TALKING ABOUT PSYCHOANALYTIC MODELS OF THE SUPERVISION.

Carla Beatriz de Souza, D.Sc. and Roosevelt Cassorla, D.Sc.

 

Supervision has became - together with personal analysis and theoretical studies - part of the basis of the psychoanalytic training. Supervision, following specific conceptual principles, offers an effective method of learning and enhancing the analytic tool of the psychoanalytic model.

Similar to the therapeutic process, supervision practice encounters some obstacles which result from the relational field in which it is situated, withe the objective of understandimg these aspects better, an investigation was undertaken involving professionals directly involved in this practice. By way of interviews, eigtht analysts who function as supervisors and seven training analysts under supervision in training institutes in So Paulo, Brazil, were studied.

Comparing the information gathered with the literature on subject, it was observed that the concept generally associated with supervision represents a learning process. In its practice, this learning relates to therapeutic aspects, thus creating difficulties in the institutional field. A consequence of this is that a problem arises in the relationship power, in the traing institutes, between those who teach and those who learn.

The transference experience presents itself as an interference in the process and, not being noticed, the results in the practice of supervision becoming more separated from the theoretic principles of the psychoanalysis.

To make supervision individually or collectively is focusing under two aspects: addressing of each one and financial circumstances in which the both kinds are submited.

Supervision was concepted originally, as analytical relationship, in individual model. After it was adaptaded to collective mode as a consequence of university education, in one hand. On the other hand, it also was a consequence of the development of the grupal psychoanalysis as a new approach of treatment. Related to the first reason, we need to remember that the creation of Psychology course and some kinds of specialization in mental health, medical sciences among other courses, in which the demand of students was high and it was impossible to do individually. Another aspect for this was a necessity of discussion groups in which was introduced clinical examples in order to illustrate with cases of the theory.

Therefore, step by step that practice became part of all kinds of formation and each time more it was associated to theoretical aspects of group analysis. In spite of this, individual supervision has been predominant in psychoanalysis institutes of formation.

Following, we have some opinions from interviewed psychoanalysts that work as supervisors:

"To me individual supervison is impossible to substitute. I believe that group supervision, in that case, is a economical issue. When one hour is divided by many people all those can show clinical material."

"For who is begining, group supervision is very interesting. But for who already is trained, it is not so interesting since he wants to change ideas with supervisor. In that case, psychoanalyst does not want to hear all people from group. Individual supervision is so rich to someone who are learning as well to someone who are teaching". According to interviewed, group supervison is due a financial problem and it can disturb the supervision relationship.

"The candidate that has no money, sometimes, needs to stay for long time in grupal supervision, instead of doing quickly his supervision. But for this, he needs to have financial resourses."

"Sometimes, a group supervision can be very useful due the several contributions that are provided. It can be very interesting, we can say that. But that is all. Each one has his own style. Someone prefers alone, other one prefers with others. No matter which one. I do not know to say which one is better and which one is worse.

"To me in a group supervision, we can reach others opinions, beyond supervisor opinion. I have perceived some elements, others people can perceive many others elements. And so, supervisor can do final synthesis. It is so interesting because he has elements from all. To me it is more rich. I just see advantages in it."

"I guess that group supervision has similar aspects like group analysis. I like both, but group supervison is more interesting, more alive."

"I prefer group supervison. When someone is reporting a session, others can see others ways that escapes to supervisor. So, it is more rich."

"Group supervison is interesting, but more hard to do."

Some psychoanalysts are unfavourable to group supervision because it can restrict the contact between supervisor and candidate and it can disturb the transferential relationship of this practice.

VALABREGA (1979) for instance, wrote that supervision can not to act as a collective approach because if it a transferential phenomenon, it can be just individual to him, analytical aims can not exist in a group context.

We had in our research some intervieweds that agreed with Valabrega's opinion:

"I think that supervision, as na easy maker of identifications, needs to be individual. Since it is a kind of close context between two people where they talk about intimate issues. On that context everything can happen. The way to perceiveing the material from a third person by identification, by empaty, needs of structure or structured ways of personality on the supervision process.

An that can not happen in a group. It can not happen with the same intensity as an individual supervison. Just in a individual context there is possibility of rising out of personal issues. In a group it is not the same. In a group, the empaty is not total. Thus, to me, individual supervision has more consistency. Futhermore, there is more time to speak. In this time, physical space, there is how to wait not just for knowledge, but for experiences too. The experience inside supervision is great. To learn from someone, to receive from someone, to stay with someone at the moment of perceiving the internal material is, strictly, a personal issue.

It is very different what happens in a group, when some empaty exists, we can see a mature relationship, but no too much besides that."

Others authors that refute this point of view, say that any situation of relationship between two people is part of a group relationships. When many people are together, each one projects his objects of inconscious fantasy over others and their relationships goes according to theses proctions. It is because that projections became part of the transference process.

PICHON-RIVIERE (1988) wrote that the group structure permits and stimulates uncounscious fantasies. These multiplicity of transference happen among group participants and between them and work inside the group. We can say that it does not change any psychoanalytic rules and does not obstruct it. On the contrary, it is a expansion of the process of supervision. Even when some psychoanalist referes to the economical situation, we can see a kind of balance between that point and many advantages inside the group supervision.

We think that the main idea that was focused by interviewees converges to this situation: psichoanalytic theory is only one, but it is incorporate in theory and can recreates it. Some approachs can desviate main ideas, but it is part of the process of appropriation of theory and all are submited to that. To work with groups in psychoanalysis is a consequence of it and some psychoanalysts used their experiences and recreate new theory in technic of psychoanalysis. It happens with supervision process since it depends on each one way.

BION was one of those that introduced new ideas about groups in psychoanalysis. At first he worked as a psychiatrist and his work was very extensive. After he changed his point of view about groups but, all his lifetime, he did not stop his interest about it. To him, it was a natural aspect of psychoanalytic man.

Returning, we have others opinions, but a this time it comes from some fellows of supervisor.

"In fact, power relationship exists inside the Psychoanalytic Society, whre we are on supervisors hands. But, it does not means that everybody have bad intentions and they abuse of power and damage their fellows. However, it can happen. I think that power relationship drives to many erros. "

"When we are in Institute, we know that we need to be evaluate in order to finish course. And it disturb us and we feel persecuted sometimes. Individual supervision causes less problems. But related to institution, it still a big problem."

"Even, when supervisor has comprehension about our problems, he also has judgment. Even when he says: "Do not worry ... There is no problem ..." In spite of this; he will authorize our career at Institute. That is the situation: someone who knows more has a superior position."

Relationship among psychoanalysts became a organization founded in a power because could not separate it from knowledge. As a result, we have ties of masters and fellows.

BALINT (1954) wrote that atmosphere inside institutes seems primitive ritual of initiation: In one side, we have knowledge involved by dogmatic rules and our authority. In other side candidates who are ready to accept any tales and totally submited to dogmatic an authoritary relationship, without protests.

This relationship can be just imaginary if supervisor did not accept its role. According with a interviewee," that relationship is very similar with mother-son relationship. First: "Education of do/do not do, do this way/do noto do this way. Like some parents that always are telling what we must do. It is a kind of power relationship."The second example is expressed by a desire: "I would like to find someone who could leave his way in order to show me may way. I want to find my own style. But I feel it as a something difficult."

As wrote WINNICOTT (1971), there are many fantasies involving our growth. For this, we need to occupy father's place. It seems, uncounsciously, something aggressive.

A third example is an association that was not refered by interviewees, but it can answer their questions. If we remember mother-son relationship, we have an example of how growth could be possible and it just depends on a mother capacity. Bion suggests that relationship can manifest of mother to be a continent of anxiety and anghish that is around of her child. All thing that for child is impossible to sustain and that could hinder his growth can be transformed in others objects and it can be extensive to every relationship. Continent contents conception was described by BION (1970) linked to the paradox of to preserve and to change, feelings that we have simultaneously. Continent is wat welcome ours ideas, ours words, our way to be and express ourselves. Through this, our thoghts can be recreated and our human experiences can be changes with other ones.

Results of this can bring to our experiences with supervision. If supervisor is a continent of that relationship can be a third element - a new style, resulted by two matrices.

Institutes of formation for psychoanalysts are preoccupied to educcate a psychoanalyst inside models and even, they want give him all kinds of virtues they suppose to have. We can mention, accoding with REZENDEC (1993) intelligence sensibility and authenticity, as virtues that come from epistemological model. Even when psychoanalyst can be helped by psychoanalytic formation to develop intelligence and sensibility, we believe that to reach authenticity is a consequence of a good continent of our masters.

Following, we have some more opinions of some supervisor:

"Supervisor can aprove or do not in supervision. If he recommend more supervision, he is disapproving to construct better."

"Sometimes supervisor is indgnant with somethigs that fellow do. But it is spontaneous indignation."

"I think that power relationship exists and it should be avoided. But, on the contrary, it is stimulated in our institutes. No just in supervision but in training analysis too. It is part of formation."

"Is too easy to judge a fellow. He makes a individual supervison and do countless acting out. Thus, we show it and if he persists, he can not to become a psychoanalyst.

"Some fellows insists to think their opinion is right."

see another aspect that is the narcissism of supervisor, some supervisors just like of his fellows, when they seems to him, when tey follow his model. On the contrary, tey should leave his fellow to find his own style.

"To me supervision creates some misunderstanding since some fellows bring clinical material to someone who has knowledge as if the has not any.

Some supervisors answes from that place, to me we should to destroy that idea."

"Is necessary that fellows make a mistake they need to do it with their own things, their own characteristic, their own personalities. It is betther than to pretend make right by a copy of supervisor. So, they need to be theirselves. Is better if they make a mistake thant to tray to imitate the supposed perfection of supervisor."

When certitude take place of right to make a mistake, the psychoanalytic theory can be used as a whole knowledge. If there is no place for something unexpected, there is no more space for analytical effects, there is no moere space for discovery. In a situation where all is foresseen, the theory is a defense rather than to be its clinical practice. Something like that we can see in medical education, but as far as we know, we alaready left that model. What we need is to reach true psychoanalytic model which should be seached inside the theory.

Now we can see some more examples by psychoanalysts who receive supervison in their work. Most of them have more experience with individual supervison and they are more prudent about groups of supervision. As far as we could know through the interviews, they usually feel too much observed and judged by their coleages. As we can see:

"I had never wanted a group supervison because in that situation, besides supervisor, there are many coleagues. It is very difficult to me."

"I am afraid, but on the same time, I like to make supervison in group. I want to know what my coleagues are seeing about my work. I want to know what they could tell to the patients, on the same situation. Actually I feel my coleagues and my supervisor like persecutors. To me it is a kind of persecution. I want, but I am afraid to."

guess that individual supervison is more confortable. I see more advantages. I have more time. In group I used to feel better because I was not the only center. It was more conveniente to me. Besides I could criticize work from others. Actually, I felt very well when I saw something silly or incompetent from others."

Interesting to observe that example as a possibility to stay in place of other. By that resourse there is identification with some aspects of supervisor. It could be a reason that the tradicional process of supervison is not object of discussion for so many supervisors.

Another point of view that makes group supervison to be a good process is the guarantee that nobody are alone in his "not to know."

"Everybody are in different levels inside the group. Sometimes I can see how my difficulties are same of my coleagues. Sometimes they make a mistake and like me they are there. In fact, they are like me or so."

Financial aspect of group supervison are focused:

"Most of time supervision in group are less expensive.'

"It is cheap because is basically the same price divided by many participants. So, I can show a clinical case after four supervisions. Obviouslly, it is less thant I need. So far I did not make individual supervision because it is expensive."

"I think that in individual supervison, we are more exposed to emotional aspects than in group. That is why individual supervision is better. When something happens we can talk about immediately. It is not the same in group, because sometimes there is someone who does not want to do it. It causes drawbacks. I already saw some people never come back to supervison after something like that. Sometimes, someone in trouble spend long time to tray resolv indiviual things inside group."

These points was touched by some autors and it are refered to both, individual and group modality of supervision. Any side uses same argument to defend his position. Arise of emotional situations is the main argument that both sides uses to justify themselves.

As far as we can see there is no disagreement between them. Basically, the difference is a fact that in a individual supervision, they have space to be considerated. As someone said:

"I prefer individual supervision because I know that I have that person, supervisor, just to me."

What happens is that group supervison is not a right place for that. In this case, we see things that could bhelp any understanding about personal problems transformed in obstructions for the process. It drives us to ask again about real mening of supervision.

Another opinion came from other inerviewed: "Individual supervision guides to personal surroundings and it needs to be touched. When it happens in group, there is no how to protect the person. If it is discussed inside group, it can drive to problems. May be someone can not feel bad about it. But usually people feel tremendously disturbed about it. To me it needs to be considerated, it needs to be treated. If it exists, it needs to be touched."

"To me individual supervision can teach me more. I see more advantages. Y can work more and deeply, with more time and intesively about all things from session. Now, I believe that, according to supervisor, some experience from supervision can be managed, in a very rich way inside group."

"In group situation, I can learn with my case and with cases from others, because all of us have something in common.

If I am interested I can learn more. In this aspect, group is better. Disadvantage of this is that I can not to dissect my own case."

"I think if I have supervision with someone else, with three or for people, ti has more utilility to me and to all those.

All opinions that we saw are very different from each other. There are advantages and disadvantages in any kind of supervision. We had some ideas of how many implications and how it refects in each person and in whole process. We could find many interpretations due to many kinds of relationships in which situations are envolved. Any way, we can say all aspects of the two modalities of supervision are consequence of now psychoanalysis has been understanding and recreated by psychoanalysts to day. There is no better modality. Everything depends on coherence of that theoretical and technical comprehension which comes from each one.

Through these personal contributions of psychoanalysts we can focus some aspects. First, we can see how all psychoanalysts maintains stable ideas about the existence and necessity of supervision but tey din not think too much about it. What is real utility of supervision? That necessity is acceptable but not questioned they use to do like if they were performing a command: for duty and belief that supervision is a guarantee of professional competence.

As far as we could observe relationship inside supervision are characteristically omnipotent, as if could be responsible for everything inside formation.

Concerning two modalities of supervision and according with answers from our interviewees, we can say that individual supervision still the ideal of supervision. When is needed, they accept collective model. And it seems a financial consequence. After they tray to find advantages on this. In spite of this, they feel they have more emotional problems inside group supervision.

We associate that this kind of supervision is more interesting for who considers supervision as a didactic process only. By interviews we could observed how they justified reason like: "if we have more opinions about our clinical material, it is better."This is the advantage that they focused in first place.

From this experience, we could confirm that emotional dificulties inside the process of supervision come from institucional compromises and it is intrinsecally linked to idea of formation. It seens suggests a conception that transmition of psychoanalysis is something that can be learned. So there, training analysts under supervision has a imaginary relationship with supervisor. The supervisor goes in relationship as if he was someone who has the knowledge. Sometimes he did not show his partner how to find his own style. As a result, his knowledge can give impression of something false. that is why is needed to overthrow it inside relationship.

When we are in contact with someone who help us in our searchs - in psychotherapic or didactic sense - we are in transference with him. So, we did not put it aside. Besides, if we agree that to be a psychoanalyst is something inside of us and it means to continue with other ones the experience of our own analysis, we can not to be little that notion. Throug this point of view, why we need to maintain institutional linkages?

Perhaps because psychoanalysts need to stay joined in order to understand real effects of psychoanalysis inside others life. It causes a big amazement that out cry for knowledge. This wish to know asks for a fellow creature.

Howeven, if formation is a effect of experience of analysis and if the institution is a effect of a internal conjunction of analytical discourse between action and knowledge, we could say that it has not a function, of formation. May be mains problems inside institutes comes from that inadequate way.

Psychoanalytic literature, as we can see, is very illustrative about it. Freud's experience showed that even when there is knowledge about transmition of psycahoanalysis, its practice falls in contraditions. So there, establishmente of institutes _ as a protection of theory and practice _ most of the time is a mixed of a church where who did not pray in same way (even to the same god), are treated as a heretic. It is due the belief that to disagree or to think with own head means to go through other way. Relationships betwees Freud and his fellows it happened a lot.

Propositions of Lacan seemed very close to the formative meaning that Freud wanted to establish. Actually, the changes from Lacan have gone furthest than Freud and showed more intensively what should be inside the task to become a psychoanalyst. But, what to say about practice reality?

As far as we can see is that, like happened with Freud, also Lacan reaches dissenchantment. Breaks, ruptures, dissensions and deaths can show it. Repetition of facts in Freud and Tausk's relationship or in Lacan and Perrier's relationship are very significant. These examples illustrates, on history of psychoanalysis, in a very tragic way, how far can go relationships between masters and fellows, inside psychoanalytic instituition.

We understand that analytical meaning of supervision could be to leave free the possibility of the symbol comes. And so, is important do not have division among thetheree levels of formation. It is just possible from fidelity with theoretical model.

Inside the psychoanalytic treatment we can reach this theoretical resonance if we depart from the patient, not vice-versa. In this way that psychoanalysis is made from in to out. Therefore, if supervision will not realize this, it can find just the way of didactic or authority established on formative mechanisms.

Since people are joined to realize something, they are exposed to be crossed over by a phenomenon that escapes to everyone. And it is from transference domain. Its manifestation is through the wish of knowledge of analyst and knowledge of supervision, the art of supervisor is to develop this love for knowledge, love for own knowledge of training analyst. After this, he can find how pleasure he can have if there is no ready answers. And so, he can believe that the answre is inside of his own patient. Thus, we do not believe there is very important to find a real definition of supervision process, since it does not contain solutions for problems from practice. But inside practice of each one that runs into debt of supervision.

We wish that search of definition of supervision could remain opened until it could be associate to theretical propositions. Because it will make sense just when we will learn that all process of knowledge is an adventure, and for this there is no security net. While supervision tries to occupy this place, it will not goes out of imaginary field. It will not exist as proposition of knowledge. Things happen ehwn decide to put ourselves in risk. With knowledge the process is the same. And so, when time of to propose a new concept of supervision will came __ if it will be necessary __ ew hope it will carry a lot of desires. Desires that come from supervisor and training analysts, as we can see with these following examples:

- Supervisor: "To me is very important to like people who I am working, because it is relationship of love. Actually, analysis is a goes beyond of what we have out of analysis. To do analysis is to live a experience of passion. Inside that analogy, it shoud be free of external influences. If we have analytical setting, where we eliminate external world, since we make a parenthesis in our evereday life in order to do analysis and inside of this space to go to unconscious, we can see all things present. Why not to do it with supervision? I think it is possible supervision also is a parenthesis in our formation. So, if it have less external influence and less institutional power is better".

__ Fellow: "I feel that I do just things when I can understand it. I keep, in some place and when I understand I use, Even when I do not what I am doing, I do not do what someone wants just because he is the supervision. I am critical person. I try to be.. Patient is with me. Not with supervision. He needs to help me because supervision is a thing for me. We need to be careful because if each supervisor has a different opinion, I do not to make a copy of his words.

It is a crasy thing. If I accept nothing of him, I can crasy too. He needs to make clear what I do not understand well. He can open my eyes. But not to use his eyes".

BIBLIOGRAPHY:

BALINT, M. Analytic training and training analysis. International, Journal of Psychoanalysis, 35 (2): 157-62, 1954.

BION, W. R. Attention and interpretation. London, Tavistock Publications, 1970.

PICHON-RIVIERE, E. Grupal process. 3 ed. So Paulo, Martins Fontes, 1988.

REZENDE, A.M. Bion and future of psychoanalysis. Campinas, SP, Papirus, 1993.

VALABREGA, J.P. La formation du psychanalyste, Paris, Belfond, 1979.

WINNICOTT, D.W. Playing and reality. London, Tavis Publications, 1971.


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Carla Beatriz de Souza


1997 - Copyright by Carla Beatriz de Souza