THE BRITISH ASSOCIATION FOR
PSYCHOANALYTIC AND PSYCHODYNAMIC
SUPERVISION
December 2007
Foreword
Chris Driver (Chair)
It is seems very timely that this
Autumn Issue offers you a Bumper pack of goodies to read over the Christmas
period. This issue includes some deeply
thought provoking pieces on the erotic transference and countertransference in
supervision which were stimulated, in part, by the conference which Joy Schaverien
gave in the Spring.
This issue includes a piece by Joy
Schaverien based on her talk, a reflection on the theme by Patsy Fauré, an
article by Lynda Norton on enchantment, and a lively piece by Val Garrett. In addition there are two book reviews, by
Annie Power and Lynda Norton on recent books on Supervision as well as
reflections on the AGM and an interesting report by Anne Rogers on the UKCP
Ethics Conference.
This Newsletter reflects the wealth of
ideas within BAPPS and it is wonderful that so many members are willing to
write and contribute to it and develop thinking and ideas about
supervision. The Newsletters over the
past few years have all contained fascinating articles and I am exploring how
we can get some of the papers linked more directly to the internet so that they
could be accessed more readily through Google searches.
We are already planning the
Newsletters for 2008 and the next one (Spring) is on the theme of Research in Supervision and the Summer
one is on the Role, Function and Format
of Clinical Notes and Case Reporting in Supervision. If any BAPPS member would like to write on
either topic please let the Publications Committee know.
Another issue that I would also like
to raise is in relation to BAPPS committees.
There are two vacancies on the Conference Committee and I do hope that
you will think about whether you could join this group and help with this
vitally important task in relation to the work of BAPPS and supervision. In addition I want to reiterate the point I made
in my AGM Chair’s report. Kristiane and
I will be standing down at the next AGM so do think about whether you would be
interested in taking on the role of Chair and Hon Sec. BAPPS is a fascinating organisation to be
part of so please think about it. If you are interested do talk to either
Kristiane or myself as we would be happy to support anyone interested in these
roles.
Finally, I would like to thank all
BAPPS committee members for their hard work in relation to BAPPS and it was
great to meet so many members at the recent conference and AGM.
I wish you all well for the New Year
and look forward to seeing you sometime in 2008.
With all good wishes for Christmas and the New
Year. Chris Driver
(Chair)
Breaking The Spell:
Countertransference,
Enchantment & the Erotic Transference in Supervision
Joy
Schaverien
There are times when the therapist,
working with diverse and sometimes disturbed states of mind, is in a condition
akin to enchantment. This is not a romantic
state but rather a very real and substantial embodiment, in the therapist, of a
psychological shadow element - an unconscious countertransference. It is as if the therapist is spellbound and
is, literally, in need of the ‘vision of another’ in order to break that
spell. It takes super-vision to extract both therapist and patient from the
spell that has woven them together.
In order to
process complex supervisory experiences a clearly boundaried setting is
necessary. Psychotherapy is often described
as framed experience and this could be extended to supervision (Langs
1994). The whole therapeutic enterprise
might be envisaged as a series of ever decreasing frames within frames which
are both real and metaphorical. The
outer frame is constructed by the physical reality of the bounded space of the
consulting room, sealed by the walls and closed door. Within this there is the metaphorical,
intangible frame, which is made up of the agreed limits of the therapeutic
relationship, including the arrangments and formal structures needed for the
safe conduct of psychotherapy. Times of
sessions, in private work the fee, and other practical arrangments are all part
of this. Within these secure outer
frames, a dynamic space is created in which the therapeutic relationship
develops. Images emerge within the space
created by these bounds and a mental picture forms in the mind of the
therapist. Finally, if we draw back
beyond the outer bounds of psychotherapy, supervision might be imagined as an
encircling, outer frame, which offers containment for the whole
enterprise.
In considering this I refer to the
theatre, that home of enchantment, as a metaphor for supervision. We might conceive of psychotherapy as a
drama, made up of different active elements.
The first is the client’s narrative, the story that is told, or conveyed
in their way of being in the room.
Then, as the therapeutic relationship becomes established, the transference/
countertransference dynamic engages the therapist together with the client, in
a live drama. Through the transference
the client attributes roles; attitudes and responses to the therapist, some of
which are ego alien to the therapist, but they may be so powerful that they are
totally believable. This may lead to a temporary loss of the symbolic
attitude. For a time the therapist may
believe or sometimes embody the projection, temporarily becoming convinced that
she is a bad therapist, an abusive or perfect parent/therapist or an idealised
saviour, lover/ therapist. The point is
that sometimes this can be a form of enchantment where the therapist loses
their own sense of self and identifies with the projection. This is because transference is like a drama
in which the protagonists experience real
emotions but it is vital to
remember that it is also, like the theatre, a symbolic relationship.
If the symbolic attitude
collapses, the projection is taken for real and there is a temporary loss of
the ‘as if’ meaning of the transference.
The client, and sometimes the therapist, become identified with the
transference and cannot separate from the unconscious projection. Identification with the projection may lead
to acting out. This is when the
therapist mistakes that which should remain symbolic for real. This is of course most evident when the
erotic transference and countertransference is weaving its spell.
The Erotic Transference
The erotic transference, and the
associated countertransference, can be a sensitive area that the therapist may
be reticent to discuss in supervision as it brings the therapist-as-person into
the material of supervision. However it
is important because awareness of bodily arousals, or lack of them, in the
therapist may indicate the level of functioning of the patient at any
particular time. For example regression
to an infantile state may evoke a maternal response or, conversely, a rejecting
repulsion, whilst Oedipal demands may arouse a genital response in the
therapist. This may be additionally confusing as such arousals arise irrespective
of the gender or conscious, sexual orientation of the therapist or
patient. These are not fixed and
perceptions of them may alter, taking different priorities during the course of
an analysis. Eros is central in the
individuation process but it is not merely one thing. The meaning of its insistent presence or
persistent absence in any particular therapeutic relationship may reveal much
about the patient’s way of being in the world.
Attention to the countertransference is often the key to the level of
functioning of this particular patient at this particular time. There are many
other countertransference responses that are less obviously demanding but the
erotic needs to be given particular attention, as it can be embarrassing to
approach in supervision.
The role of the Supervisor
The supervisor, as if from the
privileged position of the audience, witnesses the drama that unfolds in
supervision. Whilst the therapist
recounts the experience of the session, the supervisor closely attends, forming
a picture of the therapeutic relationship as a whole. As the atmosphere of therapy is recreated,
the supervisor, like the spectator in the theatre, may be moved by tragedy,
horrified by stories of abuse, saddened or angered on behalf of the client or
fear for the welfare of the therapist.
In this way she is drawn into the drama but at the same time maintains a
dispassionate and watchful eye on her own reactions. The supervisor’s task is to think with the
therapist about the meaning of the therapeutic relationship; she is attuned to
listen for the unconscious implications of the interactions presented. The therapist may be totally engaged with the
drama of the session but the supervisor is not immediately involved and so her
view is outside the dynamic.
At its best, the framed space of
supervision creates a symbolic space in the mind of the therapist - a space to
think. The therapist in supervision might be seen as similar to an actor, who
moves from the position of protagonist, to join the supervisor in observing the
action from a critical distance. She or
he may bring unprocessed and largely undifferentiated material to supervision
but the very act of supervision requires the therapist to make a psychological
split, simultaneously standing beside the supervisor, as a spectator of the
drama, as well as observing her or his part in it. In this way supervision enables the
therapist to separate from the enchantment of the transference drama, restoring
consciousness and so the symbolic attitude. Supervision is then an essential form of
emotional cleansing.
References
Langs R, (1994 )
Doing Supervision and Being Supervised,
Schaverien, J,
(2003)
‘Supervising the Erotic transference & Countertransference’ in Supervising
& Being
Supervised:a Theory in Search of a
Practice Wiener et al (eds)
(2006) (ed) Gender, Countertransference and the Erotic
Transference: Perspectives from Analytical Psychology and Psychoanalysis
Hove & New York: Routledge
(2007) ‘Framing
enchantment: Countertransference in analytical art psychotherapy supervision’
in
(eds) Schaverien,
J. & Case,C., Supervision of Art
Psychotherapy London & New
York: Routledge
Professor Joy Schaverien PhD is a Jungian Analyst, a Professional member of the
Society of Analytical Psychology in London & Visiting Professor in Art
Psychotherapy for the Northern Programme for Art Psychotherapy at the
University of Sheffield. She is a
Training Therapist & Supervisor for the British Association of
Psychotherapists (Jungian Section). Her
books about the erotic transference include Desire & the Female Therapist (1995), The Dying patient in Psychotherapy
(2002) & she is editor of Gender,
Countertransference and the Erotic Transference (2006) and (with
Caroline Case) Supervision of Art
Psychotherapy (2007) Her private
practice is in the
BAPPS Spring
Conference 19 May 2007
Facilitating
Exploration of the Erotic Countertransference
Patsy
Faure
I was drawn to this conference,
because early in my counselling career, I experienced what I later understood
was an erotic countertransference towards a male client which paralysed me for
some months. This was compounded by the
fact that this happened within the context of couple work.
Although, I worked with this couple
for two years, I now believe that the work became stuck due to my own
paralysis. What was particularly
troubling for me, was not just sitting with these difficult (sexual) feelings
towards the client for months, but the fact that I felt unable to raise this
with my supervisor, a blind-spot existed.
Elements of shame and lack of self-control hindered me.
In fact, it was after I had finished
working with this couple and discussed the situation with a different (male)
supervisor that I felt freer. Later,
while working with another male client, a male supervisor suggested that this
particular client might have sexual fantasies towards me as a therapist, i.e. in
the transference. I found this concept
very challenging, aggressive even. In
fact this enriched my work and I felt able to take more risks and challenge
clients as a result.
An ongoing thought/test for me, has
been how comfortable am I with a particular/current supervisor to discuss this
taboo in supervision.
It is with this experience in mind,
that during my recent supervision training that I began to muse about how free
my supervisees would feel to bring the ‘erotic’ into our supervision sessions.
Patsy Fauré is a Couples and Relationship
Counsellor with a private practice in Canary Wharf, she originally trained at
The Erotic
Countertransference:
Some Reflections On
Enchantment
Lynda Norton
Circe warning Odysseus
about the Sirens:
".............................................
and that man
who unsuspecting approaches them, and listens to the Sirens
singing, has no prospect of coming home and delighting
his wife and little children as they stand about him in greeting,
but the Sirens by the melody of their singing enchant him.
They sit in their meadow, but the beach before it is piled with bone heaps
of men now rotted away, and the skins shrivel upon them.
You must drive straight on past, but melt down sweet wax of honey
and with it stop your companions' ears, so none can listen;
the rest, that is, but if you yourself are wanting to hear them,
then have them tie you hand and foot on the fast ship, standing
upright against the mast with the ropes' ends lashed around it,
so that you can have joy in hearing the song of the Sirens;
but if you supplicate your men and implore them to set you
free, then they must tie you fast with even more lashings."
The Odyssey:
Book 12: The Cattle of the Sun
One of my reservations about using
enchantment as an analogy for the powerful influence of the counter
transference (Schaverien 2006) is that enchantment of late has seemingly become
domesticated. With the hubris of modern times it can be dismissively consigned
to the magic of childhood tales, and understandings of enchantment disconnected
from those of power. For a power relationship involves one person ruthlessly
manipulating another for his own purposes and is the antithesis of Eros, mature
love. As Jung observes: “Logically, the opposite to love is hate, and of Eros,
Phobos (fear) but psychologically it is the will to power,” (Jung: 1043:7:7)
In the Odyssey, Circe left Odysseus in
no doubt as to the perils which would befall him if he acquiesced to the
enchanting melody of the Sirens - and Odysseus took serious heed to this mortal
threat. For bewitchment entails the
enchanter seeking to impose their will upon an ‘Other’, by evoking both
fascination and or desire. Furthermore
the spell is not necessarily broken simply by becoming conscious of the dynamic
– although that may be helpful in illuminating a way forward – and this is
especially true where the counter transference spell is intense, as in the
realm of the erotic. So like Odysseus
the therapist may need to be lashed securely to the mast of the therapeutic/supervisory
frame in order to be able to steer a safe course and yet be open to the
experience. That is if s/he wants to explore and seek to understand the meaning
of the underlying communication and yet not act out in the joy of the melody.
The supervisor too, must confront the self-same dilemma of being securely
planted within the frame but still open to the strains of the song, even though
these strains may be more muted.
At the BAPPS conference several
members related experiences which brought enchantment out of the closet and
very much to life. They generously shared struggles with compelling, visceral
experiences of the erotic counter transference about which they felt confused
and at times ashamed. They also confided how difficult it can be to take such
embodied experiences - which touch on the very essence of the therapist - into
supervision. They feared that their
supervisor would be judgemental, unsupportive or simply unable to attend to the
dynamic and in some cases, these fears were resoundingly confirmed. In the context of the erotic
countertransference it seems that the persecutory ‘analytic super ego’ can be
acutely active in both the therapist and supervisor (Colman 2006; 2007).
Patsy’s thoughtful piece, (see foregoing) is typical of the depth of sharing
within the conference. She provides a
moving vignette which highlights the paralysing nature of the erotic counter
transference and how difficult it can be to raise such feelings in supervision. She also indicates that the occurrence of
such experiences can be a catalyst for an epic journey of exploration and self
discovery – akin to that of Odysseus – seeking widely in order to begin to gain
some insight as to what has arisen.
Hence experiences of the erotic countertransference can be purposive and
provide stimulus for professional growth.
At the conference, the reverse side of
the coin was also considered, circumstances where the erotic counter
transference is notably absent in the clinical material – often with a
deadening unrelated atmosphere in the room. There was reference to ‘medallion’
man – who presented in a confident macho way which left the therapist unmoved
despite his apparent sexual attraction outside the consulting room (Schaverien
2006; 65). This put me in mind of men
who present in a rather different way as a ‘geezer’ a shy, shambling, rough and
ready guy, no nonsense, unromantic and yet like ‘medallion’ man, outside the
consulting room seemingly a magnet for women.
In the following vignette , for the purposes of confidentiality, I
present an amalgam of several such men – some of whom I have worked with and
others I have learnt of from supervisees
– and I have set this hybrid ‘geezer’ in the context of actual
experience of supervision of the erotic countertransference which I found very
helpful and containing.
Some years ago a rather non-descript,
diffident, gangly, scarecrow of a man attended an initial consultation. His history included a string of
extra-marital liaisons – it seemed women inexplicably ‘threw’ themselves at
him. During the session it was impossible for me to conceive as to how he had
achieved such conquests ...... until he
took his leave. On the threshold of the
door, he turned, gazed deep into my eyes, smiled and thanked me. For a moment I
felt entranced by the admiration in his gaze and warmth of tone – as if I were
truly the fount of all womanhood, source of all bounty; a veritable archetypal
mother goddess. In that moment I looked at him anew and found him transformed;
I was hooked. It was all I could do to
remain stock still rather than step back and away from him. I imagined he might literally as well as
metaphorically sweep me off my feet.
After he left I felt shaken by the intensity of the experience and
questioned my part in the fantasy – after all, as my punitive analytic
super-ego told me, all he had done was smile and say thank you.... I
interrogated myself - was this grandiose fantasy his, or mine? Before the next
and subsequent sessions I became anxious in a concrete way about being in close
proximity to him especially in terms of threshold experiences – as to what
would happen as he entered or left.
I took these fears to supervision with
some trepidation even though the relationship was well established and I had
every reason to be confident that the focus would be curiosity as to what this
might communicate rather than upon any shortcomings. When presenting the material my impulse was
to rush through and evacuate the experience and it was my supervisor who slowed
the pace allowing space for exploration. .... What was the nature of the
desire? What did I fear might happen at
the time?.... in the future? Her matter
of fact and grounded response enabled me to share anxieties of intimacy,
entanglement and confusion as to what belonged to whom. Supervision opened up an arena in which we
could play together with notions of fascination and infatuation. We were both
intrigued as to how this scarecrow of a man, this ‘geezer’, had women swooning. What was so powerfully irresistible? What did
he evoke or hook into in the unconscious via projective identification with the
‘Other’? This was hard to grasp but
seemed to entail idealisation of womanliness and motherliness in powerful
fusion. As we explored we began to
notice not only how much this ‘geezer’ had got under my skin but also to
intrigue my supervisor, - the fascination was tangible - and so we began to
hear the Sirens singing softly in the distance; to wonder whether ‘fascination’
might herald ‘grooming’ of the unconscious for an erotic transference; could my
fear be that it might lead inexorably toward ‘infatuation’ and even
enactment? My supervisor reminded me
that Odysseus lashed to the ship’s mast; this enabled him to listen and be
moved by the Sirens’ song without succumbing. He was reliant upon his crew with
their ears plugged -immune to the song that might lure them all to their death
- to keep the ship on course during the crisis. She likened this motif to the
therapeutic frame which was reaffirmed and encircled by the frame of supervision.
The paradox however was that it was vital for me that my supervisor also heard
the song of fascination and yet continued to maintain the frame. She therefore also presumably needed in
parallel, a loyal crew to lash her to her own internal mast and so keep the
supervision on course – be it through her own professional support network,
experience, mature ego, benign analytic super ego or whatsoever.
Supervision was helpful in
illuminating the counter transference and containing my anxiety but to my
dismay it did not instantly dispel the dynamic; far from it. The anxieties and fantasies continued even
though the patient apparently subsequently did little or nothing to provoke
them. Indeed for several months I began
to doubt my experience; that momentary glimpse, gave way to an extended fallow
period in which I had great difficulty in seeing him as a sexual being at all
but only as a ‘geezer’. In the
countertransference I felt cut off, mechanical, unresponsive and even dead. I
could feel exasperated and yet remained fascinated. In time, huge fears of
abandonment in the context of a chaotic family structure emerged. From the countertransference and the material
it became increasingly apparent that seemingly mother had been overwhelmed and
unresponsive; father weak and ineffectual.
Again it was in supervision I was encouraged to keep faith with the
range of counter transference experiences and wait in an open and receptive way
until possible meanings and purposes could begin to surface in the material and
be explored. A terror of abandonment and consequent fragmentation slowly
emerged. It began to seem that it was essential for him to transfix mother
figures by enchantment in order to secure slavish attention and stave off
catastrophe. The ruthless manipulation
seemed to be that of a baby striving for his very survival, expressed through
the sexual desires of a boy-man.
Covington (1996) suggests the erotic
transference stems from a double failure; a failure to resolve the Oedipal
conflict with father together with an underlying earlier maternal failure in
which mother cannot contain and process her baby’s needs without becoming overwhelmed. She also suggests the desire to
act out sexually is not only a manifestation of repetition compulsion within
the transference but also has a purposive aspect – it expresses the patient’s
need to find both a loving breast and an empathic father. Hence the task of the
analyst is to meet the patient’s desire – as a man and an infant - with
understanding and yet to frustrate an enactment. Looking back on my work and that of others,
this highlights for me the dual challenge of the erotic transference/
countertransference; not to succumb AND not to split off or ignore. The sexual
desires must be acknowledged and held alongside those of the needy baby. The
temptation can be to focus upon the maternal transference which is deemed safer
and so defend against the riskier erotic transference by hearing and
acknowledging adult desires and the attendant frustrations of non consummation. To attend only to the maternal and neglect
the erotic can lead to either a stuck sadomasochistic dynamic or premature
termination.
Since that time, the impact upon me in
terms of my practice has been that I am especially mindful that supervision
needs to be a safe vessel; a boundaried space in which play and exploration of
clinical material and fantasies is facilitated.
It needs to be challenging but not persecutory. I would suggest that in terms of the erotic
transference/countertransference both therapist and supervisor have to address
Odysseus’ dilemma and find a safe passage through whilst listening attentively
to the Sirens. Both therapist and
supervisor therefore face the dual challenge presented in the realm of the
erotic; not to succumb and yet not to split off For in order to help a supervisee bear deep
and disturbing feelings such as painful excitement and shame in the erotic
countertransference it is essential that the supervisor is also able to hear
and be open to the song of the Sirens. Any defensive manoeuvre on the part of
the supervisor – using ear plugs to ward off seductive strains – means that
they are rendered deaf to both the supervisee’s distress and arousal. As in
therapy, if the erotic is not attended to, the supervisory relationship may
also terminate prematurely or become stuck in an interminable sadomasochistic
dynamic.
In my experience and that of others,
it is often possible to catch a powerful glimpse of the erotic in an early
session and for it then to remain dormant for an extended period time until it
is ready to emerge, held either in the fantasies of the therapist as an erotic
countertransference or as a sense of the erotic being notable absent
(Covington, 1996; Gerrard, 2007, Schaverien). Similarly, I am particularly
interested in accounts of threshold experiences - these represent a move
between inner and outer worlds and occur at a point of transition in the
therapeutic frame - in consequence, defences may be lower and so receptivity/
susceptibility to unconscious communication greater. I am also alert to signs that the client or
patient is ‘special’ to the therapist (or vice versa). Intense erotic transference/countertransference
experiences often occur with hysterical patients where mutual idealisation and
powerful undercurrents of a rescue fantasy can be present. Ronald Britton
highlights the dilemma presented by the countertransference eloquently and
hence I leave the last word to him:-
“It is true that we have learnt to use
the counter transference to further our understanding of our patients.........
But some things don’t change. Knowing more about tigers doesn’t make them less
dangerous. There are no tame tigers, and
animal trainers and zoo keepers need to be the first to realise it. Hannah
Segal wrote that “the countertransference is the best of servants and the worst
of masters ... the pressure to identify with it, and act it out... is always
powerful” (1981, p86). (Britton,2003, p44)
References
Britton,
R. (2003) Sex, Death and the
Superego: Experiences in Psychoanalysis.
Colman,
W. (2006) The
analytic super-ego. J.British Assn of
Psychotherapists, Vol. 44 (2), 99-114.
Colman,
W. (2007) The
Supervisor and the Super-ego BAPPS newsletter (April)
Gerrard,
J. (2007)
Enactments in the countertransference: with special reference to rescue
fantasies with hysterical patients. British
Journal of Psychotherapy 23 (2): 217-230
Schaverien,
J. (2006) ‘Supervising the erotic
transference and countertransference’
Gender, Countertransference and the Erotic Transference. Routledge
Segal,
H. (1981) ‘Countertransference’
The work of Hannah Segal.
Lynda
Norton is an
associate member of Association of Jungian Analysts in full time private
practice in Welwyn Garden City, Hertfordshire.
BAPPS Spring
Conference 19 May 2007
Making ‘Love’ and
Making ‘Babies’
A
personal response by Val Garrett
I love making babies, so when I had
finished making the flesh and blood variety, my three daughters, my unconscious
mind set about finding other ‘babies’ to make.
Of course I didn’t realise that was what was happening, I just thought I
was training to become a counsellor.
Being a rather fecund sort of person I have made lots of babies in my
counselling career and even more as a supervisor!! Sadly though, some have aborted or
miscarried. That is life. “Has she gone
completely daft?” I hear you ask. Well,
anyone who knows me well also knows that ‘being daft’ is certainly part of my
repertoire. But in this instance I
haven’t. As I sat through the excellent
conference and listened to Joy Schaverien, then joined in the discussion during
the very safe plenary session and listened to my inner world I sensed babies
being made all over the place.
Conception happens silently and in
secret, secret even from the participants – although they probably have pretty
good idea it might be on the cards!! And
that is what happened in the conference, and happens in counselling and
supervision. Joy says the ‘theatregoer
enters into the ‘as if’ of the drama with willing suspension of disbelief’ – in
other words they join in the ‘play’ of the play on the stage. We must keep our ability to play healthy and
alive whether practicing counselling or supervision. The ‘making love’ of one unconscious with
another is to let the ‘show’ commence.
We must actually believe there is more to the ‘play’ than mere
suspension of disbelief. It is the very
act of the freedom from disbelief that awakens another belief, another truth; a
shared belief and truth that we are creative and, like alchemists, turning one
set of elements into another – sometimes into gold. Can we give our unconscious
erotic ‘private parts’ permission to make love to our clients unconscious
erotic ‘private parts’ – make a meeting place - for until this meeting takes
place the gestation and labour cannot begin.
In supervision Joy sees an important
outer frame that holds and contains the setting within which contracted
boundaries provide the frame for the client’s narrative to unfold. The frame of the contract both contains and
frees the client to feel the pain and express the feelings just as the painful
contracting of the womb contains and frees the foetus from the mother. Although in supervision the task is to
‘dissolve’ the concreteness through focussing on the symbolic meaning we must
not then lose the desire or the ability to enter the ‘drama’ again.
Ruth Barnett in her appreciation of
the conference, in the last newsletter, said of our unconscious erotic fantasy
lives that, “as professionals, we keep that aspect of ourselves out of the
encounter”. Certainly we don’t talk
about them with our clients but I hope we don’t keep them out of the
encounter. Our unconscious fantasies are
rich and fecund, joyfully abundant and without boundaries except for our
unconscious censors. So let us rejoice
in them and let our unconscious fantasies loose to make ‘babies’ with our
clients and supervisees. We can still
keep those ‘babies’ safe, as we are trained midwives, working within a whole
faculty of midwives. So, at the
conference, was Joy a midwife amongst midwives, as in the safe group we incubated
and gave birth to our baby ideas. Did we
then look at and admire our ‘babies’ and other peoples’ ‘babies’ and then go home
thinking our ‘babies’ were the best?
End Note - I might have become a
midwife instead of counsellor and supervisor if my life had taken a different
course – but hey, midwives retire at sixty and I don’t have to – hooray!!
Val Garrett lives in Danbury, Essex where she practices as a
supervisor and psychodynamic counsellor, in private practice & for two WHCM
counselling agencies, one of which is for children & young people.
She achieved her MA in supervision two years ago & also
supervises schools counsellors. Val set up and runs a youth club in
her village and is pleased to say it attracts just who she would hope
- the disaffected, disillusioned and the lonely.
Future Newsletters –
Call for Articles
Summer
Edition: Note Keeping........
Note
keeping is an area in which very little has been written and where
practitioners have tended to develop creative systems of their own; it would be
good to share some of this practice.
We
would very much value articles on any aspect of this. Some ideas:
The
supervisee’s notes (from their point of view and the supervisor’s).
The
supervisor’s notes – how they may be written, how they may be used.
Training
issues around notes.
Legal
aspects of note keeping (perhaps a BAPPS member has a legal background or interest
in this area)
Autumn
Edition: Difference in Supervision......
We
are hoping that BAPPS members will write about their experience of managing
various types of difference. We had in mind the experience of difference within
any of the supervisory relationships: between supervisor and supervisee;
between different members of supervision groups; within the supervisory triangle
– for example when the supervisor and therapist are late middle aged women and
the client is a young man.
The
first ones which came to our minds were:
Race
and ethnicity
Social
class
Age
Gender
Disability
Sexual
orientation
Stage
of training
Clinical
skills
(peers who may be at the same stage
of training but whose capability is different)
BAPPS Autumn
Conference
What Shall We do with
the Narcissistic Supervisee?
Debbie
Gautier
Having agreed to contribute to this
newsletter about the paper presented by Gill Banister on the subject of working
with the Narcissistic Supervisee, my concern was would I be able to find enough
to say that would make any sense to others. However, having attended this
seminar I feel overwhelmed by the enormous quantity of stimulating thoughts it
provoked in me and wonder how I can most usefully condense all of this to pass
on the experience.
The question being asked was – how can
we effectively work with a narcissistic supervisee. Gill was quite brilliant in
her ability to make a very complex subject clear & understandable. She
provided us with two clinical vignettes from her own experience that
beautifully demonstrated how she had managed to facilitate the movement within
the supervisees both struggling with narcissism that was impacting on their
ability to relate to their clients. She introduced the idea that if the
supervisor is able to model their own ability of relating and feeling to the
supervisee, in relation to the client material, it provides the potential for
the supervisee’s narcissistic defense to be lowered.
However, of course it is not quite
that simple, what is also an essential element within this process is the tone
in which the supervisor provides that modeling. For me, an extremely helpful image
was provided by thinking about The Emperor’s New Clothes where the emperor is
only able to hear about reality of his situation by the young boy in the crowd.
The reason that this boy is able to speak with such innocence and volition and
therefore be heard by the Emperor is because he is used to really being “heard”
by his parents. It is from this undefended place that the voice has a quality
of innocence that reduces the fear of judgment and shame within the other. The
response shown be the supervisor needs to be experienced as though it is fresh
and new “in the moment” rather than with any sense historical frustration or
humiliation. The supervisee needs to endeavour to find this place within
themselves of relating to the client material in a very genuine way and
responding to the emotions evoked in them.
The second vignette helped us to think
about the supervisee who begins the training in order to become qualified and
satisfy a narcissistic desire to feel more powerful. How clearly do trainees
hear the message that although accepted onto the course, they may not qualify?
This prompted much discussion around the narcissistic defense of the training
establishment to qualify trainees. The question was raised, are we talking
about failure if someone doesn’t qualify, or is it the opportunity for them to
discover more about themselves and what they really would like to do? The
boundary between supervision & therapy was constantly being held in mind &
it was acknowledged that the supervisee needed to work with this in therapy.
Gill acknowledged her desire & pull, on occasions, to want to be able to
discuss the narcissism within the supervisee with the supervisee’s
therapist.
After the delivery of the paper Gill
suggested we form small discussion groups to tackle the topic from our own
perspectives. It was interesting to me to notice that in my group we found
ourselves, among other things, discussing the issue of retirement and when to
stop working. Personally I wondered was this a reflection of the overwhelming
sense of challenge and exhaustion that doing this work with the necessary depth
of thinking brings to us, along of course with the satisfaction and
stimulation. Later we moved back into a large group to discuss the various
themes that had come up, one of which was healthy narcissism and that this may
be recognized narcissism that we have worked with and perhaps helps us stay
more resilient at times. We considered the idea that it may be easier to
challenge narcissism in a qualified supervisee whose anxieties and defenses
were slightly less as a result of having been affirmed by qualifying.
I realize that this is a very quick
overview of what was a hugely in depth and stimulating morning and I realize I
have omitted enormous quantities of material, however I hope I have wetted your
appetite to think more about this familiar struggle and personally I look
forward to the next event.
Book Review
Supervision:
Questions and Answers for Counsellors and Therapists
By
Michael Jacobs and Moira Walker (Whurr 2004)
Annie
Power
This is a book about supervision
written largely for counsellors and therapists, but the latter sections
directly address questions which supervisors might ask. This makes it a very
useful book for supervisees and sometimes an interesting one for supervisors.
It is full of sound regular advice about supervision though parts are
controversial – such as the ideas about tape recording sessions, which the
writers have come to believe is both useful and acceptable. The approach is
recognisably psychodynamic in terms of the frame and use of unconscious process
but at the same time pragmatic. For example, on the question of whether it
might sometimes be helpful to seek additional specialist supervision for a
particular client, the authors acknowledge the danger of splitting, especially
when a client’s material involves this, but they affirm that it can work well
for an experienced counsellor to take in two supervisory views which could
reflect different aspects of the work. (35)
The authors introduce themselves as
“psychodynamic going on integrative”(xii) but intend that the book be useful to
practitioners from a wider field. The writing is beautifully clear and the
‘Question and Answer’ format makes the information very accessible. However as
I made my way through what at times felt like a medley of questions, I pondered
whether accessible and absorbable might be more different than I had assumed. I
questioned whether a regular prose text where the concepts are presented in a
more integrated structure isn’t a more effective way to help readers assimilate
material. At times this format felt like being given ready meals on a plate;
it’s very convenient but serving oneself might be more satisfying – if only
because it feels more grown up. On reflection I decided that this was a matter
of learning style, and that my personal need to have access to the whole
territory makes me uneasy with being given well-packaged material. This spoke
to me about the need for attunement to the different learning styles identified
by Honey and Mumford (1992 cited Cotton 1995 p119) and of the relevance of this
for supervision. Supervisees who are “Reflectors” will, like me, be most
receptive when their supervisor’s
offerings to be well rooted in theory, whilst I think that the question and
answer format might appeal most strongly to some of the other groups – perhaps
to “Pragmatists” who respond better when suggestions are direct and practical.
The book begins encouragingly by
addressing the central tension in supervision between the dual focus on the
client and the supervisee; the opening question asks whether supervision is
“for me or my client?” Throughout the book the authors give excellent
exposition of the ideas of a range of writers and on this issue they usefully
refer to Mattinson’s work. I was surprised that this was done without any
reference to ‘triangular’ dynamics; I was surprised again when a rather brief
section on the impact of the setting made no mention of the Clinical Rhombus
(Ekstein and Wallerstein 1972). The absence of these spatial analogies made me
wonder what it says about psychoanalytic writers and supervisors that these
geometrical shapes have taken such priority in our thinking.
Several parts provide useful succinct
essays on an aspect of supervision – such as the section on parallel process
(40) which gives an excellent chronology of the development of the concept and
a measured critique of its use today. In this section, as in some others, the
writers let us see that they take Searles as one of their mentors and they
offer a rich selection of references to his work. They remind us of Searles’
warning that supervision can involve “an inarticulate kind of competition as to
which of the two participants is to be the therapist for the other.” (1962, 601)
and not everything which gets represented in the interaction between supervisor
and supervisee is parallel process. The reflection process can also operate in
the ‘wrong’ direction. The authors include a robust view on what they see as
the over-reliance on the concept of parallel process in some circles where it
has almost “become a mantra” (44), arguing that “If it is seen everywhere it
teaches us little.” (48). Another section which impressed me was one looking at
different teaching styles (74); again in a very succinct format it provided an
interesting review of the debate and reflected the authors’ preference for a
style which is relational and flexible, and draws on Winnicott’s understanding
of play.
Several questions look at ways of
presenting clinical work to maximise learning. Various questions address the
prosaic but necessary details of how many hours of supervision are needed, and
which clients should be presented. Other questions look at ethical and legal
questions such as “How far am I responsible for the work of my supervisees?”
(80). Occasionally the answers slip into a style which I found slightly
pedantic. One answer, which looked at the records which supervisors need to
keep, read like a ‘How To’ manual. By far the majority of sections were
intelligently pragmatic; I liked the answer to a supervisor’s question about
balancing the ratio of clients to supervisees in their practice: “While it is
impossible to set down a formula for the best proportion of clients to
supervisees, the factors that make for such a decision can be outlined.” (91)
Throughout the book there is careful
acknowledgement of the different approaches which are helpful to supervisees at
different stages of training. A section which gave me pause for thought
addressed the question of whether a novice supervisor would be suitable to work
with a very experienced therapist. The authors strongly contend that this is a
suitable match because the therapist will know how to use supervision and will
have their own ideas about what is going on with their clients. They make a
strong case against the not uncommon practice of pairing novice supervisors
with novice counsellors. “Trying out newfound skills of supervision hardly
provides the most stable environment for very inexperienced counsellors, and
anxious new counsellors are hardly the most stable supervisees for supervisors
to practise upon.” (63) The sections on supervising groups and pairs also
raised interesting questions for me. I appreciated that the dynamic of
supervising a pair was explicitly thought-through (something which I have not
found covered by other texts) and likened in some ways to couple work. The
authors provide quite a menu of ideas about how the work could be structured in
a group; some of these felt quite ‘revolutionary’ to me and yet I felt they had
merit and could work well within a psychodynamic frame.
The book forms part of a series by
Whurr in which separate volumes of questions and answers address addiction,
abuse, legal concerns, sexuality and mental health. As its title suggests it
would be useful to therapists as well as containing much that is of interest to
supervisors. I enjoyed it for the exceptional clarity of the writing and the
inclusion of some well-supported robust views in amongst the more standard
advice on supervision.
References
Cotton, J.,
1995 The Theory of Learning. London
Ekstein. R., and Wallerstein. R.S., 1972. The Teaching and Learning of
Psychotherapy.
Madison ,
CT
Searles, H., 1962. Problems of psycho-analytic
supervision. Collected papers on
Schizophrenia and Related Subjects. London
Book Review
Supervision
of Art Therapy: A theoretical and practical handbook.
Edited
by Joy Schaverien and Caroline Case (Routledge 2007)
Lynda
Norton
With no background in art therapy, I
was somewhat hesitant in reviewing this book. This was despite regarding work
with the symbolic as fundamental to clinical practice. Moreover it was despite
personal experience that, from time to time and often at critical junctures,
patients bring unsolicited drawings to a session, seeking to communicate that
for which they have no words.
Following on from such reticence, my
principal interest in reading the book was therefore to reflect more deeply on
the way that we handle imagery within the therapeutic and supervisory
relationship. I wanted to tease out the areas of commonality and of differences
in working with symbolic imagery in art work from the more familiar forms of
dreams, the transference and fantasies.
In addition I hoped to develop my understandings of and confidence in
exploring pictorial imagery with patients and supervisees, as and when they
arose. To my delight I found this book a rich and stimulating resource for
these areas of interest and much more.
The book begins with a literature
review and is then divided into three sections: theoretical innovations in
individual supervision; theoretical innovations in group supervision; and
purposes and challenges in supervision and research. Written throughout with theoretical
contributions which embrace art therapy and psychoanalytic/Jungian
perspectives, in many respects the territory is well trodden; [n1] and yet.... owing to the fact that the main
target audience is analytic art therapists, the experience is akin to that of
revisiting an old and well loved cathedral with a tour guide aimed at another
culture – one discovers new and unexpected facets in the all too familiar and
new trains of thought and imagination arise.
The vividness of the case material throughout the book both underpins
and enlivens this process.
Each chapter encourages the supervisor
to reconsider relationships and question assumptions: to the art work, within
the therapeutic dyad, supervisory couple or group. A recurring theme emerges; of supervision as
shared active imagination; of ‘dreaming’ the patient/picture and of fostering
playful exploration within a safe frame.
Space does not permit a detailed commentary on each chapter however the
following may be of especial interest....
Many of you who attended the BAPPS
conference will be familiar with the theme in Joy Schaverien’s chapter entitled
‘Framing Enchantment: Countertransference
in analytical psychotherapy supervision.’ It considers counter transference
as a form of unconscious enchantment which holds the therapist spellbound. Using an analogy from the theatre she
considers how containment within supervision can frame the experience and
restore a symbolic attitude. I could
envisage that this article, including the pertinent case examples, would
stimulate useful discussion in a training setting; especially concerning the
complexities of counter transferential experience within supervision and how
these might be brought to consciousness and so break the spell. Elsewhere in this newsletter I reflect upon
the powerful nature of such enchantment; power which we underestimate at our
peril.
Caroline Case’s chapter ‘Imagery in Supervision: The non-verbal
narrative of knowing’, bears reading and re-reading. She elucidates the work of Damasio and
Suzanne Langer to develop the theme that
images express a non-verbal narrative of
knowing (primary process) to which words are subsequently given (secondary
process). A picture operates
imaginatively, presenting its constituents simultaneously and acting as a
direct, multi-layered presentation, in which there are no fixed meanings (c.f.
verbal communication using words) and to which the mind and body respond at a
feeling level. Hence she argues that working with imagery in therapy entails
working with the whole image (what is made, process of making, other
images/responses evoked in viewing) with a view to eliciting many potential
meanings rather than searching for THE meaning.
The case studies are vivid, featuring work with abuse, flight into
health and idealisation. Close attention
is paid to the image since it embodies meaning, intention and subjectivity; it
encapsulates understanding that hovers on edge of awareness and so can help
uncover the ‘non verbal narrative of knowing’ beneath the verbal content of the
session. Coincidentally, whilst reading
Caroline’s lively section regarding associations to pictures of spiders a
patient arrived at a session believing she had just walked through a spider’s
web whilst entering my room – it led to a most creative session.
Katherine Killick in her chapter ‘Working with ambivalence in the clinical
supervision of art therapists’ draws on the work of Bion, Searles and Ogden
to reflect in depth upon work where despair and futility are to the fore and
ambivalence used as a defence. This
militates against a creative supervisory relationship and the ‘capacity for
reverie’ can be abandoned in favour of the ‘capacity to know’, fuelled by a
desperate desire to ‘get it right’ - as if such a delusion of oneness was
possible. Telling case examples, in
which it is possible to painfully identify with both supervisor and supervisee,
illustrate how such defensiveness in the context of acute anxiety, can become
manifest and deprive the supervisee of the possibility of containment. She illustrates how the supervisor can
attempt to keep the possibility of reverie alive, by focussing upon maintaining
an embodied connection to the patient’s creative process which is likened to following
the trail of an animal. These difficulties in supervision may be related to a
counter transference response to the patient’s defences against terrifying
reality, or to the supervisee’s capacity to tolerate ambivalence. It may also
indicate an experience of training in which the ‘artistic’ self has not been
fully integrated and exists in a state of abandoned despair. Following on from
this, I found myself wondering about a similar impact within analytic training:
to what extent is integration of the
‘creative’ self fostered or is there a
danger of it too being abandoned in pursuit of the process of qualification
and ‘getting it right’?
The group supervision chapters are
also very worthy of attention. Riitta
Laine’s, ‘Image Consultation: Supporting
the work of art therapists’, reflects upon work in the context of peer
supervision with experienced art therapists.
She outlines and reflects upon a useful range of techniques for
observation which can help to take in the atmosphere of the picture, allow for
active reception, stay with uncertainty and fluidity and enable playful
amplification. As in other chapters, the overall focus is upon ‘how’ rather
than ‘what,’ is this picture - to be
moved by a picture entails openness to one’s own psychological woundedness and
so the capacity to identify, tolerate and process the novel and unfamiliar in
the imagery is put to the test. Groups
offer the opportunity for a rich array of responses as well the potential for
rivalry and envy; a mature group strives for coherence rather than cohesion in
its exploration.
Two chapters provide compelling
material regarding group dynamics when charged material such as racial
difference and sexual abuse are present.
Sally Skaife in ‘Working in black
and white: An art therapy supervision group’, addresses tensions in the
arena of racial difference, which can paralyse and silence members. She suggests that paradoxically such silence
is a powerful communication with an autistic quality. The vignette reveals the encapsulated
frustration and rage of participants who, rendered impotent, are unable to
grapple with and engage in the agony of communication.
Arthur Robins in ‘The art of supervision,’ as the title suggests, regards supervision
as an art form - a living breathing, creative, aesthetic space within a clear
frame of the professional relationship.
He recognises that working with demanding and challenging patients means
supervisee’s can identify with the trauma, and present themselves as victims or
perpetrators. In these circumstances – perhaps especially within a group
setting where members may take a range of conflicting stances - supervision has
a visceral impact. Rather than an intellectual exercise it is a mind/body
experience. He shares a case in which
group responses to a presentation involving sexual abuse highlight the
pervasive impact of traumatic experiences upon supervisee, other group members
and supervisor. Reading the piece
conjured in me the image of a boulder hurled into a pond with wide ranging
waves/ ramifications flooding all the participants as the supervisor sought to
reflect upon and help process the rage and projections within the frame.
Overall, I found engaging with the
material in this book provides encouragement to reflect anew and in depth upon
ways of working with the symbolic in general and with art in particular. The
use of theory is enlightening and of case studies stimulating and
pertinent. Hence if you want to develop
your understandings of working with pictures in your own practice this text
will be an invaluable resource. However for me, an additional abiding
impression has been in the arena of addressing the symbolic and fostering
negative capability: “being in uncertainties, Mysteries and doubts, without any
irritable reaching after fact and reason.” (Keats)
New Members
Susanna Wright
susannawright@aol.com [
UKCP BCP
]
Caroline
Shuttleworth
wetherick@aol.com [ UKCP ]
Rose Gardner
Rose.gardner@ntlworld.com [
UKCP ]
Gary
Hartley-Trigg 103 Cromwell Road Whitstable
gary@hartley-trigg.com [ UKCP ]
Madeleine
Barnett 29
madeleine@morn99.freeserve.co.uk
[ UKCP ]
Ruth Williams 46 Glenkerry House Burcham Street 020 7515 2012
ruthwilliams@msn.com [
UKCP ]
THE BRITISH
ASSOCIATION FOR
PSYCHOANALYTIC AND
PSYCHODYNAMIC
SUPERVISION
Supervisors’
Conference
WHEN
THINKING, KNOWING, & ACTING GET IN THE WAY OF SUPERVISION
REFLECTIONS ON OEDIPUS AND HIS CHILDREN
DAVID HEWISON
9.30 Registration
10.00 Welcome and Speaker
11.15 Coffee
11.45 Discussion groups
1.00 Lunch (There will be
a book stall)
2.00 Plenary
3.00 End
The
Tavistock Centre
Nearest
tubes:
FREE
There is no such thing as a free lunch but the next best thing is .. a
potential half price conference fee for the Spring Conference in return for a write
up (500-750 words) of the conference giving an appreciation of the conference
including personal reactions. Please
contact Annie Power.
BAPPS AGM
It has been
the tradition over the past few years to include a write up of the AGM in the
Autumn Newsletter. We hope that this
gives all BAPPS members a flavour of the issues that were considered and discussed
but they are not intended as minutes of the meeting.
This year’s
reflections on the AGM have been written by Rose Stockwell, Irene Hamilton and
Mary Perren.
Christine Driver
The
following issues came under consideration at the AGM:-
1. INSURANCE. Discussion took place about the type of insurance that BAPPS holds and
whether this needs to be extended. It was suggested that exploration be made as
to whether liability insurance for the executive is needed and indemnity
insurance for BAPPS in the event of someone, for example, complaining that a
BAPPS member had not adhered to the code of ethics or similar.
2. CONTINGENCY FUND. BAPPS has significant reserves. The membership asked that council
establish what contingency fund is needed for example what would be the costs
to wind up BAPPS. There were different feelings about whether the current
reserves are excessive, sufficient or not enough.
3. BEING A COMPANY. The major event that has happened in the previous year was the
establishment of BAPPS as a company. The impact of this move has been on the
way the accounts are kept and the level and type of auditing required. It
appears that however small the company it is necessary to be rigorous and
exacting in how financial records are now kept. There was debate as to whether
an internal audit was now permissible and whether there was anyone internally
to undertake such an audit. Some useful contact names were given of people
within BAPPS who have experience of this issue in other areas.
4. NEW PEOPLE ON
COMMITTEES. At the meeting two people offered to be on the
Ethics Committee. Other new blood is needed next year for the Conference
Committee and also for Chair and Hon Sec.
It was suggested that new and sleeping members could be invited to join.
In the discussion there seemed to be an idea that people could be invited to
shadow roles and join committees in advance of others leaving in order for
established people to hand over the knowledge etc.
Rose Stockwell
5. ETHICS COMMITTEE DISCUSSION DOCUMENT
RE UKCP
The
topic for consideration and discussion was: Should BAPPS officially resign from
UKCP and related to the discussion document that had been circulated via email
prior to the AGM.
Copies
of the document were made available to the meeting and a lively discussion
followed on this subject with points of view strongly expressed from both sides
of the argument.
IH
(Ethics Committee) started the debate and pointed out that because members are
both supervisors and therapists, and in addition some are senior practitioners
in training organisations and counselling agencies, it is important to be aware
of the possible conflict of interest in even trying to think about resigning
from UKCP. It was suggested that, for
the purpose of the discussion, members might consider matters only from the
supervisor’s point of view. BAPPS and supervision are increasingly marginalised
within UKCP. BAPPS delegates hold voting
rights about individual psychotherapy practice - not about supervision. At the
moment supervision is not a matter under discussion or much consideration
within UKCP. In this context BAPPS
Membership Fees to UKCP are over £1,000.00. Could this money be used elsewhere
in a more useful way? And/or could we apply for a reduction in membership fees?
UKCP
delegate, PW, spoke about the present general mood in UKCP against regulation
in supervision. Discussion explored the fact that there is no CPD requirement
for supervision in UKCP. ER stated that
the BPC requires 15 hours CPD in supervision per year. Concern was raised that
if BAPPS was not a member we could not contribute to the development of
supervision within UKCP.
CD
added that from her attendance at the EGM on 3rd November UKCP seemed to be in
a state of flux and that this meant a lot of issues were being debated. GC referred to the NICE report of 2004 on
management of anxiety within NHS, which includes the description of
practitioners needing to be ‘suitably trained and supervised.’ AB raised the
question of what would BAPPS gain from withdrawing and that we would have a
more significant role by staying within UKCP. IH again emphasised the high fees
paid with no place to speak on behalf of supervision. She suggested BAPPS
negotiate for a special membership fee and it was agreed that this should be
followed up.
GC
stressed that members should recognise BAPPS’ UKCP delegates’ frustration. BK, Chair of the AP-PP section (the
Analytical Psychology and Psychoanalytical Psychotherapy section) spoke about
aiming for higher requirements than the minimum. The AP-PP section reflected
the diversity of views amongst practitioners.
He recognised the implications of the financial cost of UKCP membership
but urged BAPPS members not to see UKCP as an external enemy. He said he would
take BAPPS’ concerns to the UKCP Executive and would emphasise the strength of
feelings expressed in the meeting. RM
pointed out that when BAPPS first applied to join UKCP they required to see our
Constitution and Code of Ethics. These
were then used by UKCP for their Code of Ethics. Her view was that we need to work together
for the sake of the profession. ER
questioned the figure of 70% complaints about supervision. If supervision is not recognised how can the
complaints be heard?
It
became clear that many people were undecided on the way forward at this point
and more research is needed before a decision can be taken
Irene Hamilton & Mary Perren
UKCP Ethics
Conference 6 Oct 2007
Anne
Rogers
COMPROMISE
[Neurotic symptoms] … are in the nature of a
compromise between repressed ideas and the repressing
ones.
Sigmund
Freud.
The
capacity for compromise is not a characteristic of the insane. Donald
Winnicott.
Compromise
:- arbitration: a settlement of differences by mutual concession; to involve or
bring into
question:
to expose to risk of injury, suspicion, censure, or scandal. Chambers dictionary.
The first two quotations are those of
John Woods on the opening page of his play Compromise. The quote is from
Chambers dictionary. Instead of the usual introductory key note speech this
year we were treated to a performance of the play. A play in which the
integrity of therapist, supervisor and supervisee is compromised. For those who
have not seen the play I will give a brief summary.
James Standish, recently qualified is
making a name for himself in the analytic world through writing and lecturing
on ethics and he basks in the praise of Dr. Martin Hazzard a senior figure at
the Institute. However Standish is also having an affair with his Post Graduate
psychology supervisee, Lucy, but does not seem to be aware of the inherent
contradiction between what he says and how he behaves. The arrival of a new
very distressed patient Joan Maddon who discloses that she had been having a
sexual relationship with her previous analyst Dr. Hazzard slowly starts a shift in his understanding. Joan cannot
make up her mind whether to bring a complaint against Hazzard. She begs
Standish to help her, not only with the complaint, but with her own turmoil.
Somewhat understandably at first he does not want to know, he does not want to
face himself nor does he want to hear this about his colleague. There is
something about the erotic appeal of Joan’s vulnerability that attracts him and he continues to see her
rather than send her to someone else not so intimately involved with
Hazzard. The situation between Standish
and his wife meanwhile has become fraught, he cannot talk with her and in
desperation she goes to see Hazzard. [At this point there was a gasp among the
audience at yet another boundary violation.] When Hazzard realises that Joan
has been to see Standish he tries to justify his actions to him, ‘Have you
never made compromises?’ He defends himself; ‘it was Joan’s vulnerability that
he was responding to’. He seeks Standish’s support when the complaint is
brought to Council. This Standish cannot do. At the same time he does begin to
talk with his wife and they work towards a reconciliation. In contrast to
Hazzard, Standish begins to realise the extent of some of the compromises he
has made. Two other characters in the play are Tracy the receptionist who chats
on the phone to her friends about Standish’s patients [she types up the notes!]
and seems to have little or no idea of confidentiality & the
responsibilities of her work. There is also Dr. Kay, Standish’s rather
classical analyst who seems to do little to help him look at the significance
of what he is actually doing.
It was very movingly acted/read by the
original cast and was enthusiastically received.
The play evolves around the two male
characters Standish and Hazzard. It is
their compromises that we are presented
with and how they do or do not work through their own dilemmas. The five
women are more shadowy and their characters are not so well developed.
John Woods, in discussion time, said that he felt that Joan was the character
he had least developed. I personally felt that Joan very movingly displayed the
distress and turmoil she was feeling as she had begun to realise the
significance of her affair [her words] with Hazzard. But this was not worked
through with Standish. She makes her complaint.
Interestingly although there have been
a number of papers written about work with ‘abusing therapists’ I have not
found anything written specifically about work with patients who find
themselves caught into this situation. It is often said that women who get into
this position have already experienced sexual abuse earlier in their lives, but
that is not true of all of them but perhaps many if not most have experienced
some sort of emotional abuse. There have been one or two papers written by
patients about their experiences but these have been very limited in content. I
have found nothing written about the experience of negotiating a complaint and
I often wonder how much a complaint is in itself a compromise when there seems
to be no other way forward. This is an area in which there is a need for much
more research.
In the afternoon there was a choice of
workshops, but there was the opportunity to attend only one this year. Most of
them were focused around different aspects of the play. Perspectives on legal
action; Self Care; Understanding and working with the perpetrator;
Organisational complexities of Complaints; Ethical principles; Reclaiming a
sense of boundary and What happens to
clients during ethical complaints.
Over the last twenty years or so I
have been involved in different ways and at different times in helping to
formulate Complaints Procedures. Out of this experience I have become very
interested in the experience of the client, particularly in their experience of
bringing a complaint. When trying to write a Complaints Procedure one soon
realises the immense difficulties involved and the number of compromises that
have to made in the process. The final document never comes out how it was
originally imagined or hoped. Not surprisingly the ICO has experienced enormous
problems on putting together an acceptable complaints procedure.
In the discussion after the play there
were many comments about the obvious ethical issues portrayed and
particularly those around lack of
boundaries. The recurring comments however were around supervision, and the
lack of it in the case of the protagonists in the play. There was also an
emphasis on the importance of ongoing
supervision for therapists and supervisors. This emphasis came from therapists
from many different modalities.
At last year’s BAPPS Autumn Conference
on with the erotic transference and countertransference we were beginning to
explore some of the issues for supervisors in supervising therapists who are working with those,
whether therapists or patients who have got entangled in erotic transferences.
I hope space will be found for further discussion on these important issues,
particularly in the light of this conference.
At the final summing up of the
conference James Antrican picked up on this importance of ongoing supervision.
He spoke about the importance of the work of BAPPS and suggested that perhaps
other modalities might also form similar groups to promote supervision for
their members.
The Newsletter is prepared by the Publications
Committee
Chris
Driver, Lynda Norton and Annie Power.