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Supervision: A Psychodynamic Approach

    On 31 Jan, 2024

Regular supervision is a professional requirement for therapists. It allows the clinician to reflect on their work, learn from their mistakes and grow as a therapist. Supervision is one of the ways the client is protected from unethical practices.

We spoke to three psychologists about their approach to supervision: a psychodynamic psychotherapist, a therapist with expertise in Eye Movement Desensitization and Reprocessing (EMDR) and a couples therapist using Emotionally Focused Therapy (EFT). We asked them how they became supervisors and what the structure of their supervision sessions looked like. In addition, we also asked them what they enjoyed about being a supervisor.

Contemporary psychodynamic therapy

In the first part of this series, we spoke to Tima El Jamil, a psychodynamic therapist at MapleTree Psychotherapy. Tima has a PhD in Clinical Psychology from St. John’s University in New York. She specializes in acute and developmental trauma as well as interpersonal difficulties. Tima describes her approach to therapy as one with ‘a strong relational bond’.

Tima explains further that she works in a contemporary analytical way. As a therapist, she is highly interactive, constantly assessing and monitoring the relationship in the room. She discusses transference issues and works through the patient’s original traumas through the therapeutic relationship, and not only within the trauma or the patient themselves. Tima describes her work as intimate, transparent and interactive.

Best of two worlds

Tima has 16 years of experience teaching clinical theory at both undergraduate and graduate levels. She has taught psychodynamic theories (contemporary, object relations, interpersonal theory and classic ego psychology approaches) and cognitive behavioral therapy (CBT). Hence, Tima is grounded in both theories and sees this as her strength. It helps her communicate with therapists with a CBT background, and she can be integrative in supervision. She has been supervising therapists since 2004. 

Tima says: ‘I fell in love immediately with supervising.‘  She found the best of two worlds, as she loves education and teaching, and she is passionate about clinical work. Offering supervision combines the worlds of education and therapy.

I can have a relationship with a supervisee who is having a relationship with their client. I can observe both and mentor both, indirectly and directly, both the supervisee and his or her client.

Tima El Jamil
Psychodynamic supervision

In supervision, Tima teaches supervisees to be present in the room with their patients. Junior psychologists may be anxious and may feel more guarded, boundaried and defended. Therefore, they are likely to take a more authoritative or educative approach with their patients. Tima’s approach is to be on equal par with the patient within the relationship in the room. 

Tima helps supervisees push boundaries and open up to the therapeutic process and the here-and-now. She finds it exciting to engage in this process with, for example, therapists with a CBT background, where this is a very new way for them to think about cases, approach the patient and understand their needs. Tima’s approach to supervision is also exciting to therapists with a psychodynamic or psychoanalytic background because the process can be taken to deeper levels. 

Transcripts of sessions

Tima doesn’t have a fixed structure for her supervision sessions. She explains, ‘I’m not very structured in the therapy room, so I’m not a very structured person in supervision.’ Tima encourages especially junior therapists to give her a transcription of the session as well as come prepared with their notes. Supervision is more effective when there is a transcript because then Tima knows exactly what is going on in the session. The supervisees also learn a lot more when they have transcribed sessions. They learn about what they said, why they said it, what they were feeling in sessions, and what the client may have intended by what they said. This allows the supervisor and supervisee to go much deeper.

The supervision sessions start with the supervisor and supervisee conceptualizing the case. They discuss the diagnosis and the personality character organization. The effect or impact of past traumas on the patient is explored. Tima and the supervisee discuss what trauma looks like and how it has played out in, for example, the patient’s interpersonal dynamics.

Next, the sessions move to the process. ‘Some of the questions I work on with the supervisee are: What is going on in the room? Where is there potentially an impasse? Where is the supervisee stuck? And, why might they be stuck?’, Tima explains. 

A therapeutic touch to supervision

According to Tima, the question of what the patient is triggering in the supervisee is a very important one. It forces the supervisee to explore themselves and their own personal struggles. Tima finds that this helps supervisees see what may get in the way of the therapeutic relationship or how it can be used to benefit the patient. When the supervisee uses themselves, their history and countertransference, they can begin to understand the patient and their experiences on a deeper level.

Tima concludes that sometimes supervision feels more like therapy. ‘There is sometimes an overlap between what therapy feels like and what a supervision session feels like because I ask my supervisees to become and learn to be very much in touch with the process in the room.

You can learn more about Tima’s approach to therapy and supervision here. In part two, we speak to trauma therapist and EMDR supervisor Shaima Al Fardan. Her interview can be read here. Then, in part three, we interviewed Beata Zielińska-Rocha, an EFT therapist and supervisor.  You can find her interview here.

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