranging from a model of supervision, to an analysis of the archetypal structures underpinning the supervisory dyad, to the clinical management of interpersonal dynamics and transference projections. Michael Fordham starts off the section with his classic essay, "Suggestions Toward a Theory of Supervision," in which he carefully differentiates the role and function of the supervisor in relation to supervisee and personal analyst. When a training candidate in analysis begins supervision several problematic consequences may develop, extending from a premature dilution of the analytic transference to an idealized transference onto the supervisor. Calling for a humanization of the relationship, Fordham recommends that from the very start the supervisor treat the supervisee as a junior colleague, not a patient. The supervisor is encouraged to limit discussion of the supervisee's countertransference to client-induced reactions, avoiding analytic interpretations of personal material except under exceptional conditions.

Norah Moore's chapter, "Michael Fordham's Theory and Practice of Supervision," provides the reader with a valuable and poignant reminiscence of her personal supervision with Fordham. Intermixing theory and clinical experience, Moore concisely summarizes many of Fordham's most salient contributions to supervision. The chapter succeeds in unpacking some of the practical implications of Fordham's thirty plus years of clinical writing and teaching.

In his chapter, "Supervision and the Mentor Archetype," Lionel Corbett presents an analysis of various archetypal structures underlying the process and cogently argues for developing a specifically Jungian approach focused on discerning the workings of the Self and its archetypal constituents in the supervisory process. Particularly sensitive to the importance of being conscious of the theoretical bias of both supervisor and supervisee, Corbett provides practical illustrations of how he works to develop an appreciation of the supervisee's theoretical approach in such a way as not to set up an antagonism with his own. To effectively do this, supervisors must be sensitive to the clinical effects of their own theoretical bias, as well as their "personal equation."

Jacoby's contribution, "Supervision and the Interactive Field," extends the more traditional Jungian approach to include the various dynamics of the interactive field. The classical focus on symbolic "contents" of the unconscious is expanded to include unconscious interpersonal dynamics as expressed in the therapeutic space. Subtleties of the interactive field, such as voice inflection, body language and other nonverbal communications are touched on, as well as the importance of monitoring the therapists' countertransference reactions to their patients' feelings of love, aggression, devaluation, ambivalence, and so on.

The focus on transference and countertransference dynamics is continued in Wakefield's thought-provoking paper, "Transference Projections in Supervision." The chapter explores various unconscious perceptions and expectations which may develop between supervisor and supervisee, providing useful insight into the management of these dynamics. The reader will find the review of current clinical literature on syntonic and therapist-induced countertransference reactions particularly useful. The various projections constellated between supervisor and supervisee are analyzed from the perspectives of analytical psychology, drive theory, object relations theory and self psychology.

"Styles of Supervision," by Judith Hubback, differentiates the various types of supervision ranging from the permissive to the didactic. Enabling the development of the analytic identity of supervisees involves empowering them to explore their own unique style and analytic abilities. Facilitation of this process may be improved through efforts to reduce anxiety in supervision and develop a colleague-type discussion.

The section on Individual Supervision closes with John Beebe's provocative chapter on "Sustaining the Potential Analyst's Morale." The essay is a further exploration of the supervisor's role in developing the analytic identity of the supervisee, but this time from the perspective of providing a therapeutic space to meaningfully contain and work through disappointments in their personal analysis. The supervisor is in a unique position to constructively work with and help metabolize analytic wounding which may have occurred in the supervisee's personal therapy. The author persuasively argues that perhaps the most important function the supervisor can perform is to facilitate the working through of necessary wounds to the naive idealization of analysis.

Part III, "The Case Colloquium," includes three chapters devoted to the study of supervision in clinical case seminars. This section opens with Donald Kalsched's exploration of the "Ecstasies and Agonies of Case Seminar Supervision," a moving personal account of the emotional rewards and pitfalls encountered in a case colloquium. Emphasizing the importance of the seminar as a working group, not a process group, the author sketches out the two primary tasks of the seminar: first, to develop a deeper understanding of the presenting therapist's patient and, secondarily, to gain insight into the interaction between patient and therapist. To accomplish these goals a "safe enough" atmosphere, free of judgment and evaluation, must be provided for an inquiry into the unconscious communication of patient and therapist. The shadow side of group dynamics is analyzed: splitting, acting out, sibling rivalry, envy, scapegoatism, triangulated collusive alliances, co-dependency and so on. The chapter provides a valuable antidote to the potentially toxic dynamics encountered in case seminars.

Crittenden Brookes' essay, "On Supervision in Jungian Continuous Case Seminars," examines how the extraverted dimension of the psyche may be constructively mobilized in the case colloquium to deepen the participants understanding of the therapeutic transaction. The seminar has the potential of bringing a variety of perspectives and emotional responses to bear on the clinical material presented, each opening up different and important aspects of the analytic process. To best realize this potential the group leader must work to cultivate a mutually supportive and open-ended environment, free of hierarchies and judgment.

In the final chapter of this section, "Some Thoughts on the Clinical Process," Joan Reggiori examines the differences between individual and group supervision in a variety of professional settings ranging from mental health organizations to training institutes. Various group dynamics encountered in case colloquium are discussed and practical techniques for managing them presented. Common to both individual and group supervision is the need for creating a space in which the supervisee can safely play, experiment with ideas, explore possible approaches, and become more conscious of what is already known, as well as what is as yet unknown. The chapter ends with a section summarizing three seminars on supervision conducted by Reggiori as a follow-up to her original public presentation of this material. The section provides valuable insight into the possibility of peer-group work on supervision as a means for further developing professional skills.

Part III consists of eight essays by training analysts, each grappling with formulating a personal response to the thorny issue of "Assessing Progress in Supervision." Alfred Plaut initiates the discussion by putting his criteria in the form of three questions: (1) "Can the trainee make use of supervision?", (2) "What are the obstacles which prevent the trainee from making full use of me?" and (3) "How, in practice, do I know - or believe to know - that the requisite progress has been made so that I can recommend the trainee for associate membership?" In his response to these questions, the author provides many valuable insights into dynamics encountered while evaluating the supervisee.

Assessing progress in supervision is approached from the perspective of typology by Gustav Dreifuss. While there are certain objective criteria for assessing a supervisee, the relative importance of each is very much a function of the supervisor's personality. A feeling type might emphasize the importance of empathy in the supervisee, an intuitive type look for the capacity for imagination, a thinking type value insight (consciousness), while a sensation type may focus more on adaptation to reality. Practical clinical examples are given to illustrate each type.

Michael Fordham approaches the question in terms of supervising cases of child analysis. The formal setting and basic techniques used to maximize the interactional nature of the analytic process and, hopefully reduce the child's capacity to escape into acting out types of play, are presented. Two clinical situations are examined to demonstrate the subtlety needed to evaluate the supervisee's developing analytic attitude and clinical skills. The progress can best be assessed, Fordham suggests, from comparative experiences, rather than abstract standards.

Supervision as a rite of passage is examined by Joseph Henderson, who observes that analytic training programs tend to promote the archetype of initiation, beginning with a supervisor as master-of-initiation, and ending with an assessment of progress in accordance with the requirements of the larger peer group. An important aspect in the supervisor's role includes a sensitive discussion of the moral, ethical and psychological dimensions of the incest taboo.

A number of factors are considered by Elie Humbert in assessing progress: clinical ability, general cultural development, an understanding of the relation between supervisees' personal pathology and the choice and exercise of their profession, and the way in which their own unconscious makes use of the analysis of another person. The ability to recognize changes in the unconscious, as well as the flexibility to move from one epistemological position to another, are also important factors.

The capacity to overcome the preponderant concern with "What am I supposed to do?" is of particular significance to Mario Jacoby. Assumptions such as "one ought to like one's patient," or "ought to 'understand' his dreams," or "ought to know what Jung said about animus-possession," and so on are characteristic of the "good student" attitude and often impede progress and the development of a personal analytic style. Supervisors need to be aware of their own narcissistic tendency to form and evaluate the supervisee in their own image.

How supervisees' clinical skills have developed along with the deepening of personal identity and analytic style are important criteria for Ann Ulanov. The capacity to assimilate unconscious material and to relate interpersonally also are significant factors. Is there an increase of detailed perception of the analysand and how does the supervisee monitor and therapeutically use nonverbal responses, such as body posture, breathing rates, turn of the head and so on. Does the supervisee appear trainable and has the personal style moved from the persona into the person? Ulanov's erudite essay presents a wealth of insights, not only into the assessment of progress, but also into the very nature of supervision itself.

The section on assessment concludes with Wilke's stimulating discussion of supervision from various perspectives: supervision as assistance, supervision as seconding and the supervisor as adjunct. Beginning therapists need to be supervised in the following areas: (a) understanding the dynamics of the case, (b) use of therapeutic methods, and (c) coming to a valid estimate of their role and discerning how their own complexes are integrated into the analysis of the patient. The success of supervision can partially be assessed by the extent to which the supervisee is later successfully integrated into the larger professional group.

Part V, "Phases in a Supervisor's Life," focuses on various dimensions of the professional life, beginning with the early years as a student and their emphasis on developing clinical skills and an analytic identity, continuing with becoming a training analyst and supervisor, and finally, confronting the psychological and physical realities of the aging process. The period immediately following completion of analytic training through the assumption of the responsibilities of a supervising analyst is explored by myself in the initial chapter of this section. "The Transition from Training Candidate to Supervising Analyst" can be emotionally turbulent as the recent graduate works to build up an analytic practice, undergoes acculturation into the professional community, and begins to develop the necessary analytic, didactic, and clinical skills to function as a supervising analyst. Integration of the analytic identity during this period involves meeting not only the outer institutional requirements of the profession, but also those inherent to the psyche itself.

How does an analyst prepare to become a supervisor? This question is increasingly being raised in the professional community and forms the central focus for Marga Speicher's chapter, "The Education of the Supervisor." Following a review of the current practices and requirements of supervision in Jungian training programs, the author provides a thoughtful discussion of how a program of preparation for Jungian supervisors might be designed and implemented.

The final chapter of this section, "The Aging Supervisor," is a poignant presentation of the problems encountered in old age by the supervisor. Wilke notes that many of the abilities necessary for supervision are acquired later in life, and consequently, are more vulnerable to deterioration through the aging process. This essay provides a remarkably sensitive treatment of the psychological issues associated with supervisory responsibilities and the aging analyst.

Part VI, "Supervision and Institutions," addresses the dynamics and issues encountered in supervision as it is practiced in various settings ranging from professional training institutes to mental health organizations. James Astor contrasts supervision sought for professional development with supervision undertaken for the purpose of fulfilling a training requirement, in his chapter "Supervision, Training, and the Institution as an Internal Pressure." When supervision and training come together, candidates find themselves simultaneously confronted with the complexities of an organization, its institutional mentality, and their own psychic development. The author subtly articulates the difficulties encountered keeping faith with the analytic process within the context of institutional dynamics, concluding that supervision is a necessity for all of us to counteract the deadly effects of inner institutionalization.

Using a systems approach, Jean Carr explores the institutional framework within which the process takes place to develop "A Model of Clinical Supervision." The various components of the system (patient/client, supervisee, supervisor, and organization) are outlined and a particularly useful analysis is provided of the dy- and triadic relationships making up the total network. Each relationship contains its own set of complex dynamics: transferences and countertransference, ego and shadow, ritualized behaviors, as well as overt and covert needs and alliances.

In the book's concluding chapter, Louis Zinkin turns the tables on the profession and asks how do individuals and institutions assess a good supervisor. Struggling with this question, the author helps us to better understand the impossibility of our task as supervisors. What is it this impossible profession is supervising? Certainly the supervisor is supervising something, but that something is certainly not the patient's literal analysis. What we call "supervision," Zinkin suggests, is in reality a shared fantasy - the supervisee trying to imagine what the patient has been doing in analysis and the supervisor trying to do the same. And, "supervision works best if both remain aware that what they are jointly imagining is not true."

It is hoped that the papers presented here will contribute to the advancement of our understanding Jungian supervision. Few aspects of clinical practice provide the type of professional challenge encountered in supervision. The quality of this personal experience and its potential rewards are difficult to convey in language. Perhaps this volume will help the reader develop greater empathic understanding of the vitality of the supervisory process.

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