Academic journal article American Journal of Psychotherapy

The Real Relationship in Psychotherapy Supervision

Academic journal article American Journal of Psychotherapy

The Real Relationship in Psychotherapy Supervision

Article excerpt

While the real relationship has long been addressed in psychoanalysis and psychotherapy, the matter of the real relationship in psychotherapy supervision has yet to receive any attention. Ample supervisory focus has indeed been given to the working alliance and transference-countertransference configuration (including parallel processes), but after a century of psychotherapy supervision, any mention whatsoever of real relationship phenomena is absent. In this paper, the following hypotheses are proposed: The real relationship (1) is a crucial component of the supervision relationship that has transtheoretical implications; (2) exists from the moment supervision begins until its end; (3) is the forever silent yet forever substantive contributor to supervisory process and outcome; (4) exerts a significant impact on (a) the development and establishment of the supervisory working alliance and (b) the unfolding and eventual utilization of the transference-countertransference experience in the supervisory situation; (5) consists of at least two dimensions in supervision-realism and genuineness-that vary along valence and magnitude continua (building on the works of Greenson and Gelso), and (6) deserves a place of eminence equal to the working alliance and transference-countertransference configuration if supervision theory, practice, and research are to be most fully informed. The possibility of using recent real relationship research in psychotherapy as a prototype to inform future research in supervision is presented, and two case examples are provided to illustrate the seeming power of real relationship phenomena in psychotherapy supervision.

KEYWORDS: real relationship; psychotherapy supervision; personal relationship; clinical supervision; realism; genuineness

INTRODUCTION

Over the course of the history of psychoanalysis, the real relationship has emerged as a meaningful yet puzzling concept, forever controversial yet forever enduring. Along with the therapeutic working relationship and transference-countertransference configuration, it has long been identified as a critical component of the psychoanalytic experience (Adler, 1980; Greenson, 1965, 1967, 1968; Greenson & Wexler, 1969). While Greenson can be credited with officially sanctioning the idea of "real relationship" (Frank, 2005), concern with that aspect of the analytic process - what has sometimes been referred to as the personal relationship - can actually be traced back to Freud's seminal case studies and some of his patients own published reports of their personal analyses with him (Couch, 1999). While one might expect a cool detachment and analytic neutrality to be what Freud's patients most remember, that does not appear to have been the case at all: Warmth, likability, personal attention, kindness, wit, and charm seem to have readily characterized their personal descriptions of him (see Blanton, 1971; Kardiner, 1977; Wortis, 1954). Although Freud (1911, 1912a, 1912b, 1913, 1914, 1915) identified and elaborated upon the rules of psychoanalytic technique (e.g., surgical detachment, anonymity), he does not appear to have implemented those rules in rigid, mechanistic fashion-absent attention to sensitivity, warmth, and respect for his patients under treatment.

As psychological treatment has evolved over the past century (Norcross, Vandenbos, & Freedheim, 2011), the concept of real relationship has not only maintained its place in psychoanalysis, but it also has been generalized more broadly to the practice of psychotherapy as a whole. Gelso (see Gelso & Hayes,1998), for example, has contended that: (1) all therapies involve a real relationship component, and (2) regardless of theoretical orientation, the real relationship is the forever silent, yet highly substantive contributor to the therapeutic exchange, perhaps even more fundamental than the alliance itself (Gelso, 2002, 2011). In the last decade, continuing dialogue about and research into the real relationship has seemingly escalated (Duquette, 2010; Frank, 2005; Gelso, 2002; Horvath, 2009; Wachtel, 2006), and some clear research directions and empirical findings have emerged (Gelso, 2009a, 2009b, 2011). …

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