Sometimes the need becomes apparent, in my work with my patients, for them to come in multiple times a week. This is not unheard of; but given the patient and his or her surrounding circumstances, I as a therapist might decide to seek out a clinical supervisor, or “overseer” to the case, if I feel it would be in the best interest of both my patient and myself. In my experience, looking for the right supervisor can be an arduous process, but there are several key traits I always look for. I would like to explore these traits in detail as a tribute to all my supervisors whom I’ve learned from, and who have taken the time to train me in the way I should go.
First, I look for someone with a spirit of openness—by which I mean someone with whom I could feel truly comfortable with, and feel comfortable enough with to open up my patients to, without fear of judgment or rejection (which is very similar to what my patients look for from me).
This openness leads me to the next thing I hope to find in a supervisor: recognition, both for my patients and myself, and our accompanying interactions (however colorful they may become). Recognition is one of the most important aspects in being supervised on a patient case, because it allows for exposure of both triumphs and failures in therapy, both of which are necessary to the therapeutic process. In fact, without exposure of these processes, a patient’s therapy might never make progress. Recognition from a supervisor can validate the work between a patient and myself, and provide necessary insight for improvement of shared expectations, known hurdles, and my own feelings, as a therapist and person.
I feel that supervision should provide a nesting place for my relationship with my patients—a place of familiarity, of warmth, where the relationships can gestate under a careful gaze. For me, supervision goes
Beyond basic ideas about the setting and its boundaries…what needs to be learned is not a list of steadfast rules, but an introspective and empathetic sensitivity to the actual sources and actual impact of our actions and non-actions. This is a most personal learning process that requires considerable personal exposure and is strongly influenced by the supervisory climate (Berman 2000, p. 275).
Supervisors can model for me a deep sense of empathic attunement to my patients’ needs, especially when my patients are take seriously, with a non-dismissive attitude of their thoughts, feelings and actions. A supervisor’s presence can be a comfort, bring an evenly hovering attention to the process of my work, all the while being supportive and nonintrusive. My best supervisors have not been prying eyes critical of every misdeed, but guiding hands on what could have easily been treacherous paths, which have welcomed the meanderings of my relationships with patients, even honored and respected them. In essence, supervision has provided a ‘m’othering presence that comforted me, and comforted my patients through me.
Another aspect I find comforting about supervision is the ability and willingness to be transparent in thought processes about the work between my patients and myself. At times (and perhaps at best), insights and observations have not been premeditated, but rather a genuine response to what I shared either verbally or to what is heard in audiotaped sessions. (I sometimes choose to record my sessions because I do not want to forget the most important things that occurred between my patients and me). A non-omniscient supervisor makes room for grace—that is to say, gives me permission to fail and fall without fear of shame. Without the worry about how my expression of self will be taken; with no judgment of my method, of me as a analyst, and most importantly, of me as a person, I have found the space to flourish with my patients. Knowing intrinsically of a supervisor’s support, I feel recognized and valued, and almost by proxy, so do my patients.
Jessica Benjamin (2004a), gives an example of her work as a supervisor, which I would like to note:
I often find myself helping the analyst create a space in which it is possible to accept the inevitability of causing or suffering pain, being ‘bad,’ without destroying the third…both members become involved in a symmetrical dance, each trying not to be the bad one…yet whichever side the analyst takes in this dance, taking sides itself simply perpetuates complementary relations (p. 27).
Great supervisors have been crucial in helping me understand this point. It is not a matter of patient vs. me (the analyst); such polarization destroys and tears us down, rather than build us up. Benjamin likens it to a dance. I would add that, for some of my patients and myself, it can become more the dance of two boxers, each trying to knock the other off center, and possibly out completely, in order to “win.” A good supervisor’s careful observations can, and have, shown me that if this dance continued, and my patient and I indeed knocked one another out, no one would win; and in fact, winning isn’t the point. Winning only helps one of us, and therapy and analysis, to me, strives to find a way to help each other if any headway is going to be made.
In fact, in those times when this “dance” has turned my therapy room into a boxing ring, supervision has allowed me to realize the mistake on my own without intrusion, but with continual glances in that direction. It has also helped me redeem myself and restore the relationship with my patients by witnessing compassion to them, our relationship, and myself. Benjamin (2004a), would have analysts “fostering a dyadic system based on taking responsibility, rather than disowning it or evading it under the guise of neutrality…that clinical practice…be founded in certain values, such as the acceptance of uncertainty, humility, and compassion…” (p. 34). Compassion? Humility? Uncertainty? These are the elements of great supervisors, who have ensconced and embodied all of these things; and these honest revelations of themselves in our interactions have shown me vividly and personally how I could, someday, and maybe even someday soon, interact with my patients in the same manner.