What is supervision?

This is the first in a series of blog posts exploring the topic of supervision – and as the starting point is intended as an introduction to both students, therapists, and people in therapy. 

What is supervision in a therapeutic context? To answer that question we have to go into the history of how therapy and therapists first began to develop this thing that we now call therapy, be it gestalt, cbt, person centred or any other of the many branches that have grown up over the years. There were no specific training institutions or colleges when those early ancestors of  therapy began. Instead people who had been in therapy became therapists, they learned by doing – something still at the heart of the profession as therapists (unlike say psychologists) are still expected to have had a substantial period of therapy in their own personal life. Whilst some courses are dropping this requirement it is still generally expected we begin as clients and then “move across the room”. When therapy began, in the psychoanalytic offices of Freud, Jung, Klien, Spielrein and others, the movement across the room was the only way to progress from therapist to client (although many of them studied medicine, psychiatry and other related disciplines) Naturally when one is in weekly, or even more frequently, psychoanalysis the content of your own patient (as they were then termed) work will also form part of the material discussed. Since the letters between Jung and Freud have been so extensively documented and researched we have an insight into what might be seen to be one of the earliest supervisory relationships, and its severe limitations. 

So, part of our answer to what is supervision is – it is a conversation between colleagues about their client work, in the confidential space which a therapeutic, or therapeutic adjacent space allows. In this conversation observations, reflections and insights can be shared 

The life of Spielrein one of the most important psycholanalysts of the 20th Century is sadly not as well known as it should be, partly due to her gender (she was a cis woman) and partly due to her death in the Holocaust. She published the first paper in a psychoanalytic journal on schizophrenia, wrote about sexuality being natural, and healthy for children at a time when children were shamed and punished for natural exploration, and first postulated the existence of the death instinct.

What we do know about her relationship with Jung is a huge insight into how ethics have grown and developed alongside the ideas of what supervision is, and is for.  She first met Jung as an inpatient in a sanitorium after the death of her sister. She worked for him as a lab assistant as a medical student, was his patient, who he wrote his first case study about, fell in love with him and became his lover. (Jungian scholars argue with a ferocity only scholars can about exactly what lover means here, an obsession with penis in vagina sex is the least of the issues)

How do we approach something so deeply unethical with modern eyes? Does it matter that Freud later claimed it was the relationship which led to his rupture with Jung? Is it important that Sabrina Spielmrein claimed to have had no negative impact from the relationship? I am not a Jungian, so I feel no need to defend him, or his actions. If we consider Freud in many ways to be Jungs supervisor, his letters saying that Jung must end the relationship, and that it was unethical, shows another strand of another strand of the supervisory role

What is supervision? – it is the space where our actions in regard to our clients are examined in order that we do not cause them harm 

Of course now we can expect more than a grumpy letter from a supervisor if we breach basic ethical standards. Supervision is also a regulatory space, and this aspect is perhaps one of the biggest differences from the past, but also one of the most important ones for clients. Yes, collegiate discussion between supervisee and supervisor are important, the more experienced therapist can, and does, lead, guide and advise the less experienced. People may seek specialist supervision in an area they are not familiar with, and it is ethical to do so. However the prevention of harm is at the core of the work – a supervisor must, if required, be willing to prevent harm, even if this means reporting the supervisee. It is a defence against unethical practice when no one except client and therapist are in the therapeutic space. This is why its recommended supervision be separate from line management, tutors etc, people who may have other interests at play.

The idea of walking with someone down a road they are familiar with also means that a supervisor can offer practical support. Therapy, particularly in private practice, can be a lonely profession. From how much to charge, to which social media platform is the most useful to advertise on, supervisors can be part business coach, part advisor, which brings us to the last strand of supervision which I want to highlight today.

What is supervision? It is the space where we are held, after holding others.

Imagine you have had a bad day at work, perhaps your boss shouted at you unfairly, and you get home and ask a friend/partner/housemate for a hug. You explain what happened, what your boss said, how it made you feel, receiving support and empathy allows you to put down your feelings, and relax. You may even problem solve, or simply vent. 

Imagine not being able to tell those closest to you what was said, its impact, the complexity of your feelings. You can of course ask for the hug (and its something I encourage my supervisees to do) But you cant say why. Therapists hold their feelings, and their clients feelings, and supervision is the only ethical space in which they can put them down. The joy, laughter, tears, fears, hopes, and losses. In supervision a therapist can say “this is what happened and this is how I feel about it”. In some ways, next to the ethical safety aspect, this is the most important part of supervision, as we can be simply human, feel what we feel, explore it, and then leave it behind. This keeps us, and our clients safe in a way that is often not talked about but which is vital.

If you are a person in therapy who found their way here you might have some questions about supervision, asking your therapist is one way, but here are a few, common ones?

Will my therapist talk about me in supervision and what does that mean? 

Hopefully yes, they will. By bringing clients it means we are doing our best by them, working ethically, and ensuring there is nothing we are missing. It doesn’t mean you are a “good” or “bad” client, it just means your therapist is doing the right thing. 

Will my therapist name me in supervision?

Usually no, there is no need to, they might use an initial, first name, signifer (such as client X or client y) but generally someones name is not important. 

Can I ask who my therapist’s supervisor is? 

This is one to which different people have different answers. As a member of queer, poly and kinky communities I am happy for anyone to check out any dual relationships or overlapping connections people may have with me. With all my supervisees and clients we go through a personal boundaries statement, which explores any limits on working together. So someone may need to know who I was – but other supervisors may feel differently. 

My therapist doesn’t have a supervisor. What should I do? 

At the risk of sounding alarmist – unless they are between supervisors and actively searching – run a mile. I accept there may be a scenario I have not considered which makes this OK, but consider the 3 main things supervision offers, guidance, protection from harm, and a space for the therapist to talk about their feelings. Why wouldn’t someone have this as basic good practice?

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