Shirah Vollmer MD

The Musings of Dr. Vollmer

Supervision

Posted by Dr. Vollmer on March 2, 2015

How do you become a psychotherapist? How do you become a teacher for psychotherapists? Who should be the students? Is it necessary to have a science background? How many years should it take? How many internship hours should one put in? Who should license psychotherapists? Should this be a State license or a federal license? What about lawsuits? What can people sue for? What is evidence that things went wrong in psychotherapy? These are the endless questions in which my field is dazed and confused. Psychoanalytic institutes have a model for training; a model hotly contested, since there are no empirical studies. Traditional institutes have a tripartite model which includes a personal psychoanalysis, four years of classes, and three cases under weekly supervision, where the student goes for one hour a week to report on a patient who is seen four times a week. The lines between supervision and psychoanalysis blur, because since the student goes to his/her own psychoanalyst four to five times a week, then maybe the student should bring his/her questions to his/her therapist and not a separate supervisor. And who becomes a supervisor is yet another question?

Currently, I am working towards passing an examination which will, in one boutique of psychoanalytic training, consider me both a training and a supervising analyst. The training analyst part means that I will see therapists who want to become psychoanalysts, in psychoanalysis. The supervising part has those “fifty shades of grey” which can, as the movie suggests, contain an erotic component. The boundaries in psychoanalysis are clear. The patient comes at a particular time, they pay a fee, and the subject of discussion is the inner workings of the patient’s mind. The boundaries in supervision are subject to interpretation, and hence not clear. The student is supposed to talk about his patient and the supervisor is supposed to give thoughtful feedback, but as with all dyads, unique dynamics develop and the utility of the process is open for question.

In my new study group, we are reading articles about the controversies around supervision, and once again, I am struck at the arbitrariness of the process. Howard Bacal MD writes “a pedagogic ‘big bang’ occurred within the psychoanalytic universe. The ‘tripartite’ system of analytic training officially came into being with the strict separation of its three modalities.” In other words, a model appeared, and it has stuck, and so I am stuck in it. I do not mean that I do not have options, but I do mean that understanding the history enlightens me in that I can work within the model, or I can try to change it. For now, I am working within the model, while generating fantasies about how to change it. The jury is not out whether group supervision is superior or inferior to private supervision. The jury is also not out whether a supervisor should “graduate” to this status by passing an examination, or whether a supervisor should be defined by years of practice. For now, I am growing by learning, even if I am learning just how random professional development can be.

5 Responses to “Supervision”

  1. Shelly said

    How does supervising contain an erotic component? What is the difference between group and private supervision and why would a trainee choose one over the other? Is one route shorter than another? What is the difference between being “in training” and being “under supervision?” Is there a difference between being a trainer and being a supervisor?

    • All relationships are subject to fantasies, or free associations, and as such, a supervisor/student relationship, like any other can involve erotic fantasies. Group supervision could be peer supervision in which there is no leader or there could be a leader, whereas individual supervision means there is one student and one teacher or supervisor. For analytic training, individual supervision is required so there is no shortcut. First, one gets licensed to practice in a mental health field, and then psychoanalytic training is on top of that, so “in training” could mean training for licensure or it could mean deeper training for analytic work. Being a supervisor is also vague, since one can pay someone for supervision, but within analytic institutes there are only certain people who are recognized as training analysts. I am considering taking that step to be recognized as a training analyst. Thanks.

  2. Eleanor said

    I know absolutely zero about supervision, but my first inclination would be to go with a group supervision format prehaps meeting twice a week. That would, hopefully, keep the erotic component at bay and everyone could learn from everyone else’s cases in a productive manner….. Probably a naive/simplistic answer but that’s where my mind lead me on initial consideration.

    • Yes, group supervision is rich in the variety of case material and the interesting perspectives people bring to the group, but with all group dynamics, power issues may come into play. Like the difference between family therapy and individual therapy, the issues are different, and each has their own challenges. Thanks for chiming in.

      • Eleanor said

        Ohhh yes….group dynamics…..power/competitive issues, etc, etc…… My mind wasn’t going in enough thinking directions on this one! ;-/. I was being much too simplistic !Thanks Shirah!

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