THE BRITISH ASSOCIATION FOR PSYCHOANALYTIC AND PSYCHODYNAMIC SUPERVISION
December 2006
This Edition
As the long-serving
members of the Publications Committee, (Ted, Ruth and Ann), have sadly all
stepped down, we are eagerly looking for new members. If you feel that you might
be interested in working on the newsletter please get in touch with Chris,
Lynda or myself. As all of our meetings for planning and checking over each
edition are held by telephone conference, we warmly welcome members from
outside of
We are also keen to
find effective ways of attracting contributions from the wider membership of
BAPPS. For this edition, where Chris and I were the only members, we have
themed the newsletter around the issue of supervising work with couples and we
are extremely fortunate to have contributions from three senior clinicians in
this field – Jenny Riddell, Elspeth Morley and David Hewison.
The committee have a
provisional idea to arrange one or two editions a year on a particular
supervisory issue; our hope is that this could be a way of attracting
contributions from members. When we get the chance, we press gang individuals
into sending us copy but we would like to make it clear that we warmly welcome
volunteers. We are planning for the summer edition to cover the issue of
supervising work with addiction; if you could contribute a piece on this please
let us know as soon as possible – we have room for three pieces of about 800
words.
We also welcome
suggestions or requests regarding the newsletter; it would help us to know
whether the ‘themed’ newsletter seems useful. Book reviews (of new publications
on supervision or of valued classics), are always welcome as are responses to,
or ideas for, the supervisory challenge.
The final pages of
this edition are designed to ‘cut out and keep’; the Ethics Committee have
prepared suggested guidelines for the event of illness or death - a topic which
was considered in the last newsletter.
Annie
Power Newsletter facilitator
Supervising Couple Psyhoanalytic Psychotherapy:
A view
from the Tavistock Centre for Couple Relationships
Dr. David Hewison
The Tavistock Centre
for Couple Relationships (TCCR) has a distinctive tradition of training and
thinking in staff supervision (Hughes & Pengelly 1997) and it utilises some
of this thinking in the supervision of psychoanalytic psychotherapy with
couples. There is particular attention paid to the ‘organisational setting’ of
the work, whether this be institutional practice or private work – TCCR would
consider both to be particular examples of ‘organisations’. In our experience,
the organisational nature of private work is often underplayed, on the
assumption that this is a private arena and not one that shares commonalities
with work in settings such as the Heath and Social Services, or the Voluntary
Sector. Nonetheless, TCCR has an opinion that the dynamics that are familiar in
the former setting also play out in the latter. The way of clarifying this is
to outline the supervisory dynamics that exist in each forum.
There is an attention
paid to the interlocking of two triangular dynamics (Mattinson 1997): those
between participants and those between the needs of the participants, as
indicated in the following two triangles.
Diagram 1: Participants Diagram 2: Needs
The various corners
are not identical with each other. Although, for example, the needs of the
organisation may well be held in mind by the Supervisor, they may equally be
held in mind by the Supervisee – though if there is a managerial relationship
between the two responsibility for the needs of the organisation rests
with the Supervisor. If they are in a collegial relationship, or one that
‘splits-off’ the needs of the organisation like some ‘clinical supervision’
arrangements, then the responsibility is more diffuse. Similarly, the needs of
the Clients/Patients should be foremost in the minds of both the Supervisor and
Supervisee. The Clients/Patients should be enabled to remain free of concerns
about the organisation or the practitioner – though where there is a low fee
scheme such as the CG Jung Clinic at the Society of Analytical Psychology where
intensive analysis is offered at a substantially reduced rate the
Clients/Patients may be made aware of an expected minimum period for their
analysis/therapy/counselling (see www.cgjungclinic.org.uk). In such cases the
needs of all three functions are met.
One of the things to note is that the needs of
the Supervisee are for “Professional development”, not “Personal
development”. There is no place for personal therapy in the supervision of
another practitioner’s or trainee’s work. One senior analytic supervisor takes
this as far as indicating that comments that a supervisee “to take such and
such a feeling to their analyst” should not occur: as he points out “We are
analysts so lets us proceed analytically, not as traffic policemen” (Astor 2000
p 372).
This is particularly
appropriate for a number of modalities of work, not just couple psychoanalytic
psychotherapy. In couple psychoanalytic psychotherapy there has been a history
of working with the ‘Reflection Process’ (Mattinson 1975). This developed from
a tradition of parallel single sessions with members of a couple in which it
was noticed that the dynamic within the couple was found to be influencing the
dynamic between the two therapists involved. Moving over time to a co-therapy
foursome with couples has allowed this phenomena to be better held
therapeutically – at TCCR co-therapists schedule times to meet together to discuss
their case after each session. In addition, the practice of regular
conferencing between clinicians in a regular clinical workshop allowed
split-off dynamics to be identified within that format also. It requires a
willingness to see intra-group phenomena as having their origins in the
processes of defence and communication (primarily those of projective
identification) going on between the couple.
Diagram 3: Dynamics
in Foursome Couple Psychotherapy
That these dynamics
are necessarily highly complex in foursome work is vividly illustrated in
Diagram 3, which is based on Jung’s ‘Marriage Quaternity’ (Jung 1946 para 422),
the well-known illustration of the transference-countertransference dynamics
going on between individual patient and analyst. It should be no surprise that
this would require ‘registering’ via a group setting outside the unconscious
dynamics between the couple and their therapists, between the couple, and
between the therapist pair.
What
about Practice?
Supervision of Couple
Psychoanalytic Psychotherapy is more complex that that of individual work
because, as will now be apparent, there is a highly complex matrix of
transference-countertransference dynamics at play. TCCR does not legislate for
only one style of supervision, though it does require weekly supervision
sessions as part of its Clinical Training. Core Clinical Staff at TCCR have a
weekly peer supervision meeting. In addition, trainees attend a weekly clinical
workshop that has the dual function of attending to the detail of the session,
presented by process recording, and of making explicit for investigation and
examination the dynamics within the workshop group and the light they can shed
on the couple relationship and the process of the therapy itself.
Some TCCR supervisors
require copies of process recordings to be given to them, which they then read
through as the supervisee presents. Others require the supervisee’s process
report to be delivered verbally, allowing the supervisor to be free to use their
evenly suspended attention to notice particular elements of it. These can then
be addressed in a way that matches the supervisee’s learning stage – they may
require more explanation and confirmation at the beginning of their training
and more space to be imaginative and playful, learning from their own mistakes
and successes, towards the end of their training. Attention is also paid
(usually in an informal way) to a supervisee’s preferred learning style – how
they learn best.
My general personal preference is to be more
directive about the frame and setting of the work when a
clinician is new to it as the clarity of the frame allows the individual
dynamics of the case to become clearer, particularly when it involves pressure
on the therapist to enact a conflict that the couple are not yet aware of fully
themselves. Once the frame has been sufficiently integrated into the
supervisee’s way of working then attention can be redoubled to an area that
will also have been seen to be important: the exercise of the supervisee’s
capacity to be emotionally and imaginatively in touch with the couple and their
conflicts (see eg Hewison 2005). This requires developing a disciplined
flexibility in technique and focus as the supervisee develops a therapeutic
attitude that allows them to move to and from individual- and
couple-interpretations and comments. I think it is a sign of either faulty
technique stemming from a misunderstanding of couple psychoanalytic
psychotherapy or a sign of a kind of ‘projective gridlock’ (Morgan 1995) with
the couple if a therapist continues to make only one kind of interpretation or
focuses on only one kind of emotional state/couple dynamic. This is a sign that
the therapist is caught-up in a powerful countertransference experience that
needs understanding. The same is true of the supervisor and what they allow
themselves to know about in the case and in their relationship with their
supervisee. The supervisor needs to be able to be themselves and to enable the
supervisee to be themselves too. Being oneself, however, does not mean
abrogating the painful and rather abstinent place of a psychoanalytic
psychotherapist. It means ‘being oneself in context’: the context is the
boundaried, somewhat artificial, dependency-inducing, emotionally risky practice
of committing oneself to another person/people come what may. Supervision helps
with this and it gives a chance to link together the different elements
involved in the work.
References:
Astor,
J. (2000). "Some Reflections on Empathy and Reciprocity in the Use of
Countertransference between Supervisor and Supervisee." Journal of
Analytical Psychology 45(3): 367-383.
Hewison,
D. (2005). Sex and the Imagination in Supervision and Therapy. Psychoanalytic
Perspectives on Couple Work 1: 72-87.
Hughes,
L., and Pengelly, P. (1997). Staff Supervision in a Turbulent Environment.
Jung,
C.G. (1946). Psychology of the Transference. The Practice of Psychotherapy.
Mattinson,
J. (1975). The Reflection Process in Casework Supervision.
Mattinson,
J. (1997). The Deadly Equal Triangle.
Morgan,
M. (1995). The Projective Gridlock: A Form of Projective Identification in
Couple Relationship. Intrusiveness and Intimacy in the Couple. (Eds,
Ruszczynski, S. and Fisher, J.).
Biography:
Dr
David Hewison is a Senior Staff Member and Couple Psychoanalytic
Psychotherapist at the Tavistock Centre for Couple Relations. He is also a
Jungian Analyst and Professional Member of the Society of Analytical
Psychology. He teaches supervision and supervises supervisors working in
organisations and in private practice. He is also in private practice in
The Supervision of Couple Therapy
Elspeth Morley
As a younger sibling
in the psychoanalytic family, the profession of couple psychoanalytic psychotherapy has to struggle to establish
a separate identity from that of the illustrious Founders of Psychoanalysis and
their followers who, although their theoretical work and training has focused
only on the individual patient, may nevertheless extend their practice to
include work with couples. Supervisors may follow suit, regardless of the
different dimension involved in supervising couple therapy.
So what is the
difference in the work and supervision of psychoanalytic therapy with couples?
Those who seek to minimise it will argue that it is one only of making the
couple-as-client the focus of the therapy, so that interpretations are made,
not to the clients as individuals, but to the unconscious couple fit of their
mutual projective identifications. This is already indeed a skilled process,
theoretically and clinically. It involves a painstaking observation of the
couple’s interaction to see how their unconscious choice of each other has
usually mirrored a shared emotional task arising from their attachment to, and
detachment from, their families of origin. Stereotypically this has left them
with opposite ways of tackling their shared emotional scenarios, and now often
seeking unconsciously to identify with (or reject) the partner’s way. At its
most basic, one partner may be seeking to attach indissolubly to the other
without being engulfed, while the other has sought to detach without being
abandoned.
The couple therapist will be helped in
supervision to study and compare the individual geneograms of the partners,
their ‘vertical’ inter-generational and (most importantly because so often
ignored in psychoanalytic practice) their ‘lateral’ sibling intra-generational patterns of
relationship.(Mitchell, 2005). Previous relationships will also be studied to
see particularly the repetition of family patterns, with the partners often
alternating choices of, e.g. pressurising the partner into a repeat of a parent
or sibling, or becoming themselves identified with that family figure while
giving to the partner their own discarded role in the family of origin. Again
it is particularly important to look for such re-enactments, within the context of the relationship with
the mother, on the lateral sibling level as often determined by position
in the family. E.g. It can sometimes be observed that the oldest of the family
has mutually chosen a partner who was the youngest, each seeking to repeat, or
to grapple with, an important sibling configuration. Perhaps each is a twin, or
each has a dead sibling, for whom perhaps one has felt pressured into being a
‘replacement’ child, and the other has felt excluded from fulfilling that role.
A huge variety of such mix-and-match factors can be discerned in couple choice,
rendered all the more complex by the particular impact of gender, sexuality,
age differentiation etc, uniquely for those individuals, and for the
interlocking partnerships they have formed. The couple therapist should welcome
the shared dialogue of supervision to explore the diagnosis of each unconscious
couple ‘fit’.
As in all
psychoanalytic work, the transference and countertransference between patients
and their couple therapist(s) will often be reflected in the parallel process
of the relationship with the supervisor. But in the case of couple therapy the
transference to be seen and interpreted should primarily be to the couple, rather than to the therapist. If
the couple therapist works to create and maintain a transference to
him/herself, with whom there is no unconsciously chosen couple ‘fit’, this is
unlikely to be as strong or effective a medium for work as exploring the
patients’ transference to their own couple relationship. The transference to
the therapist will become apparent, but if sought after and prioritised, above
that of the couple, as the primary agent of change, it may either be
unhelpfully competitive or ineffectively outclassed.
The couple therapist’s
countertransference, by contrast, is
generally even more important, diagnostically and therapeutically than in
individual therapy.(Siegel, 1997) The couple therapist is outnumbered by the
couple, who know each other better at every level than s/he knows either; and
they have after all many more hours together than the single weekly hour with
the therapist. S/he has far less influence or control on the volatile dynamics
acted out in couple sessions than is usual in individual work. S/he can be made
to feel like the hapless parent, or older (or indeed younger) sibling in the
face of the quarrelling siblings the couple represent. It is here that the
couple therapist can most be in need of the supervisor’s help not to enact the
countertransference by imposing order unhelpfully, bludgeoning the couple with
interpretations, or capitulating to their joint impact in a way that disables
the therapist’s capacity to think. Or s/he may give way to the sometimes
intolerable pressure to ‘divide and rule’, siding with one or the other
partner, sometimes alternately, but losing the focus of the ‘couple-as-client’.
A supervision session
may reflect the transference/countertransference issues in couple therapy, as
it does with individual work. The ‘couple’ of supervisor and therapist may
usefully reflect the patient couple’s dynamics (as can be so readily seen in
the therapist couple working with the patient couple in foursomes). But it will
be contained in the ‘thinking space’ of the supervision session, sometimes in
contrast to the uncontained therapy session where the ‘acting out’ may not have
been confined to the patient couple.
In summary,
supervision may be a yet more invaluable tool for the couple therapist than for
individual work, particularly if the therapist is working solo, rather than in
a therapeutic pair. But despite drawing heavily on psychoanalytic theory and
practice, couple therapy has a professional genre of its own and its effective
supervision needs to have the same additional dimension.
References
Mitchell,
Juliet (2003) Siblings: Sex and Violence.
Morley,
Elspeth(2005) The influence of sibling relationships on couple choice and
development.
In Sibling Relationships. Ed. Prophecy Coles. Karnac:
Seigel,
Judith(1997). Countertransference as the Focus of Consultation . Countertransference in Couples Therapy Ed.
Solomon and Siegel. Norton.
Elspeth Morley is a Senior Training Member of the
British Association of Psychotherapists, and of the Society for Couple
Psychoanalytic Psychotherapists. Her forty years of private practice with
individuals and couples includes work with her husband, Dr Robert Morley, as
co-therapist. She trains couple counsellors on the Tavistock Centre for Couple
Relationships Postgraduate Diploma in psychodynamic couple counselling.
Supervising with the Couple in Mind
Jenny
Riddell
It
is a widely held view that in couple therapy it is the couple relationship that
is the client. That is to say that the “couple fit” or mutual projective system
which results from the interaction of the two individuals’ psyches, is the
place for the therapist to observe, focus and place their interpretations. That
it is this overlap that requires containment and understanding.
My
experience of supervision of couple work broadly divides into two areas,
supervision of the therapist who works with the couple, and supervision of the
therapist who works with the individual in an intimate relationship, with a
couple problem when the partner chooses not to attend. I would like to suggest
a third area of supervision, which is working with the couple in mind. This
would include what I believe is a rather under attended area of supervision
which is the responsibility, curiosity and care of the psychotherapist to bear
in mind the intimate adult relationship of their client, when engaging in an
individual psychotherapy.
As
a psychoanalytic supervisor of couple therapy I am predominantly interested in
the reflection process in case presentation and the dynamic in the room during
supervision. How are the couple presented? Does the therapist present two
individuals, introducing separate histories, descriptions and pieces of
therapy? Or does the therapist present a couple, with an interest in
similarities or differences between the two and how and why they would choose
each other? How is the transference worked with? Is it possible to have a
“couple transference” and if so what does it look like and how is it worked
with? What is their counter transference, how does a therapist manage a couple
counter transference, which must relate to his or her own internalised couple?
In addition there is the “here and now” of the supervision session. How do the
two of us relate in the immediacy of this session and what does that tell us
about the couple being presented?
Three
in a room is charged with potential Oedipal issues and the therapist needs to
hold on to their ability to take a ‘third position” (Mattinson) within
themselves, to maintain empathy with each and with the couple and yet not be
overwhelmed or withdraw. To be with a couple as they demonstrate, both
consciously and unconsciously, their anxieties, distress, yearning, hostility
or whatever else may be immediate in the room, raw and undigested, not
recollected in tranquillity, can be very hard to bear. Supervision can and
should be a space where the therapist can allow these powerful feelings to be
safely explored.
Technically
there are also other issues to contend with in comparison with one to one work.
What happens if only one turns up, do you see them or don’t you? Do therapist
and supervisor see this differently, and if so are they holding different parts
of the dyad. Who pays for the sessions and how? How is the organisation of the
therapy managed i.e. times days and holidays, whose needs predominate?
In
spite of the complexity, supervision of couple therapy is every bit as
challenging and rewarding as the couple therapy itself. It is a privilege to be
allowed into the inner world of any other human being, but to be allowed into
the inner world of an intimate adult couple is also an opportunity to create a
“triangular space” (Britton) in which all are engaged but also watch and
observe, are included and excluded, which can be painful as well as
enlightening.
Jenny Riddell is a CAPP registered psychoanalytic psychotherapist working with
couples and individuals in private practice. She supervises and teaches on a
variety of trainings and academic courses, including Relate, TCCR, CAPP and
WPF.
References
Britton (1989) The
Oedipus Complex,
Mattinson (1981) The
Deadly Equal Triangle,
Autumn Conference October 21 2006
Supervision as a Search for Good Faith
This was my first
BAPPS conference, and my expectations were high. I would know some colleagues
and was looking forward to seeing them. I expected to get to know others. I had
an idea of an interesting, perhaps thought-provoking talk that would give me
new perspectives on my experiences as a supervisor and as a supervisee, some
small group discussion where I might even shine, a good lunch, some drawing of
thoughts together; and then the AGM: Oh well, you have to have them, and they
don’t last forever. What is more, wasn’t I getting this psychological, social
and gastronomic feast free in exchange for writing an account of it for the
newsletter?
The elements of this
conference that matched my fantasy were the people and the food. And, I had not
imagined such a pleasant garden.
Now, among the people
mentioned in the last paragraph I do include the speaker. Nevertheless, it was
Anthony Stadlen’s approach to the day that was so disconcerting. His training
and practice are both analytic and existential, a combination that perhaps
threw us all off balance. He began by suggesting we would not have groups (a
narcissistic blow for me). He wondered who we were and what we wanted, and he
put into the arena a question of his own – what to do if an agency allows
people to work privately as therapists before they are trained – and a
statement of interest in the idea of faith: what faith do supervisees have, and
is it well placed? By this time there were too many cats among the pigeons, and
watching them chase around was no fun, as far as I was concerned. Ideas about
truthfulness/lying, morality in general, faith in general as well as in the
‘well meaning’ sense that Anthony consciously intended, questions about how to
decide whether to allow a trainee to qualify, doubts about the orientation of
the speaker and the group, attempts to get the whole boiling to stay still for
a moment through questions like, ‘What are we talking about?’ If this is
confusing to read, you will have an inkling of what this first part of the day
was like for me. My impression of this session was that there was a richness of
thought, and there were lively attempts to communicate with feelings that
ranged from tentativeness through passion to fury, with any amount of confusion
mixed in. What was missing was good enough listening, or perhaps reflection, or
probably, in fact, containment.
As the day wore on we
managed to stay with it all, and even came to a place where thoughts arose more
from what had already been said, so that there a greater sense of continuity,
of one thought leading to another. I am going to quote a series of
interventions from later in the day, to give an idea of this more reflective
part of the conference. These contributions followed an example Anthony brought
of an existential trainee counselor supervised by an analytically orientated
supervisor. The trainee was expected to have interpreted the lateness of a
patient as resistance. This made no sense to the supervisee. Anthony spoke of
dogmatism on both sides, and how that can prevent us looking at what actually
happened. Then, the exchanges between us were as follows, allowing for any
inaccuracies in recording the conversation, and with apologies to anyone I
misquote. The first speaker here felt strongly, & this kind of direct
feeling seemed to me to free our thinking for a while on several occasions. The
feeling here was, I think, annoyance. (Two stars indicate a new speaker)
** That is difficult
to listen to: I don’t know a single colleague who would interpret so quickly.
** I once knew a trainee who felt a supervisor was ‘too psychodynamic.’ It
turned out the person was not ready for clinical work because they were too
frightened, If you clarify the language, it is possible to get to the human
reality that underlies the words.
** You seem to be
talking about how you enable communication. The difficulty is to find a way to
take both supervisor and supervisee to an uncomfortable area about someone not
wanting to come.
** It is uncomfortable
for some counselors to think a train might have been late!
** Or hard for the
supervisee or the patient to wait, or to think why they don’t want to come. **
Stuck between stations. You can go a long way down this line… we don’t know
where the unknown will lead us.
** We were using the
word ‘guilt’, but maybe it was about shame, and not wanting to be caught out.
This morning we were uncomfortable at not wanting to be caught out.
** “You must go by the
way in which there is no ecstasy.” (T.S.Eliot) When a tube train stops between
stations there is the terror of having nothing to think about.
** But, people are not
so stupid they can’t think.
** It’s nice not to
think. There’s a judgementalness: we were talking like tumbling bricks. Now, we
are closing down.
I want to end by
saying a little about the ‘good faith’ that was the title of the conference.
Anthony Stadlen’s thought was that the work of supervision is to enable the
supervisee not to lie to themselves about what they are doing or what they
want. There are many mixed motives and pressures hard to resist from ourselves,
from agencies and training bodies, and from supervisees and patients.
Supervisees are terrified by ‘rules’, and yet, Anthony suggested, all such
‘rules’ arise from “simple, subtle, moral questions of what is going on between
therapist and patient and what is being offered.” In spite of the chaotic
experience the conference was for me at times, I was amazed, looking at my
notes, how closely we had kept to the idea of being in a true/false position,
with reference both to our work and to what was happening in the conference
itself. I was particularly interested in the question of what honesty can mean
in view of the unconscious, and whether or not defences are beyond our
responsibility. Another thought-provoking idea for me was that if we make too
much of honesty, of good faith, we may be making it harder to be in touch with
what or how we are. Not knowing seems to be one of the most difficult and vital
states to try to keep hold of, in the shifting, developing, overlapping worlds
of ourselves and the people we work with.
Caroline
Pirquet
AGM Report 2006
The AGM this year went
efficiently and swiftly. 27 members were present and a few members had sent in proxy
votes – which meant we were on the side of a substantial quorum – thanks to
everybody who stayed after the conference, came solely for the AGM and sent
proxy forms.
All reports were voted
for unanimously. Decisions made were:
Ted Martin will be the
external auditor for the coming financial year.
Janet Scovell will
join the Membership Committee.
Jane Ungemuth will
join the Conference Committee.
Susan Harrison-Mayor
will join the Ethics Committee.
Lynda Norton will join
the Publications Committee.
Everybody proposed for
election in relation to BAPPS becoming a Company Limited by Guarantee was voted
in (please see AGM pack for details).
There were lively
discussions on how we can become more well known, the Working Party Report,
Charity Status, Institutional Membership of UKCP & the question of moving
the Spring Conference & AGM:
The Working Party
Report and proposal were accepted.
It was decided not to
enquire further into Charity Status at the moment due to a lot of changes and
watch the developments and report back in 2007.
The proposal re UKCP
membership was accepted.
It
was decided to have our main conference in March & a shorter conference +
AGM in the autumn.
I
hope this gives you a short version of the events & – in good time – you
will receive the minutes.
Kristiane
Preisinger Secretary BAPPS
Spring Conference
Supervising the Erotic Transference
& Countertransference
Speaker: Joy
Schaverien
Saturday 19 May 2007
The Tavistock Centre (Lecture Theatre)
Nearest tube: Swiss Cottage (Jubilee Line)
This will
be a FULL DAY conference
FREE
There is no such thing as a free lunch but the next best thing is .. a
potential free place at the Spring Conference. That is …. ‘Free’ to someone
will to contribute 500-750 words giving an appreciation of the conference
including their personal reactions. Please contact Annie Power.
UCKP AGM Report
Having just returned from UKCP AGM we can report that quite a lot of changes
have been voted on. Your registering member organizations will keep you fully
informed but basically our psychoanalytic section (college) will now have a
block vote at AGM and continued representation on the Governing Board. This is
a complete change from each Member Organization having a vote via their
delegate. We assume we shall get a chance to vote at our own section meetings
so that we are represented by whoever attends AGMs. The working title of our
new college at present is The Council of Psychoanalysis and Jungian Analysis.
Within the next couple of years we shall have a centralized registration system
and complaints system.
Further changes have enabled us to think about the idea of BAPPS
applying for Institutional Membership which could mean having some better
influence on supervision policies. This will need to be explored both with UKCP
and with BAPPS’ membership.
The supervision policy document received quite a lot of negative
criticism which has caused a complete full stop. We have asked for copies of
these from our psychoanalytic representative on the Standards Board.
A UKCP supervision working party is being reconstituted and our Chair
has been asked to participate. There is also planned a supervision conference
in February 2007 of which we had not been informed. This has already booked
planned speakers who are from non-psychoanalytic modalities. We made
representations to the Chair of the Standards Board (who is in charge of the
supervision policy and working party) and hopefully she will now bear our
existence in mind. We have suggested authors of important supervision texts
both psychoanalytical and humanistic who might also offer workshops. The
psychoanalytic representative on the Standards Board has asked us both to
participate in the conference.
With regard to registration, regulation & fitness to practice, the
DOH has asked for sets of competencies from each section so that differences
might define our titles. We believe BAPPS already has gone some way thinking
about competencies of supervisors in the membership application. This is not
necessary at present, but if a supervision policy comes into practice then it
will be.
We understand that revalidation and CPD will be thought of as separate
things. The former is for ‘now’ and the latter for ‘the future’. This might
need to be thought about for our continuing on the BAPPS register. Maintenance
of CPD will be important (and perhaps for a supervision policy) since HPC
(health professions council) will audit the CPD and revalidation activities of
any registrant at any time.
Finally, our Chair, Lisa Wake,
intimated that the DOH might not insist on direct registration with HPC but
might be interested in a General Psychological Council to sit under the
umbrella of HPC. We believe The British Psychological Society would be happy
with this and also British Association of Counselling and Psychotherapy. This
is the first time that the DOH has let it be known that they may be flexible.
Let us keep our fingers crossed – it will surely mean we can maintain higher
standards and ensure diversity of the theoretical amongst our own
psychoanalytic modality.
Penny Wise Geri Dogmetchi
UKCP Ethics Conference 2006
A missing Ethic: trust
as an adequate response to intimacy, risk & reciprocity?
Key speaker Tim Bond
This was a very
densely packed talk and I can in this short space only give an outline. Tim
Bond spoke of how the ethical pendulum has swung over the last 200 years. The
first ethical codes were those of the medical profession and the power was
unilaterally biased towards the professional. ‘Trust me, I am the doctor’.
After the disclosures
of the
This raised problems
when either the medical or therapeutic practitioners were working with those
whose judgement, for what ever reason, was questionable. For example, those who
were suicidal or liable to harm others.
Bond emphasised the
need to reframe this idea of autonomy away from either being unduly biased
towards the professional or towards the client, towards a balance & a
relational autonomy.
He emphasised the
importance of trust, a trust between professional and client that was strong
enough to withstand relational changes. To be trustworthy the professional
needs to be able to balance the care of the patient with their need for
autonomy and he suggested that we have not really got adequate theories on the
nature of trust.
Therapy, (and
medicine) involves risk, it is unavoidable as both therapist and client step
out into the unknown. This also has implications for the whole idea of consent.
To what is the client giving consent when they start on this new experience of
therapy?
The issue of
accountability was raised and how one of the effects of over emphasis on client
power has led to a climate of fear in many practitioners and often a reluctance
to take risks for fear of reprisals. Reciprocal trust breaks down. Is it this
perhaps more than anything that has lead to the proliferation of , and what
might be an over emphasis on, Codes of Ethics and Rules and Regulations in the
effort to be seen to be trustworthy and accountable? It is quite difficult at
times to get the balance right.
Anne Rogers
Ethics Conference Workshops
I
joined the workshop on Ethics and the Self.
‘An opportunity to look at the notion of professional
ethics’.
Don Feasey spoke of
his development of an ethical self. We then worked in groups to explore what we
understood by ethics and how our ethical learning occurred. Many questions were
posed but while it was useful to be able to talk with therapists from other
organisations there was insufficient time to explore any of the issues in any
depth, including the issue of the possible defensiveness of organisational
ethics which Don raised with us.
In the afternoon I
joined Herbert Hann’s group on ‘Dialoguing with our dreams in relation to
ethics in training and supervision. This took the form of a social dreaming
matrix. Thinking about this now I realise how this tied in with some of the
ideas on supervision that Chris Driver was writing about in the last
newsletter.
Final session
When he returned to
the hall after the workshops James Antican, the Chair of UKCP broached the
subject of the Ethics of Torture.
“There is no doubt
that torture using psychological understanding exists. It is only our attitude
towards justification that makes the difference”
The BPS has issued a
statement condemning the use of psychotherapeutic insights and methods in
torture & James asked us to consider whether UKCP should not do the same.
We were shocked into thinking about this. It was interesting that when James
tried to move the conference onto the plenary session, nobody wanted to go
there; they wanted to stay with this very important ethical issue. It was
agreed that UKCP would continue to debate this issue.
Anne
Rogers
BAPPS West Report
BAPPS
West has enthusiastically supported the development of a supervision course,
hosted by STPN, which began in September with 11 course members. Ruth Barnett
offered the introductory seminars bringing the trainee group alive and
energised by her knowledge and commitment. The course includes work discussion
and an experiential group linking theory and practice, and is a space in which
trainees can reflect on the dynamics and their experience. Details of the 2007
course are available from Ann Bowes, email ann@bowesuk.co.uk.
Closing date
Ann Bowes
BAPPS Suggested Guidelines for Professional Practice
In the event of accident, illness, death & unforeseen circumstances
Following the article
by Ted Martin in the June 2006 BAPPS Newsletter on the death of a supervisee the
BAPPS Ethics Committee took on the task of looking at guidelines from a number
of other organisations in relation to having a professional executor. As a
result of discussions within the Ethics Committee and with the BAPPS executive
the Ethics Committee have put together the following guidelines for
professional practice in relation to accident, illness, death and unforeseen
circumstances.
Contents
1. General
Guidelines
2.
Guidelines for informing your Executors of your professional arrangements.
3.
Responsibilities of the Professional Executor when informed of your sudden
illness, accident or death.
4.
Circumstances with uncertain outcome.
1. General Guidelines
1(i). To
let the Secretary of BAPPS know the name of your Professional Executor(s), including
the address(es) of the Professional Executor(s) if he/she is not a member of
BAPPS. If you are registered through another organisation and register your
Professional Executor(s) with that organisation, BAPPS should be informed of
the name of the organisation.
1(ii).To
keep and maintain a list of current supervisees, and patients/clients, with
their addresses and telephone numbers, and with the days and times of sessions
each week. This list could also include such matters as length of work
together, discussion about finishing, whether supervisee, patient/client lives
alone, or any other matter that could help your Professional Executor at a time
of crisis.
1(iii) To
maintain a current list of supervisees in training and their respective
training organisations.
1(iv).To
keep & maintain a list of professional engagements, lectures or teaching
sessions planned.
1(v). To
ensure that your Professional Executor(s) has access to your professional
premises, professional files and practice records in paper or electronic form.
1(vi). To
give your Professional Executor(s) information about your record keeping
system. You will need to make known and put in writing to your Professional Executor(s)
relevant information about your records in the event of sudden or prolonged
termination of your practice.
2.
Guidelines for informing your Estate Executor of your professional
arrangements.
2(i)
Provide your Estate Executor with the name of your Professional Executor(s)
2(ii)
Arrange that your Estate Executor be informed, if appropriate, of your sudden
illness or accident, as well as your death.
2(iii)
Request that your Estate Executor inform your Professional Executor(s) as soon
as possible of your sudden accident, illness or death so that the Professional
Executor(s) can carry out the necessary tasks to deal with your professional
practice.
3. Responsibilities of the Professional
Executor when informed of your sudden illness, accident or death.
3(i) To
inform as listed and pre-arranged all supervisees, all training organisations,
patients/clients, and professional contacts, as soon as possible, of the
situation that has occurred. Such information to be given in an appropriately
professional manner, as discussed and agreed between you.
3(ii) To
notify any relevant person and/or organisation about outstanding work e.g.
lectures, teaching.
3(iii) When
appropriate, and after discussion with the family, to inform supervisees and
professional colleagues of any funeral arrangements that may involve them.
3(iv) To
follow up supervisees, patients/clients, if appropriate, and arrange to see
them for one appointment, and then refer them on to another supervisor,
psychotherapist or counsellor.
4. Circumstances with uncertain outcome.
4(i) It is
possible to have clear guidelines in the event of sudden termination of
practice. However, when the outcome is not known, as in certain incapacitating
accidents or illnesses, a “holding” period may be needed, In this case, it is
important that supervisees, patients/clients, are regularly kept informed of
the situation.
If there is
an extended period before it is known whether, or when, you will be resuming
work, then alternative arrangements may need to be made. The Professional
Executor(s) would make this decision, possibly in discussion with you, and/or
family members.
New Members & changes in details
Anne
Baker
anne548@btinternet.com
[ BACP ]
Bruce
Kinsey
159 Huntingdon Road
BRLK1@cam.ac.uk
[
UKCP ]
Carol
Leader
caroll@freeuk.com
[
UKCP ]
Marilyn
Mathew
Marilyn.mathew@change-fx.com
[ BPC ]
Felicity Criddle
47 Hova Villas
Hove
felicitycriddle@yahoo.co.uk
[ BPC ]
Belinda
Sharp
52 Cranleigh Gardens
Phone & email same
September 2006