Illuminating the Phenomenological Challenges of Cross-Cultural Supervision

ABSTRACT

The authors discuss transference enactments that occur during cross-cultural supervision. Previous research has shown that few mental health professionals willingly talk about race during supervision and that White supervisees experience significant difficulty when directly engaged in discussions about race. They introduce a new phenomenon, “stereotypical” transference enactments, as a means for understanding the countertransference Black female clinical supervisors experience during clinical supervision of White supervisees. The findings indicated that effective cross-cultural supervision should address the intersectionality of race and gender to enhance the development of multicultural clinical skills. The clinical and educational challenges are discussed by using two case vignettes.     

The Use Of Shame and Dread in the Countertransference

Much has been written about paranoid anxieties as these occur in the patient. Less, however, has been written about primitive experiences as these occur in the therapist during the session. This paper recounts a patient's correct articulation of the therapist's self-perception, which, because of its accuracy, initially flooded the therapist with shame and dread. Nonetheless, the patient's perception was able to be used in a way that clarified, in the countertransferance, a piece of the patient's early experience in relation to her mother and strengthened the therapeutic relationship.     

Kernberg Versus Kohut: A (Case) Study in Contrasts

In this paper, the main concepts of Otto Kernberg and Heinz Kohut—two theorists who have greatly influenced clinical social work practice with severely disturbed patients—are presented, and then compared by using a case from the practice of the author. The case illustrates the value of utilizing some of the treatment principles put forward by Kernberg and Kohut without becoming too wedded to either of the overall treatment approaches they have formulated. Some aspects of the manner in which the practitioner determines when the treatment approach needs to be modified—to avoid the pitfalls of either being too wedded to an approach or too eclectic—are discussed as well.     

Keeping Your Eye on the Process: Body Image,Older Women,and Countertransference

Research on body image and older women has grown in the past decade. However, there is a gap in the literature regarding body image, older women, and countertransference. This article provides 7 case examples of racially and ethnically diverse women over 60, drawn from MSW student and agency staff supervision, and participant feedback from a national conference on aging workshop. Themes related to loss and grief, adult daughter and aging mother issues, incest, anger, disability, personality disorders, phobic reactions, and shame are discussed. Recommendations and implications for social work practice, education and research are provided.     

Resolving Therapeutic Impasses by Using the Supervisor's Countertransference

The traditional role-set of the clinical social work supervisor has grown to be much more complex. From the exclusive position of teacher, administrator, and overseer she is now an integral part of a system wherein she is influenced not only by the therapist, client, and her own promptings but is a prime source of feedback to the client through the supervisee.As clinical social workers have shifted their conceptualization of therapy to a two-person psychology, this perspective has emerged as part of the supervisory process. Now the supervisor's countertransference responses to the supervisee, to his client, and to their interaction have assumed importance in supervisory work. This article is an attempt to demonstrate through case illustrations how the supervisor's disclosure of countertransference responses to the supervisee can strengthen the supervisory alliance which then enables the client and therapist to resolve therapeutic impasses.     

Supervision of Therapy with Patients Diagnosed as Psychotic

Psychodynamic therapy with psychotics has been reviewed and studied by different analysts such as Searles (1965), Rosenfeld (1988), and others. Nevertheless, there are almost no updated articles on supervision of this therapy. The article addresses this issue and the different aspects of supervision of psychodynamic therapy of psychotics. Therapy-related issues, such as holding, communications and interpretations, differentiation, boundaries, psychotic transference, and countertransference are discussed extensively. We also explore some of the difficulties involved in these processes and the implications for the supervision process.     

Therapeutic Love and Its Permutations

Compensatory treatment theory rooted in object relations and self psychology is typically silent about issues of love in the therapeutic relationship, particularly the erotic and sensually infused affects and enactments that may permeate patient-therapist interactions, even in the treatment of preoedipal patients. This paper presents a series of case reports in which the therapist consciously or unconsciously experienced some permutation of love in response to the patient's loving and/or erotic feelings. The central thesis is that patients benefit when therapists recognize the sensual components in transference-countertransference interactions and use them to inform therapeutic interventions.     

Immigrant Therapists’ Unresolved Identity Problems and Countertransference

The difficult task of identify formation is greatly complicated by immigration in childhood or adolescence. This paper shows how the unresolved identity problems stemming from their immigration to Israel in childhood or early adolescence of three young therapists, two from Ethiopia and one from Russia, affected their countertransference in their treatment of their adolescent clients from their own countries of origin. The three examples are based on art works produced by the therapists and their clients in the framework of workshops on the integration of art therapy techniques into verbally based diagnosis and treatment. The paper highlights the need to help immigrant therapists recognize their own identity conflicts and resulting countertransference, as well as the identity issues of their immigrant clients.     

Psychotherapy and Schizophrenia: The Mirror of Countertransference

The relationship between psychotherapy and schizophrenia has undergone pronounced changes over the last several decades. The advent of psychiatric medication led to remarkable breakthroughs that obscured the existential issues inseparably tied to the lived experience of illness and overshadowed the role of psychotherapy in the treatment of schizophrenia. Recent years have brought renewed scrutiny of the place of psychotherapy in the treatment of persons with major mental illness but much less attention has been shown to matters of countertransference. The complex legacy of loss and grief assumes a special dimension in the therapeutic relationship and touches the lives of client and clinician alike. Both travel a common path and share privileged moments. It is the intersection of these life experiences, and how their confluence shapes the course of therapy that is the focus of this essay.     

When Loss Becomes Gain: Transforming Women’s ‘Internal Saboteur’

Even as they strive for their, own self-definition, women hold onto old relational ties. In this paper, two ease examples are used to elucidate the complex relationships that women have with their earliest caregivers—mainly their mothers. The cases demonstrate how women remain fixed in early familial internalizations and identifications and find themselves repeating patterns of self-sabotage that impede their success. The relational approach to psychotherapy, furthered by the analyst’s use of the transference-countertransference paradigm, can create the gateway to explore and understand patients’ internal barriers to growth. The analysis can then help patients to achieve a more integrated self-view that allows them to enjoy success and fulfillment in both their private and public lives.