Talbot N L
Department of Psychiatry, University of Rochester School of Medicine, NY, USA.
Am J Psychother. 1995 Summer;49(3):338-49. doi: 10.1176/appi.psychotherapy.1995.49.3.338.
A premise of this article is that the supervisee typically experiences shame in psychotherapy supervision. The purpose is to demonstrate that the discovery and exploration of shame by the supervisor and the supervisee enhance both the therapy and the supervision. The focus is on the supervisor's attitudes and behaviors toward the supervisee's shame. Using a case example, three important sources of that shame are discussed: (1) Shame that evolves from the relationship between therapist and patient. (2) Shame that arises from the therapist's fears of, or actual experience of, not being approved of or admired by an idealized supervisor. (3) Shame inherent in revealing personal material in a supervisory relationship. Six recommendations for exploring shame are offered to supervisors: (1) be alert to the therapist's disguised shame, (2) encourage the supervisee to explore how the therapy and supervision are experienced, (3) demonstrate the qualities of a psychotherapist by assisting the therapist in uncovering personal material that affects the psychotherapy, and (4) create an environment of safety where shame-related phenomena can be discussed with candor and curiosity. Supervisors should also (5) ease insecurities by modeling the activities they seek to encourage, and (6) avoid attempts to dissuade the supervisee of an idealizing transference toward them. Limitations of the recommendations are discussed.
本文的一个前提是,受督导者在心理治疗督导中通常会体验到羞耻感。目的是证明督导者和受督导者对羞耻感的发现与探索既能提升治疗效果,也能增强督导作用。重点在于督导者对受督导者羞耻感的态度和行为。通过一个案例,讨论了这种羞耻感的三个重要来源:(1)源于治疗师与患者关系演变而来的羞耻感。(2)源于治疗师对未得到理想化督导者认可或赞赏的恐惧或实际经历的羞耻感。(3)在督导关系中披露个人资料所固有的羞耻感。向督导者提供了六条探索羞耻感的建议:(1)留意治疗师伪装的羞耻感,(2)鼓励受督导者探索对治疗和督导的体验方式,(3)通过协助治疗师揭示影响心理治疗的个人资料来展现心理治疗师的品质,(4)营造一个安全的环境,在其中可以坦诚且好奇地讨论与羞耻感相关的现象。督导者还应(5)通过示范他们希望鼓励的活动来缓解不安全感,以及(6)避免试图劝阻受督导者对他们产生理想化移情。文中讨论了这些建议的局限性。