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<p class=MsoNormal align=center style='text-align:center;text-indent:.5in'><b
style='mso-bidi-font-weight:normal'>THOUGHTS ON PSYCHOANALYTIC SUPERVISION<o:p></o:p></b></p>
<p class=MsoNormal align=center style='text-align:center;text-indent:.5in'><b
style='mso-bidi-font-weight:normal'><o:p> </o:p></b></p>
<p class=MsoNormal align=center style='text-align:center;text-indent:.5in'><b
style='mso-bidi-font-weight:normal'>Richard L. Rubens, Ph.D.<o:p></o:p></b></p>
<p class=MsoNormal align=center style='text-align:center;text-indent:.5in'><o:p> </o:p></p>
<p class=MsoNormal style='text-indent:.5in'><o:p> </o:p></p>
<p class=MsoNormal style='text-indent:.5in'>It is my belief that psychoanalytic
supervision is a <i style='mso-bidi-font-style:normal'>psychoanalytic</i>
endeavor, rather than a didactic one.<span style='mso-spacerun:yes'>�
</span>Put succinctly, I view such supervision as psychoanalytic therapy for
one�s work.<span style='mso-spacerun:yes'>� </span>I shall first state, in the
following two paragraphs, what I believe to be the essence of the position, and
I shall then proceed to take up and expand upon various of the specifics of how
I understand and undertake to structure and participate in such endeavors.</p>
<p class=MsoNormal style='text-indent:.5in'>I view the supervisory process in
much the same way I do the analytic process itself:<span
style='mso-spacerun:yes'>� </span>it is an intimate, intense relationship,
conducted within the safety of the relationship�s confidentiality, and
following its own, mutually determined course.<span style='mso-spacerun:yes'>�
</span>In this relationship, both participants bring to bear the fullness of
their experience of the material under consideration �and of the process of
considering it together.<span style='mso-spacerun:yes'>� </span>Each is
challenged to be as open to �and with�<span style='mso-spacerun:yes'>�
</span>his or her experience as he or she is capable; and each is also
challenged to bring all of his or her skills at detailed inquiry to bear on the
examination of all aspects of that experience.</p>
<p class=MsoNormal style='text-indent:.5in'>The fundamental difference between
analysis and analytic supervision lies in the agreed upon scope of the endeavor:<span
style='mso-spacerun:yes'>� </span>in psychoanalysis, the field of inquiry
specifically needs to be unlimited; while in analytic supervision, the agreed
upon field of inquiry is essentially predetermined as that relating to the
supervisee�s analytic work.</p>
<p class=MsoNormal style='text-indent:.5in'>Personally, I am someone with
highly developed theoretical interests and philosophical concerns.<span
style='mso-spacerun:yes'>� </span>My writing and teaching on the theories of
Fairbairn and on the interactive nature of<span style='mso-spacerun:yes'>�
</span>transference and countertransference express the central thrusts of this
theoretical interest.<span style='mso-spacerun:yes'>� </span>Nevertheless, I do
<i style='mso-bidi-font-style:normal'>not</i> deem supervision to be the
appropriate forum for the pursuit of such interests �any more than I believe
psychoanalysis itself to be an appropriate arena for such foci.<span
style='mso-spacerun:yes'>� </span>While the specific developments of the course
of a supervision (or of an analysis, for that matter) may bring the theoretical
positions of one or both of the participants into consideration at any
particular time, such considerations have no intrinsic roles in the
process.<span style='mso-spacerun:yes'>� </span>To reiterate what I have stated
earlier, analytic supervision is <i style='mso-bidi-font-style:normal'>not</i>
a didactic process in my view.</p>
<p class=MsoNormal style='text-indent:.5in'>In fact, I go so far as to assert
that a psychoanalyst�s theories and metapsychology are nothing more �or less�
than an aspect of his or her countertransference.<span
style='mso-spacerun:yes'>� </span>They are a sometimes highly intellectually
elaborated countertransference, to be sure; and, at times they are a
potentially useful countertransference.<span style='mso-spacerun:yes'>�
</span>But, to the extent that theory and metapsychology are relatively
enduring patterns with which the analyst approaches his or her experiences and
through which he or she shapes and understands that experience, they must be
considered to be part of the realm of countertransference.<a style='mso-footnote-id:
ftn1' href="#_ftn1" name="_ftnref1" title=""><span class=MsoFootnoteReference><span
style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><span style='font-size:12.0pt;mso-bidi-font-size:
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mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA'>[1]</span></span><![endif]></span></span></a></p>
<p class=MsoNormal style='text-indent:.5in'>Thus, in supervision, there will be
an interaction between the theoretical positions of<span
style='mso-spacerun:yes'>� </span>supervisor and supervisee (in much the same
way as there will be such an interaction between the theoretical positions of
analyst and analysand).<a style='mso-footnote-id:ftn2' href="#_ftn2"
name="_ftnref2" title=""><span class=MsoFootnoteReference><span
style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><span style='font-size:12.0pt;mso-bidi-font-size:
10.0pt;font-family:"Times New Roman";mso-fareast-font-family:"Times New Roman";
mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA'>[2]</span></span><![endif]></span></span></a><span
style='mso-spacerun:yes'>� </span>The interaction of these positions
represents, however, nothing more or less than an aspect of the overall
interaction of the personalities and personhoods of the two participants in the
process.<span style='mso-spacerun:yes'>� </span>As with any aspect of the
interaction, the interaction between the theoretical positions represents an
appropriate subject for inquiry.<span style='mso-spacerun:yes'>� </span>As with
<i style='mso-bidi-font-style:normal'>all</i> psychoanalytic inquiry, however,
the most important level of the inquiry will relate to the
transference-countertransference interaction embodied and expressed in the
subject.</p>
<p class=MsoNormal style='text-indent:.5in'>Psychoanalytic supervision must <i
style='mso-bidi-font-style:normal'>never</i> have as its aim the inculcating of
any particular theoretical position.<span style='mso-spacerun:yes'>�
</span>Just as psychoanalysis must place no value above that of the mutual
pursuit of the unique experience of the relationship,<a style='mso-footnote-id:
ftn3' href="#_ftn3" name="_ftnref3" title=""><span class=MsoFootnoteReference><span
style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><span style='font-size:12.0pt;mso-bidi-font-size:
10.0pt;font-family:"Times New Roman";mso-fareast-font-family:"Times New Roman";
mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA'>[3]</span></span><![endif]></span></span></a>
so too must analytic supervision recognize and respect the inherent potential
for two participants adhering to different views and theoretical positions to
create growth from their psychoanalytic exploration of their joint experience.</p>
<p class=MsoNormal style='text-indent:.5in'>Since I hold that psychoanalytic
theories and metapsychologies are countertransferences �that is, that they are
aspects of personality and forms of experiencing and understanding one�s
interactions with others, it is my conclusion that the value of such
theoretical positions lies in their <i style='mso-bidi-font-style:normal'>utility</i>
for the individual holding them.<span style='mso-spacerun:yes'>� </span>It is
my opinion that the true measure of such theories is how well they fit or do
not fit with the personality of a particular analyst.<a style='mso-footnote-id:
ftn4' href="#_ftn4" name="_ftnref4" title=""><span class=MsoFootnoteReference><span
style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><span style='font-size:12.0pt;mso-bidi-font-size:
10.0pt;font-family:"Times New Roman";mso-fareast-font-family:"Times New Roman";
mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA'>[4]</span></span><![endif]></span></span></a><span
style='mso-spacerun:yes'>� </span>There is simply nothing worse than an analyst
attempting to utilize a theory that is not congruent with his or her
personality.<span style='mso-spacerun:yes'>� </span>And certainly one of the
most common experiences I have had in which theory directly enters the focus of
analytic supervision, has been that of a supervisee progressively realizing
that some aspect of his or her technical or theoretical commitments does not
fit with his or her deeper beliefs about the nature of human beings and human
interactions.</p>
<p class=MsoNormal style='text-indent:.5in'>This sort of process is most easily
demonstrated in terms of technical issues (only because the broader,
theoretical versions are more deeply and intimately bound up in the personhood
and privacy of the supervisee).<span style='mso-spacerun:yes'>� </span>Take,
for example, the case of a supervisee who has come<span
style='mso-spacerun:yes'>� </span>with a technical commitment to not sharing
emotional reactions with patients.<span style='mso-spacerun:yes'>� </span>She
has been working for three years with an analysand who, while obviously extremely
positively attached to the analyst, needs to deny any emotional connection to
the analyst and is particularly insistent in pointing out the analyst�s
complete lack of emotional attachment to her.<span style='mso-spacerun:yes'>�
</span>Now it should be understood that this analysand is, in fact, very dear
to the analyst:<span style='mso-spacerun:yes'>� </span>the analyst often has
extremely warm, empathetic responses to this analysand, and actually feels very
emotionally close to her on many levels.<span style='mso-spacerun:yes'>�
</span>A sad event occurs in the analysand�s life, and, while the analyst is
very capable in her working with the issues of the event, she feels bound by
her technical commitments not to express the rather intense sadness she feels
for the analysand�s loss.<span style='mso-spacerun:yes'>� </span>This is a
moment where the analyst feels acutely a divergence between her human impulses
and her understanding of<span style='mso-spacerun:yes'>� </span>the
requirements of technique.<span style='mso-spacerun:yes'>� </span>Were this
situation simply one in which her deep, theoretical commitments forced her to
do something personally difficult, she most certainly should have been
supported in her technical stance.<span style='mso-spacerun:yes'>� </span>In
actuality, however, the analysand had been wrestling throughout much of the
supervision with the fact that she was operating with technical positions
dictated by<span style='mso-spacerun:yes'>� </span>her prior classical analytic
training that no longer seemed warranted given the shifts in her
theoretical<span style='mso-spacerun:yes'>� </span>stance.<span
style='mso-spacerun:yes'>� </span>The immediacy of this moment in the analysis
led her to decide to return to the following session with a more emotional
acknowledgement of her feeling in the situation.<span
style='mso-spacerun:yes'>� </span>While specifically this acknowledgement was
little more than a statement of how sad she had felt thinking about the
analysand�s loss, it was understood correctly by the analysand as a declaration
of emotional involvement and attachment on the part of the analyst.<span
style='mso-spacerun:yes'>� </span>While it was clear that the analysand had always
on some level known this to be true, the analyst�s ability directly to deal
with it for the first time changed a very fundamental
transference-countertransference balance that resulted in major progress in the
analytic relationship.<span style='mso-spacerun:yes'>� </span>Moreover, the analyst
began to recognize that her adherence to the more distancing aspects of
classical technique was not only incongruent with her changing theoretical
beliefs, but in fact represented a particular resistance she had to fuller
engagement and intimacy in the analytic relationship (and, with the analysand
in question, to identificational elements she had previously been avoiding).</p>
<p class=MsoNormal style='text-indent:.5in'>Lest this initial discussion be
misleading, allow me to remind the reader that I am merely making the point that
theoretical issues <i style='mso-bidi-font-style:normal'>can</i> appropriately
enter the arena of supervisory exploration �while it is my more basic assertion
that theoretical and didactic discourse have <i style='mso-bidi-font-style:
normal'>no</i> intrinsic place in the process.<span style='mso-spacerun:yes'>�
</span>In the actual conduct of<span style='mso-spacerun:yes'>� </span>the
analytic supervision I do, the focus I attempt to create is elsewhere.</p>
<p class=MsoNormal style='text-indent:.5in'>I have stated earlier that I
believe the supervisory process to be the mutual creation of the two
participants therein.<span style='mso-spacerun:yes'>� </span>As in
psychoanalytic process similarly conceived, however, this does not suggest that
the supervisor has no role in shaping and structuring the enterprise.<span
style='mso-spacerun:yes'>� </span>There are any number of requirements I have
in order to make the work possible from my end, and any number of requests I
make on anyone who undertakes to enter supervision with me.<span
style='mso-spacerun:yes'>� </span>Conversely, I recognize that there may be any
number of requirements, needs and preferences that the supervisee may
have.<span style='mso-spacerun:yes'>� </span>As in analysis, these are facets
of the contractual agreement between the two parties, and in no way compromise
the mutuality of the enterprise.<span style='mso-spacerun:yes'>� </span>And
while there may be many areas of asymmetry in the relationship,<span
style='mso-spacerun:yes'>� </span>they in no way compromise its equality.</p>
<p class=MsoNormal style='text-indent:.5in'>I am adamant, in structuring
analytic supervision as well as analysis, that those things that I require,
need, and prefer reflect my own needs in undertaking the work �rather than
representing some �correct� or more generally �necessary� principles.<span
style='mso-spacerun:yes'>� </span>My need to collect a fee, my policies about
missed sessions, my setting a specific time period aside on a recurring basis�
all of these represent manifestations of my personal needs.<span
style='mso-spacerun:yes'>� </span>I believe that it completely valid for me to
have and seek to satisfy such needs, but I do not attempt to represent them as
having any special standing or to justify them as having any absolute validity.</p>
<p class=MsoNormal style='text-indent:.5in'>When doing analytic supervision, I
insist that the work be about the supervisee�s relationship with a single
patient.<span style='mso-spacerun:yes'>� </span>This preference reflects my
belief in the crucial importance of examining the nuance of the
transference-countertransference interaction �on the first level, between the
supervisee and his or her analysand; and, ultimately more importantly, between
the supervisee and myself.<span style='mso-spacerun:yes'>� </span>It also
contains within it my belief that the goal of supervision is the growth of the analyst,
not of the analysand.<span style='mso-spacerun:yes'>� </span>It is actually an
unavoidable fact that the supervisory process <i style='mso-bidi-font-style:
normal'>interferes</i> in the relationship between the supervisee and the
analysand.<span style='mso-spacerun:yes'>� </span>(There are, fortunately, many
instances in which this interference falls into the range of neutral to
positive; but it must be remembered that it is not uncommon for the presence of
a third party in the intimacy of the analytic relationship to adversely affect
that relationship, at least in the short term.)<span style='mso-spacerun:yes'>�
</span>So, while hopefully the supervisee�s work with <i style='mso-bidi-font-style:
normal'>all</i> of his or her patients will improve and grow as a result of the
supervisory experience, the improvement of the work with the particular
analysand upon whom the supervision is focused is not primary, and certainly is
not assured.<span style='mso-spacerun:yes'>� </span>There is a direct analogy
here to the psychoanalytic process itself:<span style='mso-spacerun:yes'>�
</span>although an analyst may focus for extended periods of time on an
analysand�s relationship with a particular individual in the analysand�s life,
the outcome of the relationship with that particular person is not ultimately
what is most at stake, but rather the growth that is possible in the
analysand�s relating more generally.<a style='mso-footnote-id:ftn5'
href="#_ftn5" name="_ftnref5" title=""><span class=MsoFootnoteReference><span
style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><span style='font-size:12.0pt;mso-bidi-font-size:
10.0pt;font-family:"Times New Roman";mso-fareast-font-family:"Times New Roman";
mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA'>[5]</span></span><![endif]></span></span></a></p>
<p class=MsoNormal style='text-indent:.5in'>Contrary to the current legal
realities, responsibility for what transpires between an analyst and analysand
can <i style='mso-bidi-font-style:normal'>only</i> be the responsibility of
that particular partnership.<a style='mso-footnote-id:ftn6' href="#_ftn6"
name="_ftnref6" title=""><span class=MsoFootnoteReference><span
style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><span style='font-size:12.0pt;mso-bidi-font-size:
10.0pt;font-family:"Times New Roman";mso-fareast-font-family:"Times New Roman";
mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA'>[6]</span></span><![endif]></span></span></a><span
style='mso-spacerun:yes'>� </span>To see the supervisor as �responsible� for
what actually transpires between his or her supervisee and that supervisee�s
patient defies logic.<span style='mso-spacerun:yes'>� </span>In the first
place, all that a supervisor really �knows� about the patient in question is
what he or she learns second hand though the report of the supervisee.<span
style='mso-spacerun:yes'>� </span>Furthermore, it is illusory to believe that a
supervisor in actuality has any real �control� over the actions of the
supervisee.</p>
<p class=MsoNormal style='text-indent:.5in'>My insistence that supervision
focus on work with a single patient (particularly in situations where this
requirement is not already dictated by training requirements) also serves to
throw into immediate focus some of these issues about the nature of analytic
supervision.<span style='mso-spacerun:yes'>� </span>In trying to decide which
analysand to present in supervision, the supervisee must grapple with the
issues implicit in why one would choose the work with a particular analysand to
present.<span style='mso-spacerun:yes'>� </span>Does one choose work that is
going particularly well, or particularly poorly; does one choose a relationship
that is relatively typical in ones practice or atypical� the choice reflects
much of one�s preconceptions about the process.<span style='mso-spacerun:yes'>�
</span>It also begins to sound themes about how a supervisee feels about his or
her work and about the process of supervision.</p>
<p class=MsoNormal style='text-indent:.5in'>My second requirement is seemingly
somewhat paradoxical.<span style='mso-spacerun:yes'>� </span>I request that a
supervision work as much from spontaneous recall as possible; and, at the same
time, I expect that the supervisee present the work in as nearly verbatim form
as possible.<span style='mso-spacerun:yes'>� </span>I do not ever agree to
listen to tapes, I most strongly request that supervisees do not take notes
during analytic sessions,<span style='mso-spacerun:yes'>� </span>and I prefer
(although I do not insist) that he or she not present from notes (<i
style='mso-bidi-font-style:normal'>viz</i>., those reconstructed after the
analytic session) in the actual supervision session.<span
style='mso-spacerun:yes'>� </span>Since my intention is to assist in the growth
of the supervisee�s actual functioning as an analyst, I attempt to recreate the
experience as it actually exists during the process.<span
style='mso-spacerun:yes'>� </span>The point is not at all to minimize the
necessity of detail and accuracy, but rather to structure a way to make this
sort of detail and accuracy more organically a part of the supervisee�s ongoing
functioning.<span style='mso-spacerun:yes'>� </span>In truth, there are
exceedingly few practicing analysts who <i style='mso-bidi-font-style:normal'>really</i>
work in the way much of supervision encourages:<span style='mso-spacerun:yes'>�
</span>we remember what detail we can during the actual encounter of the
sessions, we do not refer to our notes.<span style='mso-spacerun:yes'>�
</span>The immediacy of our reactions to our analysands comes not from a
written catalogue of notes, but from our living memory.<span
style='mso-spacerun:yes'>� </span>I shall return later to the second half of
this apparent paradox, the importance I place on specific details.</p>
<p class=MsoNormal style='text-indent:.5in'>I first feel that I must admit here
that my aversion to having supervisees take notes <i style='mso-bidi-font-style:
normal'>during</i> sessions represents a specific prejudice more that just a
technical position.<span style='mso-spacerun:yes'>� </span>Whereas many of the
positions I have enumerated in the preceding paragraph can be understood as
attempts to replicate the actual process of recall in analysis outside of
supervision, this position can not be justified on these grounds.<span
style='mso-spacerun:yes'>� </span>(Analysts can and do take notes during
sessions aside from when they are in supervision.)<span
style='mso-spacerun:yes'>� </span>It is simply true that my own bias is that
note-taking during sessions is so <i style='mso-bidi-font-style:normal'>necessarily</i>
distancing from the immediacy of the relationship, and that the immediacy of
the connection between analyst and analysand is <i style='mso-bidi-font-style:
normal'>so</i> essential to the way I work, that I have strong feelings on the
subject.<span style='mso-spacerun:yes'>� </span>I include this extended
discussion of this anomaly because I believe it serves to demonstrate another
aspect of my approach to supervision:<span style='mso-spacerun:yes'>� </span>I
believe that it is best to have such prejudices and feeling out in the open as
much as possible.<span style='mso-spacerun:yes'>� </span>I would not �forbid� a
supervisee from taking notes during sessions �and, in fact, some whom I have
successfully supervised have chosen to continue to do so.<span
style='mso-spacerun:yes'>� </span>I do, however, want the supervisee to know
that I have a strong opinion in the matter.</p>
<p class=MsoNormal style='text-indent:.5in'>This brings me to yet another
request I make very directly of my supervisees:<span style='mso-spacerun:yes'>�
</span>that they know to expect that I give my opinions and share my reactions
rather strongly and directly, but that I do not expect them to treat them as
anything other than opinions.<span style='mso-spacerun:yes'>� </span>I expect
that there is good reason for<span style='mso-spacerun:yes'>� </span>people
with whom I work to take seriously the opinions and reactions that I have �and
I believe that there is equally good reason for me to treat their opinions and
reactions in the same way.<span style='mso-spacerun:yes'>� </span>But I
certainly do not believe that either of us should take the other�s reactions
and opinions as having any more validity than our own.<a style='mso-footnote-id:
ftn7' href="#_ftn7" name="_ftnref7" title=""><span class=MsoFootnoteReference><span
style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><span style='font-size:12.0pt;mso-bidi-font-size:
10.0pt;font-family:"Times New Roman";mso-fareast-font-family:"Times New Roman";
mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA'>[7]</span></span><![endif]></span></span></a><span
style='mso-spacerun:yes'>� </span>Just as I believe that theory and metapsychology
are countertransference, so, too, do I hold that all that <i style='mso-bidi-font-style:
normal'>I</i> think or say as a supervisor is nothing more or less than a
secondary countertransference to that which the supervisee is bringing.<a
style='mso-footnote-id:ftn8' href="#_ftn8" name="_ftnref8" title=""><span
class=MsoFootnoteReference><span style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><span style='font-size:12.0pt;mso-bidi-font-size:
10.0pt;font-family:"Times New Roman";mso-fareast-font-family:"Times New Roman";
mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA'>[8]</span></span><![endif]></span></span></a><span
style='mso-spacerun:yes'>� </span>This belief is one I make explicit to
supervisees at the very outset of our work together.<span
style='mso-spacerun:yes'>� </span>It is my ongoing experience, however, that it
only becomes a fully appreciated, believable aspect of our relationship once it
has been lived through in some meaningful way.<span style='mso-spacerun:yes'>�
</span>(And, as one might imagine, this happens at different points in
supervision for different supervisees.)<span style='mso-spacerun:yes'>�
</span>It is one of my fondest beliefs, however, that almost all of the
supervisees I have worked with over the years have come �at least in the end�
meaningfully to know the reality of this position.<span
style='mso-spacerun:yes'>� </span>I have no desire to have supervisees agree
with or adopt my opinions.<span style='mso-spacerun:yes'>� </span>My main
objective is to engage in an experience in which they confront these opinions
in a way that hopefully will result in a deepening and refining of their <i
style='mso-bidi-font-style:normal'>own</i> opinions �however different they may
be from my own.</p>
<p class=MsoNormal style='text-indent:.5in'>I believe this to be so important,
because I am convinced that the direct sharing of one�s opinions and reactions
represents the first of two underlying dimensions that comprise the essence of
the analytic interaction �and, therefore, for me, of the supervisory
interaction as well.<span style='mso-spacerun:yes'>� </span>This first
dimension is the spontaneous, associative one.<span style='mso-spacerun:yes'>�
</span>It consists of all of those feelings, thoughts, associations,
speculations, day dreams, fantasies, and every other form of psychic activity
we have in the presence of another particular person.<a style='mso-footnote-id:
ftn9' href="#_ftn9" name="_ftnref9" title=""><span class=MsoFootnoteReference><span
style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><span style='font-size:12.0pt;mso-bidi-font-size:
10.0pt;font-family:"Times New Roman";mso-fareast-font-family:"Times New Roman";
mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA'>[9]</span></span><![endif]></span></span></a><span
style='mso-spacerun:yes'>� </span>One can never know if such phenomena actually
relate to the person in whose presence they occur, or, even if they do, whether
they say much about that person, as opposed to what they say about the person
having them.<span style='mso-spacerun:yes'>� </span>Nevertheless, it was with
good reason that Freud made it his basic rule of psychoanalysis that patients
should share these thoughts and feelings without subjecting them to censorship
of any kind, for he knew that to provide <i style='mso-bidi-font-style:normal'>any</i>
rationale for dismissing them would mean that patients would use that rationale
to exclude virtually everything important from analytic examination.<span
style='mso-spacerun:yes'>� </span>While analysts have many varied positions on
how much of their own spontaneous thought feelings to share directly with their
patients, increasingly there has been fairly general recognition that these
thoughts and feelings must be closely attended to, <i style='mso-bidi-font-style:
normal'>at very least</i> internally.<span style='mso-spacerun:yes'>�
</span>(It should be noted that much that passes for interpretation, and
essentially <i style='mso-bidi-font-style:normal'>all</i> that falls into the
category of dream interpretation, is<span style='mso-spacerun:yes'>� </span>in
reality a version of this spontaneous, associative dimension �no matter how
many attempts are made to disguise the fact or authoritarian claims are made to
deny it.)</p>
<p class=MsoNormal style='text-indent:.5in'>While one would think this issue
would be less difficult in supervision, it often is still highly charged.<span
style='mso-spacerun:yes'>� </span>There is often a similar reluctance to
acknowledge that the majority of the supervisor�s reactions and ideas are
essentially feelings and thoughts of this spontaneous, associative kind. While
it might be reasonably claimed that a supervisor�s thoughts and feelings should
receive a particularly attentive hearing by reason of the supervisor�s
experience and expertise, there is still no reason to accord them any absolute
authority.<span style='mso-spacerun:yes'>� </span>In fact, the <i
style='mso-bidi-font-style:normal'>main</i> reasons they deserve attention is,
first, because the supervisor is a legitimate participant in the dyad, and,
second, because by not being subject to the same repressions as the supervisee,
he or she should be able to notice things that are outside of the supervisee�s
awareness.<span style='mso-spacerun:yes'>� </span>It should be noted, however,
that these same reasons apply with respect to the value of the supervisee�s
thoughts and feelings!<a style='mso-footnote-id:ftn10' href="#_ftn10"
name="_ftnref10" title=""><span class=MsoFootnoteReference><span
style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><span style='font-size:12.0pt;mso-bidi-font-size:
10.0pt;font-family:"Times New Roman";mso-fareast-font-family:"Times New Roman";
mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA'>[10]</span></span><![endif]></span></span></a><span
style='mso-spacerun:yes'>� </span>One of the central thrusts of my work as an
analytic supervisor is to attempt to make clear the utility of recognizing,
acknowledging and sharing the thoughts and feelings of both parties.<span
style='mso-spacerun:yes'>� </span>I insist on two things in relation to these
thoughts and feelings:<span style='mso-spacerun:yes'>� </span>one, that they
have value simply because they occur in the context of relating to this other
particular human being; and, two, that they have no special status beyond the
simple fact that they have so occurred �which is to say that they are nothing
more or less than spontaneous, associative material.</p>
<p class=MsoNormal style='text-indent:.5in'>The second of the two underlying
dimensions that comprise the essence of the analytic interaction �and,
therefore, for me, of the supervisory interaction� is detailed inquiry.<span
style='mso-spacerun:yes'>� </span>In order to be truly meaningful, the
spontaneous, associative material needs to be subjected to a thoroughgoing
process of detailed inquiry.<span style='mso-spacerun:yes'>� </span>In the
mutually conceived relationship of analytic supervision, both parties bring to
the process their spontaneous, associative material and together subject the
various aspects of their separate and joint experience to a rigorous examination.<span
style='mso-spacerun:yes'>� </span>They must set about to understand what their
respective experience actually is as well as what the experience of the other
is �each in the terms of the personal experience of each participant.<span
style='mso-spacerun:yes'>� </span>The goal is not consensus, but rather an in
depth exploration of how their experience relates �in its similarities as well
as its differences.</p>
<p class=MsoNormal style='text-indent:.5in'>I have mentioned earlier my belief
in the importance of presenting clinical material in supervision in great
detail �as close to <i style='mso-bidi-font-style:normal'>verbatim</i> as
possible.<span style='mso-spacerun:yes'>� </span>The process of detailed
inquiry <i style='mso-bidi-font-style:normal'>necessitates</i> this level of
detail.<span style='mso-spacerun:yes'>� </span>The awareness of this reality is
one of the most important legacies of the Interpersonal Psychoanalytic
tradition.<span style='mso-spacerun:yes'>� </span>Without the detail, one
simply cannot begin to know what the experience is truly about.<span
style='mso-spacerun:yes'>� </span>My eschewing the use of tapes and notes is
meant in no way to lessen the level of detail, but rather to shift its
nature.<span style='mso-spacerun:yes'>� </span>The subjective element, even of
detailed recall, is no small part of the material.<span
style='mso-spacerun:yes'>� </span>For example, I find it more important to have
a supervisee recognize where the lacunae are in his or her recall, then to have
an artificially complete record separate from his or her personal experience.</p>
<p class=MsoNormal style='text-indent:.5in'>While the apparent subject matter
of an analytic supervision is the supervisee�s work relationship with his or
her analysand, the actual subject matter eventually is the relationship of
supervisor and supervisee.<span style='mso-spacerun:yes'>� </span>In this way,
the supervisory relationship almost completely parallels the analytic one.</p>
<p class=MsoNormal style='text-indent:.5in'>Which brings us again to the
central and crucial difference between psychoanalysis and psychoanalytic
supervision: whereas in the former, the scope of the mutual exploration is by
definition without preset boundaries, in the latter, the scope of the
exploration is limited by contractual agreement to the supervisee�s work.<span
style='mso-spacerun:yes'>� </span>Now, to be sure, the full understanding of a
person�s analytic work potentially can include every aspect of his or her
personality, since all of an analyst�s personality most certainly comes into the
analyst�s work in one way or another. <span
style='mso-spacerun:yes'>�</span>And, in any particular supervisory dyad, there
may be great latitude appropriately permitted in what is open for
exploration.<span style='mso-spacerun:yes'>� </span>Nevertheless, the only <i
style='mso-bidi-font-style:normal'>expectably</i> agreed upon area of
exploration for any supervisory relationship is a more limited version of the
area of psychoanalytic work.<span style='mso-spacerun:yes'>� </span>If the
exploration is to go beyond these immediate limits, it has to be with the
explicit agreement of both participants, and with the absolutely explicit
permission of the supervisee.<span style='mso-spacerun:yes'>� </span>In this
matter, the supervisee must have absolute veto power. Should the supervisory
relationship be such as to make attractive the following of some issue beyond
the more generally accepted limits of supervisory exploration, it must be
because the trust, closeness, and previous positive history of that
relationship supports going farther.<span style='mso-spacerun:yes'>�
</span>But, even then, the supervisor must respect absolutely the supervisee�s
decision to call a halt or even sound a retreat.</p>
<p class=MsoNormal style='text-indent:.5in'>Since trust and the reasonable
expectation of safety plays such a crucial role in any analytic exploration �be
it supervisory or therapeutic, confidentiality understandably is a crucial
concern.<span style='mso-spacerun:yes'>� </span>Confidentiality is by
definition an issue in supervision, even only because the basic material the
analyst is bringing to the supervisor from his or her work <i style='mso-bidi-font-style:
normal'>already</i> requires such protection by law.<a style='mso-footnote-id:
ftn11' href="#_ftn11" name="_ftnref11" title=""><span
class=MsoFootnoteReference><span style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><span style='font-size:12.0pt;mso-bidi-font-size:
10.0pt;font-family:"Times New Roman";mso-fareast-font-family:"Times New Roman";
mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA'>[11]</span></span><![endif]></span></span></a><span
style='mso-spacerun:yes'>� </span>But the confidentiality of the supervisee
him- or herself also needs protection if the process can be successful in
progressing in an analytic way.</p>
<p class=MsoNormal style='text-indent:.5in'>There is, of course, a built-in
limitation to the confidentiality of the supervision conducted as part of any
training program:<span style='mso-spacerun:yes'>� </span>in addition to the
growth function of the supervision, there is also a necessary evaluative
function.<span style='mso-spacerun:yes'>� </span>The legality of this component
is, of course, of no consequence:<span style='mso-spacerun:yes'>� </span>it
simply is made clear as part of the particular contractual agreement between
supervisor and supervisee that this evaluation and reporting component will
exist.<span style='mso-spacerun:yes'>� </span>The more difficult issues involve
the extent of the agreed upon exception and its subject matter.<span
style='mso-spacerun:yes'>� </span>In my understanding, <i style='mso-bidi-font-style:
normal'>at the very most</i>, the exception to confidentiality relates <i
style='mso-bidi-font-style:normal'>only</i> to those explorations having
directly and specifically to do with work issues, and <i style='mso-bidi-font-style:
normal'>never</i> to any explorations that are undertaken beyond or outside of
that narrow boundary.<span style='mso-spacerun:yes'>� </span>I always show a
supervisee any report I am going to submit in advance of submitting it, and I
am also quite explicit as to what I intend to say verbally.<span
style='mso-spacerun:yes'>� </span>Moreover, I always make sure to share with a
supervisee exactly what I<span style='mso-spacerun:yes'>� </span>have said
about them in any evaluation meeting, after the fact.<span
style='mso-spacerun:yes'>� </span>It is a compromise that I discuss openly and
in great detail with my supervisees, and it has functioned quite satisfactorily
for me and them over the course of my many years doing analytic supervision.</p>
<p class=MsoNormal style='text-indent:.5in'>As I imagine is obvious from what I
have presented, I am rather extreme in my defense of the confidentiality of
those with whom I do any form of analytic work.<span style='mso-spacerun:yes'>�
</span>The reason, too, should be clear:<span style='mso-spacerun:yes'>��
</span>I believe this condition to be an absolutely necessary condition for the
process of psychoanalysis and of psychoanalytic supervision.<span
style='mso-spacerun:yes'>� </span>Accordingly, I have chosen to present a
basically theoretical description of my views on psychoanalytic supervision and
been most sparing in my presentation of<span style='mso-spacerun:yes'>�
</span>clinical examples.</p>
<p class=MsoNormal style='text-indent:.5in'><o:p> </o:p></p>
<p align=center style='margin-left:1.0in;text-align:center'><a
href="http://www.rlrubens.com/publications.html">Return to Richard L. Rubens
PUBLICATIONS Page.<o:p></o:p></a></p>
<p class=MsoNormal align=center style='text-align:center;text-indent:.5in'><o:p> </o:p></p>
</div>
<div style='mso-element:footnote-list'><![if !supportFootnotes]><br clear=all>
<hr align=left size=1 width="33%">
<![endif]>
<div style='mso-element:footnote' id=ftn1>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn1' href="#_ftnref1"
name="_ftn1" title=""><span class=MsoFootnoteReference><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><span
style='font-size:10.0pt;font-family:"Times New Roman";mso-fareast-font-family:
"Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US;
mso-bidi-language:AR-SA'>[1]</span></span><![endif]></span></span></a> It must
be noted that I utilize here �and elsewhere� an inclusive definition of
transference and countertransference:<span style='mso-spacerun:yes'>� </span>I
understand these categories to refer to the whole of a person�s organization of
experience and not to any �distorted� or otherwise specified segmentation of
that experiential organization.</p>
</div>
<div style='mso-element:footnote' id=ftn2>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn2' href="#_ftnref2"
name="_ftn2" title=""><span class=MsoFootnoteReference><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><span
style='font-size:10.0pt;font-family:"Times New Roman";mso-fareast-font-family:
"Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US;
mso-bidi-language:AR-SA'>[2]</span></span><![endif]></span></span></a> I adhere
to the belief that analysands have their theories and metapsychologies �albeit
that in the case of the latter these may or may not be as intellectually or
consciously conceptualized.<span style='mso-spacerun:yes'>� </span>(One might
note that this may also be true of certain analysts!)<span
style='mso-spacerun:yes'>� </span>But many of our analysands are themselves
students of analytic theory.<span style='mso-spacerun:yes'>� </span>Moreover,
there exist analysands who are in no way conversant with the corpus of analytic
theory and yet have highly developed theories of human personality functioning
that put to shame the theoretical thinking of many analysts.</p>
</div>
<div style='mso-element:footnote' id=ftn3>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn3' href="#_ftnref3"
name="_ftn3" title=""><span class=MsoFootnoteReference><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><span
style='font-size:10.0pt;font-family:"Times New Roman";mso-fareast-font-family:
"Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US;
mso-bidi-language:AR-SA'>[3]</span></span><![endif]></span></span></a> I am
opposed to any value being appended to the analytic endeavor.<span
style='mso-spacerun:yes'>� </span>One can be a Marxist (for which can be
substituted �feminist,� �segregationist,� or �integrationist,� <i
style='mso-bidi-font-style:normal'>etc</i>.) who is an analyst, but it is
problematic in my opinion to identify oneself as a �Marxist analyst,� as this
amalgamation suggests that there is some other competing value that is being
given equal billing with the values inherent in the analytic enterprise itself.</p>
</div>
<div style='mso-element:footnote' id=ftn4>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn4' href="#_ftnref4"
name="_ftn4" title=""><span class=MsoFootnoteReference><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><span
style='font-size:10.0pt;font-family:"Times New Roman";mso-fareast-font-family:
"Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US;
mso-bidi-language:AR-SA'>[4]</span></span><![endif]></span></span></a> The
question may reasonably be raised as to whether certain personality
configurations may be so antithetical to the therapeutic endeavor as to be
considered inappropriate as the basis for a theoretical style.<span
style='mso-spacerun:yes'>� </span>While this, of course, can be true, it does
not mean that therapists with such personality configurations would be better
off <i style='mso-bidi-font-style:normal'>compounding</i> the problem by
covering them with an incongruent theoretical position.<span
style='mso-spacerun:yes'>� </span>It simply means that such people are not good
therapists.</p>
</div>
<div style='mso-element:footnote' id=ftn5>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn5' href="#_ftnref5"
name="_ftn5" title=""><span class=MsoFootnoteReference><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><span
style='font-size:10.0pt;font-family:"Times New Roman";mso-fareast-font-family:
"Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US;
mso-bidi-language:AR-SA'>[5]</span></span><![endif]></span></span></a> This
assertion is not to be construed as suggesting that the importance of any
particular relationship in an analysand�s life is not to be seen as
important.<span style='mso-spacerun:yes'>� </span>It suggests only that it is a
mistake for the analyst to become too focused on or dedicated to the maintenance
of<span style='mso-spacerun:yes'>� </span>any such particular relationship.</p>
</div>
<div style='mso-element:footnote' id=ftn6>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn6' href="#_ftnref6"
name="_ftn6" title=""><span class=MsoFootnoteReference><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><span
style='font-size:10.0pt;font-family:"Times New Roman";mso-fareast-font-family:
"Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US;
mso-bidi-language:AR-SA'>[6]</span></span><![endif]></span></span></a> While
the analyst may have special responsibilities within the relationship that
apply only to the analyst (e.g., for maintaining confidentiality and for not
abusing the analyst�s position in the relationship, to mention two extremely
important ones), the responsibility for the overall life of the relationship
must be a joint one.<span style='mso-spacerun:yes'>� </span>This in no way
contradicts the fact that the two participants may have a whole range of individual
responsibilities to which they have contractually obligated themselves.)</p>
</div>
<div style='mso-element:footnote' id=ftn7>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn7' href="#_ftnref7"
name="_ftn7" title=""><span class=MsoFootnoteReference><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><span
style='font-size:10.0pt;font-family:"Times New Roman";mso-fareast-font-family:
"Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US;
mso-bidi-language:AR-SA'>[7]</span></span><![endif]></span></span></a> In this
regard, I have often been known to quote the Marx Brothers to a supervisee (or
analysand):<span style='mso-spacerun:yes'>� </span>on one of the many occasions
that Groucho is trying to con Chico into agreeing to something against his
better judgment, Groucho says to him, �Who are you going to believe �me or your
own eyes?�</p>
</div>
<div style='mso-element:footnote' id=ftn8>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn8' href="#_ftnref8"
name="_ftn8" title=""><span class=MsoFootnoteReference><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><span
style='font-size:10.0pt;font-family:"Times New Roman";mso-fareast-font-family:
"Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US;
mso-bidi-language:AR-SA'>[8]</span></span><![endif]></span></span></a> To be
completely accurate, I must distinguish that this is true of only my reactions
to the supervisee�s <i style='mso-bidi-font-style:normal'>patient</i>.<span
style='mso-spacerun:yes'>� </span>My reactions to the supervisee him- or
herself, of course, represent a primary countertransference in their own right.</p>
</div>
<div style='mso-element:footnote' id=ftn9>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn9' href="#_ftnref9"
name="_ftn9" title=""><span class=MsoFootnoteReference><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><span
style='font-size:10.0pt;font-family:"Times New Roman";mso-fareast-font-family:
"Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US;
mso-bidi-language:AR-SA'>[9]</span></span><![endif]></span></span></a> I say
�in the presence of� another particular individual because I am specifically
avoiding the phrase, �in reaction to.�<span style='mso-spacerun:yes'>�
</span>While, of course, I understand, that it includes things that quite literally
are �in reaction to� another person, and while I recognize that not all of that
to which I am referring is quite literally �in the presence of� the other, I am
very pointedly trying to be clear that I believe it to be a tremendous error to
assume,<i style='mso-bidi-font-style:normal'> in general</i>, that the
phenomena I am describing are <i style='mso-bidi-font-style:normal'>necessarily</i>
reactive.</p>
</div>
<div style='mso-element:footnote' id=ftn10>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn10' href="#_ftnref10"
name="_ftn10" title=""><span class=MsoFootnoteReference><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><span
style='font-size:10.0pt;font-family:"Times New Roman";mso-fareast-font-family:
"Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US;
mso-bidi-language:AR-SA'>[10]</span></span><![endif]></span></span></a> The
reciprocal nature of the latter reason was best elucidated by Margaret Little,
when she noted that viewing one�s unconscious was a little like trying to see
the back of one�s own head �it was much easier to see the back of someone
else�s.</p>
</div>
<div style='mso-element:footnote' id=ftn11>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn11' href="#_ftnref11"
name="_ftn11" title=""><span class=MsoFootnoteReference><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><span
style='font-size:10.0pt;font-family:"Times New Roman";mso-fareast-font-family:
"Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US;
mso-bidi-language:AR-SA'>[11]</span></span><![endif]></span></span></a> It is
very disturbing to hear supervisor�s presenting clinical material gleaned from
their supervisees.<span style='mso-spacerun:yes'>� </span>As difficult as it is
to present clinical material from one�s <i style='mso-bidi-font-style:normal'>own</i>
psychoanalytic<span style='font-size:12.0pt;mso-bidi-font-size:10.0pt'> </span>work
in such a way as to insure the confidentiality of one�s patients, it is
virtually <i style='mso-bidi-font-style:normal'>impossible</i> to do so with
work that is an extra step removed.<span style='mso-spacerun:yes'>�
</span>Understanding that one simply cannot adequately disguise clinical
material in a<span style='mso-spacerun:yes'>� </span>way that insures it will
not be recognized if the hearer knows the patient in question and knows that he
or she has been in treatment with a particular person, it becomes very risky
business indeed to present material from which one is that far removed: one
simply does not have any idea to whom the situation may be familiar.<span
style='mso-spacerun:yes'>� </span>At very least, supervisors need to be <i
style='mso-bidi-font-style:normal'>more</i> guarded about sharing material from
their supervisees than from their own work.</p>
</div>
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