The Supervisory Alliance

SUSAN GILL (ED.): The Supervisory Alliance. Jason Aronson, Northvale, NJ, 2001, 242 pp., $45.00, ISBN 0-7657-0307-6. Psychotherapy supervision has always occupied a core place in the education of psychoanalytic therapists even if it has remained relatively neglected in the psychoanalytic literature. As analytic theory and practice have changed, especially toward a more collaborative and less authoritarian conception of the therapeutic relationship, the supervisory relationship has also become a subject of renewed interest and academic attention. How do we conceptualize the parallel couples of therapist-trainee/patient and supervisor/supervisee? How do we reconcile traditions of didactic and administrative authority with a desire to promote a facilitating environment for mutual inquiry? How do we understand and resolve impasses in supervision, and deal with problems of secrecy, countertransference enactment, shame, and interpersonal binds? What are the similarities and necessary differences between therapeutic relationships and supervisory relationships? CSW, PhD, and psychoanalytic institute supervisor Susan Gill's compendium of essays, The Supervisory Alliance, revisits and attempts to reformulate traditional conceptions of psychotherapy supervision in the light of neoclassical, object-relational, and intersubjective models of psychotherapy. The Supervisory Alliance is divided into two large sections, the first about facilitation of learning in psychotherapy supervision, and the second about working with countertransference in supervision. Each section is multi-authored, and like many such volumes it suffers from considerable unevenness in sophistication, relevance, and coherence in design. Stanley Teitelbaum sets a historical context for the other essays by describing a move away from a purely didactic view of supervision (in which the supervisor was expected to have "super vision") toward an experiential perspective that democratizes the supervisory process. Modern views of supervision are far less authoritarian and more nurturing, aiming to facilitate the creation of an "internal supervisor" who relieves anxiety and fosters creative thought. Teitelbaum describes various obstacles to an open alliance in supervision, including the impulse of some supervisors to interpret the supervisee's character, or to compete with the supervisee for intellectual and clinical authority. Some essays are outstanding for their synthesis of theoretical perspective and clinical example. Lawrence Epstein describes a paradigm he calls "collusive selective inattention" to negative impacts of the supervisory relationship. Bound by a traditional "authoritarian tilt" of the supervisor-supervisee contract, both parties can fall into a pattern of unhelpful enactment that is prolonged by their mutual reluctance to speak about their dilemma. The supervisee is reluctant to challenge authority, and the supervisor may become increasingly entrenched in trying to manage the therapy case rather than attend to the emerging impasse in supervision. Epstein wisely notes having learned through experience that the "supervisory impulse," which makes supervisors want to seem brilliant, helpful, or admired by the supervisee, can itself become a major impediment to a successful supervisory relationship. The resolution of such impasses in the supervisory relationship facilitates resolution of parallel impasses in the therapy that is under supervision. He recommends balancing the supervisor's attention between the case material and the needs of the supervisee. Sydney Arkowitz uses the metaphor of perfectionism to explore obstacles in the supervisory relationship. …