The document explores the transition from 'ordinary' to 'extraordinary' experiences in psychodynamic supervision, focusing on the current inadequacies in psychotherapy training. It emphasizes the need for a more relational and integrative approach to supervision that encourages self-awareness and personal experience, contrasting this with prevailing issues such as sterile supervision and compliance dynamics. The presentation argues for a reevaluation of supervisory practices to foster a more authentic and effective learning environment for trainees.

1. The Shift from “Ordinary”
to “Extraordinary” Experience
in Psychodynamic Supervision
James Tobin, Ph.D.

2. The Shift from “Ordinary” to “Extraordinary”
Experience in Psychodynamic Supervision
James Tobin, Ph.D.
Private Practice, Newport Beach, CA
Assistant Professor of Clinical Psychology
Argosy University, Orange County, CA
phone: 949-338-4388
web: www.jamestobinphd.com
email: jt@jamestobinphd.com
2

3. Introduction
In this presentation, I will describe an approach
to psychodynamic supervision inspired by my
work with a particular student.
Her use of the word “extraordinary” in a
discussion helped me to conceptualize an
important process in dynamic supervision: the
shift from “ordinary” to “extraordinary”
experience; this has become a central
organizing metaphor in my work and I will
attempt to outline its heuristic value.
3

4. Introduction
If we agree, as Ablon and Jones (2005, p. 564-565)
observed in their research on the analytic
process, that “psychological knowledge of the
self can develop only in the context of a
relationship within which the psychotherapist
endeavors to understand the mind of the patient
through the medium of their interaction”, then I
hope this presentation will provide a pragmatic
framework for how to support supervisees’
capacity to utilize this medium through the
metaphor of the “extraordinary.”
4

5. Psychotherapy Training: A Fairly Bleak Picture
Numerous writers have portrayed a fairly bleak
picture of the efficacy of psychotherapy
training at all levels of professional
development, including the training of
psychoanalytic candidates.
5

6. Psychotherapy Training Issues
Major problems with current training approaches
are well documented in a comprehensive review
by Fauth et al. (2007) and include:
• Too narrow of a focus on therapeutic micro-skills;
• Emphasis on technical adherence to theoretical
orientations at the expense of more global
capacities;
6

7. Psychotherapy Training Issues
• Strict adherence to manual-guided
techniques;
• The failure to foster durable improvements in
overall therapeutic effectiveness.
7

8. Binder’s Critique
In two important papers in which he evaluated
the empirical and theoretical literature re:
psychotherapy training, Binder (1993, 2002)
concluded that we lack a research-informed
pedagogy for formal psychotherapy education
and training, and that the effectiveness of our
graduate training programs is assumed
largely on faith.
8

9. Binder’s Critique
He observed that clinical psychology programs
customarily teach specific procedures and
skills in a progression from simple to more
complex performances, with an emphasis on
micro-skills in which discrete teaching
modules expose students to particular facets
of the clinical situation and interventions
(e.g., active listening, open-ended questions,
etc.).
9

10. Binder’s Critique
He stated, “It appears, however, that while
these ‘micro’ components of interviewing can
be effectively taught, the components do not
easily gel into the more complex performance
skills actually used in clinical interviewing”
(Binder, 2002, p. 4).
10

11. Binder’s Critique
Curricula expose students to theories and
procedures associated with various treatment
models, followed by “an abrupt transition to
‘practicing’ with real patients” (Binder, 2002,
p. 5).
Yet conceptual knowledge is not readily
available to students about how a treatment
is actually conducted.
11

12. Binder’s Critique
Additionally, Binder (1993) suggested that it is
highly likely supervision is being conducted
incompetently by many supervisors.
12

13. Negative Perceptions of Supervision
Many supervisees view supervision to be an
unhelpful and, at times, a highly negative
experience (Fauth et al., 2007; Ramos-Sanchez
et al., 2002).
Galante (1998), for example, found that 47% of
trainees had experienced at least one
ineffective supervisory relationship.
13

14. Lack of Training/Not a Distinct Professional Activity
Little formal training is offered for supervisors
(Russell & Petrie, 1994) and supervision itself
is not typically perceived as a distinct
professional activity with its own unique
processes and goals.
14

15. Stylistic Preferences and Rigidity of Roles
Many supervisors approach supervision in a
vague, undetermined way (Milne & James,
2002), often resulting in their being primarily
didactic or adopting a largely supportive or
collegial role.
The personality of the supervisor tends to
correspond to broad supervisory styles (taskoriented, interpersonally-focused, etc.)
(Freidlander & Ward, 1984; Shanfield & Gil,
1985) that unwittingly shape and determine
the supervision experience.
15

16. Perpetuation of Poor Supervisory Models
Supervisors also tend to repeat the mistakes
made by their own supervisors (Worthington,
1987).
16

17. Something is not working ...
Given all of the issues, something is clearly not
working in how we teach, train and supervise
students and psychotherapists-in-training.
17

18. Ladany’s “Litmus Test”
Ladany (2007) observed that we have not done
a good job in determining graduate school
admission criteria that reliably predict
psychotherapy competence.
18

19. Ladany’s “Litmus Test”
He (2007) wrote, “It should not surprise us, then,
that a decent percentage of students graduate
who are not well equipped to be reasonably
good therapists. A good litmus test for this
supposition is to ask ourselves whether we
would refer a family member (that we liked!)
to a therapist whom we are graduating. I
would venture a guess that about a third of
the time the answer would be no” (p. 395).
19

20. But the Good News Is We Are Making Progress!
Despite these training problems and the
corresponding lack of a consensual model for
conceptualizing and implementing
supervision, we are making significant strides!
20

21. Expansion of the Supervisory Function
The supervisor’s task is no longer viewed as
solely didactic or focused on merely imparting
technical or theoretical knowledge; instead,
the supervisory function consists of
numerous interrelated roles that include
supportive, technical and modeling
components directed toward the cultivation
of a therapeutic identity (Milne and James,
2002).
21

22. Developmental Stage Models
Developmental stage models (e.g., Heppner &
Roehlke, 1984; Stoltenberg & Delworth, 1987,
1988) have helped to define approaches to
supervisory intervention based on the
supervisee’s level of competence and
experience.
22

23. Relational Emphasis
The supervisory relationship (e.g., Ekstein &
Wallerstein, 1972; Hedges, in press; Watkins,
1997, 2011; Worthen & McNeil, 1996) has
also been emphasized as a primary framework
for understanding how complex, co-creative
interpersonal patterns of interaction and
enactment between supervisor and
supervisee may correspond to the trainee’s
relationships with her patients.
23

24. Relational Emphasis
This emphasis reflects the notable empirical
finding (which has transtheoretical
implications) that, more than any other factor,
the quality of the psychotherapeutic
relationship remains the strongest predictor
of treatment outcome (Hedges, in press;
Norcross, 2002; Orlinsky et al., 1994).
24

25. The Educational Pyramid
A triadic model (Bernstein, 1982; Seidman &
Rappaport, 1974) in which the interrelationships of the three figures of
psychotherapy training (client, trainee, and
supervisor) has contributed to the design of
empirical research programs that assess
supervision efficacy and the degree to which
it actually predicts trainees’ interventions
and the outcomes of their therapy cases.
25

26. Moving from Micro-Skills to Super-ordinate Goals
Micro-skills continue to be addressed in
supervision yet are so within a broader set of
therapeutic competencies and super-ordinate
goals that more realistically reflect the
professional role of therapist.
26

27. Moving from Micro-Skills to Super-ordinate Goals
For example, Binder (2002) defined 4 superordinate goals for the student in supervision:
(1) to conceptualize clinical material; (2) to
select and apply therapeutic interventions; (3)
to develop professional beliefs and values; and
(4) to behave ethically.
For Binder, the best supervisors find ways to link
these 4 goals into a cohesive learning
experience for the trainee.
27

28. Self-Awareness as a Therapeutic Competency
Beyond knowledge- and skill-based approaches
to supervision intervention, there has been
increasing interest in encouraging the
supervisee’s self-awareness and ability to
understand and use the self in the clinical
situation (Ladany, 2007).
28

29. Tuckett’s Three Frames
For example, in an attempt to conceptualize the
competence of psychoanalytic candidates,
Tuckett (2005) theorized that advanced skill
level is characterized by the capacity to
sustain three linked lenses or frames: (1)
participant-observational, (2)conceptual and
(3) interventional.
29

30. Tuckett’s Three Frames
As described by Sarnat (2010, p. 21), Tuckett
(2005) defined the participant-observational
frame as “ ‘the way the analyst is with the
patient’ (p. 37), and emphasized the analyst’s
capacity to bear and process, rather than act,
on the emotional states that the patient
evokes within her or him.”
30

31. Self-awareness/Use of the Self: The Lack of a Clear
Pedagogic Method
Self-awareness and the use of the self in the
clinical situation are contextually valid and
fundamental components of therapeutic
work, clearly evident in the technique of
highly-skilled and experienced therapists.
But the capacity to identify and use selfexperience is difficult to cultivate and refine
in trainees, and often is not even approached
by supervisors (due, in my opinion, to the lack
of a clear pedagogic method for how to do
so).
31

32. A Major But Under-emphasized Issue:
“Sterile” Supervision
In my review of the supervision literature, and
upon reflection on my own work and the work
of my colleagues, I have often wondered if the
lack of a clear pedagogic method for
promoting the supervisee’s use of selfexperience results in “sterile” supervision.
32

33. Sterile Supervision
Sterile supervision may be characterized by
content and process factors which dilute the
authentic experience of the supervisee (and
of the supervisor as well), attenuating the
interaction significantly and restricting the
range of interpersonal experience and
psychological inquiry to safe comfortable
zones.
33

34. Sterile Supervision
Sterile supervision, in my opinion, arises from
pressures (within the supervisee, the
supervisor and/or within the institution in
which treatment and supervision are
occurring) toward standard forms of social
etiquette and decorum that tend to
predominate the supervisory interaction.
34

35. Sterile Supervision
We have all heard about or experienced supervisory
sessions that seem no different in tone or content
from formal business transactions or professional
engagements!
Although these modes of interaction are, at times,
reasonable and appropriate for the supervisory
relationship, I believe the patterned and
consistent dilution of the supervision experience
represents a more insidious problem.
35

36. Evidence of Sterile Supervision
For years, anecdotal evidence and empirical
research have suggested that the supervisory
interaction is frequently inauthentic, falsified
and/or censored.
Gabbard (2010) notes that supervisees’
presentations of clinical material are
commonly filtered or distorted.
36

37. Compliance and Social Desirability
Many supervisees, of course, experience a
conflict between presenting what makes them
“look good” to their supervisor vs. sharing
their struggles and difficulties “which may
maximize the learning process but could
result in a less glowing evaluation” (Gabbard,
2010, p. 193).
37

38. Compliance and Social Desirability
In my own discussions with students and
practicing professionals, some quite
sophisticated, many indicate that they still feel
as if they have “to be” a certain way clinically
and in supervision in order to appeal to the
overt and covert preferences of their
supervisors or peers in consultation groups.
38

39. Empirical Evidence of Compliance in Supervision
Further, there is a growing body of research that
indicates strong bidirectional processes of
control, compliance/submission and social
desirability in clinical supervision.
39

40. Empirical Evidence of Compliance in Supervision
Using an intensive case study method to
evaluate speech acts throughout one
semester of supervision, Martin et al. (1987)
found that the supervisor being evaluated
frequently acted in a controlling and assertive
manner as compared to the more compliant
supervisee.
40

41. Empirical Evidence of Compliance in Supervision
Alpher (1991), in a study of short-term
psychodynamic treatment, found that the
interpersonal process between supervisor and
trainee frequently consisted of control
behaviors on the part of the supervisor and
submitting behaviors on the part of the
trainee. Interestingly, these observations
corresponded with additional data showing
that, at times, the patient viewed the traineetherapist to be controlling as well.
41

42. Empirical Evidence of Compliance Supervision
Alpher (1991) also noted that as the supervisor’s
controlling acts evoked a greater degree of
submission on the part of the trainee, the
supervision progressively became more and
more narrowed in scope, with content
condensing to the trainee’s requests for
specific instructions from the supervisor and
the articulation of the supervisor’s insights.
42

43. Empirical Evidence of Compliance in Supervision
Alpher concluded that control and submission
appear to be dominant interactive evocations in
supervision, and that such evocations provide
evidence of parallel process in which
“interdependent transactions occur in a
coherent manner across the dyads” of
supervisee-supervisor and supervisee-patient
(Alpher, 1991, p. 228).
43

44. Empirical Evidence of Compliance in Supervision
Alpher’s (1991) data and inferences are
particularly relevant for my concerns because
they imply that sterile supervision likely
corresponds to sterile therapy (more on this
later!).
44

45. The Supervisor’s Social Desirability
Also contributing to sterile supervision is the
need on the part of supervisors to be seen
favorably by their supervisees, particularly in
settings in which trainees’ ratings of
supervisors are perceived by administrators
as indicative of supervisor competence.
45

46. The Supervisor’s Social Desirability
Supervisors also tend to face a conflict between
what they personally value as meaningful for
teaching and supervision and the prevailing
rules, norms and policies of the organization
in which the therapy and supervision occur
(Fauth et al., 2007).
46

47. Supervisors’ Desire to Protect, Shield and Prevent
Narcissistic Injury
I also believe there is a tendency among many
supervisors who, conscious of trainees’ fears,
naiveté, demoralization and low professional
self-esteem, over-compensate by attempting
to shield supervisees from common realistic
challenges of the therapy situation and selfexperience (e.g., narcissistic injury) often
associated with the growing pains of learning
the complex task of psychotherapy.
47

48. Supervisors’ Desire to Protect, Shield and Prevent
Narcissistic Injury
I once heard a story of a supervisor who, when
the potential to add family therapy as a
treatment modality in the training clinic where
he work was discussed, vehemently argued
against the idea.
He felt trainees were having enough difficulty
with individual therapy and anticipated that
the complexity of family therapy would be
overwhelming.
48

49. An Implicit Rule: “We have a very nice relationship …”
An additional factor contributing to sterile
supervision is the mutual avoidance of conflict or
dissonance in the supervisory relationship.
Recihelt and Skjerva (2002, p. 770) claim that an
implicit rule is often embedded in the
supervisory process and mutually reinforced by
both supervisor and trainee: “We have a very
nice relationship, and do not want to say or do
anything that may make it less pleasant” (as
cited by Binder, 2002, p. 18).
49

50. The Avoidance of “Touchy Issues”
Similarly, Lizzio et al. (2009, p. 129) observed
about the supervisor’s role: “However, it is not
only important to provide support, but also to
do so at an appropriate level. While a
perceived lack of supervisor support can have
negative consequences for supervision, too
much support, in the absence of other
important supervisory relating behaviours,
can also inhibit the effectiveness of
supervision. For example, if a supervisor is
50

51. The Avoidance of “Touchy Issues”
overly concerned with ‘being supportive’ they
may become too permissive and not address
‘touchy issues’ such as supervisee competence
or performance. This can result in a ‘phoney’
supervision relationship where the needs of
the client are relegated behind the
supervisor’s need for acceptance and
approval or their avoidance of conflict ...”
51

52. Toward a Definition of “Ordinary” Experience
The many factors contributing to sterile
supervision suggest the potential for a
patterned interpersonal dynamic between
supervisee and supervisor restricted to
conventional forms of relatedness.
52

53. Toward a Definition of “Ordinary” Experience
In this conventional relatedness, discomfort,
tensions and anxieties are suppressed or
avoided via numerous conscious and
unconscious activities falling within a profile
of affirmation, decorum, censorship,
politeness, rapport, compliance and social
desirability (i.e., the “ordinary”).
53

54. Toward a Definition of “Ordinary” Experience
Phony or sterile supervision is facilitated by the
supervisor and trainee colluding so as to
reside within a sanctioned safe zone
relegated to a fundamentally ordinary
relatedness to which both parties are wellaccustomed.
54

55. The Press Toward the Ordinary
Unfortunately, many of our training institutions
embody a culture of ordinary relatedness that
fails our students and supervisees in
numerous ways, including not socializing
trainees to the potential power of a true
therapeutic environment unencumbered by
the restrictions of social mores.
55

56. The Press Toward the Ordinary
Relegation to the ordinary in sterile supervision
does not engage the trainee in an
“interpersonal atmosphere for generating an
appreciation of the power of the professional
relationship itself” (Hedges, in press),
especially the pursuit of self-experience that
may be controversial or viewed as
inappropriate when conceived of in the
context of typical social discourse.
56

57. The Press Toward the Ordinary
Consequently, activating the trainee’s selfawareness/use of self in the clinical situation is not
really possible because it is not activated in the
process of supervision; self-experience is largely
censored in supervision as supervision becomes
categorically associated with standard social
discourse.
In this way, the trainee is not provided with a
relational experience that adheres to the distinct
self- and self-other relatedness that characterizes
a psychoanalytically-informed model.
57

58. The Press Toward the Ordinary
I think the press toward the ordinary may be
due, at least in part, to a misguided
exaggerated use of the conclusions drawn
from the large body of work on the relational
paradigm (e.g., Bordin, 1983; Frawley-O’Dea
& Sarnat, 2008; Gill, 2001; Hedges, in press;
Ladany, 2004; Watkins, 2011).
58

59. The Press Toward the Ordinary
Emphasis on the alliance often becomes
reduced conceptually and interactively (both
by supervisor and supervisee) to an
exaggerated focus on rapport-building and
the avoidance of discomfort, conflict and
distress -- at the expense of other vital
elements of the therapeutic process.
59

60. The Press Toward the Ordinary
Many supervisors also seem to fundamentally
misconstrue what will ultimately promote the
supervisee’s self-assuredness, confidence and
deeper learning (Lizzio et al., 2005;
Ronnesttad & Skovholy, 1993); standard forms
of assurance and corrective feedback seem
less productive in this regard than exploring
and legitimizing the supervisee’s experience
of learning to be a therapist.
60

61. My Central Thesis
My main point thus far is that due to benign and
protective motives on the part of many
supervisors, as well as more insidious
processes of control, submission and
compliance in supervision, the supervisee’s
subjective experience as therapist,
learner and person
may be ordinarily
thwarted.
61

62. My Central Thesis
Overly-protecting, supporting or instructing the
supervisee can have the unintended
consequence of ultimately invalidating her
self-experience; yet the ability to access and
use self-experience is a crucial therapeutic
competence and serves as both an anchor
and compass for negotiating the challenges
of actual clinical work.
62

63. Being “Supported Away”
Many of the supervisees I encounter are
discouraged or demoralized because their
own views have seldom been inquired about
or allowed to stand as valid sentiments in
supervision (e.g., a supervisee once told me
she felt like most of her concerns as a
therapist-in-training had been “supported
away”).
63

64. Humility: A Rite of Passage in Training
A common issue for many trainees is their
newly-emerging realization that they cannot
combat or overcome the severity and
refractory nature of the dilemmas and
characterological problems in patients who
present for treatment.
64

65. Drama of the Gifted Child
This realization is especially unbearable for
some students who are encountering,
perhaps for the first time, the limitations of
their long-held proclivity to heal, a proclivity
born in their own personal histories and that
prompted a way of being in the world which
inspired their very entry into the mental
health profession (e.g., Alice Miller’s Drama of
the Gifted Child); feelings related to this
cannot and should not be supported away!
65

66. Emulation of the Ordinary
Exposure to sterile supervision leaves the
supervisee with a constricted perspective of
therapeutic relatedness.
A natural consequence is the supervisee’s
proclivity to emulate the “ordinary” with her
own psychotherapy patients, manifested in
similar or identical forms of tension
reduction, avoidance and
conformity/control/submission dynamics
embedded in the supervisory process.
66

67. My Approach: The Shift to Extraordinary Experience
The pedagogic principle I am proposing is that
psychodynamic supervision should facilitate in
the supervisee a transition from common
forms of social discourse and convention
including conflict avoidance, compliance and
social desirability (“ordinary” experience) to
an alternative form of relatedness that
inherently values an ambience of inquiry,
uncensored subjectivity and acceptance
(“extraordinary” experience).
67

68. Supervision as “Metaphoric Experience”
The traditional notion that personal therapy is
the best way to gain self-awareness and one
of the best ways to learn how to actually do
psychotherapy (Ladany, 2007, p. 393) is a bit
misguided, from my standpoint.
Instead, I believe the supervisory experience can
provide a “metaphoric experience” of the
dynamic therapy situation, which, at its core,
revolves around one mind attempting to
make contact with and understand deeply
the mind of another.
68

69. Supervision as “Metaphoric Experience”
This sentiment is reflected in Sarnat’s writings:
“Although the supervisory and clinical tasks
are different, the supervisor demonstrates
competencies in supervising that are closely
related to those she is striving to develop in
her supervisee” (Sarnat, 2010, p. 26).
69

70. The Supervisee’s Self-Experience
The supervisee is seen not as a narcissistically
vulnerable figure who needs consistent
support and cheerleading, but as a maturing
professional whose therapeutic identity will
be promoted primarily by a close inspection
and understanding
of her particular experience.
70

71. The Supervisee’s Self-Experience
Therefore, in my view, it is the supervisor’s
primary task to explore extensively the
supervisee’s self-experience with relative
abstinence in order to (1) affirm its validity
and (2) model for the supervisee a mode of
“being with” another’s experience.
71

72. The Supervisee’s Self-Experience
As in psychotherapy, this approach assumes that
due to a variety of interpersonal and
intrapsychic factors there will be resistances
to the expression, examination and tolerance
of the supervisee’s uniquely personal
experience.
72

73. My Primary Task As Supervisor
Therefore, I see my primary task as one of
coaxing into expression the supervisee’s selfexperience; my sense is that if the
supervisor's self-experience cannot be
engaged and validated, then meta-cognitive
competencies underlying psychodynamic
psychotherapy including the use of the self,
intuition, pattern recognition, spontaneity and
self-assuredness will not be promoted.
73

74. Supervision Vignette
• A supervisee, in a practicum placement at a
university psychology clinic, discusses her
patient who has recently no-showed for a
session; the supervisee begins to reflect on
what it has been like for her to work with this
particular patient; in one supervision session,
she says, “I find myself oscillating between
being my self and being a professional self,
and this makes me feel anxious, not in
balance.
74

75. Supervision Vignette
• When I am too much the professional me, I
become blocked in my thoughts, in my
perceptions and in my freedom during
sessions. Often, I get this way with her. With
other clients, I am more natural and there
seems to be a balance of the real me and the
professional me. I find myself and I find a
professional identity almost at the same time.
75

76. Supervision Vignette
• But with her, I get kind of defensive. I don’t
think I really am all that defensive in actuality,
I just feel it. At those times, I become too
much of a therapy-me. Again, it’s the issue of
feeling too much of one vs. too much of the
other. But at other times with her I get too
reactive and I become too much me. It’s
strange. I am unable to integrate this all into
one me. Wow! That’s cool. (I inquire about
what’s cool.)
76

77. Supervision Vignette
• I didn’t realize this all before. Just describing
it really helps. It’s not really anxiety, now that
I reflect on it, it’s just that with her I
sometimes get uncomfortable ... Yeah, this is
cool. (Cool?) Just the fact that I am seeing
how I am with her, naming the way I feel
when I am with her. I have not been able to
describe it before or even identity it. So
you’re helping me capture it now.
77

78. Supervision Vignette
• Sometimes I’ll be more spontaneous, the
natural me, but I feel like it’s too much me
with her … Yeah, I’ve read about stuff like this,
I’ve had courses where it’s been talked about,
but to actually experience it is exciting, it’s
extraordinary, really. I’m actually
experiencing it, I am in it, rather than just
reading about it. I am seeing myself as I am
with her.
78

79. Supervision Vignette
• I blurt this all out to you now, without really
thinking about it or organizing it. I guess I
am allowing myself to be spontaneous with
you, which is ironic as I am talking about not
being able to be that way with her. That’s
funny, really. With her, when I allow myself to
be spontaneous I feel like it bleeds into being
impulsive, and when that happens, I get really
restrictive and rigid again.
79

80. Supervision Vignette
• I then become my professional self, and I think
that makes me withdraw from her. I feel a
distance between her and me and I can’t
connect with her, it’s a kind of psychological
distance. When I am more me-me, I feel like
her buddy, I feel closer to her and comfortable
with her, the way I’d be with someone I know
and am close to. I seem to be one way or the
other with her.
80

81. Supervision Vignette
• And I guess this all isn’t really a bad thing,
I’m just putting it into words. This is really
exciting. (It’s exciting because?) It’s exciting
because the person who did the original
assessment on her described her as borderline.
I am not sure about that view of her, but I
obviously feel a certain split and maybe it has
to do with something in the patient or with
something in me in being with her. I don’t
know. I just don’t know.
81

82. Supervision Vignette
• At some point in my last session with her, I
couldn't bring myself to tell her what I really
wanted to say. I was fighting back the
natural me and I don’t know why; maybe it
was because I have some fear of expressing
the natural me. That if I did, I would be in
trouble somehow. I would easily say what I
was thinking to a friend, but with her I didn’t
sense she could tolerate or use what I wanted
to say, so I just held onto my ideas.
82

83. Supervision Vignette
• So there’s this professional me and a natural
me, and I am realizing as I talk to you that
this is all a part of me getting to know her.
Just thinking about it is really helpful. This is
all a bit of a roller coaster ride. (Roller
coaster?) Extreme, intense. But it’s nice to just
be able to ramble on about it all. Talking
about it and verbalizing my thoughts are really
good. And you seem to be able to prod me
along.”
83

84. Evidence of the Supervisee’s Growth: Reduced Fear of
“Expressing the Natural Me”
This supervisee began working with me with a
heightened degree of self-consciousness and
self-criticality, along with a constant worry that
she wasn’t “doing it” right.
84

85. Evidence of the Supervisee’s Growth: Reduced Fear of
“Expressing the Natural Me”
For a long time, she would not even directly
expose me to her work (via listening to
audiotaped recordings of sessions) and I often
felt that our sessions were overly cordial and
inauthentic (she was, I believe, “fighting back
the natural me” with me). This clearly has
changed!
85

86. Evidence of the Supervisee’s Growth: Reduced Fear of
“Expressing the Natural Me”
She now approaches her own reflections in
supervision without judgment, although fears
of “doing something wrong” with her patient
still remain; but she observes that her ideas
and feelings, and the troubling dynamics with
her patient, are not necessarily “bad,” just a
part of how she is getting to know and
understand her patient.
86

87. Evidence of the Supervisee’s Growth: Awe and
Disinhibition
The clinical process previously made her
extremely anxious, clearly not excited, and she
certainly didn’t view it with any wonder or
awe as she does now.
Now, she is remarkably spontaneous with me,
free to blurt out things and eager to find
meaning in what she allows herself to put
forth.
87

88. Evidence of the Supervisee’s Growth: Increasing
Autonomy and Fewer Preoccupations
Before, she seemed to rely heavily on me and
other prior supervisors for direction.
Now, she is relatively autonomous in a large
portion of her work, and she seems content
to use supervision primarily as a space for
her to identify her self-experience without
being preoccupied with the need to
determine meaning or formulate
interventions.
88

89. Evidence of the Supervisee’s Growth: Recognition of
the Patient’s Character Structure and Relational
Dynamics
While the supervisee previously seemed to
objectify her patient (she tended to “fit” the
patient to a theoretical idea or intervention),
she is now beginning to appreciate the
complexity of her patient’s character
structure and how it impacts their relational
connection.
89

90. Evidence of the Supervisee’s Growth: Recognition of
the Patient’s Character Structure and Relational
Dynamics
This development reflects Sarnat’s (2010, p. 20)
view:“Effective psychodynamic intervention is
derived from what the psychotherapist has
experienced, processed, and conceptualized
about the relationship with the client and
about the client’s internal object world.”
90

91. Evidence of the Supervisee’s Growth: Emergence of a
Therapeutic Identity
Previously, the supervisee seemed to lack a
professional-therapeutic identity; her
interventions were frequently impulsive
and raw or, conversely, had the quality of
mimicking what she thought a therapist
should do/say.
91

92. Evidence of the Supervisee’s Growth: Emergence of a
Therapeutic Identity
Now, her progress is striking: she is clearly
formulating a more substantive therapeutic
identity (manifested in her naming of and
reckoning with it) and is devoting attention to
issues and drawbacks re: integrating her
personal and therapeutic proclivities and
attitudes.
92

93. Evidence of the Supervisee’s Growth: A Shift Out of
the Ordinary
In the emergence of her therapeutic identity, she is
beginning to recognize moments when she
fears expressing something to her patient
(often represented in the guise of what the
patient is believed not to be able to tolerate).
In my view, this represents a crucial progression:
she is essentially acknowledging for the first
time the possible adherence to “ordinary”
relatedness that is infiltrating her burgeoning
therapeutic identity
93

94. Evidence of the Supervisee’s Growth: A Shift Out of
the Ordinary
It is an interesting paradox (not just for this
supervisee, but for many others) that in one of
the most intimate of all settings -- the
therapeutic situation, the expression of the
natural me (or “me-me”) is often inhibited,
perhaps due to various conscious and
unconscious assumptions about therapy and
about the therapist’s role that reflect the
censorship of standard decorum.
94

95. Evidence of the Supervisee’s Growth: A Shift Out of
the Ordinary
My supervisee, though, is clearly in transition on
this, which represents movement out of the
ordinary.
She is beginning to realize the potential for a
greater degree of intimacy with her client in
the clinical situation, as well as its risks.
This likely reflects a greater degree of freedom
and intimacy she felt toward me in
supervision.
95

96. Evidence of the Supervisee’s Growth: A Shift Out of
the Ordinary
She now appears invested in creating an
ambience with patients and within herself
that is “extraordinary,” i.e., it is
fundamentally different from how she
typically is in her “real life.”
96

97. Evidence of the Supervisee’s Growth: A Shift Out of
the Ordinary
More specifically, this ambience consists of the
supervisee’s newly conscious awareness of
the desire to relate and express, as well as
the willingness to be related to and reflect on
this relatedness.
97

98. Evidence of the Supervisee’s Growth: A Shift Out of
the Ordinary
Further, she is newly cautious about introducing
her own personhood too impulsively into the
clinical situation.
At the same time, she also is attending to
reasons why elements of her spontaneity
(her “natural me”) do not yet comfortably
carry over into her relationship with her
patient (e.g., Renik, 1996, 1999).
98

99. Evidence of the Supervisee’s Growth: A Shift Out of
the Ordinary
This suggests the need in ongoing supervision to
examine lingering reservations and fears of
deeper, more intimate contact with patients
unencumbered by social convention in which
she can be more “real” (Renik, 1999).
99

100. Techniques and Guiding Principles
In conclusion, I would like to propose 6
supervisory techniques and guiding principles
emerging from my work with this student and
other supervisees like her that has informed
my approach.
100

101. Techniques and Guiding Principles:
(1.) Limit Convention and Compliance/Social
Desirability
Fundamentally, I attempt to create an
atmosphere in supervision relatively devoid
of aspects of social convention that obstruct
the supervisee’s exposure to an alternative
form of relatedness consisting of freedom of
self-expression and a reduced focus on
appealing to the other.
101

102. Techniques and Guiding Principles:
(1.) Limit Convention and Compliance/Social
Desirability
For example, I directly observe to the supervisee
“ordinary” social phenomena as it occurs
(both in relation to me and between the
trainee and her client), and I invite an
exploration of its purpose and utility within
the clinical situation as well as within
supervision.
102

103. Techniques and Guiding Principles:
(1.) Limit Convention and Compliance/Social
Desirability
Head nodding in standard social discourse is an
easily recognizable example of the many
forms of social convention to which I attempt
to sensitize the supervisee; therapists-intraining often cue their patients (and their
supervisors) with head nods.
103

104. Techniques and Guiding Principles:
(1.) Limit Convention and Compliance/Social
Desirability
I work hard to sensitize the supervisee to this
social convention and how it, like many other
conventional behaviors, generally promotes
restricted (“ordinary”) relational experience
that inhibits the more expansive, wideranging and uncensored quality of the
distinctive therapeutic experience we are
seeking to potentiate.
104

105. Techniques and Guiding Principles:
(1.) Limit Convention and Compliance/Social
Desirability
Many supervisees have reported to me how
striking and productive it is when they begin
to practice not returning the head nods of
their patients (or not do offer a head nod
themselves!) -- which often promotes
important discussions in supervision of
traditional analytic notions of abstinence and
neutrality and their continued relevance.
105

106. Techniques and Guiding Principles:
(1.) Limit Convention and Compliance/Social
Desirability
Similarly, I try to sensitize the supervisee to a host
of dynamics and events between themselves and
their clients (including violations of the frame,
hypervigilance re: the other’s discomfort, fears of
not being liked or viewed as good/helpful,
avoidance tactics, rigid unconditional positive
regard, etc.) that may represent adherences to
social convention and a loyalty to ordinary
personas within the trainee as well as her
patient.
106

107. Techniques and Guiding Principles:
(1.) Limit Convention and Compliance/Social
Desirability
As supervision proceeds, I hope to continue to
engender in the supervisee a relinquishment
of her “ordinary persona” which may be
characterized by an array of previously
unexamined attitudes and tendencies.
Simultaneously, I aim to cultivate an alternative
therapeutic persona.
107

108. Techniques and Guiding Principles:
(2.) “Don’t just do something, sit there!”
As a central supervisory technique, my listening
approach is primarily neutral/abstinent,
embodying the spirit of “Don’t just do
something, sit there!” (Alonso & Rutan, 1996).
108

109. Techniques and Guiding Principles:
(2.) “Don’t just do something, sit there!”
As I listen, I hope to model a “self-reflective
capacity” (Sarnat, 2010, p. 24) in which I
demonstrate a highly attuned experiencing of
the supervisee and what she is telling me.
I am also attempting to expose the supervisee to
the fact that this capacity is not usually all
that concerned with reactivity or action “of
an automatic, habitual pattern” (i.e., that
often constitutes “ordinary” experience).
109

110. Techniques and Guiding Principles:
(2.) “Don’t just do something, sit there!”
Occasionally I will offer questions and educative
instruction, and will self-disclose, but I
generally maintain a stance of listening,
experiencing and reflecting.
I also attempt to limit discussions of highly
abstract theoretical concepts and a “Q and A”
rhythm to supervisory sessions, which more
often than not reinforces the supervisee’s
dependency and impedes self-agency.
110

111. Techniques and Guiding Principles:
(3.) Promote Mindfulness Via the Extraordinary
In listening to and experiencing the supervisee, I
attempt to model a residence in the
“extraordinary” promoted by the metacognitive skill known as “mindfulness” (i.e.,
the moment-to-moment awareness of one’s
experience) (e.g., Binder, 2002, 2004; Fauth et
al., 2007; Germer, 2005; Safran & Muran,
2000, 2001).
111

112. Techniques and Guiding Principles:
(3.) Promote Mindfulness Via the Extraordinary
“... psychotherapist mindfulness represents ...
sustained attention toward the immediate
experience of the session, accompanied by an
attitude of acceptance and compassion, as
opposed to judgment, toward all that arises”
(Fauth et al., 2007, pp. 386-387).
112

113. Techniques and Guiding Principles:
(3.) Promote Mindfulness Via the Extraordinary
Bishop et al. (2004, p. 235) indicated that “in a
state of mindfulness, thoughts and feelings
are observed as events in the mind, without
over identifying with them and without
reacting to them in an automatic, habitual
pattern of reactivity” (as cited by Fauth et
al., 2007, p. 387).
113

114. Techniques and Guiding Principles:
(3.) Promote Mindfulness Via the Extraordinary
As I listen mindfully to the supervisee, I hope to
provide a metaphoric experience in which the
supervisee feels closely attended to, not
judged or acted upon, and begins to
experience the moment-to-moment process
of supervision as a process in and of itself
worthy of investigation and inquiry (rather
than supervision merely being a mandatory
appointment in which therapy sessions are
reviewed and evaluated).
114

115. Techniques and Guiding Principles:
(4.) Attend to Shame
The experience of shame in therapists,
particularly those early in their careers, is
ubiquitous (i.e., the therapist wants to help or
cure the patient and fails). Yet, to my
knowledge, shame in not extensively
addressed in the supervision literature.
115

116. Techniques and Guiding Principles:
(4.) Attend to Shame
Shame is a universal human experience that has
been conceptualized in numerous ways (e.g.,
Alonso & Rutan, 1988; Gans & Weber, 2000;
Nathanson, 1987).
With regard to supervision, the perspective on
shame I am most aligned with is the affective
experience arising from the failure to achieve
a desired response from an important object
(Alonso & Rutan, 1988); for the trainee, this
important object is her patient.
116

117. Techniques and Guiding Principles:
(4.) Attend to Shame
Winnicott’s (1969, 1975) distinction between
object “usage” vs. “relatedness” is relevant
here.
117

118. Techniques and Guiding Principles:
(4.) Attend to Shame
The supervisor gradually begins to realize that
she is not acting on the patient so much as
being acted upon by the patient (via the
specific quality of object-relatedness the
patient needs to enact).
The same could be said for supervision: the
supervisor is acted upon by the trainee and
must accept this fate!
118

119. Techniques and Guiding Principles:
(4.) Attend to Shame
The supervisee often struggles with the fact that
patients will not necessarily “use” them in
the ways she would typically like (“ordinary”
relatendess).
What’s more, the supervisee faces the
additional challenge of accepting Winnicott’s
vital observation that the patient needs to
destroy the object before it can be used.
119

120. Techniques and Guiding Principles:
(4.) Attend to Shame
Thus, shame is a predominant affective
response as the supervisee acknowledges
these emerging dilemmas and becomes more
aware of her reluctance, and corresponding
attitudinal and behavioral responses, to
being related to (not used) by the patient.
120

121. Techniques and Guiding Principles:
(5.) Dispel Expectations of Progress and Social
Comparison
I try to dispel the trainee’s expectations about
where she thinks she “should be” in terms of
development and skill level, especially when
comparisons with peers are routinely made.
Similarly, I try to directly challenge
the supervisee’s vision of her
patients – these often reflect
curative fantasies and a
narcissistic desire to heal.
121

122. Techniques and Guiding Principles:
(5.) Dispel Expectations of Progress and Social
Comparison
My attempt here is to socialize the supervisee
into a view of herself and her development as
unique and acceptable, just as therapy is a
forum for the patient to define and contend
with his/her individuality.
Comparisons with others, then, represent
another form of conventionality and
“ordinary” experience I am attempting to free
the supervisee from.
122

123. Techniques and Guiding Principles:
(5.) Dispel Expectations of Progress and Social
Comparison
In a similar vein, I make ongoing attempts to
disengage the trainee from my own value
system and clinical approach; e.g., supervisees
often ask me, “Is that what you would do?,”
and I respond, “It doesn’t matter what I
would do – you and I are different.”
More often than not, this drives home the point
that all interventions are motivated by some
element of our unique personhoods which
simultaneously may limit and expand our
potential with particular clients.
123

124. Techniques and Guiding Principles:
(6.) Promote Acceptance of Unconscious Relational
Forces
I attempt to downplay standard views of and
conventional opinions on therapeutic course
and action; instead, I emphasize an
acceptance of what is occurring in the clinical
process as reported by the supervisee,
especially its thorny and unclear nature, and
the ongoing evaluation of its many potential
meanings.
124

125. Techniques and Guiding Principles:
(6.) Promote Acceptance of Unconscious Relational
Forces
To expand on this idea, I attempt to move the
supervisee away from “inert clinical knowledge”
(Binder, 2002, p. 11) and, instead, encourage her
to become her own repository of clinical
experience, including all failures and
achievements, intentions and outcomes.
This hopefully marks the transition from Am I doing
it right? or Do you agree with what I did? to This
is what happened between us at that moment.
125

126. Techniques and Guiding Principles:
(5.) Promote Acceptance of Unconscious Relational
Forces
To this end, in supervision I often claim that
“there are no mistakes in therapy” to
encourage supervisees to move past a right/
wrong approach to their work and begin to
appreciate the mutually co-constructed
unconscious dynamics between client and
therapist that profoundly impact how each
thinks, feels and acts upon the other.
126

127. Techniques and Guiding Principles:
(5.) Promote Acceptance of Unconscious Relational
Forces
For example, trainees are often terrified as they
begin to see clearly, from the perch of
supervision, how they have “acted out” with
their patients countertransferentially.
Acknowledging the strength and complexity of
unconscious relational forces is initially
startling for many trainees, but gradually
these forces become viewed more benignly as
constituents of psychoanalytically-informed
treatment.
127

128. Techniques and Guiding Principles:
(6.) Pursue “Professional Me”/“Natural Me” Tensions
Finally, I actively conceptualize the learning
process for trainees as contending with the
emerging tensions of disparity and
integration vis-a-vis the “professional me”
and the “natural me” in their clinical work.
128

129. Techniques and Guiding Principles:
(6.) Pursue “Professional Me”/“Natural Me” Tensions
Pragmatically, this often translates into
encouraging inhibited supervisees to bring
into sessions more of their “natural me,” and
encouraging disinhibited supervisees to
develop a greater degree of caution.
129

130. Techniques and Guiding Principles:
(6.) Pursue “Professional Me”/“Natural Me” Tensions
At a deeper level, it fosters an exploration of
how the supervisee may be unwittingly
exposed to herself, her patient (Aaron, 1991;
Hoffman, 1983) and her supervisor in the
course of psychotherapy and training, how to
tolerate these exposures, and how to make
use of them clinically.
130

131. Techniques and Guiding Principles:
(6.) Pursue “Professional Me”/“Natural Me” Tensions
Finally, a consideration of these tensions
hopefully stimulates and encourages the
trainee’s career-long analysis of the ways in
which her professional role actually mobilizes
(does not obstruct) profoundly intimate
contact with patients unattainable in any
other social realm.
131

132. Summary
Given the unchartered territory of
psychotherapy, supervisees typically rely on
what has worked for them so far in their
personal and professional lives (i.e.,
conventional attitudes and relational
tendencies), many of which are nontransferrable and often disadvantageous for
psychoanalytically-informed psychotherapy.
132

133. Summary
In this presentation, I have outlined an approach
to supervision that seeks to engender in the
supervisee an attitudinal and behavioral shift
from “ordinary” (i.e., the restrictions of social
convention) to “extraordinary” experience in
which the patient's subjectivity, and that of
the therapist-in-training as well, is
authentically expressed, acknowledged and
understood.
133

134. Summary
For the many reasons I have described, both
supervisee and supervisor may collude in a
press for the ordinary which detracts from
exposing the supervisee to an alternative
mode of self- and self-other relatedness akin
to the psychoanalytic model.
Consequently, qualities of sterile supervision are
often emulated and transferred into the
trainee’s work with her own patients.
134

135. Summary
My supervisory approach argues that an
invaluable function of the supervisor is to
model a way of being that transcends
standard forms of social etiquette.
In this way, internal representations not only of
the supervisor as role model (Gabbard, 2010;
Gitterman, 1972), but of the relational
experience the supervisor enacted with the
trainee, will support the supervisee's ultimate
therapeutic potential.
135

136. Discussion and Evaluation
The Shift from “Ordinary” to “Extraordinary”
Experience in Psychodynamic Supervision
James Tobin, Ph.D.
Private Practice, Newport Beach, CA
Assistant Professor of Clinical Psychology, Argosy
University, Orange County, CA
phone: 949-338-4388
web: www.jamestobinphd.com
email: jt@jamestobinphd.com
136

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146

147. Biography: James Tobin, Ph.D., Licensed Psychologist
PSY 22074
Dr. Tobin is a licensed psychologist in private
practice in Newport Beach, CA, and is Assistant
Professor of Clinical Psychology at Argosy
University/The American School of Professional
Psychology in Orange, CA, where he currently
supervises graduate students at the Argosy
University Therapeutic Assessment and
Psychotherapy Service (AUTAPS). He also participates
in an ongoing supervision group at the Newport
Psychoanalytic Institute with Lawrence Hedges,
Ph.D., the institute’s founder.
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148. Biography: James Tobin, Ph.D., Licensed Psychologist
PSY 22074
Dr. Tobin is a former advanced candidate in
psychoanalysis at the Psychoanalytic Institute of New
England, East and former staff psychologist in the
Department of Psychiatry at the Massachusetts
General Hospital and Clinical Instructor, Harvard
Medical School. Dr. Tobin received an A.B. magna
cum laude in Psychology and Social Relations from
Harvard University, and a Ph.D. in Clinical Psychology
from The Catholic University of America in
Washington, D.C.
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