My next example illustrates the latter point well. It is unclear how closely it relates to what is going on in the student's interaction with his client because the only material provided about the interaction between supervisee and client is that the client made an "oedipal reference" in communicating to the student-therapist, i.e., that the client was having some sort of strong emotional response (love; hate; jealousy...) to the therapist as a figure of authority and trust (a symbolic parent). As we shall see from the text of the example, supervisor and supervisee are involved in what may fairly be described as an "oedipal" interaction. Therefore the lessons to be learned by self-reflection in the supervisory situation may be directly relevant to the therapy. But, even if this is not the case (and my purpose in using this example does not depend on it), we will see that the supervisory interaction provides a valuable opportunity for the student (and the supervisor!) to work through important aspects of human relations in asymmetrical communication situations.
This example has the virtue of the clarity which comes from brevity. It also shows how problems can arise from good intentions, i.e., that good will is not sufficient to ensure good communication or healthful social relations. Paul Dewald, who, by the time he wrote up the incident, had become a highly senior psychoanalyst and supervisor, relates an incident from his own experience as a student:
...[S]ome of the candidate's behavior may involve regressive transferences to the supervisor rather than countertransferences to the patient. As a student I had a supervisor whom I idealized and wished to impress. I had observed in the material a very obvious oedipal reference, but when my supervisor asked what I thought was going on, my reaction was to feel that the oedipal reference was too elementary for him to have commented on and that I must have missed something much deeper and more elaborate. I launched into a lengthy free association on preoedipal factors, only to have my supervisor look at me incredulously, point out the oedipal theme, and interpret that I was having a countertransference response to the patient, inasmuch as I could not see her oedipal transference. I did not at that time have the courage to correct him, but instead I listened quietly to his interpretation. (Dewald, 1987, pp. 22-3)This is indeed a sad story of misunderstanding between a young person and his mentor whom the young person both overidealized and also by whom he felt intimidated -- surely itself a kind of "oedipal problem" (i.e., a possible analog to the patient's problem). The supervisor completely missed this dynamic in his interaction with the supervisee (thereby precluding examining to see if any use could be made of comparing the supervisory and therapy interactions).
The student sees the supervisory interaction somewhat more accurately than the supervisor. At least he is aware of the supervisor's mistake, and of his own lack of courage in failing to correct it, which may indeed be described as "a regressive transference to the supervisor." The student, however, fails to speculate on any possible analogy between his behavior vis-à-vis his supervisor and his patient's behavior vis-à-vis himself, which, as an oedipal reference, is itself another "regressive transference." (In an ironic parallel to the Freudian interpretation of the Oedipus myth, blame here is focused on the student [son], even though the facts clearly indicate the supervisor's [father's] wrongdoing caused the problem, and that the student's [son's] intentions were good, even if ultimately their consequences were grossly counterproductive.)
This leads me to speculate how the student understood the "obvious oedipal reference." Since he did not have the self-possession to stand up for himself vis-à-vis his supervisor, and did not think to inquire about a possible analogy between the therapy situation and what was going on in the supervisory interaction, perhaps the student didn't really "connect" with, i.e., empathically understand, the patient's experience in the therapy situation. The student may have been glibly applying a taxonomic label, rather than "seeing himself in the patient's shoes" and having a vivid sense of what was going on in the patient. That the student so easily doubted the accuracy of his perception of the situation is suggestive evidence for this possibility: Had the student felt his understanding deeply, he would not likely so blithely have been able to go off on alternative speculations, since his previous sense of what had happened would keep intruding upon his attempts to see it differently.
The supervisor, in his turn, illustrates the interpretive technique of "jumping to conclusions," and the [un]empathic interactive style of self-righteous indignation. Was this student so "dense" as the supervisor's response implies? That seems unlikely from the way Dewald says he idealized and wished to impress the man (a struggling student will not likely even try to impress his or her teacher, but rather humbly try to get "basic" help from him or her). The supervisor even implies as much by attributing the student's behavior to "countertransference" instead of ignorance.
Now, let us consider two rescripts of this interaction in which the participants make use of this rich communicative material. In the first, the student corrects his teacher. In the second, the teacher questions his own behavior.
The student might have said something like:
Excuse me; I'm sorry. But I did think of what you said. It's just that it seemed so obvious to me that I thought you must be looking for something more subtle. I assumed I must have made the student's frequent mistake of thinking something is obvious because I have not yet learned to recognize subtle signs of difference.At this point, the student would have at least partly have overcome his "regressive transference to the supervisor," even if he still didn't understand it.
The supervisor could then have replied:
It seems I was the one who thought something was obvious because I failed to recognize subtle signs of difference, as you so well put it. I assumed that, as a student, you had missed something obvious, whereas what was really going on was you were giving me too much credit for arcane powers of interpretation. I apologize for what I did.This would lead both supervisor and supervisee to cultivate more sensitive listening, including, but not restricted to what their patients say. For one possibility, if, in future, a patient had the courage to disagree with the student-therapist, but couched his or her demurral in apologetic terms, the student-therapist might recall his experience here, and empathically explore with the patient why the patient felt too intimidated to express him or herself more self-assertively.
You overestimated me and I underestimated you. We were both guilty of too quickly subsuming a particular situation under a general rule, whereas the heart of psychoanalysis is careful attention to context.
I'm really glad you spoke up for yourself. On the other hand, I think I do still note some oedipal transference in the deferential way you expressed yourself to me. I mean, it was my mistake; you had nothing to apologize for. Funny, isn't it, that we were talking about the patient's "oedipal material" and missed our own. Maybe there's also something more to what the patient said that we've both missed by so quickly categorizing it as just "an obvious oedipal reference." Let's see.
The second alternative I wish to explore would be for the supervisor himself to pick up on his mistake. He could say something like:
Wait a minute. You seem to be just sitting there not saying anything after that criticism I just made of you. Did I miss something? Even if I didn't miss anything, I didn't set a very good example by interpreting so peremptorily, which, if one did that in therapy would tend to cut off the patient exploring further and trying to integrate the therapist's insight into his own understanding. It certainly wouldn't be likely to nurture the patient's self-esteem, or, in this case, yours.This continuation by the supervisor would set an example for the student how to deal with his own possible mistakes as a therapist, and, even more generally, how to deal with any situation in which a patient reacts to an intervention by withdrawing. The student would have experienced a model for overcoming a patient's discouragement or silent hostility, and encouraging the patient's continued working in the therapy, without which the therapist's intervention, even if, in abstracto, it is brilliantly insightful, will not help the patient.
Earlier, I quoted Ruesch and Bateson's contention that asymmetrical social relations, extended beyond the exigencies of infantile dependence, lead to disturbances of communication and so-called mental illness (Ruesch & Bateson, 1951, p. 38). Here is an instance. It is highly unlikely that Dewald would have been so unsure of himself, had he been conversing with a fellow student instead of an esteemed "superior," i.e., had he been engaged in a symmetrical communicative interaction. He probably would have answered the initial question by asking why his conversant was asking about something seemingly so obvious. This example clearly shows the opportunity which the supervisor's evaluative role provides for the supervisee (and the supervisor, too!) to explore the dynamics of asymmetrical communication, for their own growth, and to be better able to help their patients (including helping patients deal constructively with the asymmetry of the therapist-patient relation, itself).
Since we do not know exactly what the patient did (what exactly the "obvious oedipal reference" was), it is not possible confidently to elaborate this example much further. But, to repeat, the point of this example is not to be elaborate, but to illustrate my basic thesis that there is a lot to be learned from self-reflection in the supervisory interaction which is highly relevant to improving the supervisee's (and, especially in this case, also the supervisor's!) competence and efficacy, not just as a therapist but as a person (i.e., contributory to enhancing therapeutic effectiveness from the deep roots of greater wisdom).
A student reports what happened in a therapy session and Langs critiques what the student did. Student:
Well [the patient] was referring to a comment that I made when she said something about her [former] psychiatrist's visit to the hospital [the patient had just had a miscarriage] and his having said that she was sick because she wanted to be sick. I had questioned her, said something like, That is what he said? I raised a question that the patient felt indicated that I didn't believe her, and she got angry. (p. 127)Langs proposes that the patient correctly heard as hurtful what the student had said to her:
[T]he odds are overwhelmingly in favor of there having been a valid core to her perception of your intervention. We can even look to some validation of this thesis in what you did in presenting the session to us. First, you left out your interventions entirely, and second, when you reported what you had said to the patient, you left out what is clearly the most important intervention of the hour -- at least for the patient, and she is probably right about that. These defensive behaviors on your part give us a clue that there is a countertransference problem at work. So notice that here in a rather unusual way, we have taken the conscious associations of the patient as a clue to a countertransference problem in the therapist, and then observed the therapist's behavior and found some confirmatory indications that this is the case. (p. 130)Langs does not elaborate further on what can be learned by examining the presenter's behavior in the present interaction, but continues by further critiquing the therapist's interaction with the client.
The student's problem here being addressed appears to be a kind of communicative insensitivity. The patient seemed to perceive the student as being more concerned about whether the incident with the former therapist really happened than about what the incident meant to the patient or why she felt it important to tell the new therapist about it. Langs' approach is to teach the student about this, and it is reasonable to expect this may be helpful, although at best it requires the student to figure out how to translate and apply a message from one medium to another (didactic instruction versus eliciting feelings).
By taking more interest in what the student did in the therapy session than in what the experience of reporting it in the seminar meant to the student, Langs seems to be repeating in the supervisory session what the student did in the therapy session. Had Langs focused instead on the student's feelings in the supervisory situation, he could have provided the student with an experience of the kind of communicative sensitivity of which the student seems oblivious, as a model and practice for being more effective in this regard in future therapeutic interactions (as well as in the rest of life): Instead of the supervisor [student] focusing on determining what happened in the student's therapy session [the patient's interaction with the former therapist], the supervisor [student] could have "bracketed" this and focused on determining what the behavior by the student [patient] relative to the putative outside event meant. I hypothesize the quality of this learning experience would have been less affected by exactly what the supervisor and the student decided was happening "in the room" (either the therapy room or the seminar room), than by [the "medium" of] them focusing primarily on what went on between themselves rather than on what speculatively happened in the client session (impact of "message" versus impact of "medium").
Langs continues with an observation to the seminar which seems, consequently, to apply as much to himself as he makes the remark as it applies to the student's behavior in the therapy interaction, which is the remark's manifest theme. Langs gives no indication of himself being aware of any self-reflective dimension to his words.
The speculation that I offered just a little while ago, that it may well be that this therapist has been somewhat hostile or destructive with this patient for some time, now has some degree of confirmation.... Here, we sense another kind of misalliance, one of a sado-masochistic interchange. (pp. 130-1)The student continues his report of the communicative exchange in the therapy session, with Langs' interspersing remarks, and nobody saying anything about the communicative interaction taking place in the seminar. The student's last words report verbatim more of what the patient said:
So.... you know, my mother also says that I don't need therapy. And my husband again says that I don't need it. But what do you say? What do you think? Do you think I need therapy? Please answer me; just this time; just this question. I know you don't want to answer me. (p. 154)Langs then proceeds to bring the session to a close with some more content-oriented remarks (including something about patients wanting medication as a way of dealing with disappointment over their therapists' interventions), and no acknowledgment of the student's feelings.
Let me propose another way Langs could have ended the seminar session, an ending which would model for the presenting student (and for the other students observing their interaction) the kind of communicative sensitivity the student seems to need to develop (i.e., what both Langs and I seem to agree is an important pedagogical objective in the present case):
You know, something probably implausible just struck me, but it would at least be consistent with what we have been studying in this session to check it out. We saw that when your patient told you about the former therapist's hurtful remark, maybe she was obliquely telling you she was afraid you would hurt her too. I wonder if your ending this presentation by reporting the patient's plea that the you tell her whether she should be in therapy is an oblique way of your telling me you think I might need therapy, or maybe it's an oblique way of your asking me whether I think you'll ever become a therapist. [pause to let this sink in]I imagine the class ending at this point with a laugh of recognition and relief. Through this personal but non-threatening message, Langs would have conveyed the importance of listening for what a person is obliquely trying to say, and some sense of how to go about doing this, far more meaningfully than by directly lecturing on these points. The message would likely have "connected" for everybody, all around (especially for the presenting student, who all the time had been "on the hot seat"), in an evocative way that might appealingly come to mind in future situations, both therapeutic and other.
I admit it sounds implausible, since you didn't choose what the patient said, but, then again, they are the words you said, and the stress of this supervisory session may have raised in you feelings which you hesitated to express. As both Gregory Bateson and Erving Goffman would say: the more rigidly structured a social interaction is [pause while teacher recalls quotation], the more evident it becomes that the persons involved in the interaction actually have a curious freedom to impose their own interpretations upon the behaviors they have no choice not to enact.
Maybe this speculation of mine will lead you to something -- or maybe not. I hope I have been of some use to you. We will stop now, until next week.
This rescripting uses the communicative interaction to convey yet another lesson which, while not narrowly decisive for the exact interpretation of the particular therapeutic transaction under consideration, is pervasively important for all of living and all of therapy: It really does not matter much what exactly happened in the particular interaction being examined, since, in any case, it is past. What matters is the present and its future: what persons are doing now and will do with the rest of their available lives. A key here is to be open to considering a rich variety of options in effective ways -- Mead's notion of the truly free imagination. To lecture this point, like any other instruction, probably will not have much effect, although, if one lectures it over and over again, it may have more effect and thus the lecturing will seem to have been successful. A single existentially lively encounter with a notion, however, may impress it deeply and effectively.
In the present case, the student was busy trying to report exactly what the patient said. It was probably the furthest thing from the student's mind to ask about Langs' opinion of himself, and, even if the student did think of it, he kept it to himself and did not elaborate it (because he had no reason to expect anything encouraging from it). To be presented with this new possibility "out of nowhere" would give the student an experience of a possibly important idea coming inadvertently to mind. That the idea is treated as something to check out and think about, and of possible use even if it is wrong, further encourages imaginative exploration of possibilities. That the possibility explored here, even if the student was not thinking about it, is one with which he likely would strongly agree after having been scrutinized so harshly by Langs, would further convince the student that a rich fantasy may be more valuable for life than an impoverished truth. If the student had thought this idea and been afraid to mention it, having Langs give permission to have the idea without requiring its confession would truly give the student encouragement to elaborate such speculations in future, because he would be less afraid of them.
Unbeknownst to me, at the same time, the supervisor was telling one of my fellow students, who was also in supervision with this supervisor, more or less the same thing. Clearly, the supervisor was either lying or "splitting" (lying to him- or herself), since two different things cannot both be unique. In the "group", which both us uniquities compulsorily attended, the supervisor accused the other of us of doing something really stupid, and I assumed my fellow student had indeed done something stupid (since that's how I saw a lot of what my fellow students did). Sometime after this accusation, I found out from the other supervisee about the supervisor's two-facedness. Had I known at the time of the supervisor's public belittling of the other student that the other student was not being stupid but being intimidated, I would probably have come to the student's defense vis-à-vis the supervisor (I would have "exposed" the supervisor -- I'd done such things before...). But the supervisor's manipulation of us students by keeping us each in ignorance of what was happening to the other precluded such a reconciliation of accounts. None of this was ever dealt with by anyone, at least beyond the training institute's deciding that my difficulties with the supervisor indicated serious personal problems which might prevent me from ever being an even minimally competent therapist, and that I needed even closer "supervision", in the form of a kind of probation in which, in the end, I failed to prove myself to have overcome my problems. Part of the evidence for this was that I sought a supervisor who, even though [by a kind of political-historical mistake, was] on the list of "approved supervisors", was not part of the faculty clique, and thus could not be counted on to monitor me appropriately. True to expectation, this supervisor only evaluated my work with patients (which no one ever questioned, beyond accusing me of "too much empathy"!), and not my submission to faculty authority, which latter was the faculty's primarily interest....
Regarding the rogue supervisor, who was, to the best of my knowledge, never censured or even shunned by the rest of the institute's faculty, the best we students were able to do was gain an exemption from having to attend a third compulsory semester of group supervision under this self-styled follower of Wilfred Bion, i.e., whose professed theory of group supervision was to say nothing, with the objective of making the supervisees as uncomfortable as possible. The problem, of course, was that, in this person's case, "saying nothing" was not just noetic empty space, but rather was filled with mendacity and spite. One of the problems here was that I had risked telling the supervisor [in individual supervision] that, after talking over my difficulties vis-à-vis the supervision with my personal analyst (who was not connected with the training institute!), she and I had come to the conclusion that I was reexperiencing with the supervisor something that had been a leitmotiv of my life, and which, consequently, the supervision might offer me an opportunity to work through, namely: having to deal with a person in a position of power over me who was incapable of understanding me. The supervisor proved too deficient (and too inadequately analyzed) to even be able to be of use in this role of helping me deal better with such disappointments in life. And, when I suggested to the supervisor that (s)he might go get further analysis to help him or her cope with his or her problems in this regard, that was interpreted by the supervisor as: "the last straw".]
Other times, however, it really is not possible for a conversant to figure out what is going on in a conversation just by inspection of the manifest proceedings in the room (the "here-and-now") where the interaction is occurring. Sometimes there are non-immanent realities which must be taken into account to make sense of what is going on. This issue can get side-tracked by questions of how much of their personal lives supervisor and supervisee should reveal to each other (and how much of their personal life therapists should reveal to patients). I shall not address that question here. I shall limit myself to those aspects of the supervisor's or supervisee's or therapist's [putatively] "outside" life which are so tightly internal (integral) to the supervisory or therapy process that, unless situated in context of that material, what transpires "in" the supervision or therapy either makes no sense or appears in a misleadingly false light. In Goffman's terminology, I shall consider "external" factors only insofar as they reframe the manifest proceedings and therefore are key aspects of the situation which is really occurring.
An example of such apparently external but really internal factors is that, in a "con game," the fact that the target of the scam is being duped is not manifest in the interaction, but the interaction cannot be understood apart from this -- hidden -- factor. While this (commonplace) example emphasizes fabrication and intended deception, purposefully duplicitous intent is not a necessary aspect of the phenomena here under consideration. Since forms of social life are frequently informally learned through practice as part of the transmission of the social unconscious, none of the participants need be aware of these laminations and other distortions which they enact in the communicative interaction. Even when one or more participants are aware of them, they may consider them to be "natural," "the way things ought to be," or, even if not admirable, at least "nothing to speak of." In an "honor code" boy's school, if a student cheats on a test and then turns himself in and the Headmaster deigns to punish him only by making him take the course over (instead of expelling him from the school or putting an indelible "F" on his transcript), all parties involved may be sincerely acting in good faith, without any sense that what they consider immutable laws of social life are really deutero-propositions -- what Habermas, as quoted above, described as: "ideologically frozen relations of dependence that can in principle be transformed" (Habermas, 1968/1971, p. 310).[fn.113a]
In such cases, as in Hegel's parable of "evil and forgiveness" (Hegel, 1807/1931, pp. 667-679), the persons on both sides of the relation may learn that the pattern of social action which separates as well as binding them, the pattern of interaction through which they get their human needs met in a process which iatrogenically produces new unpleasures, can be re-formed to become unambivalently nurturing. Instead of blindly repeating the old pattern, they can enter into conversation to restructure their relationship (their social surround) into something less self-conflicted and more mutually rewarding. This is the process of changing the factically given communicative matrix into self-accountable conversation through self-reflection within the conversation itself. In my example of the student in the "honor code" school, the Headmaster might say to the student something like:
You are a sincere and conscientious young man. I suspect there is some good reason why you couldn't study effectively enough to be able confidently to do the exam without cheating. Let's try to figure out what that was and see if we can change things around so that, in future, a good person such as yourself will not so easily find himself in such a difficult situation.My example from psychotherapy supervision here, however, is not so straightforwardly a mutually unwitting case of persons believing they are doing the right thing and not recognizing that they have any alternative (Edward Hall's "social unconscious" in action!). It is rather a case of "nothing to speak of" on one side and helpless deception on the other. This example is the core of the material on which the Study Group on Supervision of the Committee on Psychoanalytic Education of the American Psychoanalytic Association [[a.k.a.: "COPE"]] based a report which, after nearly 15 years' efforts, ultimately appeared as the book: Becoming a Psychoanalyst (Wallerstein, Ed., 1981).
In this case, the supervisor purposely hides information from the supervisee, with the effect that the supervisee is unable realistically to orient himself to the supervisory situation. The supervisor, however, while he consciously knows he is hiding something from the supervisee, probably thinks he is not doing anything "really bad."
This example differs from my other examples in not requiring verbatim text of the supervisory interaction to be understood. Part of the reason for this, surely, is that all the verbatim text is operating under a reframing, so that the specific content of the material is far less important than the status of the participants' awareness (or lack of same) of the frame structure which no particular words directly represent, but which contextually pervades "everything."
The supervisee in this case is a Ph.D. psychologist who has been admitted to a classical American-style Freudian psychoanalytic training program as an exception case (normally only M.D. psychiatrists were admitted to these programs at the time). As part of his special dispensation, the student is expected to do some research related to psychoanalysis. Some candidates treat this requirement as a kind of sham, but this student takes his commitment seriously, and, in his work with his analytic client, he writes extensive process notes to build up a database for possible subsequent research. The supervisor was aware of this situation:
These issues were all the more troublesome when I felt I had to take up with the candidate the possible deleterious effect on the conduct of the analysis of his own avowed research interest in the patient, feeling as I did that on this issue my own hands were not clean. (p. 286)The supervisor kept all this a secret from the supervisee. The supervisor's main response to the supervisee was to be annoyed by the extensiveness of the supervisee's notes. The supervisee submitted his notes to the supervisor in advance of each supervisory session and expected the supervisor would look over the notes before their meeting, so that the supervisory time could be most effectively spent discussing treatment issues without taking so much time for simple informational reporting. The supervisor did not do this, although the supervisee later found out that the supervisor would sometimes read the notes after the sessions, to check up on what the supervisee had said in the session (i.e., the supervisor did have time to read the notes when it suited the supervisor's interests). One reason this issue was not directly confronted was that the supervisor was also the supervisee's direct manager in the supervisee's job in the same institution (a large teaching hospital), and, furthermore, the supervisee had previously had some interactional difficulties with this person. Therefore, in the supervision, the supervisee tried to do everything in an unexceptionably proper way. (This latter intention only resulted in the supervisor finding the supervisee too "rigid" in his work in supervision.)
Following are some of the supervisor's own thoughts about these matters, as he recorded them while the supervision was in process:
I may have been anticipating this candidate would be (i.e., it may have been my need that he be) a better analyst at this stage of his development than he, in fact, was....Not only did the supervisor not share any of these concerns with the supervisee. The supervisor's reason for taking notes (of which the supervisee was unaware) was not the supervisor's private edification, but rather that the Study committee was using this particular supervisory relationship as it's main example for studying the supervisory process, and the supervisor was writing up his interactions with the supervisee for the Study committee's extended examination (this material appears in chap. 5 of the book).
...I have become increasingly uncomfortable about the supervision on several counts. Though the analyst prepares exhaustive notes we do not use (i.e., they are too long to be read and discussed during the supervisory hour), he is also concerned to "give me the picture" orally and is very punctilious about his self-imposed task. I do not feel, however, that I am really in touch with what he is doing with the patient, and tend to feel that I am being held off at arm's length -- defensively kept out of things. The "picture" he gives is often a synthetic account of the week, ignoring chronology. I am not acting entirely natural with this candidate, a feeling I can relate in part to the nature of these presentations which make me feel I am being made into an "audience" for him. I have often felt it necessary to try to penetrate the obscurity of these "clear" reports and, detectivelike, try to find out what is actually going on. Yet I have felt constrained from directly taking up with the analyst the nature and the impact of his way of presentation.
I am not certain about all the motives that may underlie the candidate's behavior. He is characteristically a person who likes things well organized and can be quite argumentative in pursuit of an issue or when he believes a "principle is involved." But during this supervision he has been most courteous, though at times quite stubborn, as by listening politely to me but not dealing squarely with the substance of what I have to say.... For my part, I find myself being more passive than is customary for me. (pp. 289-90)
The supervisee had no idea this was going on. Even after the supervision had ended, and the ex-supervisor visited him one day, and the ex-supervisee talked about some research he was doing, the ex-supervisor said nothing about his own earlier research using the supervisee as unwitting experimental subject. The supervisee tells how he finally found out about what had happened, some time later:
I first learned of the research when I received a package in the mail whose contents surprised me. I learned from the enclosed manuscript that I had been the subject of a study on the nature of psychoanalytic supervision. These pages were written by one of the two supervisors on my second control case. He had supervised the case for two and a half years; the case was brought to a successful conclusion a year later with the help of a second supervisor. At first I found myself utterly baffled by what I had received, especially since not so long before I had prevailed on my first supervisor, when he was paying a visit to his old friends and colleagues, to let me show him my laboratory. In retrospect, I realized he seemed quite interested in finding out about the case he had supervised some time before, and I was pleased to tell him. He acted surprised by the generally favorable outcome I reported to him and asked me how I accounted for it, a question that surprised me in my turn. But during that visit he mentioned nothing about the supervision study, although the supervision and analysis were long over. Now I had before me a considerable number of pages of manuscript written by him on my case. The question, "Why was I not told?" leaped into my thoughts. How could they (whoever they were was not yet known to me) undertake this study without notifying me, without me notifying my patient? How could he (my erstwhile supervisor) do this to me? The first outburst of anger dissipated and was then replaced by a sense of hurt. I came to appreciate that the word grievance contains within it the word grief -- for a grievance is based on a loss, a loss of esteem for oneself and for others who have arbitrarily inflicted this loss. (pp. 312-3)Ultimately the ex-supervisee threatened legal action if the book was published without his permission (p. 314). After mediation, an agreement was worked out whereby the book would be published, but with the addition of two chapters written by the ex-supervisee and expressing his perspective on the matter (p. 314) (the above quote is from these additions).
I feel the book as finally published, with the ex-supervisee's candid response to the research project, and the ex-supervisor's extensive commentary, constitutes a remarkable document concerning the mystified communications which are unfortunately not rare exceptions in the world of psychotherapy and its supervision -- and in all of social life. But, to repeat Harold Searles' observation, these interactional processes may be exceptionally illuminating in the psychotherapy supervision situation, since all the parties involved are not just communicators (a.k.a. "people"), but each is (is at least supposed to be) also an expert on human communication (the difference I have in mind here is somewhat analogous to the difference between naturally occurring uranium ore in which fission occurs but never intensely enough to be able to set off a chain reaction, and what can happen with artificially enriched uranium).
In the course of the supervision, as stated, the supervisee had no idea what was going on. The supervisor himself noticed certain effects upon himself, including:
I have the initial feeling that I do not remember this supervision as clearly as I should.... I am not sure whether to attribute this to my involvement in process recording in this case, which I believe has a tendency to take the place of memory....There is highly suggestive material here for self-reflection on the supervisory process. These reflections, by a securely professionally established supervising analyst, if taken seriously and applied back to the far more vulnerable situation of a candidate in training, raise far-reaching questions about much that happens to supervisees and is, often not just by the supervisors, but by the supervisees as well, considered "natural" (etc.). The supervisor himself remarks (although he does not appear to "take the ball and run with it"...): "Perhaps my ordeal is only a replica of the anxiety of the candidate in presenting his material to the supervisor" (p. 286).
I think I underestimated considerably the impact that taking notes for the COPE Study Group on Supervision would have on me and on the supervision. First of all, I underestimated grossly the amount of effort and trouble it would be to prepare notes... for an existing group of well-known colleagues than it is to prepare notes for my own curiosity....
...I was as concerned about understanding and remembering for a third party as I was with the primary task of supervising. I cannot be sure just how much interference my divided attention caused. I think it influenced me somewhat in my behavior with the analyst. At the very least, my sense of spontaneity was affected, and my wish to demonstrate "teaching" may have been an intrusion. When I observe that the atmosphere between the analyst and me was "stiffer" than with other candidates, I wonder how much responsibility I bear for this. (pp. 285-6)
The specific point I want to pursue in this example is simple: The supervisor could have told the supervisee about the proposed study before using the supervision as material for the study. The situation here may be compared with our first example, where the supervisee's agreement to tape record the supervisory sessions was obtained in advance. Fleming and Benedek note, however, that:
Probably the agreement as well as the almost unnoticeable reaction to the recording machine was the consequence of the fact that [the supervisor] at that time intended to study the material for a special research interest in [the patient's] pathology, not for the supervision itself. (Fleming & Benedek, 1982, p. 59)The effect upon their interaction of interactants knowing that their interaction is being recorded seems to vary from situation to situation. Theoretical positions on this issue also vary widely, even for a particular theoretician. Formerly, Robert Langs, with his emphasis upon the exquisite sensitivity of the patient to deviations from the ideal frame of therapeutic interaction, felt that where therapy sessions were recorded, the patient's "unconscious" material in the session would tend primarily to concern itself with the intrusion of the recording into the therapeutic interaction (see, e.g., Langs, 1981, pp. 32, 110, 141). More recently, I speculate in part due to his increasing interest in quantitative time-interval "scoring" of the contents of therapy sessions which simply is not possible without recordings, Langs has backed off from his earlier position (see, e.g., Langs, 1992b, pp. 41, 214-5). Many researchers seem to believe that the participants in an interaction eventually become "used" (i.e., accustomed) to being recorded and the effects of the recording gradually fade out. Edward Glover, however, argued strongly that, among other ethically and pragmatically nefarious effects, "dictaphone records... would totally destroy the most essential aspects of [the analyst's spontaneous emotional reactions to the patient]" (Glover, 1955, p. 111).
Fleming and Benedek's speculation seems highly plausible here, in light of the emphasis of both psychoanalysis and communication theory on the importance of context in determining behavior and its meaning. It may be somewhat naive for a supervisee to not think about the possible uses of a recording (and, there is always the possibility of unwitting effects), but it seems a very different situation for supervisor and supervisee to be talking into the recorder [conversing as a we-subject] with the mutual intention of capturing information about the patient's dynamics, in which case it is understood that information about the supervisor and supervisee will not be scrutinized even though it could be, in contrast to a situation where supervisor and supervisee are aware that the main material which will be analyzed from the tapes is their own personal participation in the interaction [where the parties enter into outside observers' conversation not as co-conversants but as content strategically talked about].
In the present example, the supervisor himself acknowledges (although, I repeat, not to the supervisee!) that using this supervision for research pervasively influenced his own (the supervisor's) behavior as supervisor, although he sees this mainly in terms of protecting the supervisee from too harsh evaluation by the Study Group:
It was my hope in agreeing to present this case from the beginning that it would turn out to be a "normal" supervision with no serious problems so that the group could remain focused on the supervisory process, in particular on the activity of the supervisor. This wish to offer an "average expectable supervision" for study contributed to my reluctance to report my own feelings of uneasiness about the progress of the supervision as deeply and as soon as I felt them.... (p. 288)It seems reasonable to speculate that, had the supervisee been told about the projected use of his supervision, he too would have interacted differently. Assuming the supervisee agreed to participate at all, the Study Group would likely have been far less confident in the usefulness of their material, wondering how much of it was straight and how much framed and fabricated for themselves as its intended audience.
Does this mean that the communication interactions of supervisor and supervisee, however potentially rich a source of communicative material they may be, cannot be studied, due to ethical and/or logistical issues? I think not. What I think it does mean is that unreflective supervisory interactions cannot be studied except surreptitiously, i.e., by the participants thinking they are not being recorded when in fact they are (which many persons, including myself and the supervisee in the above example, would argue is unethical), or in conditions of inanition (where the participants don't care about their interaction being exposed to third parties -- complicity by researchers with persons having such an [perhaps either debased or grandiose] attitude about themselves seems also an ethical issue).
If, however, supervisor and supervisee approach their relationship as, for themselves, an object of continuing self-reflective communicative study, then they can study it as deeply as time and mutual trust will allow, the only proviso being that the kind of supervisory relationship being studied is one which is reflectively attuned to examining itself, and not the naive kind of supervision in which the focus of the interaction between supervisor and supervisee is generally on the supervisee's therapeutic work, and on the supervisee's personal and professional limitations, but in which the supervisory interaction itself is generally not an object of its participants' study. If my arguments in this dissertation have weight, this latter kind of supervision is relatively inefficacious on principle. Therefore, like many other forms of praxis in the history of the development of society, it -- together with its correlative modes of being studied -- simply needs to die off and be replaced by the demonstrably better alternative which presents itself (so that it is not important whether it is a form of social interaction which can be studied).
Of course, whether a self-reflective supervisory couple will see fit to expose the results of their examination of their interaction to the outside world will depend on whether they feel it is safe to do so. Just as it is sometimes lamented that there is no psychoanalytic "Journal of Failed Cases," so here as well we may anticipate that some interesting but not universally laudable material would never see the light of day. This problem is not unique to my proposed modifications to supervisory interaction. Even for a few "felicitous" self-reflectively elaborated supervisions to be reported in the literature would vastly expand the imaginative horizons of supervisors to be able to offer their supervisees richer supervisory experiences, and for supervisees, if they have the good fortune to learn of this literature, to come to have higher expectations of supervision and be better able to cope when their supervision does not go well.
Had the supervisor in our above example told the supervisee about the research while the supervision was in progress (or had the supervisee somehow managed to find out about it), an important lesson it seems to me both participants could have learned from the experience is something highly relevant to the supervisee's therapeutic work as well. Part of a therapist's work is enabling the patient to see when the patient is interacting inappropriately based on distorted understanding of other persons and social life. As the supervisee commented once he found out about the study: "[D]istortions in communication can only be appreciated when we know something about the reality prevailing at the time of the communication" (p. 230).
Supervisor and supervisee could have reflected on the ways their communication had been distorted by the supervisee's former unawareness of important reality factors, as a model for becoming more sensitive to how patients' productions are easily misunderstood and the patient made to appear "crazier" (etc.) than the patient is -- as here the student was made to appear "dumber" than he was -- when these factors are not known. This example emphasizes how "self-reflection" differs from "introspection," in that the object of self-reflection is the conversation-which-is itself, including whatever parts of the ["external"] world it affects or affect it, in the precise way(s) they affect or are affected by it (whereas introspection only looks inward, to phenomena cognized as individual psychological processes). [It is perhaps (always and everywhere) worth repeating: The here-and-now is, in a way, all things; i.e., conversation is where everything finds its place, and, consequently, conversation is our home[coming].]
 Ruesch & Bateson, 1951, p. 219.
 Material quoted from this book Copyright 1981, by International Universities Press, is reproduced by permission of the publisher, for use in this dissertation only, and may not be further reproduced without written permission of the publisher.
 This is a reasonable approach if both supervisor and supervisee are genuinely interested in the supervision for its own sake. If, however, the supervisor is very busy, the supervisor may not have time to read the reports, and, logically, should discuss this constraint with the supervisee to negotiate the best feasible compromise. If, on the other hand, the supervisor is not interested in the supervision per se, but only in such factors as the fee the supervisee pays for the supervisory sessions, then for the supervisee to try to get the supervisor to do extra work outside their session-time may be a way for the supervisee to try to get more service from the supervisor than the supervisee is paying for, etc. Alternatively, the supervisee may naively think the supervisor is genuinely interested in the supervision, and prepare the reports, imagining the supervisor will welcome them, when, in truth, the supervisor is not interested. Thus we see that even a seemingly minor detail like this offers rich opportunities for study.
|Return to Brad McCormick's resume.
Return to Brad McCormick's home page.
Go to site map.
Copyright © 1998 Brad McCormick, Ed.D.
14 March 2006 [07 August 1999]