What is supervision of psychodynamic counselling
Integral to the training and on-going CPD of psychodynamic counselling practice is clinical supervision. This is where counsellors whether training or qualified bring their cases to an experienced supervisor of psychodynamic counselling and/or psychotherapy to present and discuss their cases. All trainee psychodynamic counsellors are required to undertake 1.5 hours supervision per case a month. At the Highgate Counselling Centre, trainees are committed to join a group of four members for weekly supervision of their counselling cases. The trainee is allocated clients via the initial assessment process. Once allocated a client, the counsellor begins a long-term process of once weekly psychodynamic counselling sessions. In order to qualify for BACP registration, the trainee counsellor is expected to complete 100 hours of supervised clinical work.
How to Begin
It may sound paradoxical and not without thought that I start this conversation with advice I give my students as they begin the process of working with their cases. How not to be helpful…. This advice may fly in the face of an altruistic vision, easily relatable to as the passage of a counselling journey begins, when often what might be uppermost in the mind of the trainee counsellor is I want to be of help.
Of course, the inclination to want to help is strong. Yet in practice, psychodynamic counselling and the work we do in supervision, invites a more complex kind of helping, one that involves thinking, feeling and allowing space to unknow.
The purpose of supervision
Supervision of psychodynamic counselling at the Highgate Counselling Centre is where trainee counsellors, often alongside staff counsellors, bring their cases to unpick, explore and understand a dynamic between counsellor and client presented by the unique peculiarity of the therapeutic relationship. This relationship as it begins and unfolds, may mirror something of the client’s relationships in the wider world. This mirror helps counsellors to understand the relational patterns and how to address the ebb and flow of feelings and actions as they play out.
Navigating feelings in the room
As work begins with a client the psychodynamic counsellor is tested by their own feelings which may well intrude on the counselling space and a struggle unfolds. This may take shape in a need to work out what feelings belong to them, the counsellor, and what feelings belong to the client. This is a common and to my mind often an improbable task – a concern nonetheless, brought to the supervision space. While this concern may be real and true, it is helpful to understand that whatever is going on in the room between you and your client is actually about what is going on between you and your client. Your feelings as counsellor are part of that relational field; they are responses to and relating with your client’s feelings in that session, they are a unique meeting of mind and feeling, in that space. This is what we call the countertransference experience.
Transference and the meaning of the encounter
How we understand much of the client’s experience in the world, their view of themselves, their relationships, their historic family dynamics, what was then and what is now, is communicated in the room in its unique and peculiar form which is the transference. Because the psychodynamic counsellor brings only their presence and their active listening skills, the client hopefully develops a sense of reflectiveness and awareness that what’s on their mind is delicately reflected back to them, as well as an independent mind of the counsellor, who may interpret a meaning of what the client’s unconscious feelings communicate.
An example: The Late Client
In supervision of psychodynamic counselling for example, we might explore why a client is repeatedly at least 10 minutes late for their sessions. Over the weeks there may be numerous reasons, traffic, delayed trains, work demands, children requiring attention. Each explanation is plausible. Yet as the pattern repeats, it invites reflection, leading us to think about why the client can’t have the whole session time of 50 minutes.
The counsellors in the supervision group might take this on at several levels. A distinctive transference response from each group member may vary. We can, of course, take the lateness at face value as each week the reason for lateness is just as plausible as the previous week. But we might also ask–could there be another communication hidden within this behaviour? Is it possible that behind the reasonable reasons there’s another communication? This is how we can broaden our thinking about what the client may be trying to tell their counsellor and how each group member might also be having a different response or reaction to what the client is communicating. As each counsellor in the group responds to the client’s actions, each member might be holding different aspects or even conflicted perspectives emerge–what we call a parallel process to the clinical work.
This allows for a way to think together about different ways to approach and present to the client an understanding that doesn’t undermine the defence, the conscious reason for their being late. Equally, the counsellor can also suggest that there may be another important communication here…. Might it be that the client wants to convey an unhappiness, a grievance to the counsellor–I need to keep you waiting. I need to know that you will wait for me. I need you to think about me while you’re waiting for me. Grievances, time lost, losses, may all have meaning in the client’s past story. Here there could be links to multiple ways of communicating an indirect dissatisfaction. I reject you before you reject me, for example.
Through such reflection, as a supervision group, we begin to think beyond behaviour and towards meaning – we consider how the counsellor can bring understanding to the client without undermining their client’s conscious defences.
Sitting with the impasse
I’d like to return now to how this conversation began when I said that an important learning for the psychodynamic counsellor is how not to be helpful. One of the hardest tests in this work is how to sit with an impasse or a feeling of being stuck where anything the counsellor might offer or say is rejected. It is not unusual that the client who wishes for change is equally resistant to change. This may seem both paradoxical but also relatable to, when we pause and reflect. For the counsellor it can feel deeply uncomfortable, especially when the counsellor’s predisposition is to carry knowing and how to facilitate change. Yet in supervision the psychodynamic counsellor can be reminded that such resistance is not a failure but a communication–a potential for greater understanding of how to withstand not knowing.
The paradox of change
Here is the paradox of the work and how the internal conflict of the client presents in the psychodynamic counselling relationship. Change is sought while might also be fought against. In supervision of psychodynamic counselling our endeavour is to find ways to name and accept the spaces between where the client is and where they hope to go and what might be obstructing them to get there.
In closing
Supervision of psychodynamic counselling at the Highgate Counselling Centre is not a guide to right or wrong answers. It is an essential, shared exploration toward safe therapeutic practice. It offers trainees the opportunity to think, to feel and to grow into the reflective stance that underpins all good therapeutic work.
The purpose of the supervision group is a reflective holding space for counsellors to bear uncertainty, tolerate frustrations and to cultivate their curiosity rather than forge a need to solve.
Learning to bear how not to be helpful is, paradoxically, one of the most helpful things we can do–for our clients, our development as psychodynamic counsellors, and for the integrity of the therapeutic process itself.
———Written by Kate Hardwicke, a psychoanalytic psychotherapist and psychodynamic supervisor. She is one of the supervisors at the Highgate Counselling Centre.
