Int J Psychoanal (2001) 82 71

SUPERVISIONA CONTAINERndashCONTAINED APPROACH

VIR GINIA R UN GAR AND LUISA BU SCH D E AHU M ADA BU ENOS AIRES

The authors illustrate an approach to the supervisory process as a learning experience forboth supervisee and supervisor built on the containment of unconscious anxieties It isargued that a core function of psychoanalytic supervision is to help contain the emotionalturbulence and the unconscious anxieties arising and evolving in the two interacting domainsof the analytic and the supervisory sessions From this perspective the analystndashpatientinteraction and that of the supervisee and supervisor can be understood as twin tieredtransformational arenas the supervisory one being at the service of holding and grasping theroles the superviseeanalyst goes through as part of the analytic process On the basis ofdetailed clinical material from a disturbed 7-year-old girl the authors explore the interrelat-ed issues and difficulties in containing anxieties and turbulence in both the analytic and thesupervisory situation W hen emotional containment is adequately handled the supervisionhelps the understanding and development of the superviseersquos use of hisher own personalityas a treatment instrument as advocated by Fleming and Benedek decades ago T he supervi-sory session thus furthers the resolution of clinical issues through symbol-formation clinicalsessions and supervision being twin domains for recording and understanding emotionalevolution1

In their classic paper lsquoSupervision a methodfor learning psychoanalysisrsquo F leming andBenedek (1964) hold that success depends onthe studentrsquos ability to develop and use his ownpersonality as an instrument in the treatmentprocess by means of achieving insight and self-discipline After learning from his experienceas a patient in his personal analysis to listen toassociations perceive multip le meanings andto use his interpretative functions on himselfthe candidate needs to learn how to apply thisin treating patients this is to continue to learnabout himself and to exercise his perceptive-ness his introspection and empathy focusingon a third party the patient The supervisinganalyst helps recognise learning blocks and toapply what he has learned of self-knowledge

and theory Citing H elen Ross F leming andBenedek present the supervising analystrsquos jobas Janus-like being simultaneously bothteacher and therapist They underline that thesupervisory situation deals with experiences asintimately affect-provoking as does the analy-sis itself such emotion-laden contexts they putforward as the overall frame for the supervi-sory lsquolearning alliancersquo

Arlow (1963) notes that the supervisor isaware that the student tells (and knows) a greatdeal more than is apparent in the record whichallows him he maintains the opportunity toobserve simultaneously the interactionbetween patient and analyst between analystand supervisor and finally the subtle effects ofthe organisational relationship to the institute

1 This is a revised and extended draft of a clinical presentation at the Barcelona Training Analyst Pre-CongressVirginia R Ungar is a training analyst and Luisa Busch de Ahumada was at the time a third-year candidate atthe Institute of the Buenos Aires Psychoanalytic Association

72 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

Arlow highlights how during the supervisorysession the therapist often unconsciouslyshifts in the presentation of his material fromreporting the data of his experience with hispatient in the role of the observer to lsquoexperi-encingrsquo the experience of the patient by way ofthe enactment of an identificat ion The recordof the analytic interaction having been editedunconsciously the supervisory session affordsthe studentanalyst the opportunity to relive intranquillity his emotional experiences with thepatient mainly the complex problems of hisability to tolerate empathic contact

In a comment on F leming and Benedekrsquoswork G rinberg (1970) also puts the accent onthe various layers of the supervisory field ana-lystndashpatient superviseendashsupervisor andpatientndashsupervisor As we attempt to approachclinically the supervisory process as an ongo-ing shared learning experience for both ana-lystsupervisee and supervisor we must begforbearance regarding the expository difficul-ties involved in describing the intertwinedissues at these diverse levels We shall focus clin-ically on the containment of anxieties in bothanalytic and supervisory sessions In the case tobe approached this will involve describing theevolution of the clinical process from an initia lstate of fragmentation and massive enactmentthrough incipient (though in this case reversed)individuation amid emotional turbulence to itsresultant genuine symbol-formation as a crea-tive transformation We shall consider in detailclinical materia l from a girlrsquos analysis addingthe impressions of both supervisee and super-visor To the clinica l record of the analyt ic ses-sions reconstructed on the same day andappearing in italics with the analyst mostlyusing the first person we add the drawings onwhich much of the material centres To recordthe supervisory process each of us took notesafter the supervisory sessions

The fact that this clinical presentation iswritten by both supervisor and supervisee iswitness to a shift of emphasis which emergeswhen we compare the themes of the previousCongress at San Francisco lsquoThe multiple func-tions of the supervisorrsquo with the theme of the

present Barcelona Training Analystsrsquo Confer-ence lsquoLearning in the supervision a mutualexperiencersquo This more explicit passage from aone-person to a two-person psychology in theapproach to the handling of psychoanalyticsupervision is but a further unfolding of thewider understanding of the analytic processcontinuing from the sixties As we hope tomake explicit a shift from a one-person to atwo-person psychology framework allows us tore-examine the supervisory task in terms of atwo-tiered containerndashcontained model Aboveand beyond whatever more direct teaching thesupervisor provides it will be the supervisorrsquostask to help trace contain and disclose theimpact of the unconscious anxieties the analystmay not have managed sufficiently and thor-oughly to think through in the analytic ses-sions This back-and-forth dynamic betweenthe two scenes the session and the supervisionis to our eyes the fulcrum for lsquolearning fromexperiencersquo in the supervision As held byArlow F leming and Benedek and G rinbergthe patientrsquos emotions and psychopathologyare on the one hand the object of study for thesupervision and on the other hand they arethe primum movens at the supervisory situa-tion of the ongoing unconscious processesthat supervision must help contain and deci-pher We prefer to use the terms lsquosharedrsquo as dis-tinct from lsquomutual experiencersquo to emphasiseour conceptual differences from the lsquointersub-jectivityrsquo stances which are inclined to considerthe intermixing of personal boundaries as theprocess goes on as not just unavoidable butalso as therapeutic in itself

As we see it each aspect of the Eitingon tri-pod has its function To the candidatersquos coreexperiences in his ongoing training analysissupervision adds a coexistent experientiallearning arena allowing himher to work uponfrom diverse vertices his countertransferenceand his projective counter-identificatio ns withhis analysandrsquos psychic turmoil The supervi-sory ideology here is based on the idea of help-ing and containing the therapist rather than ondirect teaching or correcting As long as thereare hints of an ongoing clinical process and

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 73

unless the interpretive process appears tohinder it the supervisor strives not to interfereor raise objections whether or not the therapistchooses to take the roles allotted by the patientTo give an example whether or not the analystdecides to let the child clean her dirty hands onher clothing is thought to be part of the thera-pistrsquos personal style Only in the case where theprocess comes to an impasse would it be theoccasion to review more actively what went onU nless and until this happens the supervisorhelps to support grasp and put further intowords the ongoing issues

BACK GR OU ND MATER IAL

I now present some data now on Valeria a7-year-old girl sent for treatment because ofher bizarre behaviour at school and her severelearning blocks The youngest of three chil-dren she has a sister several years older and abrother older by two years Her father in hisearly fifties is retired Previously he happenedto spend months and months at work awayfrom home The mother a teacher in her earlyforties not currently working volunteered thatshe was used to making decisions and manag-ing the children U nable to learn to read andwrite Valeria was about to repeat her first yearat school It fell upon the school not the fam-ily to try to find out what was wrong with herThis led to a request for a diagnostic evaluationand then treatment Initia lly the mother per-haps characteristically did not want to recog-nise that the girl had emotional problems sheput it down to simple naughtiness She blamedValeriarsquos inability to read and write on the inex-perience of present-day teachers pointing outthat it was the school that had requested a con-sultation they wouldnrsquot be requesting it bythemselves The father accepted Valeriarsquosnaughtiness but was surprised that to give anexample lsquoif a shoelace is longer than the othershe wonrsquot walk till this is sorted out or sherefuses to walk so that the soles of her shoesdonrsquot get dirty and she canrsquot wait when prom-ised something she cries and relentlessly

demands until she gets itrsquo The mother volun-teered falsely that Valeria got along well withschoolmates that she was invited out every-where (it turned out that she was actually uni-versally shunned) She was not close to herolder sister but played a lot with her brotherM ostly they got along well but sometimes theyfought Predictably the parentsrsquo attitudesmade negotiating the setting difficult It wasfinally agreed to start thrice-weekly sessionswhich while infrequent enough was the mostthey would agree to As she had been evaluatedelsewhere Valeriarsquos first interview was dealtwith as her first analytic session

The mother who brought her in stayed inthe waiting room while Valeria followed me tothe consulting room She ran through the cor-ridor stamping her feet She spoke loudly andconstantly moved about aimlessly whichseemed to be her way of venting her anxietiesIntroducing myself I asked her whether sheknew what she had come for Valeria did notanswer The alternative which was often thecourse she took would be her respondingloudly or shouting often with no evident senseAt times she put her hands on her hips andshouted lsquoSi-lencersquo or repeated ly lsquoThe confer-encersquo When asked what she meant she did notrespond She kept away from toys but she didpick up a pad on the back of which she drewsaying lsquoitrsquos for yoursquo Starting on the second orthird session she came in saying lsquoShit fartpeersquo and she duly farted which she was able todo at will She sat on me and farted lsquoSo thatyou get all smellyrsquo She used up pads of paper inno time making balls she then threw at meoften saying lsquoItrsquos shitrsquo Sometimes she shotthem at my chest lsquoSo that you have shit on yourtitsrsquo Alternatively she made food out of plasti-cine sausages hamburgers gnocchi or pota-toes She was usually on the move and spokealmost constantly At times she climbed on to achair and then asked me for a handmdashshe wasafraid of falling and cautious in this sense Shesang screaming tunelessly that she was aclown that her mother was a clown that herfather was a clown and then it all started overagain This created a stream of lsquofart-shit-peersquo

74 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

and verbal attacks openly enacted and enunci-ated Some sessions revealed her attempts tokeep herself together by way of obsessivedefences She often sharpened her pencilswashed her hands when she touched anythingor she obsessively tidied and reordered her toy-box

Amid such chaos an initia l supervisor sug-gested dyadic interviews including the motherValeria did not want her mother to enter theconsulting room She turned her back on hershouting lsquoG o away go awayrsquo The motherreplied sententiously that she should not betreated like this This went on and on Aftersome time Valeria asked her mum to draw hera Christmas tree to which the mother repliedthat she should do it herself because she didknow how to do it herself Valeria insisted andthe mother responded stereotypically despitemounting anguish and suffering F inally thegirl lay down whimpering in front of the doorI asked the mother to cuddle her which she diduntil Valeria calmed down The mother com-mented lsquoYou are naughtier than everrsquo In a sec-ond interview Valeria drew a sun within acircle and the mother commented lsquoH ow nice Ilike you to draw whatever you want but you putthe sun in a globe poor sun he doesnrsquot like it but do as you want poor sun I like you to drawwhat you want but poor sun helliprsquo Valeriastopped drawing amid growing devita lisationand despair This illustrates the paradoxicalinteractions I thought that Valeria might wellwant to stop her mother and that her shoutinglsquoSi-lencersquo to me presumably had to do withthat As an observational field this was interest-ing enough but in view of the anxieties involvedit seemed prudent to put a stop to interactionalinterviews

The sequences described kept up during thefirst sessions and indeed alternated for manymonths from then on She shouted fartedinvented and sang unmelodious songs and shedid not answer when questioned N o discerni-ble playing emerged Another item which alsostarted in the first weeks and continued fromthat time was her writing lsquoM om D ad ValeriaAlbertorsquo completely covering the sheet with

no blank spaces This she wrote from memoryjust as if she were drawing with no acknowl-edgement of what a letter lsquomeansrsquo that is oftheir having a definite sound and somehowlinking up to form words She knew each let-terrsquos name M y general attitude was to followher around trying to keep emotional contactand striving to receive her projections in thehope of modulating them whatever this meantin such a context When she was drawing let-ters I would tell her that she must feel in quitea bind when pushed into a situation in whichshe must know how to write when she did notI would add that it must be difficult to be toldby her mother or teacher to lsquogo on writersquo whenshe did not know how to and so she went ondrawing these memorised words This line ofthought led later on to her playing the role ofteachermother while ascribing to me the roleof the girl Valeria lsquowho does not knowrsquo and wasurged to lsquodo what you canrsquo

For the next few months of treatmen t atwhich time the training supervision startedsuch a pattern emerged at times amid theongoing apparently senseless barrage of ver-bal and enacted attacks As mentioned shewould more and more often take the role of thedemanding motherteacher while I wasascribed that of the girl Valeria who must beforced to learn how to write In her role asmotherteacher she controlled and gave ordersto me at times aggressively at others less soLitt le by litt le within this high-speed turmoilof orders indicat ions and changes of context itbecame clearer whether she was being motheror teacher At this time and in contrast to herinitia l sessions in which she obsessively kepther toy-box scrupulously neat it was messydirty and full of broken things When she couldnot find something in her messed-up box shegot paranoid (lsquoSomebody must have taken itoutrsquo) On the days following a a holiday or sick-ness break or whenever she was brought in byher mother and not by her father as usual ses-sions seemed especially chaotic Often shecame in shouting lsquoShit fart peersquo lsquoF uck yoursquoor lsquoShit shit shitrsquo At other times she got on tothe table on all fours and farted in the four

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 75

direct ions Whenever she came at her most hos-tile she ended up anguished and fearful in acorner mostly against the door saying lsquoLetme let mersquo A displacemen t of hostility wasenacted on the pillows She stamped on themand somewhat later verbalised what she wasdoing lsquoI stamp on you and on what you sayrsquoAt other times she wanted to clean her handson my clothing when they were wet or dirtyfrom the plasticine

When she was in a better mood she justordered me about Her indications to do this orthat revolved around school and schoolworksaying to me lsquoWrite do it just as it comes outrsquoAt first she did not give herself any particularname then in what retrospectively appears to bea significant enough index of an ongoing indi-viduation process she started to call herselfLuciacutea when she enacted the mother or theteacher

As a way to get out of her often manifeststate of terror after her triumphant mood shelsquomeasuredrsquo me up (my feet my back) with sell-otape used as metr ic tape or she tied my feetwith it A few times later on she got out of herterror by lying on the couch and putting herfeet on my lap and rocking them softlymdashlsquoPlay-ing as a baby does with her mumrsquo I told hermdashand then she would ask me to tie her shoelacesup which seemed to convey some request forhelp Also and mostly towards the end of thehour in the last ten or fifteen minutes she cameto celebrate a birthday sometimes mine as thegirl Valeria at other times that of another sonAlberto At those times there was plenty offood around She might send me to the shop tofetch it (lsquoGo go you are already a big girlrsquo) orshe might cook it herself using plasticine as theingredientsmdashpastries sausagesmdashand insistedthat I ate it all She never spoke about whathappens out of sessions except to say that shehad a cat or about a trip she took which sheexplained to me by way of lsquomapsrsquo Amid thisraucous and repetitive material my interpre-tive attempts at intervention centred alterna-tively on her confusion and on how badly shecame to feel when she unleashed her aggression

or I focused on her feelings of triumph as hap-pened after she stamped on the pillows

The session to be presented took place aftera year of treatment five months into the super-vision

A SUPERVISOR Y SESSION

At the start Valeria ran along the corridorand closed the door to the consulting roomshutting me out Through a crack she said qui-etly lsquoWait two minutes OK rsquo Sitting in mychair she took her folder drawing pad pencilsetc from her box and said lsquoReadyrsquo

Sounding important (seemingly in the roleof the teacher) she said lsquoTake out a sheetToday we will have a little task You cut moonsout like this and afterwards we will stick theminrsquo I asked her to explain to me how shewanted the moons to look and the girl drew acloud on the sheet of paper instead and saidlsquoG o on draw and cut out moons in all coloursI will tell you afterwards what to dorsquo I dutifullydrew and cut out the cloudmoons while Vale-ria silently cut out and stuck scraps of variouslycoloured shiny paper on to a sheet of papergrouped by colours Then she said lsquoGive methe moonsrsquo She stuck them on folded sheets ofshiny paper around the coloured scraps alreadystuck on I asked her what it was that she didand she answered lsquoD onrsquot you see M oonsmoons sitting on the chairs Itrsquos a tiny task amaquettersquo (see F ig 1)

In supervision the analystsuperviseeremarked lsquoI think Valeria felt very importantand proud in my chair She was the one whoknew the one to be admired She felt thatsomehow she had placed herself at the centre ofthe space she has been shaping with the shinypaper and the cloudmoons in their chairsadmiring herrsquo The game her being left out atthe start while the girl arranged the setting orbeing out of her normal chair failed to get thetherapist to feel excluded or irritated she feltthat as analyst she had been quite genuinelyready to accept the allotted roles

76 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

When she was done Valeria headed for thedoor and attempted to pin up the sheet ofpaper on it It fell She tried again and saidlsquoCome on help memdashcanrsquot you see itrsquos fallingoffrsquo I helped her and we stuck it up on thedoor inside the playroom (In the next sessionshe threw this sheet of paper into the rubbishbin I rescued it later on)

On looking at the drawing the supervisorwas amazed After all we had been working forjust a few months with this highly disorganisedgirl who at the start amid evacuative outburstsand enormous excitement was quite unable toset up orderly game sequences Then repetitivegames set in involving a teacher and a pupilwho wrote down isolated letters the names sheuttered for the letters did not coincide with thelet ters she wrote her drawings too were quitechaotic N ow in the present drawing the ele-

ments were grouped together and surroundedby bars which suggested containment thecloudmoons lsquosatrsquo on these bars

The supervisor commented that the girl hadfirst asked her analyst for moons but then sheherself drew a cloud instead and the analyst fol-lowed suit The analyst remarked that she hadhesitated and then had done as the girl hadfinally requested She asked if she did right stat-ing more generally that if the supervisor did notconsider it to be right she should tell her andcorrect hermdashthat she should not be afraid to doso The supervisor answered that it was not herway of supervising to tell her if she did right orwrong When an analytica l process is underway the setting and the analytica l situation areinstalled she would rather watch and makeremarks to observe jointly how the transferencerelationship evolved The supervisor went on

F igure 1

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 77

Figure 2

78 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

to say that the analyst herself might have cor-rected the patient telling her that what she haddrawn was not a moon but a cloud

Since the analyst had decided not to andthat it would be best now to see the effects onthe session of keeping to the mooncloud con-fusion her impression was that by not cor-rect ing her patient and taking to the role ofpupil the analyst had helped sustain the pro-jection of the role of lsquothe girl who does notunderstandrsquo This seemed to lead to some-thing that the girl in the role of analyst stuckon pieces of paper and then lsquoassembledrsquo a con-tainer around it We agreed that keeping to theconfusion in the session might have allowedsome element related to the cloudmoons toshow up upon the analystrsquos taking the role oflsquothe girl Valeria who does not knowrsquo Thesupervisor remarked that compared to thisgirlrsquos usual evacuative outbursts these inter-changes would seem nicely to fit Bionrsquos (1962)idea of thought involving alpha-functionwhich requires an object containing the pro-jections and returning them in more organisedmanners with some anxieties processed Suchan objectrsquos reverie function seemed to havepermitted Valeria to put herself together andturn on her own alpha-function

The clinical narrative shows that the analystpartly grasped what had happened Readingthe session again and talking about it it grewmore articulated in her mind It is notable thatfor the first time in all these months the ana-lystsupervisee asked for correction she firsttook this event to be a simple react ion of with-drawal in the face of what took place but at asecond view and as is again apparent in thefollowing paragraphs this request for correc-tion would seem to correspond precisely to anenactment in the supervisory session of therole of the lsquogirl that doesnrsquot knowrsquo or the lsquogirlin the wrongrsquo which Valeria consistently pro-jected into her in the sessions

Valeria said lsquoAll right now wersquoll carry outanother lit tle assignment Write this downCopy it out This is a story which Irsquoll tell youlaterrsquo (She named each let ter while writingthem down) lsquoAnd here it says ldquopipipirdquorsquo (She

drew rays emanating from it) lsquoAnd now draw aspring flower (spring had started just five daysbefore this session) and write ldquopri-ma-ve-rardquorsquo(lsquospringrsquo in Spanish she spelled the word outthough with mistakes) As she said this shewrote the word on her own sheet of paper (F ig2) while I had to do the same on anothersheet lsquoVery good Now make two hearts gotogether like this (she drew lines linking them)and two balloons Remember that you areValeria the girl and Irsquom Luciacutea the teacherYou are 7 years old and Irsquom 40rsquo She wrotedown 7 and 40 and drew a square aroundthem Then she linked each by a line to thedrawing of the hearts

Faced with the girlrsquos drawing the supervi-sor noticed that for the first time she had writ-ten a word lsquopimabrarsquo The analyst hadrealised this as it happened and then wasfrightened by the idea that the parents mightpull the girl out of treatment as soon as shelearned to write so she felt ambivalent aboutthis development The supervisor remarkedthat it would seem that when the analyst man-aged to accept the identificatory projection ofan infantile aspect of the self that misunder-stood and felt misunderstood the girl man-aged to write her first word She added thatbesides feelings of mutual love the two linkedhearts might point also to two minds workingtogether and also that the drawing wouldseem to appear as a sort of blend of a familytree and a family organisational introductorychart with the ages of each Luciacutea the 40-year-old teacher and Valeria the 7-year-old pupilAt that point the supervisor realised that theword Luciacutea contained almost the same letter swith just one misplaced vowel as Luisa theanalystrsquos first name and asked if the girl andher family called her this or her more usualnickname She said surprised that they calledher Luisa not knowing her nickname

To the supervisor this seemed to supportthe notion that the word lsquospringrsquo so obviouslylinked to budding birth and flowering pointsto a creative link-up of two heartsmindsworking together Perhaps also the budding ofthe ability the development of which would of

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 79

course demand some lengthy work of learningto share with others mainly her peers

We went on with the session Valeria askedordered me to continue working lsquoAnd we putldquoChrdquo of cheese ldquocherdquo ldquocheerdquo2 and draw anapple with the little stick and five fingers(counts up to five) It has eyes and a mouthand two different feetmdashthatrsquos wrongrsquo She cor-rected one of the feet on my sheet She gave mea small piece of shiny paper and assignedanother to herself lsquoAnd now write on ldquoprimav-erardquo and the flower and you and mersquo Sheasked me to draw two squares with the ages 40and 7 She continued lsquoM ake a house and atreemdashdonrsquot worry just do it as well as you canEveryone does it as well as they canrsquo I inter-preted lsquoWhen we do lit tle assignmentstogether and you are the one who knows andyou teach me you get everything rightrsquo

Valeria looked attentively and said lsquoYeswersquore right arenrsquot we N ow write the headlineand underline it N ow Irsquoll tell you the story(Pretended to read) Once upon a time therewas a mother and a daughter and the motherwould tell the father ldquoYou go to the shoppingmallrdquo The mother and the children went outfor a while and went to M cDonaldrsquos and hadsodas and then went to the park and the fatherwas at the mall and then they came back homeand thatrsquos the end of the storyrsquo

It was the end of the session Valeria put thematerial in her box including the drawingwhich was stuck on the door

As the supervisory session also drew to itsend the supervisor mused on the effects of theanalystrsquos intervention on this last lsquostoryrsquo nar-rated by Valeria which might restate thecourse of the work carried out together withthe ages in a little square The flagrant demiseof the father whom the mother lsquoordersrsquo to theshopping mall while she and their children gofor an outing drives the girlrsquos felt experience(most likely related to a denial of the primalscene in the link to both therapist and mother)that for the time being the father has beenrejected

CONTAINMENT AN D TEACH ING IN THE

APPR OACH TO TH E SUPERVISORY PROCESS

We find the supervisory experiencedescribed has been apt for containing anxietiesand for thinking out the events of the sessionsupplying a frame for the emotional develop-ments leading to the patientrsquos first writtenthought-out word pimabra as distinct fromthose drawn from memory The analyst beingpart of the ongoing process was aware of somebut only some dimensions of what went onwhich illustrates the various levels encom-passed by lsquomaking the unconscious consciousrsquoAs her final interventionmdashlsquoWhen we do littleassignments together and you are the one whoknows and you teach me you get everythingrightrsquomdashshows she clearly perceived how andwhy roles were allotted in the actual contextbuilt by the evolving anxieties allowing thechild-analysand free use of the denial implicitin her demand that in the play context theyswitch their identit ies She was not howeverfully aware of the ongoing advances in theprocess of symbol-formation As the sayinggoes one cannot write history while making it

The supervisory session transcribed illus-trates containment at two transformationallevels On the one hand at that of the patientwho after putting together in her maquette herown experience of emotional containmentdrew two linked hearts along with her firstwritten word The result of an evolving emo-tional containment stands represented by thisaccomplishment of symbol-formation thejoint initials of patient and analyst with theirsupposed (but reversed) ages enclosed withina box The second level of transformation cor-responds to the supervisorsupervisee link Toput it in Arlowrsquos terms this has to do with thefact that being target to the unconscious anxi-eties of the analytic process the supervisee feelsand knows more than what she has managedto lsquothink throughrsquo and can become apparent inthe record This is the sphere of transforma-tions at the level of psychoanalytic awareness

2 lsquoQue Qui Quorsquo in Spanish

80 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

It must be surmised here that the supervisorrsquosgreater distance from the emotional scenehelped quite a bit It allowed her to grasp thehomology Luciacutea-Luisa illuminating the activeidentificato ry processes in the ongoing reversalof identities in the session

The clinical example presented demon-strates the difficulties inherent in emotionallyframing and instancing creative symbol-for-mation difficulties resulting from the emo-tional turbulence falling upon both membersin the analytic sessions Containment of theongoing anxieties and the opportunities itopens up for an emerging creativity in the ses-sion has required in the case of the analysanda domain of action to be shared with an analystwho can somehow be both lsquooutsidersquo andlsquoinsidersquo the psychic turbulence involved This isalso valid for the handling of the clinical mate-rial in supervision Session and supervisionthus turn into coexistent arenas for recordingand grasping emotional developments

The supervisory approach presenteddeparts as much as circumstances allow fromdirect lsquoteachingrsquo and it privileges the contain-ment and disclosure of the superviseersquos una-voidable anxieties that are part and parcel ofthe course of her analytic task In the Janus-likedilemma of the supervisor a dilemma whichparaphrasing F leming and Benedek can bethought of in terms of containment versusteaching it is our belief that the converse direc-tive teaching approach on the part of the super-visor tends to increase the paranoid anxieties inthe supervisory situation at the expense of con-tainment

It is a main tenet of this presentat ion that theactual learning process within the supervisoryexperience can be better obtained by the super-visorrsquos facilit ating attitude This facilitatio n canonly take place when a sufficient degree ofholding to and grasping of the vicissitudes ofthe superviseersquos involvement in the analyticprocess itself is achieved The supervisorymaterial presented documents the superviseersquostendency to fall into the role of the pupil at thetime when she asks to be told whether she actedcorrect ly H owever the supervisory stance

described may well have helped the analystbear the role of lsquopupilrsquo her patient so stronglyforced her into It may foreseeably have beentoo hard on her to bear the brunt of beinglsquopupilrsquo on both sides in which case we can sur-mise our stance which approaches the supervi-sorrsquos role somewhat to the side of the holdingfunctions of the analyst in session has helpedmake proper place for our little patientrsquos needto assign roles to her analyst and have themsustained The dangers of an overzealoussupervisorteacher pushing the superviseeana-lyst in the pupilrsquos place has been previously andto our mind duly stressed by Solnit (1970) Aswe envision it supervision furthers the recon-sideration of the therapistrsquos clinica l task pro-moting the examination of the evidence thesharing of doubts and the harbouring of evolv-ing ideas

Bearing the solitude of our psychoanalyticwork is in the best of cases problematic evenseasoned analysts need to talk over informallywith colleagues the events in their consultingrooms and have them help think these out Wehope our paper allows the reader to share inwhat supervisee and supervisor learned fromthis difficult but rewarding analytic experience

TRANSLATION S OF SUMMAR Y

Les auteurs illustrent une approche du processusde supervision comme une expeacuterience drsquoapprentissagepour le superviseacute et le superviseur qui est construite surla capaciteacute de contenir les angoisses inconscientesElles montrent qursquoune des fonctions centrale de la su-pervision psychanalytique est drsquoaider agrave contenir lrsquoagi-tation eacutemotionnelle et les angoisses inconscientes quisurgissent et eacutevoluent dans les deux domaines interac-tifs de la seacuteance analytique et de la seacuteance de supervi-sion Dans cette perspective lrsquointeraction analyste-patient ainsi que celle du superviseacute et du superviseurpeuvent ecirctre comprises comme des espaces de trans-formation superposeacutees jumelles lrsquoespace du supervi-seur eacutetant au service de contenir et de comprendre lesrocircles agrave travers lesquels va lrsquoanalyste superviseacute en tantque partie du processus analytique Agrave partir du mateacute-riel clinique deacutetailleacute drsquoune fille troubleacutee de 7 ans lesauteurs explorent les problegravemes relieacutes entre eux et lesdifficulteacutes preacutesenteacutees pour contenir les angoisses etlrsquoagitation preacutesentes agrave la fois dans la situation analyt-ique et en supervision Lorsque la capaciteacute de contenir

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 81

les eacutemotions est adeacutequate la supervision contribue agrave lacompreacutehension et au deacuteveloppement de lrsquoutilisationpar lela superviseacute(e) de sa propre personnaliteacute en tantqursquoinstrument du traitement ainsi que lrsquoont montreacuteF leming et Benedek il y des deacutecades de cela La seacuteancede supervision favorise donc les reacutesolutions des pro-blegravemes cliniques agrave travers la formation de symbole lesseacuteances cliniques et la supervision eacutetant des domainesjumeaux pour enregistrer et comprendre lrsquoeacutevolutioneacutemotionnelle

Die Autoren stellen einen Zugang zum Supervisi-onsprozess dar der ihn als eine Lernerfahrung fuumlrSupervisanden und Supervisor ansieht die auf demContainment von unbewussten Aumlngsten beruht Sieargumentieren dass es eine Hauptfunktion psycho-analytischer Supervision ist dazu beizutragen dieemotionale Verstoumlrung und die unbewussten Aumlngstedie in den zwei interagierenden Bereichen der ana-lytischen und der Supervisionssitzungen auftauchenzu containenldquo Aus dieser Sichtweise lassen sich dieInteraktion zwischen Analytiker und Patient und diezwischen Supervisanden und Supervisor als gleicharti-ge gestufte Transformationsbereiche verstehen wobeider Supervisionsbereich dazu dient die Rollen die derSupervisandAnalytiker durchlaumluft zu halten und zuverstehen Mithilfe von ausfuumlhrlichem klinischem Ma-terial von einem gestoumlrten 7-jaumlhrigen Maumldchen unter-suchen die Autoren die miteinander verbundenenProbleme und Schwierigkeiten die Aumlngste undStoumlrungen in der analytischen und der Supervisionssi-tuation zu containenldquo Wenn emotionales Contain-ment adaumlquat gehandhabt wird hilft die Supervisiondie Verwendung der Persoumlnlichkeit des Supervisandenals Behandlungsinstrument zu verstehen und zu ent-wickeln wie es F leming und Benedek vor Jahrzehntenvertraten Die Supervisionssitzung hilft auf diese

Weise klinische Probleme durch Symbolbildung auf-zuloumlsen wobei therapeutische Sitzungen und Supervi-sion gleichartige Bereiche zur Erfassung und zumVerstehen emotionaler Entwicklung sind

Las autoras enfocan el proceso de la supervisioacutencomo una experiencia de aprendizaje tanto para elsupervisado como para el supervisor la cual se lleva acabo sobre la contencioacuten de las ansiedades incon-scientes Se sostiene que lo esencial de la funcioacuten de lasupervisioacuten psicoanaliacutetica es contribuir a contener laturbulencia emocional y las ansiedades inconscientesque surgen y evolucionan en dos terrenos que inter-actuacutean entre siacute el de las sesiones de anaacutelisis y el de lassesiones de supervisioacuten Desde esta perspectiva lasinteracciones analistandashpaciente y supervisado-supervi-sor pueden ser consideradas como espacios abiertoscon gradas gemelas y cambiantes estando el espaciode la supervisioacuten al servicio de sostener y apuntalar elque las funciones del analistasupervisado sigan ade-lante ya que son parte del proceso analiacutetico Partien-do de un material cliacutenico expuesto en detalle yrelativo a una nintildea de 7 antildeos que presentaba muchosconflictos las autoras estudian algunos puntos inter-relacionados y las dificultades para contener las ansie-dades y los conflictos tanto en la situacioacuten analiacuteticacomo en la de supervisioacuten Cuando los contenidosemocionales son manejados de un modo adecuado lasupervisioacuten contribuye a la comprensioacuten y tambieacuten almejor uso de la misma personalidad del supervisadoacomo instrumento del tratamiento tal como fue de-fendido por F leming y Benedek hace algunas deacutecadasEs de este modo como las sesiones de supervisioacuten con-tribuyen a la solucioacuten de algunos aspectos cliacutenicos atraveacutes de la formacioacuten de siacutembolos ya que las sesionescliacutenicas y la supervisioacuten son terrenos gemelos pararegistrar y comprender la evolucioacuten emocional

R EF ER ENCES

ARLOW J (1963) The supervisory situation JA mer Psychoanal A ssn 11 576ndash94

BION W R (1962) L earning from ExperienceLondon Heinemann

F LEMING J amp BENEDEK T (1964) SupervisionA method of teaching psychoanalysis Psycho-anal Q 33 71ndash96

G RINBERG L (1970) The problems of supervisionin psychoanalytic education Int J Psychoanal51 371ndash82

SOLNIT A J (1970) Learning from psychoanalyt-ic supervision Int J Psychoanal 51 359ndash62

Virginia R U ngar and Luisa Busch de Ahumada Copyright copy Institu te of Psychoanalysis London 2001Dr U ngarBillinghurst 2533 1425 Buenos Aires(Initia l version received 1698)(F irst revised version received 19799)(F inal revised version received 14600)

72 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

Arlow highlights how during the supervisorysession the therapist often unconsciouslyshifts in the presentation of his material fromreporting the data of his experience with hispatient in the role of the observer to lsquoexperi-encingrsquo the experience of the patient by way ofthe enactment of an identificat ion The recordof the analytic interaction having been editedunconsciously the supervisory session affordsthe studentanalyst the opportunity to relive intranquillity his emotional experiences with thepatient mainly the complex problems of hisability to tolerate empathic contact

In a comment on F leming and Benedekrsquoswork G rinberg (1970) also puts the accent onthe various layers of the supervisory field ana-lystndashpatient superviseendashsupervisor andpatientndashsupervisor As we attempt to approachclinically the supervisory process as an ongo-ing shared learning experience for both ana-lystsupervisee and supervisor we must begforbearance regarding the expository difficul-ties involved in describing the intertwinedissues at these diverse levels We shall focus clin-ically on the containment of anxieties in bothanalytic and supervisory sessions In the case tobe approached this will involve describing theevolution of the clinical process from an initia lstate of fragmentation and massive enactmentthrough incipient (though in this case reversed)individuation amid emotional turbulence to itsresultant genuine symbol-formation as a crea-tive transformation We shall consider in detailclinical materia l from a girlrsquos analysis addingthe impressions of both supervisee and super-visor To the clinica l record of the analyt ic ses-sions reconstructed on the same day andappearing in italics with the analyst mostlyusing the first person we add the drawings onwhich much of the material centres To recordthe supervisory process each of us took notesafter the supervisory sessions

The fact that this clinical presentation iswritten by both supervisor and supervisee iswitness to a shift of emphasis which emergeswhen we compare the themes of the previousCongress at San Francisco lsquoThe multiple func-tions of the supervisorrsquo with the theme of the

present Barcelona Training Analystsrsquo Confer-ence lsquoLearning in the supervision a mutualexperiencersquo This more explicit passage from aone-person to a two-person psychology in theapproach to the handling of psychoanalyticsupervision is but a further unfolding of thewider understanding of the analytic processcontinuing from the sixties As we hope tomake explicit a shift from a one-person to atwo-person psychology framework allows us tore-examine the supervisory task in terms of atwo-tiered containerndashcontained model Aboveand beyond whatever more direct teaching thesupervisor provides it will be the supervisorrsquostask to help trace contain and disclose theimpact of the unconscious anxieties the analystmay not have managed sufficiently and thor-oughly to think through in the analytic ses-sions This back-and-forth dynamic betweenthe two scenes the session and the supervisionis to our eyes the fulcrum for lsquolearning fromexperiencersquo in the supervision As held byArlow F leming and Benedek and G rinbergthe patientrsquos emotions and psychopathologyare on the one hand the object of study for thesupervision and on the other hand they arethe primum movens at the supervisory situa-tion of the ongoing unconscious processesthat supervision must help contain and deci-pher We prefer to use the terms lsquosharedrsquo as dis-tinct from lsquomutual experiencersquo to emphasiseour conceptual differences from the lsquointersub-jectivityrsquo stances which are inclined to considerthe intermixing of personal boundaries as theprocess goes on as not just unavoidable butalso as therapeutic in itself

As we see it each aspect of the Eitingon tri-pod has its function To the candidatersquos coreexperiences in his ongoing training analysissupervision adds a coexistent experientiallearning arena allowing himher to work uponfrom diverse vertices his countertransferenceand his projective counter-identificatio ns withhis analysandrsquos psychic turmoil The supervi-sory ideology here is based on the idea of help-ing and containing the therapist rather than ondirect teaching or correcting As long as thereare hints of an ongoing clinical process and

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 73

unless the interpretive process appears tohinder it the supervisor strives not to interfereor raise objections whether or not the therapistchooses to take the roles allotted by the patientTo give an example whether or not the analystdecides to let the child clean her dirty hands onher clothing is thought to be part of the thera-pistrsquos personal style Only in the case where theprocess comes to an impasse would it be theoccasion to review more actively what went onU nless and until this happens the supervisorhelps to support grasp and put further intowords the ongoing issues

BACK GR OU ND MATER IAL

I now present some data now on Valeria a7-year-old girl sent for treatment because ofher bizarre behaviour at school and her severelearning blocks The youngest of three chil-dren she has a sister several years older and abrother older by two years Her father in hisearly fifties is retired Previously he happenedto spend months and months at work awayfrom home The mother a teacher in her earlyforties not currently working volunteered thatshe was used to making decisions and manag-ing the children U nable to learn to read andwrite Valeria was about to repeat her first yearat school It fell upon the school not the fam-ily to try to find out what was wrong with herThis led to a request for a diagnostic evaluationand then treatment Initia lly the mother per-haps characteristically did not want to recog-nise that the girl had emotional problems sheput it down to simple naughtiness She blamedValeriarsquos inability to read and write on the inex-perience of present-day teachers pointing outthat it was the school that had requested a con-sultation they wouldnrsquot be requesting it bythemselves The father accepted Valeriarsquosnaughtiness but was surprised that to give anexample lsquoif a shoelace is longer than the othershe wonrsquot walk till this is sorted out or sherefuses to walk so that the soles of her shoesdonrsquot get dirty and she canrsquot wait when prom-ised something she cries and relentlessly

demands until she gets itrsquo The mother volun-teered falsely that Valeria got along well withschoolmates that she was invited out every-where (it turned out that she was actually uni-versally shunned) She was not close to herolder sister but played a lot with her brotherM ostly they got along well but sometimes theyfought Predictably the parentsrsquo attitudesmade negotiating the setting difficult It wasfinally agreed to start thrice-weekly sessionswhich while infrequent enough was the mostthey would agree to As she had been evaluatedelsewhere Valeriarsquos first interview was dealtwith as her first analytic session

The mother who brought her in stayed inthe waiting room while Valeria followed me tothe consulting room She ran through the cor-ridor stamping her feet She spoke loudly andconstantly moved about aimlessly whichseemed to be her way of venting her anxietiesIntroducing myself I asked her whether sheknew what she had come for Valeria did notanswer The alternative which was often thecourse she took would be her respondingloudly or shouting often with no evident senseAt times she put her hands on her hips andshouted lsquoSi-lencersquo or repeated ly lsquoThe confer-encersquo When asked what she meant she did notrespond She kept away from toys but she didpick up a pad on the back of which she drewsaying lsquoitrsquos for yoursquo Starting on the second orthird session she came in saying lsquoShit fartpeersquo and she duly farted which she was able todo at will She sat on me and farted lsquoSo thatyou get all smellyrsquo She used up pads of paper inno time making balls she then threw at meoften saying lsquoItrsquos shitrsquo Sometimes she shotthem at my chest lsquoSo that you have shit on yourtitsrsquo Alternatively she made food out of plasti-cine sausages hamburgers gnocchi or pota-toes She was usually on the move and spokealmost constantly At times she climbed on to achair and then asked me for a handmdashshe wasafraid of falling and cautious in this sense Shesang screaming tunelessly that she was aclown that her mother was a clown that herfather was a clown and then it all started overagain This created a stream of lsquofart-shit-peersquo

74 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

and verbal attacks openly enacted and enunci-ated Some sessions revealed her attempts tokeep herself together by way of obsessivedefences She often sharpened her pencilswashed her hands when she touched anythingor she obsessively tidied and reordered her toy-box

Amid such chaos an initia l supervisor sug-gested dyadic interviews including the motherValeria did not want her mother to enter theconsulting room She turned her back on hershouting lsquoG o away go awayrsquo The motherreplied sententiously that she should not betreated like this This went on and on Aftersome time Valeria asked her mum to draw hera Christmas tree to which the mother repliedthat she should do it herself because she didknow how to do it herself Valeria insisted andthe mother responded stereotypically despitemounting anguish and suffering F inally thegirl lay down whimpering in front of the doorI asked the mother to cuddle her which she diduntil Valeria calmed down The mother com-mented lsquoYou are naughtier than everrsquo In a sec-ond interview Valeria drew a sun within acircle and the mother commented lsquoH ow nice Ilike you to draw whatever you want but you putthe sun in a globe poor sun he doesnrsquot like it but do as you want poor sun I like you to drawwhat you want but poor sun helliprsquo Valeriastopped drawing amid growing devita lisationand despair This illustrates the paradoxicalinteractions I thought that Valeria might wellwant to stop her mother and that her shoutinglsquoSi-lencersquo to me presumably had to do withthat As an observational field this was interest-ing enough but in view of the anxieties involvedit seemed prudent to put a stop to interactionalinterviews

The sequences described kept up during thefirst sessions and indeed alternated for manymonths from then on She shouted fartedinvented and sang unmelodious songs and shedid not answer when questioned N o discerni-ble playing emerged Another item which alsostarted in the first weeks and continued fromthat time was her writing lsquoM om D ad ValeriaAlbertorsquo completely covering the sheet with

no blank spaces This she wrote from memoryjust as if she were drawing with no acknowl-edgement of what a letter lsquomeansrsquo that is oftheir having a definite sound and somehowlinking up to form words She knew each let-terrsquos name M y general attitude was to followher around trying to keep emotional contactand striving to receive her projections in thehope of modulating them whatever this meantin such a context When she was drawing let-ters I would tell her that she must feel in quitea bind when pushed into a situation in whichshe must know how to write when she did notI would add that it must be difficult to be toldby her mother or teacher to lsquogo on writersquo whenshe did not know how to and so she went ondrawing these memorised words This line ofthought led later on to her playing the role ofteachermother while ascribing to me the roleof the girl Valeria lsquowho does not knowrsquo and wasurged to lsquodo what you canrsquo

For the next few months of treatmen t atwhich time the training supervision startedsuch a pattern emerged at times amid theongoing apparently senseless barrage of ver-bal and enacted attacks As mentioned shewould more and more often take the role of thedemanding motherteacher while I wasascribed that of the girl Valeria who must beforced to learn how to write In her role asmotherteacher she controlled and gave ordersto me at times aggressively at others less soLitt le by litt le within this high-speed turmoilof orders indicat ions and changes of context itbecame clearer whether she was being motheror teacher At this time and in contrast to herinitia l sessions in which she obsessively kepther toy-box scrupulously neat it was messydirty and full of broken things When she couldnot find something in her messed-up box shegot paranoid (lsquoSomebody must have taken itoutrsquo) On the days following a a holiday or sick-ness break or whenever she was brought in byher mother and not by her father as usual ses-sions seemed especially chaotic Often shecame in shouting lsquoShit fart peersquo lsquoF uck yoursquoor lsquoShit shit shitrsquo At other times she got on tothe table on all fours and farted in the four

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 75

direct ions Whenever she came at her most hos-tile she ended up anguished and fearful in acorner mostly against the door saying lsquoLetme let mersquo A displacemen t of hostility wasenacted on the pillows She stamped on themand somewhat later verbalised what she wasdoing lsquoI stamp on you and on what you sayrsquoAt other times she wanted to clean her handson my clothing when they were wet or dirtyfrom the plasticine

When she was in a better mood she justordered me about Her indications to do this orthat revolved around school and schoolworksaying to me lsquoWrite do it just as it comes outrsquoAt first she did not give herself any particularname then in what retrospectively appears to bea significant enough index of an ongoing indi-viduation process she started to call herselfLuciacutea when she enacted the mother or theteacher

As a way to get out of her often manifeststate of terror after her triumphant mood shelsquomeasuredrsquo me up (my feet my back) with sell-otape used as metr ic tape or she tied my feetwith it A few times later on she got out of herterror by lying on the couch and putting herfeet on my lap and rocking them softlymdashlsquoPlay-ing as a baby does with her mumrsquo I told hermdashand then she would ask me to tie her shoelacesup which seemed to convey some request forhelp Also and mostly towards the end of thehour in the last ten or fifteen minutes she cameto celebrate a birthday sometimes mine as thegirl Valeria at other times that of another sonAlberto At those times there was plenty offood around She might send me to the shop tofetch it (lsquoGo go you are already a big girlrsquo) orshe might cook it herself using plasticine as theingredientsmdashpastries sausagesmdashand insistedthat I ate it all She never spoke about whathappens out of sessions except to say that shehad a cat or about a trip she took which sheexplained to me by way of lsquomapsrsquo Amid thisraucous and repetitive material my interpre-tive attempts at intervention centred alterna-tively on her confusion and on how badly shecame to feel when she unleashed her aggression

or I focused on her feelings of triumph as hap-pened after she stamped on the pillows

The session to be presented took place aftera year of treatment five months into the super-vision

A SUPERVISOR Y SESSION

At the start Valeria ran along the corridorand closed the door to the consulting roomshutting me out Through a crack she said qui-etly lsquoWait two minutes OK rsquo Sitting in mychair she took her folder drawing pad pencilsetc from her box and said lsquoReadyrsquo

Sounding important (seemingly in the roleof the teacher) she said lsquoTake out a sheetToday we will have a little task You cut moonsout like this and afterwards we will stick theminrsquo I asked her to explain to me how shewanted the moons to look and the girl drew acloud on the sheet of paper instead and saidlsquoG o on draw and cut out moons in all coloursI will tell you afterwards what to dorsquo I dutifullydrew and cut out the cloudmoons while Vale-ria silently cut out and stuck scraps of variouslycoloured shiny paper on to a sheet of papergrouped by colours Then she said lsquoGive methe moonsrsquo She stuck them on folded sheets ofshiny paper around the coloured scraps alreadystuck on I asked her what it was that she didand she answered lsquoD onrsquot you see M oonsmoons sitting on the chairs Itrsquos a tiny task amaquettersquo (see F ig 1)

In supervision the analystsuperviseeremarked lsquoI think Valeria felt very importantand proud in my chair She was the one whoknew the one to be admired She felt thatsomehow she had placed herself at the centre ofthe space she has been shaping with the shinypaper and the cloudmoons in their chairsadmiring herrsquo The game her being left out atthe start while the girl arranged the setting orbeing out of her normal chair failed to get thetherapist to feel excluded or irritated she feltthat as analyst she had been quite genuinelyready to accept the allotted roles

76 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

When she was done Valeria headed for thedoor and attempted to pin up the sheet ofpaper on it It fell She tried again and saidlsquoCome on help memdashcanrsquot you see itrsquos fallingoffrsquo I helped her and we stuck it up on thedoor inside the playroom (In the next sessionshe threw this sheet of paper into the rubbishbin I rescued it later on)

On looking at the drawing the supervisorwas amazed After all we had been working forjust a few months with this highly disorganisedgirl who at the start amid evacuative outburstsand enormous excitement was quite unable toset up orderly game sequences Then repetitivegames set in involving a teacher and a pupilwho wrote down isolated letters the names sheuttered for the letters did not coincide with thelet ters she wrote her drawings too were quitechaotic N ow in the present drawing the ele-

ments were grouped together and surroundedby bars which suggested containment thecloudmoons lsquosatrsquo on these bars

The supervisor commented that the girl hadfirst asked her analyst for moons but then sheherself drew a cloud instead and the analyst fol-lowed suit The analyst remarked that she hadhesitated and then had done as the girl hadfinally requested She asked if she did right stat-ing more generally that if the supervisor did notconsider it to be right she should tell her andcorrect hermdashthat she should not be afraid to doso The supervisor answered that it was not herway of supervising to tell her if she did right orwrong When an analytica l process is underway the setting and the analytica l situation areinstalled she would rather watch and makeremarks to observe jointly how the transferencerelationship evolved The supervisor went on

F igure 1

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 77

Figure 2

78 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

to say that the analyst herself might have cor-rected the patient telling her that what she haddrawn was not a moon but a cloud

Since the analyst had decided not to andthat it would be best now to see the effects onthe session of keeping to the mooncloud con-fusion her impression was that by not cor-rect ing her patient and taking to the role ofpupil the analyst had helped sustain the pro-jection of the role of lsquothe girl who does notunderstandrsquo This seemed to lead to some-thing that the girl in the role of analyst stuckon pieces of paper and then lsquoassembledrsquo a con-tainer around it We agreed that keeping to theconfusion in the session might have allowedsome element related to the cloudmoons toshow up upon the analystrsquos taking the role oflsquothe girl Valeria who does not knowrsquo Thesupervisor remarked that compared to thisgirlrsquos usual evacuative outbursts these inter-changes would seem nicely to fit Bionrsquos (1962)idea of thought involving alpha-functionwhich requires an object containing the pro-jections and returning them in more organisedmanners with some anxieties processed Suchan objectrsquos reverie function seemed to havepermitted Valeria to put herself together andturn on her own alpha-function

The clinical narrative shows that the analystpartly grasped what had happened Readingthe session again and talking about it it grewmore articulated in her mind It is notable thatfor the first time in all these months the ana-lystsupervisee asked for correction she firsttook this event to be a simple react ion of with-drawal in the face of what took place but at asecond view and as is again apparent in thefollowing paragraphs this request for correc-tion would seem to correspond precisely to anenactment in the supervisory session of therole of the lsquogirl that doesnrsquot knowrsquo or the lsquogirlin the wrongrsquo which Valeria consistently pro-jected into her in the sessions

Valeria said lsquoAll right now wersquoll carry outanother lit tle assignment Write this downCopy it out This is a story which Irsquoll tell youlaterrsquo (She named each let ter while writingthem down) lsquoAnd here it says ldquopipipirdquorsquo (She

drew rays emanating from it) lsquoAnd now draw aspring flower (spring had started just five daysbefore this session) and write ldquopri-ma-ve-rardquorsquo(lsquospringrsquo in Spanish she spelled the word outthough with mistakes) As she said this shewrote the word on her own sheet of paper (F ig2) while I had to do the same on anothersheet lsquoVery good Now make two hearts gotogether like this (she drew lines linking them)and two balloons Remember that you areValeria the girl and Irsquom Luciacutea the teacherYou are 7 years old and Irsquom 40rsquo She wrotedown 7 and 40 and drew a square aroundthem Then she linked each by a line to thedrawing of the hearts

Faced with the girlrsquos drawing the supervi-sor noticed that for the first time she had writ-ten a word lsquopimabrarsquo The analyst hadrealised this as it happened and then wasfrightened by the idea that the parents mightpull the girl out of treatment as soon as shelearned to write so she felt ambivalent aboutthis development The supervisor remarkedthat it would seem that when the analyst man-aged to accept the identificatory projection ofan infantile aspect of the self that misunder-stood and felt misunderstood the girl man-aged to write her first word She added thatbesides feelings of mutual love the two linkedhearts might point also to two minds workingtogether and also that the drawing wouldseem to appear as a sort of blend of a familytree and a family organisational introductorychart with the ages of each Luciacutea the 40-year-old teacher and Valeria the 7-year-old pupilAt that point the supervisor realised that theword Luciacutea contained almost the same letter swith just one misplaced vowel as Luisa theanalystrsquos first name and asked if the girl andher family called her this or her more usualnickname She said surprised that they calledher Luisa not knowing her nickname

To the supervisor this seemed to supportthe notion that the word lsquospringrsquo so obviouslylinked to budding birth and flowering pointsto a creative link-up of two heartsmindsworking together Perhaps also the budding ofthe ability the development of which would of

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 79

course demand some lengthy work of learningto share with others mainly her peers

We went on with the session Valeria askedordered me to continue working lsquoAnd we putldquoChrdquo of cheese ldquocherdquo ldquocheerdquo2 and draw anapple with the little stick and five fingers(counts up to five) It has eyes and a mouthand two different feetmdashthatrsquos wrongrsquo She cor-rected one of the feet on my sheet She gave mea small piece of shiny paper and assignedanother to herself lsquoAnd now write on ldquoprimav-erardquo and the flower and you and mersquo Sheasked me to draw two squares with the ages 40and 7 She continued lsquoM ake a house and atreemdashdonrsquot worry just do it as well as you canEveryone does it as well as they canrsquo I inter-preted lsquoWhen we do lit tle assignmentstogether and you are the one who knows andyou teach me you get everything rightrsquo

Valeria looked attentively and said lsquoYeswersquore right arenrsquot we N ow write the headlineand underline it N ow Irsquoll tell you the story(Pretended to read) Once upon a time therewas a mother and a daughter and the motherwould tell the father ldquoYou go to the shoppingmallrdquo The mother and the children went outfor a while and went to M cDonaldrsquos and hadsodas and then went to the park and the fatherwas at the mall and then they came back homeand thatrsquos the end of the storyrsquo

It was the end of the session Valeria put thematerial in her box including the drawingwhich was stuck on the door

As the supervisory session also drew to itsend the supervisor mused on the effects of theanalystrsquos intervention on this last lsquostoryrsquo nar-rated by Valeria which might restate thecourse of the work carried out together withthe ages in a little square The flagrant demiseof the father whom the mother lsquoordersrsquo to theshopping mall while she and their children gofor an outing drives the girlrsquos felt experience(most likely related to a denial of the primalscene in the link to both therapist and mother)that for the time being the father has beenrejected

CONTAINMENT AN D TEACH ING IN THE

APPR OACH TO TH E SUPERVISORY PROCESS

We find the supervisory experiencedescribed has been apt for containing anxietiesand for thinking out the events of the sessionsupplying a frame for the emotional develop-ments leading to the patientrsquos first writtenthought-out word pimabra as distinct fromthose drawn from memory The analyst beingpart of the ongoing process was aware of somebut only some dimensions of what went onwhich illustrates the various levels encom-passed by lsquomaking the unconscious consciousrsquoAs her final interventionmdashlsquoWhen we do littleassignments together and you are the one whoknows and you teach me you get everythingrightrsquomdashshows she clearly perceived how andwhy roles were allotted in the actual contextbuilt by the evolving anxieties allowing thechild-analysand free use of the denial implicitin her demand that in the play context theyswitch their identit ies She was not howeverfully aware of the ongoing advances in theprocess of symbol-formation As the sayinggoes one cannot write history while making it

The supervisory session transcribed illus-trates containment at two transformationallevels On the one hand at that of the patientwho after putting together in her maquette herown experience of emotional containmentdrew two linked hearts along with her firstwritten word The result of an evolving emo-tional containment stands represented by thisaccomplishment of symbol-formation thejoint initials of patient and analyst with theirsupposed (but reversed) ages enclosed withina box The second level of transformation cor-responds to the supervisorsupervisee link Toput it in Arlowrsquos terms this has to do with thefact that being target to the unconscious anxi-eties of the analytic process the supervisee feelsand knows more than what she has managedto lsquothink throughrsquo and can become apparent inthe record This is the sphere of transforma-tions at the level of psychoanalytic awareness

2 lsquoQue Qui Quorsquo in Spanish

80 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

It must be surmised here that the supervisorrsquosgreater distance from the emotional scenehelped quite a bit It allowed her to grasp thehomology Luciacutea-Luisa illuminating the activeidentificato ry processes in the ongoing reversalof identities in the session

The clinical example presented demon-strates the difficulties inherent in emotionallyframing and instancing creative symbol-for-mation difficulties resulting from the emo-tional turbulence falling upon both membersin the analytic sessions Containment of theongoing anxieties and the opportunities itopens up for an emerging creativity in the ses-sion has required in the case of the analysanda domain of action to be shared with an analystwho can somehow be both lsquooutsidersquo andlsquoinsidersquo the psychic turbulence involved This isalso valid for the handling of the clinical mate-rial in supervision Session and supervisionthus turn into coexistent arenas for recordingand grasping emotional developments

The supervisory approach presenteddeparts as much as circumstances allow fromdirect lsquoteachingrsquo and it privileges the contain-ment and disclosure of the superviseersquos una-voidable anxieties that are part and parcel ofthe course of her analytic task In the Janus-likedilemma of the supervisor a dilemma whichparaphrasing F leming and Benedek can bethought of in terms of containment versusteaching it is our belief that the converse direc-tive teaching approach on the part of the super-visor tends to increase the paranoid anxieties inthe supervisory situation at the expense of con-tainment

It is a main tenet of this presentat ion that theactual learning process within the supervisoryexperience can be better obtained by the super-visorrsquos facilit ating attitude This facilitatio n canonly take place when a sufficient degree ofholding to and grasping of the vicissitudes ofthe superviseersquos involvement in the analyticprocess itself is achieved The supervisorymaterial presented documents the superviseersquostendency to fall into the role of the pupil at thetime when she asks to be told whether she actedcorrect ly H owever the supervisory stance

described may well have helped the analystbear the role of lsquopupilrsquo her patient so stronglyforced her into It may foreseeably have beentoo hard on her to bear the brunt of beinglsquopupilrsquo on both sides in which case we can sur-mise our stance which approaches the supervi-sorrsquos role somewhat to the side of the holdingfunctions of the analyst in session has helpedmake proper place for our little patientrsquos needto assign roles to her analyst and have themsustained The dangers of an overzealoussupervisorteacher pushing the superviseeana-lyst in the pupilrsquos place has been previously andto our mind duly stressed by Solnit (1970) Aswe envision it supervision furthers the recon-sideration of the therapistrsquos clinica l task pro-moting the examination of the evidence thesharing of doubts and the harbouring of evolv-ing ideas

Bearing the solitude of our psychoanalyticwork is in the best of cases problematic evenseasoned analysts need to talk over informallywith colleagues the events in their consultingrooms and have them help think these out Wehope our paper allows the reader to share inwhat supervisee and supervisor learned fromthis difficult but rewarding analytic experience

TRANSLATION S OF SUMMAR Y

Les auteurs illustrent une approche du processusde supervision comme une expeacuterience drsquoapprentissagepour le superviseacute et le superviseur qui est construite surla capaciteacute de contenir les angoisses inconscientesElles montrent qursquoune des fonctions centrale de la su-pervision psychanalytique est drsquoaider agrave contenir lrsquoagi-tation eacutemotionnelle et les angoisses inconscientes quisurgissent et eacutevoluent dans les deux domaines interac-tifs de la seacuteance analytique et de la seacuteance de supervi-sion Dans cette perspective lrsquointeraction analyste-patient ainsi que celle du superviseacute et du superviseurpeuvent ecirctre comprises comme des espaces de trans-formation superposeacutees jumelles lrsquoespace du supervi-seur eacutetant au service de contenir et de comprendre lesrocircles agrave travers lesquels va lrsquoanalyste superviseacute en tantque partie du processus analytique Agrave partir du mateacute-riel clinique deacutetailleacute drsquoune fille troubleacutee de 7 ans lesauteurs explorent les problegravemes relieacutes entre eux et lesdifficulteacutes preacutesenteacutees pour contenir les angoisses etlrsquoagitation preacutesentes agrave la fois dans la situation analyt-ique et en supervision Lorsque la capaciteacute de contenir

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 81

les eacutemotions est adeacutequate la supervision contribue agrave lacompreacutehension et au deacuteveloppement de lrsquoutilisationpar lela superviseacute(e) de sa propre personnaliteacute en tantqursquoinstrument du traitement ainsi que lrsquoont montreacuteF leming et Benedek il y des deacutecades de cela La seacuteancede supervision favorise donc les reacutesolutions des pro-blegravemes cliniques agrave travers la formation de symbole lesseacuteances cliniques et la supervision eacutetant des domainesjumeaux pour enregistrer et comprendre lrsquoeacutevolutioneacutemotionnelle

Die Autoren stellen einen Zugang zum Supervisi-onsprozess dar der ihn als eine Lernerfahrung fuumlrSupervisanden und Supervisor ansieht die auf demContainment von unbewussten Aumlngsten beruht Sieargumentieren dass es eine Hauptfunktion psycho-analytischer Supervision ist dazu beizutragen dieemotionale Verstoumlrung und die unbewussten Aumlngstedie in den zwei interagierenden Bereichen der ana-lytischen und der Supervisionssitzungen auftauchenzu containenldquo Aus dieser Sichtweise lassen sich dieInteraktion zwischen Analytiker und Patient und diezwischen Supervisanden und Supervisor als gleicharti-ge gestufte Transformationsbereiche verstehen wobeider Supervisionsbereich dazu dient die Rollen die derSupervisandAnalytiker durchlaumluft zu halten und zuverstehen Mithilfe von ausfuumlhrlichem klinischem Ma-terial von einem gestoumlrten 7-jaumlhrigen Maumldchen unter-suchen die Autoren die miteinander verbundenenProbleme und Schwierigkeiten die Aumlngste undStoumlrungen in der analytischen und der Supervisionssi-tuation zu containenldquo Wenn emotionales Contain-ment adaumlquat gehandhabt wird hilft die Supervisiondie Verwendung der Persoumlnlichkeit des Supervisandenals Behandlungsinstrument zu verstehen und zu ent-wickeln wie es F leming und Benedek vor Jahrzehntenvertraten Die Supervisionssitzung hilft auf diese

Weise klinische Probleme durch Symbolbildung auf-zuloumlsen wobei therapeutische Sitzungen und Supervi-sion gleichartige Bereiche zur Erfassung und zumVerstehen emotionaler Entwicklung sind

Las autoras enfocan el proceso de la supervisioacutencomo una experiencia de aprendizaje tanto para elsupervisado como para el supervisor la cual se lleva acabo sobre la contencioacuten de las ansiedades incon-scientes Se sostiene que lo esencial de la funcioacuten de lasupervisioacuten psicoanaliacutetica es contribuir a contener laturbulencia emocional y las ansiedades inconscientesque surgen y evolucionan en dos terrenos que inter-actuacutean entre siacute el de las sesiones de anaacutelisis y el de lassesiones de supervisioacuten Desde esta perspectiva lasinteracciones analistandashpaciente y supervisado-supervi-sor pueden ser consideradas como espacios abiertoscon gradas gemelas y cambiantes estando el espaciode la supervisioacuten al servicio de sostener y apuntalar elque las funciones del analistasupervisado sigan ade-lante ya que son parte del proceso analiacutetico Partien-do de un material cliacutenico expuesto en detalle yrelativo a una nintildea de 7 antildeos que presentaba muchosconflictos las autoras estudian algunos puntos inter-relacionados y las dificultades para contener las ansie-dades y los conflictos tanto en la situacioacuten analiacuteticacomo en la de supervisioacuten Cuando los contenidosemocionales son manejados de un modo adecuado lasupervisioacuten contribuye a la comprensioacuten y tambieacuten almejor uso de la misma personalidad del supervisadoacomo instrumento del tratamiento tal como fue de-fendido por F leming y Benedek hace algunas deacutecadasEs de este modo como las sesiones de supervisioacuten con-tribuyen a la solucioacuten de algunos aspectos cliacutenicos atraveacutes de la formacioacuten de siacutembolos ya que las sesionescliacutenicas y la supervisioacuten son terrenos gemelos pararegistrar y comprender la evolucioacuten emocional

R EF ER ENCES

ARLOW J (1963) The supervisory situation JA mer Psychoanal A ssn 11 576ndash94

BION W R (1962) L earning from ExperienceLondon Heinemann

F LEMING J amp BENEDEK T (1964) SupervisionA method of teaching psychoanalysis Psycho-anal Q 33 71ndash96

G RINBERG L (1970) The problems of supervisionin psychoanalytic education Int J Psychoanal51 371ndash82

SOLNIT A J (1970) Learning from psychoanalyt-ic supervision Int J Psychoanal 51 359ndash62

Virginia R U ngar and Luisa Busch de Ahumada Copyright copy Institu te of Psychoanalysis London 2001Dr U ngarBillinghurst 2533 1425 Buenos Aires(Initia l version received 1698)(F irst revised version received 19799)(F inal revised version received 14600)

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 73

unless the interpretive process appears tohinder it the supervisor strives not to interfereor raise objections whether or not the therapistchooses to take the roles allotted by the patientTo give an example whether or not the analystdecides to let the child clean her dirty hands onher clothing is thought to be part of the thera-pistrsquos personal style Only in the case where theprocess comes to an impasse would it be theoccasion to review more actively what went onU nless and until this happens the supervisorhelps to support grasp and put further intowords the ongoing issues

BACK GR OU ND MATER IAL

I now present some data now on Valeria a7-year-old girl sent for treatment because ofher bizarre behaviour at school and her severelearning blocks The youngest of three chil-dren she has a sister several years older and abrother older by two years Her father in hisearly fifties is retired Previously he happenedto spend months and months at work awayfrom home The mother a teacher in her earlyforties not currently working volunteered thatshe was used to making decisions and manag-ing the children U nable to learn to read andwrite Valeria was about to repeat her first yearat school It fell upon the school not the fam-ily to try to find out what was wrong with herThis led to a request for a diagnostic evaluationand then treatment Initia lly the mother per-haps characteristically did not want to recog-nise that the girl had emotional problems sheput it down to simple naughtiness She blamedValeriarsquos inability to read and write on the inex-perience of present-day teachers pointing outthat it was the school that had requested a con-sultation they wouldnrsquot be requesting it bythemselves The father accepted Valeriarsquosnaughtiness but was surprised that to give anexample lsquoif a shoelace is longer than the othershe wonrsquot walk till this is sorted out or sherefuses to walk so that the soles of her shoesdonrsquot get dirty and she canrsquot wait when prom-ised something she cries and relentlessly

demands until she gets itrsquo The mother volun-teered falsely that Valeria got along well withschoolmates that she was invited out every-where (it turned out that she was actually uni-versally shunned) She was not close to herolder sister but played a lot with her brotherM ostly they got along well but sometimes theyfought Predictably the parentsrsquo attitudesmade negotiating the setting difficult It wasfinally agreed to start thrice-weekly sessionswhich while infrequent enough was the mostthey would agree to As she had been evaluatedelsewhere Valeriarsquos first interview was dealtwith as her first analytic session

The mother who brought her in stayed inthe waiting room while Valeria followed me tothe consulting room She ran through the cor-ridor stamping her feet She spoke loudly andconstantly moved about aimlessly whichseemed to be her way of venting her anxietiesIntroducing myself I asked her whether sheknew what she had come for Valeria did notanswer The alternative which was often thecourse she took would be her respondingloudly or shouting often with no evident senseAt times she put her hands on her hips andshouted lsquoSi-lencersquo or repeated ly lsquoThe confer-encersquo When asked what she meant she did notrespond She kept away from toys but she didpick up a pad on the back of which she drewsaying lsquoitrsquos for yoursquo Starting on the second orthird session she came in saying lsquoShit fartpeersquo and she duly farted which she was able todo at will She sat on me and farted lsquoSo thatyou get all smellyrsquo She used up pads of paper inno time making balls she then threw at meoften saying lsquoItrsquos shitrsquo Sometimes she shotthem at my chest lsquoSo that you have shit on yourtitsrsquo Alternatively she made food out of plasti-cine sausages hamburgers gnocchi or pota-toes She was usually on the move and spokealmost constantly At times she climbed on to achair and then asked me for a handmdashshe wasafraid of falling and cautious in this sense Shesang screaming tunelessly that she was aclown that her mother was a clown that herfather was a clown and then it all started overagain This created a stream of lsquofart-shit-peersquo

74 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

and verbal attacks openly enacted and enunci-ated Some sessions revealed her attempts tokeep herself together by way of obsessivedefences She often sharpened her pencilswashed her hands when she touched anythingor she obsessively tidied and reordered her toy-box

Amid such chaos an initia l supervisor sug-gested dyadic interviews including the motherValeria did not want her mother to enter theconsulting room She turned her back on hershouting lsquoG o away go awayrsquo The motherreplied sententiously that she should not betreated like this This went on and on Aftersome time Valeria asked her mum to draw hera Christmas tree to which the mother repliedthat she should do it herself because she didknow how to do it herself Valeria insisted andthe mother responded stereotypically despitemounting anguish and suffering F inally thegirl lay down whimpering in front of the doorI asked the mother to cuddle her which she diduntil Valeria calmed down The mother com-mented lsquoYou are naughtier than everrsquo In a sec-ond interview Valeria drew a sun within acircle and the mother commented lsquoH ow nice Ilike you to draw whatever you want but you putthe sun in a globe poor sun he doesnrsquot like it but do as you want poor sun I like you to drawwhat you want but poor sun helliprsquo Valeriastopped drawing amid growing devita lisationand despair This illustrates the paradoxicalinteractions I thought that Valeria might wellwant to stop her mother and that her shoutinglsquoSi-lencersquo to me presumably had to do withthat As an observational field this was interest-ing enough but in view of the anxieties involvedit seemed prudent to put a stop to interactionalinterviews

The sequences described kept up during thefirst sessions and indeed alternated for manymonths from then on She shouted fartedinvented and sang unmelodious songs and shedid not answer when questioned N o discerni-ble playing emerged Another item which alsostarted in the first weeks and continued fromthat time was her writing lsquoM om D ad ValeriaAlbertorsquo completely covering the sheet with

no blank spaces This she wrote from memoryjust as if she were drawing with no acknowl-edgement of what a letter lsquomeansrsquo that is oftheir having a definite sound and somehowlinking up to form words She knew each let-terrsquos name M y general attitude was to followher around trying to keep emotional contactand striving to receive her projections in thehope of modulating them whatever this meantin such a context When she was drawing let-ters I would tell her that she must feel in quitea bind when pushed into a situation in whichshe must know how to write when she did notI would add that it must be difficult to be toldby her mother or teacher to lsquogo on writersquo whenshe did not know how to and so she went ondrawing these memorised words This line ofthought led later on to her playing the role ofteachermother while ascribing to me the roleof the girl Valeria lsquowho does not knowrsquo and wasurged to lsquodo what you canrsquo

For the next few months of treatmen t atwhich time the training supervision startedsuch a pattern emerged at times amid theongoing apparently senseless barrage of ver-bal and enacted attacks As mentioned shewould more and more often take the role of thedemanding motherteacher while I wasascribed that of the girl Valeria who must beforced to learn how to write In her role asmotherteacher she controlled and gave ordersto me at times aggressively at others less soLitt le by litt le within this high-speed turmoilof orders indicat ions and changes of context itbecame clearer whether she was being motheror teacher At this time and in contrast to herinitia l sessions in which she obsessively kepther toy-box scrupulously neat it was messydirty and full of broken things When she couldnot find something in her messed-up box shegot paranoid (lsquoSomebody must have taken itoutrsquo) On the days following a a holiday or sick-ness break or whenever she was brought in byher mother and not by her father as usual ses-sions seemed especially chaotic Often shecame in shouting lsquoShit fart peersquo lsquoF uck yoursquoor lsquoShit shit shitrsquo At other times she got on tothe table on all fours and farted in the four

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 75

direct ions Whenever she came at her most hos-tile she ended up anguished and fearful in acorner mostly against the door saying lsquoLetme let mersquo A displacemen t of hostility wasenacted on the pillows She stamped on themand somewhat later verbalised what she wasdoing lsquoI stamp on you and on what you sayrsquoAt other times she wanted to clean her handson my clothing when they were wet or dirtyfrom the plasticine

When she was in a better mood she justordered me about Her indications to do this orthat revolved around school and schoolworksaying to me lsquoWrite do it just as it comes outrsquoAt first she did not give herself any particularname then in what retrospectively appears to bea significant enough index of an ongoing indi-viduation process she started to call herselfLuciacutea when she enacted the mother or theteacher

As a way to get out of her often manifeststate of terror after her triumphant mood shelsquomeasuredrsquo me up (my feet my back) with sell-otape used as metr ic tape or she tied my feetwith it A few times later on she got out of herterror by lying on the couch and putting herfeet on my lap and rocking them softlymdashlsquoPlay-ing as a baby does with her mumrsquo I told hermdashand then she would ask me to tie her shoelacesup which seemed to convey some request forhelp Also and mostly towards the end of thehour in the last ten or fifteen minutes she cameto celebrate a birthday sometimes mine as thegirl Valeria at other times that of another sonAlberto At those times there was plenty offood around She might send me to the shop tofetch it (lsquoGo go you are already a big girlrsquo) orshe might cook it herself using plasticine as theingredientsmdashpastries sausagesmdashand insistedthat I ate it all She never spoke about whathappens out of sessions except to say that shehad a cat or about a trip she took which sheexplained to me by way of lsquomapsrsquo Amid thisraucous and repetitive material my interpre-tive attempts at intervention centred alterna-tively on her confusion and on how badly shecame to feel when she unleashed her aggression

or I focused on her feelings of triumph as hap-pened after she stamped on the pillows

The session to be presented took place aftera year of treatment five months into the super-vision

A SUPERVISOR Y SESSION

At the start Valeria ran along the corridorand closed the door to the consulting roomshutting me out Through a crack she said qui-etly lsquoWait two minutes OK rsquo Sitting in mychair she took her folder drawing pad pencilsetc from her box and said lsquoReadyrsquo

Sounding important (seemingly in the roleof the teacher) she said lsquoTake out a sheetToday we will have a little task You cut moonsout like this and afterwards we will stick theminrsquo I asked her to explain to me how shewanted the moons to look and the girl drew acloud on the sheet of paper instead and saidlsquoG o on draw and cut out moons in all coloursI will tell you afterwards what to dorsquo I dutifullydrew and cut out the cloudmoons while Vale-ria silently cut out and stuck scraps of variouslycoloured shiny paper on to a sheet of papergrouped by colours Then she said lsquoGive methe moonsrsquo She stuck them on folded sheets ofshiny paper around the coloured scraps alreadystuck on I asked her what it was that she didand she answered lsquoD onrsquot you see M oonsmoons sitting on the chairs Itrsquos a tiny task amaquettersquo (see F ig 1)

In supervision the analystsuperviseeremarked lsquoI think Valeria felt very importantand proud in my chair She was the one whoknew the one to be admired She felt thatsomehow she had placed herself at the centre ofthe space she has been shaping with the shinypaper and the cloudmoons in their chairsadmiring herrsquo The game her being left out atthe start while the girl arranged the setting orbeing out of her normal chair failed to get thetherapist to feel excluded or irritated she feltthat as analyst she had been quite genuinelyready to accept the allotted roles

76 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

When she was done Valeria headed for thedoor and attempted to pin up the sheet ofpaper on it It fell She tried again and saidlsquoCome on help memdashcanrsquot you see itrsquos fallingoffrsquo I helped her and we stuck it up on thedoor inside the playroom (In the next sessionshe threw this sheet of paper into the rubbishbin I rescued it later on)

On looking at the drawing the supervisorwas amazed After all we had been working forjust a few months with this highly disorganisedgirl who at the start amid evacuative outburstsand enormous excitement was quite unable toset up orderly game sequences Then repetitivegames set in involving a teacher and a pupilwho wrote down isolated letters the names sheuttered for the letters did not coincide with thelet ters she wrote her drawings too were quitechaotic N ow in the present drawing the ele-

ments were grouped together and surroundedby bars which suggested containment thecloudmoons lsquosatrsquo on these bars

The supervisor commented that the girl hadfirst asked her analyst for moons but then sheherself drew a cloud instead and the analyst fol-lowed suit The analyst remarked that she hadhesitated and then had done as the girl hadfinally requested She asked if she did right stat-ing more generally that if the supervisor did notconsider it to be right she should tell her andcorrect hermdashthat she should not be afraid to doso The supervisor answered that it was not herway of supervising to tell her if she did right orwrong When an analytica l process is underway the setting and the analytica l situation areinstalled she would rather watch and makeremarks to observe jointly how the transferencerelationship evolved The supervisor went on

F igure 1

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 77

Figure 2

78 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

to say that the analyst herself might have cor-rected the patient telling her that what she haddrawn was not a moon but a cloud

Since the analyst had decided not to andthat it would be best now to see the effects onthe session of keeping to the mooncloud con-fusion her impression was that by not cor-rect ing her patient and taking to the role ofpupil the analyst had helped sustain the pro-jection of the role of lsquothe girl who does notunderstandrsquo This seemed to lead to some-thing that the girl in the role of analyst stuckon pieces of paper and then lsquoassembledrsquo a con-tainer around it We agreed that keeping to theconfusion in the session might have allowedsome element related to the cloudmoons toshow up upon the analystrsquos taking the role oflsquothe girl Valeria who does not knowrsquo Thesupervisor remarked that compared to thisgirlrsquos usual evacuative outbursts these inter-changes would seem nicely to fit Bionrsquos (1962)idea of thought involving alpha-functionwhich requires an object containing the pro-jections and returning them in more organisedmanners with some anxieties processed Suchan objectrsquos reverie function seemed to havepermitted Valeria to put herself together andturn on her own alpha-function

The clinical narrative shows that the analystpartly grasped what had happened Readingthe session again and talking about it it grewmore articulated in her mind It is notable thatfor the first time in all these months the ana-lystsupervisee asked for correction she firsttook this event to be a simple react ion of with-drawal in the face of what took place but at asecond view and as is again apparent in thefollowing paragraphs this request for correc-tion would seem to correspond precisely to anenactment in the supervisory session of therole of the lsquogirl that doesnrsquot knowrsquo or the lsquogirlin the wrongrsquo which Valeria consistently pro-jected into her in the sessions

Valeria said lsquoAll right now wersquoll carry outanother lit tle assignment Write this downCopy it out This is a story which Irsquoll tell youlaterrsquo (She named each let ter while writingthem down) lsquoAnd here it says ldquopipipirdquorsquo (She

drew rays emanating from it) lsquoAnd now draw aspring flower (spring had started just five daysbefore this session) and write ldquopri-ma-ve-rardquorsquo(lsquospringrsquo in Spanish she spelled the word outthough with mistakes) As she said this shewrote the word on her own sheet of paper (F ig2) while I had to do the same on anothersheet lsquoVery good Now make two hearts gotogether like this (she drew lines linking them)and two balloons Remember that you areValeria the girl and Irsquom Luciacutea the teacherYou are 7 years old and Irsquom 40rsquo She wrotedown 7 and 40 and drew a square aroundthem Then she linked each by a line to thedrawing of the hearts

Faced with the girlrsquos drawing the supervi-sor noticed that for the first time she had writ-ten a word lsquopimabrarsquo The analyst hadrealised this as it happened and then wasfrightened by the idea that the parents mightpull the girl out of treatment as soon as shelearned to write so she felt ambivalent aboutthis development The supervisor remarkedthat it would seem that when the analyst man-aged to accept the identificatory projection ofan infantile aspect of the self that misunder-stood and felt misunderstood the girl man-aged to write her first word She added thatbesides feelings of mutual love the two linkedhearts might point also to two minds workingtogether and also that the drawing wouldseem to appear as a sort of blend of a familytree and a family organisational introductorychart with the ages of each Luciacutea the 40-year-old teacher and Valeria the 7-year-old pupilAt that point the supervisor realised that theword Luciacutea contained almost the same letter swith just one misplaced vowel as Luisa theanalystrsquos first name and asked if the girl andher family called her this or her more usualnickname She said surprised that they calledher Luisa not knowing her nickname

To the supervisor this seemed to supportthe notion that the word lsquospringrsquo so obviouslylinked to budding birth and flowering pointsto a creative link-up of two heartsmindsworking together Perhaps also the budding ofthe ability the development of which would of

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 79

course demand some lengthy work of learningto share with others mainly her peers

We went on with the session Valeria askedordered me to continue working lsquoAnd we putldquoChrdquo of cheese ldquocherdquo ldquocheerdquo2 and draw anapple with the little stick and five fingers(counts up to five) It has eyes and a mouthand two different feetmdashthatrsquos wrongrsquo She cor-rected one of the feet on my sheet She gave mea small piece of shiny paper and assignedanother to herself lsquoAnd now write on ldquoprimav-erardquo and the flower and you and mersquo Sheasked me to draw two squares with the ages 40and 7 She continued lsquoM ake a house and atreemdashdonrsquot worry just do it as well as you canEveryone does it as well as they canrsquo I inter-preted lsquoWhen we do lit tle assignmentstogether and you are the one who knows andyou teach me you get everything rightrsquo

Valeria looked attentively and said lsquoYeswersquore right arenrsquot we N ow write the headlineand underline it N ow Irsquoll tell you the story(Pretended to read) Once upon a time therewas a mother and a daughter and the motherwould tell the father ldquoYou go to the shoppingmallrdquo The mother and the children went outfor a while and went to M cDonaldrsquos and hadsodas and then went to the park and the fatherwas at the mall and then they came back homeand thatrsquos the end of the storyrsquo

It was the end of the session Valeria put thematerial in her box including the drawingwhich was stuck on the door

As the supervisory session also drew to itsend the supervisor mused on the effects of theanalystrsquos intervention on this last lsquostoryrsquo nar-rated by Valeria which might restate thecourse of the work carried out together withthe ages in a little square The flagrant demiseof the father whom the mother lsquoordersrsquo to theshopping mall while she and their children gofor an outing drives the girlrsquos felt experience(most likely related to a denial of the primalscene in the link to both therapist and mother)that for the time being the father has beenrejected

CONTAINMENT AN D TEACH ING IN THE

APPR OACH TO TH E SUPERVISORY PROCESS

We find the supervisory experiencedescribed has been apt for containing anxietiesand for thinking out the events of the sessionsupplying a frame for the emotional develop-ments leading to the patientrsquos first writtenthought-out word pimabra as distinct fromthose drawn from memory The analyst beingpart of the ongoing process was aware of somebut only some dimensions of what went onwhich illustrates the various levels encom-passed by lsquomaking the unconscious consciousrsquoAs her final interventionmdashlsquoWhen we do littleassignments together and you are the one whoknows and you teach me you get everythingrightrsquomdashshows she clearly perceived how andwhy roles were allotted in the actual contextbuilt by the evolving anxieties allowing thechild-analysand free use of the denial implicitin her demand that in the play context theyswitch their identit ies She was not howeverfully aware of the ongoing advances in theprocess of symbol-formation As the sayinggoes one cannot write history while making it

The supervisory session transcribed illus-trates containment at two transformationallevels On the one hand at that of the patientwho after putting together in her maquette herown experience of emotional containmentdrew two linked hearts along with her firstwritten word The result of an evolving emo-tional containment stands represented by thisaccomplishment of symbol-formation thejoint initials of patient and analyst with theirsupposed (but reversed) ages enclosed withina box The second level of transformation cor-responds to the supervisorsupervisee link Toput it in Arlowrsquos terms this has to do with thefact that being target to the unconscious anxi-eties of the analytic process the supervisee feelsand knows more than what she has managedto lsquothink throughrsquo and can become apparent inthe record This is the sphere of transforma-tions at the level of psychoanalytic awareness

2 lsquoQue Qui Quorsquo in Spanish

80 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

It must be surmised here that the supervisorrsquosgreater distance from the emotional scenehelped quite a bit It allowed her to grasp thehomology Luciacutea-Luisa illuminating the activeidentificato ry processes in the ongoing reversalof identities in the session

The clinical example presented demon-strates the difficulties inherent in emotionallyframing and instancing creative symbol-for-mation difficulties resulting from the emo-tional turbulence falling upon both membersin the analytic sessions Containment of theongoing anxieties and the opportunities itopens up for an emerging creativity in the ses-sion has required in the case of the analysanda domain of action to be shared with an analystwho can somehow be both lsquooutsidersquo andlsquoinsidersquo the psychic turbulence involved This isalso valid for the handling of the clinical mate-rial in supervision Session and supervisionthus turn into coexistent arenas for recordingand grasping emotional developments

The supervisory approach presenteddeparts as much as circumstances allow fromdirect lsquoteachingrsquo and it privileges the contain-ment and disclosure of the superviseersquos una-voidable anxieties that are part and parcel ofthe course of her analytic task In the Janus-likedilemma of the supervisor a dilemma whichparaphrasing F leming and Benedek can bethought of in terms of containment versusteaching it is our belief that the converse direc-tive teaching approach on the part of the super-visor tends to increase the paranoid anxieties inthe supervisory situation at the expense of con-tainment

It is a main tenet of this presentat ion that theactual learning process within the supervisoryexperience can be better obtained by the super-visorrsquos facilit ating attitude This facilitatio n canonly take place when a sufficient degree ofholding to and grasping of the vicissitudes ofthe superviseersquos involvement in the analyticprocess itself is achieved The supervisorymaterial presented documents the superviseersquostendency to fall into the role of the pupil at thetime when she asks to be told whether she actedcorrect ly H owever the supervisory stance

described may well have helped the analystbear the role of lsquopupilrsquo her patient so stronglyforced her into It may foreseeably have beentoo hard on her to bear the brunt of beinglsquopupilrsquo on both sides in which case we can sur-mise our stance which approaches the supervi-sorrsquos role somewhat to the side of the holdingfunctions of the analyst in session has helpedmake proper place for our little patientrsquos needto assign roles to her analyst and have themsustained The dangers of an overzealoussupervisorteacher pushing the superviseeana-lyst in the pupilrsquos place has been previously andto our mind duly stressed by Solnit (1970) Aswe envision it supervision furthers the recon-sideration of the therapistrsquos clinica l task pro-moting the examination of the evidence thesharing of doubts and the harbouring of evolv-ing ideas

Bearing the solitude of our psychoanalyticwork is in the best of cases problematic evenseasoned analysts need to talk over informallywith colleagues the events in their consultingrooms and have them help think these out Wehope our paper allows the reader to share inwhat supervisee and supervisor learned fromthis difficult but rewarding analytic experience

TRANSLATION S OF SUMMAR Y

Les auteurs illustrent une approche du processusde supervision comme une expeacuterience drsquoapprentissagepour le superviseacute et le superviseur qui est construite surla capaciteacute de contenir les angoisses inconscientesElles montrent qursquoune des fonctions centrale de la su-pervision psychanalytique est drsquoaider agrave contenir lrsquoagi-tation eacutemotionnelle et les angoisses inconscientes quisurgissent et eacutevoluent dans les deux domaines interac-tifs de la seacuteance analytique et de la seacuteance de supervi-sion Dans cette perspective lrsquointeraction analyste-patient ainsi que celle du superviseacute et du superviseurpeuvent ecirctre comprises comme des espaces de trans-formation superposeacutees jumelles lrsquoespace du supervi-seur eacutetant au service de contenir et de comprendre lesrocircles agrave travers lesquels va lrsquoanalyste superviseacute en tantque partie du processus analytique Agrave partir du mateacute-riel clinique deacutetailleacute drsquoune fille troubleacutee de 7 ans lesauteurs explorent les problegravemes relieacutes entre eux et lesdifficulteacutes preacutesenteacutees pour contenir les angoisses etlrsquoagitation preacutesentes agrave la fois dans la situation analyt-ique et en supervision Lorsque la capaciteacute de contenir

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 81

les eacutemotions est adeacutequate la supervision contribue agrave lacompreacutehension et au deacuteveloppement de lrsquoutilisationpar lela superviseacute(e) de sa propre personnaliteacute en tantqursquoinstrument du traitement ainsi que lrsquoont montreacuteF leming et Benedek il y des deacutecades de cela La seacuteancede supervision favorise donc les reacutesolutions des pro-blegravemes cliniques agrave travers la formation de symbole lesseacuteances cliniques et la supervision eacutetant des domainesjumeaux pour enregistrer et comprendre lrsquoeacutevolutioneacutemotionnelle

Die Autoren stellen einen Zugang zum Supervisi-onsprozess dar der ihn als eine Lernerfahrung fuumlrSupervisanden und Supervisor ansieht die auf demContainment von unbewussten Aumlngsten beruht Sieargumentieren dass es eine Hauptfunktion psycho-analytischer Supervision ist dazu beizutragen dieemotionale Verstoumlrung und die unbewussten Aumlngstedie in den zwei interagierenden Bereichen der ana-lytischen und der Supervisionssitzungen auftauchenzu containenldquo Aus dieser Sichtweise lassen sich dieInteraktion zwischen Analytiker und Patient und diezwischen Supervisanden und Supervisor als gleicharti-ge gestufte Transformationsbereiche verstehen wobeider Supervisionsbereich dazu dient die Rollen die derSupervisandAnalytiker durchlaumluft zu halten und zuverstehen Mithilfe von ausfuumlhrlichem klinischem Ma-terial von einem gestoumlrten 7-jaumlhrigen Maumldchen unter-suchen die Autoren die miteinander verbundenenProbleme und Schwierigkeiten die Aumlngste undStoumlrungen in der analytischen und der Supervisionssi-tuation zu containenldquo Wenn emotionales Contain-ment adaumlquat gehandhabt wird hilft die Supervisiondie Verwendung der Persoumlnlichkeit des Supervisandenals Behandlungsinstrument zu verstehen und zu ent-wickeln wie es F leming und Benedek vor Jahrzehntenvertraten Die Supervisionssitzung hilft auf diese

Weise klinische Probleme durch Symbolbildung auf-zuloumlsen wobei therapeutische Sitzungen und Supervi-sion gleichartige Bereiche zur Erfassung und zumVerstehen emotionaler Entwicklung sind

Las autoras enfocan el proceso de la supervisioacutencomo una experiencia de aprendizaje tanto para elsupervisado como para el supervisor la cual se lleva acabo sobre la contencioacuten de las ansiedades incon-scientes Se sostiene que lo esencial de la funcioacuten de lasupervisioacuten psicoanaliacutetica es contribuir a contener laturbulencia emocional y las ansiedades inconscientesque surgen y evolucionan en dos terrenos que inter-actuacutean entre siacute el de las sesiones de anaacutelisis y el de lassesiones de supervisioacuten Desde esta perspectiva lasinteracciones analistandashpaciente y supervisado-supervi-sor pueden ser consideradas como espacios abiertoscon gradas gemelas y cambiantes estando el espaciode la supervisioacuten al servicio de sostener y apuntalar elque las funciones del analistasupervisado sigan ade-lante ya que son parte del proceso analiacutetico Partien-do de un material cliacutenico expuesto en detalle yrelativo a una nintildea de 7 antildeos que presentaba muchosconflictos las autoras estudian algunos puntos inter-relacionados y las dificultades para contener las ansie-dades y los conflictos tanto en la situacioacuten analiacuteticacomo en la de supervisioacuten Cuando los contenidosemocionales son manejados de un modo adecuado lasupervisioacuten contribuye a la comprensioacuten y tambieacuten almejor uso de la misma personalidad del supervisadoacomo instrumento del tratamiento tal como fue de-fendido por F leming y Benedek hace algunas deacutecadasEs de este modo como las sesiones de supervisioacuten con-tribuyen a la solucioacuten de algunos aspectos cliacutenicos atraveacutes de la formacioacuten de siacutembolos ya que las sesionescliacutenicas y la supervisioacuten son terrenos gemelos pararegistrar y comprender la evolucioacuten emocional

R EF ER ENCES

ARLOW J (1963) The supervisory situation JA mer Psychoanal A ssn 11 576ndash94

BION W R (1962) L earning from ExperienceLondon Heinemann

F LEMING J amp BENEDEK T (1964) SupervisionA method of teaching psychoanalysis Psycho-anal Q 33 71ndash96

G RINBERG L (1970) The problems of supervisionin psychoanalytic education Int J Psychoanal51 371ndash82

SOLNIT A J (1970) Learning from psychoanalyt-ic supervision Int J Psychoanal 51 359ndash62

Virginia R U ngar and Luisa Busch de Ahumada Copyright copy Institu te of Psychoanalysis London 2001Dr U ngarBillinghurst 2533 1425 Buenos Aires(Initia l version received 1698)(F irst revised version received 19799)(F inal revised version received 14600)

74 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

and verbal attacks openly enacted and enunci-ated Some sessions revealed her attempts tokeep herself together by way of obsessivedefences She often sharpened her pencilswashed her hands when she touched anythingor she obsessively tidied and reordered her toy-box

Amid such chaos an initia l supervisor sug-gested dyadic interviews including the motherValeria did not want her mother to enter theconsulting room She turned her back on hershouting lsquoG o away go awayrsquo The motherreplied sententiously that she should not betreated like this This went on and on Aftersome time Valeria asked her mum to draw hera Christmas tree to which the mother repliedthat she should do it herself because she didknow how to do it herself Valeria insisted andthe mother responded stereotypically despitemounting anguish and suffering F inally thegirl lay down whimpering in front of the doorI asked the mother to cuddle her which she diduntil Valeria calmed down The mother com-mented lsquoYou are naughtier than everrsquo In a sec-ond interview Valeria drew a sun within acircle and the mother commented lsquoH ow nice Ilike you to draw whatever you want but you putthe sun in a globe poor sun he doesnrsquot like it but do as you want poor sun I like you to drawwhat you want but poor sun helliprsquo Valeriastopped drawing amid growing devita lisationand despair This illustrates the paradoxicalinteractions I thought that Valeria might wellwant to stop her mother and that her shoutinglsquoSi-lencersquo to me presumably had to do withthat As an observational field this was interest-ing enough but in view of the anxieties involvedit seemed prudent to put a stop to interactionalinterviews

The sequences described kept up during thefirst sessions and indeed alternated for manymonths from then on She shouted fartedinvented and sang unmelodious songs and shedid not answer when questioned N o discerni-ble playing emerged Another item which alsostarted in the first weeks and continued fromthat time was her writing lsquoM om D ad ValeriaAlbertorsquo completely covering the sheet with

no blank spaces This she wrote from memoryjust as if she were drawing with no acknowl-edgement of what a letter lsquomeansrsquo that is oftheir having a definite sound and somehowlinking up to form words She knew each let-terrsquos name M y general attitude was to followher around trying to keep emotional contactand striving to receive her projections in thehope of modulating them whatever this meantin such a context When she was drawing let-ters I would tell her that she must feel in quitea bind when pushed into a situation in whichshe must know how to write when she did notI would add that it must be difficult to be toldby her mother or teacher to lsquogo on writersquo whenshe did not know how to and so she went ondrawing these memorised words This line ofthought led later on to her playing the role ofteachermother while ascribing to me the roleof the girl Valeria lsquowho does not knowrsquo and wasurged to lsquodo what you canrsquo

For the next few months of treatmen t atwhich time the training supervision startedsuch a pattern emerged at times amid theongoing apparently senseless barrage of ver-bal and enacted attacks As mentioned shewould more and more often take the role of thedemanding motherteacher while I wasascribed that of the girl Valeria who must beforced to learn how to write In her role asmotherteacher she controlled and gave ordersto me at times aggressively at others less soLitt le by litt le within this high-speed turmoilof orders indicat ions and changes of context itbecame clearer whether she was being motheror teacher At this time and in contrast to herinitia l sessions in which she obsessively kepther toy-box scrupulously neat it was messydirty and full of broken things When she couldnot find something in her messed-up box shegot paranoid (lsquoSomebody must have taken itoutrsquo) On the days following a a holiday or sick-ness break or whenever she was brought in byher mother and not by her father as usual ses-sions seemed especially chaotic Often shecame in shouting lsquoShit fart peersquo lsquoF uck yoursquoor lsquoShit shit shitrsquo At other times she got on tothe table on all fours and farted in the four

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 75

direct ions Whenever she came at her most hos-tile she ended up anguished and fearful in acorner mostly against the door saying lsquoLetme let mersquo A displacemen t of hostility wasenacted on the pillows She stamped on themand somewhat later verbalised what she wasdoing lsquoI stamp on you and on what you sayrsquoAt other times she wanted to clean her handson my clothing when they were wet or dirtyfrom the plasticine

When she was in a better mood she justordered me about Her indications to do this orthat revolved around school and schoolworksaying to me lsquoWrite do it just as it comes outrsquoAt first she did not give herself any particularname then in what retrospectively appears to bea significant enough index of an ongoing indi-viduation process she started to call herselfLuciacutea when she enacted the mother or theteacher

As a way to get out of her often manifeststate of terror after her triumphant mood shelsquomeasuredrsquo me up (my feet my back) with sell-otape used as metr ic tape or she tied my feetwith it A few times later on she got out of herterror by lying on the couch and putting herfeet on my lap and rocking them softlymdashlsquoPlay-ing as a baby does with her mumrsquo I told hermdashand then she would ask me to tie her shoelacesup which seemed to convey some request forhelp Also and mostly towards the end of thehour in the last ten or fifteen minutes she cameto celebrate a birthday sometimes mine as thegirl Valeria at other times that of another sonAlberto At those times there was plenty offood around She might send me to the shop tofetch it (lsquoGo go you are already a big girlrsquo) orshe might cook it herself using plasticine as theingredientsmdashpastries sausagesmdashand insistedthat I ate it all She never spoke about whathappens out of sessions except to say that shehad a cat or about a trip she took which sheexplained to me by way of lsquomapsrsquo Amid thisraucous and repetitive material my interpre-tive attempts at intervention centred alterna-tively on her confusion and on how badly shecame to feel when she unleashed her aggression

or I focused on her feelings of triumph as hap-pened after she stamped on the pillows

The session to be presented took place aftera year of treatment five months into the super-vision

A SUPERVISOR Y SESSION

At the start Valeria ran along the corridorand closed the door to the consulting roomshutting me out Through a crack she said qui-etly lsquoWait two minutes OK rsquo Sitting in mychair she took her folder drawing pad pencilsetc from her box and said lsquoReadyrsquo

Sounding important (seemingly in the roleof the teacher) she said lsquoTake out a sheetToday we will have a little task You cut moonsout like this and afterwards we will stick theminrsquo I asked her to explain to me how shewanted the moons to look and the girl drew acloud on the sheet of paper instead and saidlsquoG o on draw and cut out moons in all coloursI will tell you afterwards what to dorsquo I dutifullydrew and cut out the cloudmoons while Vale-ria silently cut out and stuck scraps of variouslycoloured shiny paper on to a sheet of papergrouped by colours Then she said lsquoGive methe moonsrsquo She stuck them on folded sheets ofshiny paper around the coloured scraps alreadystuck on I asked her what it was that she didand she answered lsquoD onrsquot you see M oonsmoons sitting on the chairs Itrsquos a tiny task amaquettersquo (see F ig 1)

In supervision the analystsuperviseeremarked lsquoI think Valeria felt very importantand proud in my chair She was the one whoknew the one to be admired She felt thatsomehow she had placed herself at the centre ofthe space she has been shaping with the shinypaper and the cloudmoons in their chairsadmiring herrsquo The game her being left out atthe start while the girl arranged the setting orbeing out of her normal chair failed to get thetherapist to feel excluded or irritated she feltthat as analyst she had been quite genuinelyready to accept the allotted roles

76 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

When she was done Valeria headed for thedoor and attempted to pin up the sheet ofpaper on it It fell She tried again and saidlsquoCome on help memdashcanrsquot you see itrsquos fallingoffrsquo I helped her and we stuck it up on thedoor inside the playroom (In the next sessionshe threw this sheet of paper into the rubbishbin I rescued it later on)

On looking at the drawing the supervisorwas amazed After all we had been working forjust a few months with this highly disorganisedgirl who at the start amid evacuative outburstsand enormous excitement was quite unable toset up orderly game sequences Then repetitivegames set in involving a teacher and a pupilwho wrote down isolated letters the names sheuttered for the letters did not coincide with thelet ters she wrote her drawings too were quitechaotic N ow in the present drawing the ele-

ments were grouped together and surroundedby bars which suggested containment thecloudmoons lsquosatrsquo on these bars

The supervisor commented that the girl hadfirst asked her analyst for moons but then sheherself drew a cloud instead and the analyst fol-lowed suit The analyst remarked that she hadhesitated and then had done as the girl hadfinally requested She asked if she did right stat-ing more generally that if the supervisor did notconsider it to be right she should tell her andcorrect hermdashthat she should not be afraid to doso The supervisor answered that it was not herway of supervising to tell her if she did right orwrong When an analytica l process is underway the setting and the analytica l situation areinstalled she would rather watch and makeremarks to observe jointly how the transferencerelationship evolved The supervisor went on

F igure 1

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 77

Figure 2

78 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

to say that the analyst herself might have cor-rected the patient telling her that what she haddrawn was not a moon but a cloud

Since the analyst had decided not to andthat it would be best now to see the effects onthe session of keeping to the mooncloud con-fusion her impression was that by not cor-rect ing her patient and taking to the role ofpupil the analyst had helped sustain the pro-jection of the role of lsquothe girl who does notunderstandrsquo This seemed to lead to some-thing that the girl in the role of analyst stuckon pieces of paper and then lsquoassembledrsquo a con-tainer around it We agreed that keeping to theconfusion in the session might have allowedsome element related to the cloudmoons toshow up upon the analystrsquos taking the role oflsquothe girl Valeria who does not knowrsquo Thesupervisor remarked that compared to thisgirlrsquos usual evacuative outbursts these inter-changes would seem nicely to fit Bionrsquos (1962)idea of thought involving alpha-functionwhich requires an object containing the pro-jections and returning them in more organisedmanners with some anxieties processed Suchan objectrsquos reverie function seemed to havepermitted Valeria to put herself together andturn on her own alpha-function

The clinical narrative shows that the analystpartly grasped what had happened Readingthe session again and talking about it it grewmore articulated in her mind It is notable thatfor the first time in all these months the ana-lystsupervisee asked for correction she firsttook this event to be a simple react ion of with-drawal in the face of what took place but at asecond view and as is again apparent in thefollowing paragraphs this request for correc-tion would seem to correspond precisely to anenactment in the supervisory session of therole of the lsquogirl that doesnrsquot knowrsquo or the lsquogirlin the wrongrsquo which Valeria consistently pro-jected into her in the sessions

Valeria said lsquoAll right now wersquoll carry outanother lit tle assignment Write this downCopy it out This is a story which Irsquoll tell youlaterrsquo (She named each let ter while writingthem down) lsquoAnd here it says ldquopipipirdquorsquo (She

drew rays emanating from it) lsquoAnd now draw aspring flower (spring had started just five daysbefore this session) and write ldquopri-ma-ve-rardquorsquo(lsquospringrsquo in Spanish she spelled the word outthough with mistakes) As she said this shewrote the word on her own sheet of paper (F ig2) while I had to do the same on anothersheet lsquoVery good Now make two hearts gotogether like this (she drew lines linking them)and two balloons Remember that you areValeria the girl and Irsquom Luciacutea the teacherYou are 7 years old and Irsquom 40rsquo She wrotedown 7 and 40 and drew a square aroundthem Then she linked each by a line to thedrawing of the hearts

Faced with the girlrsquos drawing the supervi-sor noticed that for the first time she had writ-ten a word lsquopimabrarsquo The analyst hadrealised this as it happened and then wasfrightened by the idea that the parents mightpull the girl out of treatment as soon as shelearned to write so she felt ambivalent aboutthis development The supervisor remarkedthat it would seem that when the analyst man-aged to accept the identificatory projection ofan infantile aspect of the self that misunder-stood and felt misunderstood the girl man-aged to write her first word She added thatbesides feelings of mutual love the two linkedhearts might point also to two minds workingtogether and also that the drawing wouldseem to appear as a sort of blend of a familytree and a family organisational introductorychart with the ages of each Luciacutea the 40-year-old teacher and Valeria the 7-year-old pupilAt that point the supervisor realised that theword Luciacutea contained almost the same letter swith just one misplaced vowel as Luisa theanalystrsquos first name and asked if the girl andher family called her this or her more usualnickname She said surprised that they calledher Luisa not knowing her nickname

To the supervisor this seemed to supportthe notion that the word lsquospringrsquo so obviouslylinked to budding birth and flowering pointsto a creative link-up of two heartsmindsworking together Perhaps also the budding ofthe ability the development of which would of

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 79

course demand some lengthy work of learningto share with others mainly her peers

We went on with the session Valeria askedordered me to continue working lsquoAnd we putldquoChrdquo of cheese ldquocherdquo ldquocheerdquo2 and draw anapple with the little stick and five fingers(counts up to five) It has eyes and a mouthand two different feetmdashthatrsquos wrongrsquo She cor-rected one of the feet on my sheet She gave mea small piece of shiny paper and assignedanother to herself lsquoAnd now write on ldquoprimav-erardquo and the flower and you and mersquo Sheasked me to draw two squares with the ages 40and 7 She continued lsquoM ake a house and atreemdashdonrsquot worry just do it as well as you canEveryone does it as well as they canrsquo I inter-preted lsquoWhen we do lit tle assignmentstogether and you are the one who knows andyou teach me you get everything rightrsquo

Valeria looked attentively and said lsquoYeswersquore right arenrsquot we N ow write the headlineand underline it N ow Irsquoll tell you the story(Pretended to read) Once upon a time therewas a mother and a daughter and the motherwould tell the father ldquoYou go to the shoppingmallrdquo The mother and the children went outfor a while and went to M cDonaldrsquos and hadsodas and then went to the park and the fatherwas at the mall and then they came back homeand thatrsquos the end of the storyrsquo

It was the end of the session Valeria put thematerial in her box including the drawingwhich was stuck on the door

As the supervisory session also drew to itsend the supervisor mused on the effects of theanalystrsquos intervention on this last lsquostoryrsquo nar-rated by Valeria which might restate thecourse of the work carried out together withthe ages in a little square The flagrant demiseof the father whom the mother lsquoordersrsquo to theshopping mall while she and their children gofor an outing drives the girlrsquos felt experience(most likely related to a denial of the primalscene in the link to both therapist and mother)that for the time being the father has beenrejected

CONTAINMENT AN D TEACH ING IN THE

APPR OACH TO TH E SUPERVISORY PROCESS

We find the supervisory experiencedescribed has been apt for containing anxietiesand for thinking out the events of the sessionsupplying a frame for the emotional develop-ments leading to the patientrsquos first writtenthought-out word pimabra as distinct fromthose drawn from memory The analyst beingpart of the ongoing process was aware of somebut only some dimensions of what went onwhich illustrates the various levels encom-passed by lsquomaking the unconscious consciousrsquoAs her final interventionmdashlsquoWhen we do littleassignments together and you are the one whoknows and you teach me you get everythingrightrsquomdashshows she clearly perceived how andwhy roles were allotted in the actual contextbuilt by the evolving anxieties allowing thechild-analysand free use of the denial implicitin her demand that in the play context theyswitch their identit ies She was not howeverfully aware of the ongoing advances in theprocess of symbol-formation As the sayinggoes one cannot write history while making it

The supervisory session transcribed illus-trates containment at two transformationallevels On the one hand at that of the patientwho after putting together in her maquette herown experience of emotional containmentdrew two linked hearts along with her firstwritten word The result of an evolving emo-tional containment stands represented by thisaccomplishment of symbol-formation thejoint initials of patient and analyst with theirsupposed (but reversed) ages enclosed withina box The second level of transformation cor-responds to the supervisorsupervisee link Toput it in Arlowrsquos terms this has to do with thefact that being target to the unconscious anxi-eties of the analytic process the supervisee feelsand knows more than what she has managedto lsquothink throughrsquo and can become apparent inthe record This is the sphere of transforma-tions at the level of psychoanalytic awareness

2 lsquoQue Qui Quorsquo in Spanish

80 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

It must be surmised here that the supervisorrsquosgreater distance from the emotional scenehelped quite a bit It allowed her to grasp thehomology Luciacutea-Luisa illuminating the activeidentificato ry processes in the ongoing reversalof identities in the session

The clinical example presented demon-strates the difficulties inherent in emotionallyframing and instancing creative symbol-for-mation difficulties resulting from the emo-tional turbulence falling upon both membersin the analytic sessions Containment of theongoing anxieties and the opportunities itopens up for an emerging creativity in the ses-sion has required in the case of the analysanda domain of action to be shared with an analystwho can somehow be both lsquooutsidersquo andlsquoinsidersquo the psychic turbulence involved This isalso valid for the handling of the clinical mate-rial in supervision Session and supervisionthus turn into coexistent arenas for recordingand grasping emotional developments

The supervisory approach presenteddeparts as much as circumstances allow fromdirect lsquoteachingrsquo and it privileges the contain-ment and disclosure of the superviseersquos una-voidable anxieties that are part and parcel ofthe course of her analytic task In the Janus-likedilemma of the supervisor a dilemma whichparaphrasing F leming and Benedek can bethought of in terms of containment versusteaching it is our belief that the converse direc-tive teaching approach on the part of the super-visor tends to increase the paranoid anxieties inthe supervisory situation at the expense of con-tainment

It is a main tenet of this presentat ion that theactual learning process within the supervisoryexperience can be better obtained by the super-visorrsquos facilit ating attitude This facilitatio n canonly take place when a sufficient degree ofholding to and grasping of the vicissitudes ofthe superviseersquos involvement in the analyticprocess itself is achieved The supervisorymaterial presented documents the superviseersquostendency to fall into the role of the pupil at thetime when she asks to be told whether she actedcorrect ly H owever the supervisory stance

described may well have helped the analystbear the role of lsquopupilrsquo her patient so stronglyforced her into It may foreseeably have beentoo hard on her to bear the brunt of beinglsquopupilrsquo on both sides in which case we can sur-mise our stance which approaches the supervi-sorrsquos role somewhat to the side of the holdingfunctions of the analyst in session has helpedmake proper place for our little patientrsquos needto assign roles to her analyst and have themsustained The dangers of an overzealoussupervisorteacher pushing the superviseeana-lyst in the pupilrsquos place has been previously andto our mind duly stressed by Solnit (1970) Aswe envision it supervision furthers the recon-sideration of the therapistrsquos clinica l task pro-moting the examination of the evidence thesharing of doubts and the harbouring of evolv-ing ideas

Bearing the solitude of our psychoanalyticwork is in the best of cases problematic evenseasoned analysts need to talk over informallywith colleagues the events in their consultingrooms and have them help think these out Wehope our paper allows the reader to share inwhat supervisee and supervisor learned fromthis difficult but rewarding analytic experience

TRANSLATION S OF SUMMAR Y

Les auteurs illustrent une approche du processusde supervision comme une expeacuterience drsquoapprentissagepour le superviseacute et le superviseur qui est construite surla capaciteacute de contenir les angoisses inconscientesElles montrent qursquoune des fonctions centrale de la su-pervision psychanalytique est drsquoaider agrave contenir lrsquoagi-tation eacutemotionnelle et les angoisses inconscientes quisurgissent et eacutevoluent dans les deux domaines interac-tifs de la seacuteance analytique et de la seacuteance de supervi-sion Dans cette perspective lrsquointeraction analyste-patient ainsi que celle du superviseacute et du superviseurpeuvent ecirctre comprises comme des espaces de trans-formation superposeacutees jumelles lrsquoespace du supervi-seur eacutetant au service de contenir et de comprendre lesrocircles agrave travers lesquels va lrsquoanalyste superviseacute en tantque partie du processus analytique Agrave partir du mateacute-riel clinique deacutetailleacute drsquoune fille troubleacutee de 7 ans lesauteurs explorent les problegravemes relieacutes entre eux et lesdifficulteacutes preacutesenteacutees pour contenir les angoisses etlrsquoagitation preacutesentes agrave la fois dans la situation analyt-ique et en supervision Lorsque la capaciteacute de contenir

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 81

les eacutemotions est adeacutequate la supervision contribue agrave lacompreacutehension et au deacuteveloppement de lrsquoutilisationpar lela superviseacute(e) de sa propre personnaliteacute en tantqursquoinstrument du traitement ainsi que lrsquoont montreacuteF leming et Benedek il y des deacutecades de cela La seacuteancede supervision favorise donc les reacutesolutions des pro-blegravemes cliniques agrave travers la formation de symbole lesseacuteances cliniques et la supervision eacutetant des domainesjumeaux pour enregistrer et comprendre lrsquoeacutevolutioneacutemotionnelle

Die Autoren stellen einen Zugang zum Supervisi-onsprozess dar der ihn als eine Lernerfahrung fuumlrSupervisanden und Supervisor ansieht die auf demContainment von unbewussten Aumlngsten beruht Sieargumentieren dass es eine Hauptfunktion psycho-analytischer Supervision ist dazu beizutragen dieemotionale Verstoumlrung und die unbewussten Aumlngstedie in den zwei interagierenden Bereichen der ana-lytischen und der Supervisionssitzungen auftauchenzu containenldquo Aus dieser Sichtweise lassen sich dieInteraktion zwischen Analytiker und Patient und diezwischen Supervisanden und Supervisor als gleicharti-ge gestufte Transformationsbereiche verstehen wobeider Supervisionsbereich dazu dient die Rollen die derSupervisandAnalytiker durchlaumluft zu halten und zuverstehen Mithilfe von ausfuumlhrlichem klinischem Ma-terial von einem gestoumlrten 7-jaumlhrigen Maumldchen unter-suchen die Autoren die miteinander verbundenenProbleme und Schwierigkeiten die Aumlngste undStoumlrungen in der analytischen und der Supervisionssi-tuation zu containenldquo Wenn emotionales Contain-ment adaumlquat gehandhabt wird hilft die Supervisiondie Verwendung der Persoumlnlichkeit des Supervisandenals Behandlungsinstrument zu verstehen und zu ent-wickeln wie es F leming und Benedek vor Jahrzehntenvertraten Die Supervisionssitzung hilft auf diese

Weise klinische Probleme durch Symbolbildung auf-zuloumlsen wobei therapeutische Sitzungen und Supervi-sion gleichartige Bereiche zur Erfassung und zumVerstehen emotionaler Entwicklung sind

Las autoras enfocan el proceso de la supervisioacutencomo una experiencia de aprendizaje tanto para elsupervisado como para el supervisor la cual se lleva acabo sobre la contencioacuten de las ansiedades incon-scientes Se sostiene que lo esencial de la funcioacuten de lasupervisioacuten psicoanaliacutetica es contribuir a contener laturbulencia emocional y las ansiedades inconscientesque surgen y evolucionan en dos terrenos que inter-actuacutean entre siacute el de las sesiones de anaacutelisis y el de lassesiones de supervisioacuten Desde esta perspectiva lasinteracciones analistandashpaciente y supervisado-supervi-sor pueden ser consideradas como espacios abiertoscon gradas gemelas y cambiantes estando el espaciode la supervisioacuten al servicio de sostener y apuntalar elque las funciones del analistasupervisado sigan ade-lante ya que son parte del proceso analiacutetico Partien-do de un material cliacutenico expuesto en detalle yrelativo a una nintildea de 7 antildeos que presentaba muchosconflictos las autoras estudian algunos puntos inter-relacionados y las dificultades para contener las ansie-dades y los conflictos tanto en la situacioacuten analiacuteticacomo en la de supervisioacuten Cuando los contenidosemocionales son manejados de un modo adecuado lasupervisioacuten contribuye a la comprensioacuten y tambieacuten almejor uso de la misma personalidad del supervisadoacomo instrumento del tratamiento tal como fue de-fendido por F leming y Benedek hace algunas deacutecadasEs de este modo como las sesiones de supervisioacuten con-tribuyen a la solucioacuten de algunos aspectos cliacutenicos atraveacutes de la formacioacuten de siacutembolos ya que las sesionescliacutenicas y la supervisioacuten son terrenos gemelos pararegistrar y comprender la evolucioacuten emocional

R EF ER ENCES

ARLOW J (1963) The supervisory situation JA mer Psychoanal A ssn 11 576ndash94

BION W R (1962) L earning from ExperienceLondon Heinemann

F LEMING J amp BENEDEK T (1964) SupervisionA method of teaching psychoanalysis Psycho-anal Q 33 71ndash96

G RINBERG L (1970) The problems of supervisionin psychoanalytic education Int J Psychoanal51 371ndash82

SOLNIT A J (1970) Learning from psychoanalyt-ic supervision Int J Psychoanal 51 359ndash62

Virginia R U ngar and Luisa Busch de Ahumada Copyright copy Institu te of Psychoanalysis London 2001Dr U ngarBillinghurst 2533 1425 Buenos Aires(Initia l version received 1698)(F irst revised version received 19799)(F inal revised version received 14600)

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 75

direct ions Whenever she came at her most hos-tile she ended up anguished and fearful in acorner mostly against the door saying lsquoLetme let mersquo A displacemen t of hostility wasenacted on the pillows She stamped on themand somewhat later verbalised what she wasdoing lsquoI stamp on you and on what you sayrsquoAt other times she wanted to clean her handson my clothing when they were wet or dirtyfrom the plasticine

When she was in a better mood she justordered me about Her indications to do this orthat revolved around school and schoolworksaying to me lsquoWrite do it just as it comes outrsquoAt first she did not give herself any particularname then in what retrospectively appears to bea significant enough index of an ongoing indi-viduation process she started to call herselfLuciacutea when she enacted the mother or theteacher

As a way to get out of her often manifeststate of terror after her triumphant mood shelsquomeasuredrsquo me up (my feet my back) with sell-otape used as metr ic tape or she tied my feetwith it A few times later on she got out of herterror by lying on the couch and putting herfeet on my lap and rocking them softlymdashlsquoPlay-ing as a baby does with her mumrsquo I told hermdashand then she would ask me to tie her shoelacesup which seemed to convey some request forhelp Also and mostly towards the end of thehour in the last ten or fifteen minutes she cameto celebrate a birthday sometimes mine as thegirl Valeria at other times that of another sonAlberto At those times there was plenty offood around She might send me to the shop tofetch it (lsquoGo go you are already a big girlrsquo) orshe might cook it herself using plasticine as theingredientsmdashpastries sausagesmdashand insistedthat I ate it all She never spoke about whathappens out of sessions except to say that shehad a cat or about a trip she took which sheexplained to me by way of lsquomapsrsquo Amid thisraucous and repetitive material my interpre-tive attempts at intervention centred alterna-tively on her confusion and on how badly shecame to feel when she unleashed her aggression

or I focused on her feelings of triumph as hap-pened after she stamped on the pillows

The session to be presented took place aftera year of treatment five months into the super-vision

A SUPERVISOR Y SESSION

At the start Valeria ran along the corridorand closed the door to the consulting roomshutting me out Through a crack she said qui-etly lsquoWait two minutes OK rsquo Sitting in mychair she took her folder drawing pad pencilsetc from her box and said lsquoReadyrsquo

Sounding important (seemingly in the roleof the teacher) she said lsquoTake out a sheetToday we will have a little task You cut moonsout like this and afterwards we will stick theminrsquo I asked her to explain to me how shewanted the moons to look and the girl drew acloud on the sheet of paper instead and saidlsquoG o on draw and cut out moons in all coloursI will tell you afterwards what to dorsquo I dutifullydrew and cut out the cloudmoons while Vale-ria silently cut out and stuck scraps of variouslycoloured shiny paper on to a sheet of papergrouped by colours Then she said lsquoGive methe moonsrsquo She stuck them on folded sheets ofshiny paper around the coloured scraps alreadystuck on I asked her what it was that she didand she answered lsquoD onrsquot you see M oonsmoons sitting on the chairs Itrsquos a tiny task amaquettersquo (see F ig 1)

In supervision the analystsuperviseeremarked lsquoI think Valeria felt very importantand proud in my chair She was the one whoknew the one to be admired She felt thatsomehow she had placed herself at the centre ofthe space she has been shaping with the shinypaper and the cloudmoons in their chairsadmiring herrsquo The game her being left out atthe start while the girl arranged the setting orbeing out of her normal chair failed to get thetherapist to feel excluded or irritated she feltthat as analyst she had been quite genuinelyready to accept the allotted roles

76 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

When she was done Valeria headed for thedoor and attempted to pin up the sheet ofpaper on it It fell She tried again and saidlsquoCome on help memdashcanrsquot you see itrsquos fallingoffrsquo I helped her and we stuck it up on thedoor inside the playroom (In the next sessionshe threw this sheet of paper into the rubbishbin I rescued it later on)

On looking at the drawing the supervisorwas amazed After all we had been working forjust a few months with this highly disorganisedgirl who at the start amid evacuative outburstsand enormous excitement was quite unable toset up orderly game sequences Then repetitivegames set in involving a teacher and a pupilwho wrote down isolated letters the names sheuttered for the letters did not coincide with thelet ters she wrote her drawings too were quitechaotic N ow in the present drawing the ele-

ments were grouped together and surroundedby bars which suggested containment thecloudmoons lsquosatrsquo on these bars

The supervisor commented that the girl hadfirst asked her analyst for moons but then sheherself drew a cloud instead and the analyst fol-lowed suit The analyst remarked that she hadhesitated and then had done as the girl hadfinally requested She asked if she did right stat-ing more generally that if the supervisor did notconsider it to be right she should tell her andcorrect hermdashthat she should not be afraid to doso The supervisor answered that it was not herway of supervising to tell her if she did right orwrong When an analytica l process is underway the setting and the analytica l situation areinstalled she would rather watch and makeremarks to observe jointly how the transferencerelationship evolved The supervisor went on

F igure 1

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 77

Figure 2

78 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

to say that the analyst herself might have cor-rected the patient telling her that what she haddrawn was not a moon but a cloud

Since the analyst had decided not to andthat it would be best now to see the effects onthe session of keeping to the mooncloud con-fusion her impression was that by not cor-rect ing her patient and taking to the role ofpupil the analyst had helped sustain the pro-jection of the role of lsquothe girl who does notunderstandrsquo This seemed to lead to some-thing that the girl in the role of analyst stuckon pieces of paper and then lsquoassembledrsquo a con-tainer around it We agreed that keeping to theconfusion in the session might have allowedsome element related to the cloudmoons toshow up upon the analystrsquos taking the role oflsquothe girl Valeria who does not knowrsquo Thesupervisor remarked that compared to thisgirlrsquos usual evacuative outbursts these inter-changes would seem nicely to fit Bionrsquos (1962)idea of thought involving alpha-functionwhich requires an object containing the pro-jections and returning them in more organisedmanners with some anxieties processed Suchan objectrsquos reverie function seemed to havepermitted Valeria to put herself together andturn on her own alpha-function

The clinical narrative shows that the analystpartly grasped what had happened Readingthe session again and talking about it it grewmore articulated in her mind It is notable thatfor the first time in all these months the ana-lystsupervisee asked for correction she firsttook this event to be a simple react ion of with-drawal in the face of what took place but at asecond view and as is again apparent in thefollowing paragraphs this request for correc-tion would seem to correspond precisely to anenactment in the supervisory session of therole of the lsquogirl that doesnrsquot knowrsquo or the lsquogirlin the wrongrsquo which Valeria consistently pro-jected into her in the sessions

Valeria said lsquoAll right now wersquoll carry outanother lit tle assignment Write this downCopy it out This is a story which Irsquoll tell youlaterrsquo (She named each let ter while writingthem down) lsquoAnd here it says ldquopipipirdquorsquo (She

drew rays emanating from it) lsquoAnd now draw aspring flower (spring had started just five daysbefore this session) and write ldquopri-ma-ve-rardquorsquo(lsquospringrsquo in Spanish she spelled the word outthough with mistakes) As she said this shewrote the word on her own sheet of paper (F ig2) while I had to do the same on anothersheet lsquoVery good Now make two hearts gotogether like this (she drew lines linking them)and two balloons Remember that you areValeria the girl and Irsquom Luciacutea the teacherYou are 7 years old and Irsquom 40rsquo She wrotedown 7 and 40 and drew a square aroundthem Then she linked each by a line to thedrawing of the hearts

Faced with the girlrsquos drawing the supervi-sor noticed that for the first time she had writ-ten a word lsquopimabrarsquo The analyst hadrealised this as it happened and then wasfrightened by the idea that the parents mightpull the girl out of treatment as soon as shelearned to write so she felt ambivalent aboutthis development The supervisor remarkedthat it would seem that when the analyst man-aged to accept the identificatory projection ofan infantile aspect of the self that misunder-stood and felt misunderstood the girl man-aged to write her first word She added thatbesides feelings of mutual love the two linkedhearts might point also to two minds workingtogether and also that the drawing wouldseem to appear as a sort of blend of a familytree and a family organisational introductorychart with the ages of each Luciacutea the 40-year-old teacher and Valeria the 7-year-old pupilAt that point the supervisor realised that theword Luciacutea contained almost the same letter swith just one misplaced vowel as Luisa theanalystrsquos first name and asked if the girl andher family called her this or her more usualnickname She said surprised that they calledher Luisa not knowing her nickname

To the supervisor this seemed to supportthe notion that the word lsquospringrsquo so obviouslylinked to budding birth and flowering pointsto a creative link-up of two heartsmindsworking together Perhaps also the budding ofthe ability the development of which would of

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 79

course demand some lengthy work of learningto share with others mainly her peers

We went on with the session Valeria askedordered me to continue working lsquoAnd we putldquoChrdquo of cheese ldquocherdquo ldquocheerdquo2 and draw anapple with the little stick and five fingers(counts up to five) It has eyes and a mouthand two different feetmdashthatrsquos wrongrsquo She cor-rected one of the feet on my sheet She gave mea small piece of shiny paper and assignedanother to herself lsquoAnd now write on ldquoprimav-erardquo and the flower and you and mersquo Sheasked me to draw two squares with the ages 40and 7 She continued lsquoM ake a house and atreemdashdonrsquot worry just do it as well as you canEveryone does it as well as they canrsquo I inter-preted lsquoWhen we do lit tle assignmentstogether and you are the one who knows andyou teach me you get everything rightrsquo

Valeria looked attentively and said lsquoYeswersquore right arenrsquot we N ow write the headlineand underline it N ow Irsquoll tell you the story(Pretended to read) Once upon a time therewas a mother and a daughter and the motherwould tell the father ldquoYou go to the shoppingmallrdquo The mother and the children went outfor a while and went to M cDonaldrsquos and hadsodas and then went to the park and the fatherwas at the mall and then they came back homeand thatrsquos the end of the storyrsquo

It was the end of the session Valeria put thematerial in her box including the drawingwhich was stuck on the door

As the supervisory session also drew to itsend the supervisor mused on the effects of theanalystrsquos intervention on this last lsquostoryrsquo nar-rated by Valeria which might restate thecourse of the work carried out together withthe ages in a little square The flagrant demiseof the father whom the mother lsquoordersrsquo to theshopping mall while she and their children gofor an outing drives the girlrsquos felt experience(most likely related to a denial of the primalscene in the link to both therapist and mother)that for the time being the father has beenrejected

CONTAINMENT AN D TEACH ING IN THE

APPR OACH TO TH E SUPERVISORY PROCESS

We find the supervisory experiencedescribed has been apt for containing anxietiesand for thinking out the events of the sessionsupplying a frame for the emotional develop-ments leading to the patientrsquos first writtenthought-out word pimabra as distinct fromthose drawn from memory The analyst beingpart of the ongoing process was aware of somebut only some dimensions of what went onwhich illustrates the various levels encom-passed by lsquomaking the unconscious consciousrsquoAs her final interventionmdashlsquoWhen we do littleassignments together and you are the one whoknows and you teach me you get everythingrightrsquomdashshows she clearly perceived how andwhy roles were allotted in the actual contextbuilt by the evolving anxieties allowing thechild-analysand free use of the denial implicitin her demand that in the play context theyswitch their identit ies She was not howeverfully aware of the ongoing advances in theprocess of symbol-formation As the sayinggoes one cannot write history while making it

The supervisory session transcribed illus-trates containment at two transformationallevels On the one hand at that of the patientwho after putting together in her maquette herown experience of emotional containmentdrew two linked hearts along with her firstwritten word The result of an evolving emo-tional containment stands represented by thisaccomplishment of symbol-formation thejoint initials of patient and analyst with theirsupposed (but reversed) ages enclosed withina box The second level of transformation cor-responds to the supervisorsupervisee link Toput it in Arlowrsquos terms this has to do with thefact that being target to the unconscious anxi-eties of the analytic process the supervisee feelsand knows more than what she has managedto lsquothink throughrsquo and can become apparent inthe record This is the sphere of transforma-tions at the level of psychoanalytic awareness

2 lsquoQue Qui Quorsquo in Spanish

80 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

It must be surmised here that the supervisorrsquosgreater distance from the emotional scenehelped quite a bit It allowed her to grasp thehomology Luciacutea-Luisa illuminating the activeidentificato ry processes in the ongoing reversalof identities in the session

The clinical example presented demon-strates the difficulties inherent in emotionallyframing and instancing creative symbol-for-mation difficulties resulting from the emo-tional turbulence falling upon both membersin the analytic sessions Containment of theongoing anxieties and the opportunities itopens up for an emerging creativity in the ses-sion has required in the case of the analysanda domain of action to be shared with an analystwho can somehow be both lsquooutsidersquo andlsquoinsidersquo the psychic turbulence involved This isalso valid for the handling of the clinical mate-rial in supervision Session and supervisionthus turn into coexistent arenas for recordingand grasping emotional developments

The supervisory approach presenteddeparts as much as circumstances allow fromdirect lsquoteachingrsquo and it privileges the contain-ment and disclosure of the superviseersquos una-voidable anxieties that are part and parcel ofthe course of her analytic task In the Janus-likedilemma of the supervisor a dilemma whichparaphrasing F leming and Benedek can bethought of in terms of containment versusteaching it is our belief that the converse direc-tive teaching approach on the part of the super-visor tends to increase the paranoid anxieties inthe supervisory situation at the expense of con-tainment

It is a main tenet of this presentat ion that theactual learning process within the supervisoryexperience can be better obtained by the super-visorrsquos facilit ating attitude This facilitatio n canonly take place when a sufficient degree ofholding to and grasping of the vicissitudes ofthe superviseersquos involvement in the analyticprocess itself is achieved The supervisorymaterial presented documents the superviseersquostendency to fall into the role of the pupil at thetime when she asks to be told whether she actedcorrect ly H owever the supervisory stance

described may well have helped the analystbear the role of lsquopupilrsquo her patient so stronglyforced her into It may foreseeably have beentoo hard on her to bear the brunt of beinglsquopupilrsquo on both sides in which case we can sur-mise our stance which approaches the supervi-sorrsquos role somewhat to the side of the holdingfunctions of the analyst in session has helpedmake proper place for our little patientrsquos needto assign roles to her analyst and have themsustained The dangers of an overzealoussupervisorteacher pushing the superviseeana-lyst in the pupilrsquos place has been previously andto our mind duly stressed by Solnit (1970) Aswe envision it supervision furthers the recon-sideration of the therapistrsquos clinica l task pro-moting the examination of the evidence thesharing of doubts and the harbouring of evolv-ing ideas

Bearing the solitude of our psychoanalyticwork is in the best of cases problematic evenseasoned analysts need to talk over informallywith colleagues the events in their consultingrooms and have them help think these out Wehope our paper allows the reader to share inwhat supervisee and supervisor learned fromthis difficult but rewarding analytic experience

TRANSLATION S OF SUMMAR Y

Les auteurs illustrent une approche du processusde supervision comme une expeacuterience drsquoapprentissagepour le superviseacute et le superviseur qui est construite surla capaciteacute de contenir les angoisses inconscientesElles montrent qursquoune des fonctions centrale de la su-pervision psychanalytique est drsquoaider agrave contenir lrsquoagi-tation eacutemotionnelle et les angoisses inconscientes quisurgissent et eacutevoluent dans les deux domaines interac-tifs de la seacuteance analytique et de la seacuteance de supervi-sion Dans cette perspective lrsquointeraction analyste-patient ainsi que celle du superviseacute et du superviseurpeuvent ecirctre comprises comme des espaces de trans-formation superposeacutees jumelles lrsquoespace du supervi-seur eacutetant au service de contenir et de comprendre lesrocircles agrave travers lesquels va lrsquoanalyste superviseacute en tantque partie du processus analytique Agrave partir du mateacute-riel clinique deacutetailleacute drsquoune fille troubleacutee de 7 ans lesauteurs explorent les problegravemes relieacutes entre eux et lesdifficulteacutes preacutesenteacutees pour contenir les angoisses etlrsquoagitation preacutesentes agrave la fois dans la situation analyt-ique et en supervision Lorsque la capaciteacute de contenir

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 81

les eacutemotions est adeacutequate la supervision contribue agrave lacompreacutehension et au deacuteveloppement de lrsquoutilisationpar lela superviseacute(e) de sa propre personnaliteacute en tantqursquoinstrument du traitement ainsi que lrsquoont montreacuteF leming et Benedek il y des deacutecades de cela La seacuteancede supervision favorise donc les reacutesolutions des pro-blegravemes cliniques agrave travers la formation de symbole lesseacuteances cliniques et la supervision eacutetant des domainesjumeaux pour enregistrer et comprendre lrsquoeacutevolutioneacutemotionnelle

Die Autoren stellen einen Zugang zum Supervisi-onsprozess dar der ihn als eine Lernerfahrung fuumlrSupervisanden und Supervisor ansieht die auf demContainment von unbewussten Aumlngsten beruht Sieargumentieren dass es eine Hauptfunktion psycho-analytischer Supervision ist dazu beizutragen dieemotionale Verstoumlrung und die unbewussten Aumlngstedie in den zwei interagierenden Bereichen der ana-lytischen und der Supervisionssitzungen auftauchenzu containenldquo Aus dieser Sichtweise lassen sich dieInteraktion zwischen Analytiker und Patient und diezwischen Supervisanden und Supervisor als gleicharti-ge gestufte Transformationsbereiche verstehen wobeider Supervisionsbereich dazu dient die Rollen die derSupervisandAnalytiker durchlaumluft zu halten und zuverstehen Mithilfe von ausfuumlhrlichem klinischem Ma-terial von einem gestoumlrten 7-jaumlhrigen Maumldchen unter-suchen die Autoren die miteinander verbundenenProbleme und Schwierigkeiten die Aumlngste undStoumlrungen in der analytischen und der Supervisionssi-tuation zu containenldquo Wenn emotionales Contain-ment adaumlquat gehandhabt wird hilft die Supervisiondie Verwendung der Persoumlnlichkeit des Supervisandenals Behandlungsinstrument zu verstehen und zu ent-wickeln wie es F leming und Benedek vor Jahrzehntenvertraten Die Supervisionssitzung hilft auf diese

Weise klinische Probleme durch Symbolbildung auf-zuloumlsen wobei therapeutische Sitzungen und Supervi-sion gleichartige Bereiche zur Erfassung und zumVerstehen emotionaler Entwicklung sind

Las autoras enfocan el proceso de la supervisioacutencomo una experiencia de aprendizaje tanto para elsupervisado como para el supervisor la cual se lleva acabo sobre la contencioacuten de las ansiedades incon-scientes Se sostiene que lo esencial de la funcioacuten de lasupervisioacuten psicoanaliacutetica es contribuir a contener laturbulencia emocional y las ansiedades inconscientesque surgen y evolucionan en dos terrenos que inter-actuacutean entre siacute el de las sesiones de anaacutelisis y el de lassesiones de supervisioacuten Desde esta perspectiva lasinteracciones analistandashpaciente y supervisado-supervi-sor pueden ser consideradas como espacios abiertoscon gradas gemelas y cambiantes estando el espaciode la supervisioacuten al servicio de sostener y apuntalar elque las funciones del analistasupervisado sigan ade-lante ya que son parte del proceso analiacutetico Partien-do de un material cliacutenico expuesto en detalle yrelativo a una nintildea de 7 antildeos que presentaba muchosconflictos las autoras estudian algunos puntos inter-relacionados y las dificultades para contener las ansie-dades y los conflictos tanto en la situacioacuten analiacuteticacomo en la de supervisioacuten Cuando los contenidosemocionales son manejados de un modo adecuado lasupervisioacuten contribuye a la comprensioacuten y tambieacuten almejor uso de la misma personalidad del supervisadoacomo instrumento del tratamiento tal como fue de-fendido por F leming y Benedek hace algunas deacutecadasEs de este modo como las sesiones de supervisioacuten con-tribuyen a la solucioacuten de algunos aspectos cliacutenicos atraveacutes de la formacioacuten de siacutembolos ya que las sesionescliacutenicas y la supervisioacuten son terrenos gemelos pararegistrar y comprender la evolucioacuten emocional

R EF ER ENCES

ARLOW J (1963) The supervisory situation JA mer Psychoanal A ssn 11 576ndash94

BION W R (1962) L earning from ExperienceLondon Heinemann

F LEMING J amp BENEDEK T (1964) SupervisionA method of teaching psychoanalysis Psycho-anal Q 33 71ndash96

G RINBERG L (1970) The problems of supervisionin psychoanalytic education Int J Psychoanal51 371ndash82

SOLNIT A J (1970) Learning from psychoanalyt-ic supervision Int J Psychoanal 51 359ndash62

Virginia R U ngar and Luisa Busch de Ahumada Copyright copy Institu te of Psychoanalysis London 2001Dr U ngarBillinghurst 2533 1425 Buenos Aires(Initia l version received 1698)(F irst revised version received 19799)(F inal revised version received 14600)

76 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

When she was done Valeria headed for thedoor and attempted to pin up the sheet ofpaper on it It fell She tried again and saidlsquoCome on help memdashcanrsquot you see itrsquos fallingoffrsquo I helped her and we stuck it up on thedoor inside the playroom (In the next sessionshe threw this sheet of paper into the rubbishbin I rescued it later on)

On looking at the drawing the supervisorwas amazed After all we had been working forjust a few months with this highly disorganisedgirl who at the start amid evacuative outburstsand enormous excitement was quite unable toset up orderly game sequences Then repetitivegames set in involving a teacher and a pupilwho wrote down isolated letters the names sheuttered for the letters did not coincide with thelet ters she wrote her drawings too were quitechaotic N ow in the present drawing the ele-

ments were grouped together and surroundedby bars which suggested containment thecloudmoons lsquosatrsquo on these bars

The supervisor commented that the girl hadfirst asked her analyst for moons but then sheherself drew a cloud instead and the analyst fol-lowed suit The analyst remarked that she hadhesitated and then had done as the girl hadfinally requested She asked if she did right stat-ing more generally that if the supervisor did notconsider it to be right she should tell her andcorrect hermdashthat she should not be afraid to doso The supervisor answered that it was not herway of supervising to tell her if she did right orwrong When an analytica l process is underway the setting and the analytica l situation areinstalled she would rather watch and makeremarks to observe jointly how the transferencerelationship evolved The supervisor went on

F igure 1

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 77

Figure 2

78 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

to say that the analyst herself might have cor-rected the patient telling her that what she haddrawn was not a moon but a cloud

Since the analyst had decided not to andthat it would be best now to see the effects onthe session of keeping to the mooncloud con-fusion her impression was that by not cor-rect ing her patient and taking to the role ofpupil the analyst had helped sustain the pro-jection of the role of lsquothe girl who does notunderstandrsquo This seemed to lead to some-thing that the girl in the role of analyst stuckon pieces of paper and then lsquoassembledrsquo a con-tainer around it We agreed that keeping to theconfusion in the session might have allowedsome element related to the cloudmoons toshow up upon the analystrsquos taking the role oflsquothe girl Valeria who does not knowrsquo Thesupervisor remarked that compared to thisgirlrsquos usual evacuative outbursts these inter-changes would seem nicely to fit Bionrsquos (1962)idea of thought involving alpha-functionwhich requires an object containing the pro-jections and returning them in more organisedmanners with some anxieties processed Suchan objectrsquos reverie function seemed to havepermitted Valeria to put herself together andturn on her own alpha-function

The clinical narrative shows that the analystpartly grasped what had happened Readingthe session again and talking about it it grewmore articulated in her mind It is notable thatfor the first time in all these months the ana-lystsupervisee asked for correction she firsttook this event to be a simple react ion of with-drawal in the face of what took place but at asecond view and as is again apparent in thefollowing paragraphs this request for correc-tion would seem to correspond precisely to anenactment in the supervisory session of therole of the lsquogirl that doesnrsquot knowrsquo or the lsquogirlin the wrongrsquo which Valeria consistently pro-jected into her in the sessions

Valeria said lsquoAll right now wersquoll carry outanother lit tle assignment Write this downCopy it out This is a story which Irsquoll tell youlaterrsquo (She named each let ter while writingthem down) lsquoAnd here it says ldquopipipirdquorsquo (She

drew rays emanating from it) lsquoAnd now draw aspring flower (spring had started just five daysbefore this session) and write ldquopri-ma-ve-rardquorsquo(lsquospringrsquo in Spanish she spelled the word outthough with mistakes) As she said this shewrote the word on her own sheet of paper (F ig2) while I had to do the same on anothersheet lsquoVery good Now make two hearts gotogether like this (she drew lines linking them)and two balloons Remember that you areValeria the girl and Irsquom Luciacutea the teacherYou are 7 years old and Irsquom 40rsquo She wrotedown 7 and 40 and drew a square aroundthem Then she linked each by a line to thedrawing of the hearts

Faced with the girlrsquos drawing the supervi-sor noticed that for the first time she had writ-ten a word lsquopimabrarsquo The analyst hadrealised this as it happened and then wasfrightened by the idea that the parents mightpull the girl out of treatment as soon as shelearned to write so she felt ambivalent aboutthis development The supervisor remarkedthat it would seem that when the analyst man-aged to accept the identificatory projection ofan infantile aspect of the self that misunder-stood and felt misunderstood the girl man-aged to write her first word She added thatbesides feelings of mutual love the two linkedhearts might point also to two minds workingtogether and also that the drawing wouldseem to appear as a sort of blend of a familytree and a family organisational introductorychart with the ages of each Luciacutea the 40-year-old teacher and Valeria the 7-year-old pupilAt that point the supervisor realised that theword Luciacutea contained almost the same letter swith just one misplaced vowel as Luisa theanalystrsquos first name and asked if the girl andher family called her this or her more usualnickname She said surprised that they calledher Luisa not knowing her nickname

To the supervisor this seemed to supportthe notion that the word lsquospringrsquo so obviouslylinked to budding birth and flowering pointsto a creative link-up of two heartsmindsworking together Perhaps also the budding ofthe ability the development of which would of

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 79

course demand some lengthy work of learningto share with others mainly her peers

We went on with the session Valeria askedordered me to continue working lsquoAnd we putldquoChrdquo of cheese ldquocherdquo ldquocheerdquo2 and draw anapple with the little stick and five fingers(counts up to five) It has eyes and a mouthand two different feetmdashthatrsquos wrongrsquo She cor-rected one of the feet on my sheet She gave mea small piece of shiny paper and assignedanother to herself lsquoAnd now write on ldquoprimav-erardquo and the flower and you and mersquo Sheasked me to draw two squares with the ages 40and 7 She continued lsquoM ake a house and atreemdashdonrsquot worry just do it as well as you canEveryone does it as well as they canrsquo I inter-preted lsquoWhen we do lit tle assignmentstogether and you are the one who knows andyou teach me you get everything rightrsquo

Valeria looked attentively and said lsquoYeswersquore right arenrsquot we N ow write the headlineand underline it N ow Irsquoll tell you the story(Pretended to read) Once upon a time therewas a mother and a daughter and the motherwould tell the father ldquoYou go to the shoppingmallrdquo The mother and the children went outfor a while and went to M cDonaldrsquos and hadsodas and then went to the park and the fatherwas at the mall and then they came back homeand thatrsquos the end of the storyrsquo

It was the end of the session Valeria put thematerial in her box including the drawingwhich was stuck on the door

As the supervisory session also drew to itsend the supervisor mused on the effects of theanalystrsquos intervention on this last lsquostoryrsquo nar-rated by Valeria which might restate thecourse of the work carried out together withthe ages in a little square The flagrant demiseof the father whom the mother lsquoordersrsquo to theshopping mall while she and their children gofor an outing drives the girlrsquos felt experience(most likely related to a denial of the primalscene in the link to both therapist and mother)that for the time being the father has beenrejected

CONTAINMENT AN D TEACH ING IN THE

APPR OACH TO TH E SUPERVISORY PROCESS

We find the supervisory experiencedescribed has been apt for containing anxietiesand for thinking out the events of the sessionsupplying a frame for the emotional develop-ments leading to the patientrsquos first writtenthought-out word pimabra as distinct fromthose drawn from memory The analyst beingpart of the ongoing process was aware of somebut only some dimensions of what went onwhich illustrates the various levels encom-passed by lsquomaking the unconscious consciousrsquoAs her final interventionmdashlsquoWhen we do littleassignments together and you are the one whoknows and you teach me you get everythingrightrsquomdashshows she clearly perceived how andwhy roles were allotted in the actual contextbuilt by the evolving anxieties allowing thechild-analysand free use of the denial implicitin her demand that in the play context theyswitch their identit ies She was not howeverfully aware of the ongoing advances in theprocess of symbol-formation As the sayinggoes one cannot write history while making it

The supervisory session transcribed illus-trates containment at two transformationallevels On the one hand at that of the patientwho after putting together in her maquette herown experience of emotional containmentdrew two linked hearts along with her firstwritten word The result of an evolving emo-tional containment stands represented by thisaccomplishment of symbol-formation thejoint initials of patient and analyst with theirsupposed (but reversed) ages enclosed withina box The second level of transformation cor-responds to the supervisorsupervisee link Toput it in Arlowrsquos terms this has to do with thefact that being target to the unconscious anxi-eties of the analytic process the supervisee feelsand knows more than what she has managedto lsquothink throughrsquo and can become apparent inthe record This is the sphere of transforma-tions at the level of psychoanalytic awareness

2 lsquoQue Qui Quorsquo in Spanish

80 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

It must be surmised here that the supervisorrsquosgreater distance from the emotional scenehelped quite a bit It allowed her to grasp thehomology Luciacutea-Luisa illuminating the activeidentificato ry processes in the ongoing reversalof identities in the session

The clinical example presented demon-strates the difficulties inherent in emotionallyframing and instancing creative symbol-for-mation difficulties resulting from the emo-tional turbulence falling upon both membersin the analytic sessions Containment of theongoing anxieties and the opportunities itopens up for an emerging creativity in the ses-sion has required in the case of the analysanda domain of action to be shared with an analystwho can somehow be both lsquooutsidersquo andlsquoinsidersquo the psychic turbulence involved This isalso valid for the handling of the clinical mate-rial in supervision Session and supervisionthus turn into coexistent arenas for recordingand grasping emotional developments

The supervisory approach presenteddeparts as much as circumstances allow fromdirect lsquoteachingrsquo and it privileges the contain-ment and disclosure of the superviseersquos una-voidable anxieties that are part and parcel ofthe course of her analytic task In the Janus-likedilemma of the supervisor a dilemma whichparaphrasing F leming and Benedek can bethought of in terms of containment versusteaching it is our belief that the converse direc-tive teaching approach on the part of the super-visor tends to increase the paranoid anxieties inthe supervisory situation at the expense of con-tainment

It is a main tenet of this presentat ion that theactual learning process within the supervisoryexperience can be better obtained by the super-visorrsquos facilit ating attitude This facilitatio n canonly take place when a sufficient degree ofholding to and grasping of the vicissitudes ofthe superviseersquos involvement in the analyticprocess itself is achieved The supervisorymaterial presented documents the superviseersquostendency to fall into the role of the pupil at thetime when she asks to be told whether she actedcorrect ly H owever the supervisory stance

described may well have helped the analystbear the role of lsquopupilrsquo her patient so stronglyforced her into It may foreseeably have beentoo hard on her to bear the brunt of beinglsquopupilrsquo on both sides in which case we can sur-mise our stance which approaches the supervi-sorrsquos role somewhat to the side of the holdingfunctions of the analyst in session has helpedmake proper place for our little patientrsquos needto assign roles to her analyst and have themsustained The dangers of an overzealoussupervisorteacher pushing the superviseeana-lyst in the pupilrsquos place has been previously andto our mind duly stressed by Solnit (1970) Aswe envision it supervision furthers the recon-sideration of the therapistrsquos clinica l task pro-moting the examination of the evidence thesharing of doubts and the harbouring of evolv-ing ideas

Bearing the solitude of our psychoanalyticwork is in the best of cases problematic evenseasoned analysts need to talk over informallywith colleagues the events in their consultingrooms and have them help think these out Wehope our paper allows the reader to share inwhat supervisee and supervisor learned fromthis difficult but rewarding analytic experience

TRANSLATION S OF SUMMAR Y

Les auteurs illustrent une approche du processusde supervision comme une expeacuterience drsquoapprentissagepour le superviseacute et le superviseur qui est construite surla capaciteacute de contenir les angoisses inconscientesElles montrent qursquoune des fonctions centrale de la su-pervision psychanalytique est drsquoaider agrave contenir lrsquoagi-tation eacutemotionnelle et les angoisses inconscientes quisurgissent et eacutevoluent dans les deux domaines interac-tifs de la seacuteance analytique et de la seacuteance de supervi-sion Dans cette perspective lrsquointeraction analyste-patient ainsi que celle du superviseacute et du superviseurpeuvent ecirctre comprises comme des espaces de trans-formation superposeacutees jumelles lrsquoespace du supervi-seur eacutetant au service de contenir et de comprendre lesrocircles agrave travers lesquels va lrsquoanalyste superviseacute en tantque partie du processus analytique Agrave partir du mateacute-riel clinique deacutetailleacute drsquoune fille troubleacutee de 7 ans lesauteurs explorent les problegravemes relieacutes entre eux et lesdifficulteacutes preacutesenteacutees pour contenir les angoisses etlrsquoagitation preacutesentes agrave la fois dans la situation analyt-ique et en supervision Lorsque la capaciteacute de contenir

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 81

les eacutemotions est adeacutequate la supervision contribue agrave lacompreacutehension et au deacuteveloppement de lrsquoutilisationpar lela superviseacute(e) de sa propre personnaliteacute en tantqursquoinstrument du traitement ainsi que lrsquoont montreacuteF leming et Benedek il y des deacutecades de cela La seacuteancede supervision favorise donc les reacutesolutions des pro-blegravemes cliniques agrave travers la formation de symbole lesseacuteances cliniques et la supervision eacutetant des domainesjumeaux pour enregistrer et comprendre lrsquoeacutevolutioneacutemotionnelle

Die Autoren stellen einen Zugang zum Supervisi-onsprozess dar der ihn als eine Lernerfahrung fuumlrSupervisanden und Supervisor ansieht die auf demContainment von unbewussten Aumlngsten beruht Sieargumentieren dass es eine Hauptfunktion psycho-analytischer Supervision ist dazu beizutragen dieemotionale Verstoumlrung und die unbewussten Aumlngstedie in den zwei interagierenden Bereichen der ana-lytischen und der Supervisionssitzungen auftauchenzu containenldquo Aus dieser Sichtweise lassen sich dieInteraktion zwischen Analytiker und Patient und diezwischen Supervisanden und Supervisor als gleicharti-ge gestufte Transformationsbereiche verstehen wobeider Supervisionsbereich dazu dient die Rollen die derSupervisandAnalytiker durchlaumluft zu halten und zuverstehen Mithilfe von ausfuumlhrlichem klinischem Ma-terial von einem gestoumlrten 7-jaumlhrigen Maumldchen unter-suchen die Autoren die miteinander verbundenenProbleme und Schwierigkeiten die Aumlngste undStoumlrungen in der analytischen und der Supervisionssi-tuation zu containenldquo Wenn emotionales Contain-ment adaumlquat gehandhabt wird hilft die Supervisiondie Verwendung der Persoumlnlichkeit des Supervisandenals Behandlungsinstrument zu verstehen und zu ent-wickeln wie es F leming und Benedek vor Jahrzehntenvertraten Die Supervisionssitzung hilft auf diese

Weise klinische Probleme durch Symbolbildung auf-zuloumlsen wobei therapeutische Sitzungen und Supervi-sion gleichartige Bereiche zur Erfassung und zumVerstehen emotionaler Entwicklung sind

Las autoras enfocan el proceso de la supervisioacutencomo una experiencia de aprendizaje tanto para elsupervisado como para el supervisor la cual se lleva acabo sobre la contencioacuten de las ansiedades incon-scientes Se sostiene que lo esencial de la funcioacuten de lasupervisioacuten psicoanaliacutetica es contribuir a contener laturbulencia emocional y las ansiedades inconscientesque surgen y evolucionan en dos terrenos que inter-actuacutean entre siacute el de las sesiones de anaacutelisis y el de lassesiones de supervisioacuten Desde esta perspectiva lasinteracciones analistandashpaciente y supervisado-supervi-sor pueden ser consideradas como espacios abiertoscon gradas gemelas y cambiantes estando el espaciode la supervisioacuten al servicio de sostener y apuntalar elque las funciones del analistasupervisado sigan ade-lante ya que son parte del proceso analiacutetico Partien-do de un material cliacutenico expuesto en detalle yrelativo a una nintildea de 7 antildeos que presentaba muchosconflictos las autoras estudian algunos puntos inter-relacionados y las dificultades para contener las ansie-dades y los conflictos tanto en la situacioacuten analiacuteticacomo en la de supervisioacuten Cuando los contenidosemocionales son manejados de un modo adecuado lasupervisioacuten contribuye a la comprensioacuten y tambieacuten almejor uso de la misma personalidad del supervisadoacomo instrumento del tratamiento tal como fue de-fendido por F leming y Benedek hace algunas deacutecadasEs de este modo como las sesiones de supervisioacuten con-tribuyen a la solucioacuten de algunos aspectos cliacutenicos atraveacutes de la formacioacuten de siacutembolos ya que las sesionescliacutenicas y la supervisioacuten son terrenos gemelos pararegistrar y comprender la evolucioacuten emocional

R EF ER ENCES

ARLOW J (1963) The supervisory situation JA mer Psychoanal A ssn 11 576ndash94

BION W R (1962) L earning from ExperienceLondon Heinemann

F LEMING J amp BENEDEK T (1964) SupervisionA method of teaching psychoanalysis Psycho-anal Q 33 71ndash96

G RINBERG L (1970) The problems of supervisionin psychoanalytic education Int J Psychoanal51 371ndash82

SOLNIT A J (1970) Learning from psychoanalyt-ic supervision Int J Psychoanal 51 359ndash62

Virginia R U ngar and Luisa Busch de Ahumada Copyright copy Institu te of Psychoanalysis London 2001Dr U ngarBillinghurst 2533 1425 Buenos Aires(Initia l version received 1698)(F irst revised version received 19799)(F inal revised version received 14600)

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 77

Figure 2

78 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

to say that the analyst herself might have cor-rected the patient telling her that what she haddrawn was not a moon but a cloud

Since the analyst had decided not to andthat it would be best now to see the effects onthe session of keeping to the mooncloud con-fusion her impression was that by not cor-rect ing her patient and taking to the role ofpupil the analyst had helped sustain the pro-jection of the role of lsquothe girl who does notunderstandrsquo This seemed to lead to some-thing that the girl in the role of analyst stuckon pieces of paper and then lsquoassembledrsquo a con-tainer around it We agreed that keeping to theconfusion in the session might have allowedsome element related to the cloudmoons toshow up upon the analystrsquos taking the role oflsquothe girl Valeria who does not knowrsquo Thesupervisor remarked that compared to thisgirlrsquos usual evacuative outbursts these inter-changes would seem nicely to fit Bionrsquos (1962)idea of thought involving alpha-functionwhich requires an object containing the pro-jections and returning them in more organisedmanners with some anxieties processed Suchan objectrsquos reverie function seemed to havepermitted Valeria to put herself together andturn on her own alpha-function

The clinical narrative shows that the analystpartly grasped what had happened Readingthe session again and talking about it it grewmore articulated in her mind It is notable thatfor the first time in all these months the ana-lystsupervisee asked for correction she firsttook this event to be a simple react ion of with-drawal in the face of what took place but at asecond view and as is again apparent in thefollowing paragraphs this request for correc-tion would seem to correspond precisely to anenactment in the supervisory session of therole of the lsquogirl that doesnrsquot knowrsquo or the lsquogirlin the wrongrsquo which Valeria consistently pro-jected into her in the sessions

Valeria said lsquoAll right now wersquoll carry outanother lit tle assignment Write this downCopy it out This is a story which Irsquoll tell youlaterrsquo (She named each let ter while writingthem down) lsquoAnd here it says ldquopipipirdquorsquo (She

drew rays emanating from it) lsquoAnd now draw aspring flower (spring had started just five daysbefore this session) and write ldquopri-ma-ve-rardquorsquo(lsquospringrsquo in Spanish she spelled the word outthough with mistakes) As she said this shewrote the word on her own sheet of paper (F ig2) while I had to do the same on anothersheet lsquoVery good Now make two hearts gotogether like this (she drew lines linking them)and two balloons Remember that you areValeria the girl and Irsquom Luciacutea the teacherYou are 7 years old and Irsquom 40rsquo She wrotedown 7 and 40 and drew a square aroundthem Then she linked each by a line to thedrawing of the hearts

Faced with the girlrsquos drawing the supervi-sor noticed that for the first time she had writ-ten a word lsquopimabrarsquo The analyst hadrealised this as it happened and then wasfrightened by the idea that the parents mightpull the girl out of treatment as soon as shelearned to write so she felt ambivalent aboutthis development The supervisor remarkedthat it would seem that when the analyst man-aged to accept the identificatory projection ofan infantile aspect of the self that misunder-stood and felt misunderstood the girl man-aged to write her first word She added thatbesides feelings of mutual love the two linkedhearts might point also to two minds workingtogether and also that the drawing wouldseem to appear as a sort of blend of a familytree and a family organisational introductorychart with the ages of each Luciacutea the 40-year-old teacher and Valeria the 7-year-old pupilAt that point the supervisor realised that theword Luciacutea contained almost the same letter swith just one misplaced vowel as Luisa theanalystrsquos first name and asked if the girl andher family called her this or her more usualnickname She said surprised that they calledher Luisa not knowing her nickname

To the supervisor this seemed to supportthe notion that the word lsquospringrsquo so obviouslylinked to budding birth and flowering pointsto a creative link-up of two heartsmindsworking together Perhaps also the budding ofthe ability the development of which would of

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 79

course demand some lengthy work of learningto share with others mainly her peers

We went on with the session Valeria askedordered me to continue working lsquoAnd we putldquoChrdquo of cheese ldquocherdquo ldquocheerdquo2 and draw anapple with the little stick and five fingers(counts up to five) It has eyes and a mouthand two different feetmdashthatrsquos wrongrsquo She cor-rected one of the feet on my sheet She gave mea small piece of shiny paper and assignedanother to herself lsquoAnd now write on ldquoprimav-erardquo and the flower and you and mersquo Sheasked me to draw two squares with the ages 40and 7 She continued lsquoM ake a house and atreemdashdonrsquot worry just do it as well as you canEveryone does it as well as they canrsquo I inter-preted lsquoWhen we do lit tle assignmentstogether and you are the one who knows andyou teach me you get everything rightrsquo

Valeria looked attentively and said lsquoYeswersquore right arenrsquot we N ow write the headlineand underline it N ow Irsquoll tell you the story(Pretended to read) Once upon a time therewas a mother and a daughter and the motherwould tell the father ldquoYou go to the shoppingmallrdquo The mother and the children went outfor a while and went to M cDonaldrsquos and hadsodas and then went to the park and the fatherwas at the mall and then they came back homeand thatrsquos the end of the storyrsquo

It was the end of the session Valeria put thematerial in her box including the drawingwhich was stuck on the door

As the supervisory session also drew to itsend the supervisor mused on the effects of theanalystrsquos intervention on this last lsquostoryrsquo nar-rated by Valeria which might restate thecourse of the work carried out together withthe ages in a little square The flagrant demiseof the father whom the mother lsquoordersrsquo to theshopping mall while she and their children gofor an outing drives the girlrsquos felt experience(most likely related to a denial of the primalscene in the link to both therapist and mother)that for the time being the father has beenrejected

CONTAINMENT AN D TEACH ING IN THE

APPR OACH TO TH E SUPERVISORY PROCESS

We find the supervisory experiencedescribed has been apt for containing anxietiesand for thinking out the events of the sessionsupplying a frame for the emotional develop-ments leading to the patientrsquos first writtenthought-out word pimabra as distinct fromthose drawn from memory The analyst beingpart of the ongoing process was aware of somebut only some dimensions of what went onwhich illustrates the various levels encom-passed by lsquomaking the unconscious consciousrsquoAs her final interventionmdashlsquoWhen we do littleassignments together and you are the one whoknows and you teach me you get everythingrightrsquomdashshows she clearly perceived how andwhy roles were allotted in the actual contextbuilt by the evolving anxieties allowing thechild-analysand free use of the denial implicitin her demand that in the play context theyswitch their identit ies She was not howeverfully aware of the ongoing advances in theprocess of symbol-formation As the sayinggoes one cannot write history while making it

The supervisory session transcribed illus-trates containment at two transformationallevels On the one hand at that of the patientwho after putting together in her maquette herown experience of emotional containmentdrew two linked hearts along with her firstwritten word The result of an evolving emo-tional containment stands represented by thisaccomplishment of symbol-formation thejoint initials of patient and analyst with theirsupposed (but reversed) ages enclosed withina box The second level of transformation cor-responds to the supervisorsupervisee link Toput it in Arlowrsquos terms this has to do with thefact that being target to the unconscious anxi-eties of the analytic process the supervisee feelsand knows more than what she has managedto lsquothink throughrsquo and can become apparent inthe record This is the sphere of transforma-tions at the level of psychoanalytic awareness

2 lsquoQue Qui Quorsquo in Spanish

80 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

It must be surmised here that the supervisorrsquosgreater distance from the emotional scenehelped quite a bit It allowed her to grasp thehomology Luciacutea-Luisa illuminating the activeidentificato ry processes in the ongoing reversalof identities in the session

The clinical example presented demon-strates the difficulties inherent in emotionallyframing and instancing creative symbol-for-mation difficulties resulting from the emo-tional turbulence falling upon both membersin the analytic sessions Containment of theongoing anxieties and the opportunities itopens up for an emerging creativity in the ses-sion has required in the case of the analysanda domain of action to be shared with an analystwho can somehow be both lsquooutsidersquo andlsquoinsidersquo the psychic turbulence involved This isalso valid for the handling of the clinical mate-rial in supervision Session and supervisionthus turn into coexistent arenas for recordingand grasping emotional developments

The supervisory approach presenteddeparts as much as circumstances allow fromdirect lsquoteachingrsquo and it privileges the contain-ment and disclosure of the superviseersquos una-voidable anxieties that are part and parcel ofthe course of her analytic task In the Janus-likedilemma of the supervisor a dilemma whichparaphrasing F leming and Benedek can bethought of in terms of containment versusteaching it is our belief that the converse direc-tive teaching approach on the part of the super-visor tends to increase the paranoid anxieties inthe supervisory situation at the expense of con-tainment

It is a main tenet of this presentat ion that theactual learning process within the supervisoryexperience can be better obtained by the super-visorrsquos facilit ating attitude This facilitatio n canonly take place when a sufficient degree ofholding to and grasping of the vicissitudes ofthe superviseersquos involvement in the analyticprocess itself is achieved The supervisorymaterial presented documents the superviseersquostendency to fall into the role of the pupil at thetime when she asks to be told whether she actedcorrect ly H owever the supervisory stance

described may well have helped the analystbear the role of lsquopupilrsquo her patient so stronglyforced her into It may foreseeably have beentoo hard on her to bear the brunt of beinglsquopupilrsquo on both sides in which case we can sur-mise our stance which approaches the supervi-sorrsquos role somewhat to the side of the holdingfunctions of the analyst in session has helpedmake proper place for our little patientrsquos needto assign roles to her analyst and have themsustained The dangers of an overzealoussupervisorteacher pushing the superviseeana-lyst in the pupilrsquos place has been previously andto our mind duly stressed by Solnit (1970) Aswe envision it supervision furthers the recon-sideration of the therapistrsquos clinica l task pro-moting the examination of the evidence thesharing of doubts and the harbouring of evolv-ing ideas

Bearing the solitude of our psychoanalyticwork is in the best of cases problematic evenseasoned analysts need to talk over informallywith colleagues the events in their consultingrooms and have them help think these out Wehope our paper allows the reader to share inwhat supervisee and supervisor learned fromthis difficult but rewarding analytic experience

TRANSLATION S OF SUMMAR Y

Les auteurs illustrent une approche du processusde supervision comme une expeacuterience drsquoapprentissagepour le superviseacute et le superviseur qui est construite surla capaciteacute de contenir les angoisses inconscientesElles montrent qursquoune des fonctions centrale de la su-pervision psychanalytique est drsquoaider agrave contenir lrsquoagi-tation eacutemotionnelle et les angoisses inconscientes quisurgissent et eacutevoluent dans les deux domaines interac-tifs de la seacuteance analytique et de la seacuteance de supervi-sion Dans cette perspective lrsquointeraction analyste-patient ainsi que celle du superviseacute et du superviseurpeuvent ecirctre comprises comme des espaces de trans-formation superposeacutees jumelles lrsquoespace du supervi-seur eacutetant au service de contenir et de comprendre lesrocircles agrave travers lesquels va lrsquoanalyste superviseacute en tantque partie du processus analytique Agrave partir du mateacute-riel clinique deacutetailleacute drsquoune fille troubleacutee de 7 ans lesauteurs explorent les problegravemes relieacutes entre eux et lesdifficulteacutes preacutesenteacutees pour contenir les angoisses etlrsquoagitation preacutesentes agrave la fois dans la situation analyt-ique et en supervision Lorsque la capaciteacute de contenir

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 81

les eacutemotions est adeacutequate la supervision contribue agrave lacompreacutehension et au deacuteveloppement de lrsquoutilisationpar lela superviseacute(e) de sa propre personnaliteacute en tantqursquoinstrument du traitement ainsi que lrsquoont montreacuteF leming et Benedek il y des deacutecades de cela La seacuteancede supervision favorise donc les reacutesolutions des pro-blegravemes cliniques agrave travers la formation de symbole lesseacuteances cliniques et la supervision eacutetant des domainesjumeaux pour enregistrer et comprendre lrsquoeacutevolutioneacutemotionnelle

Die Autoren stellen einen Zugang zum Supervisi-onsprozess dar der ihn als eine Lernerfahrung fuumlrSupervisanden und Supervisor ansieht die auf demContainment von unbewussten Aumlngsten beruht Sieargumentieren dass es eine Hauptfunktion psycho-analytischer Supervision ist dazu beizutragen dieemotionale Verstoumlrung und die unbewussten Aumlngstedie in den zwei interagierenden Bereichen der ana-lytischen und der Supervisionssitzungen auftauchenzu containenldquo Aus dieser Sichtweise lassen sich dieInteraktion zwischen Analytiker und Patient und diezwischen Supervisanden und Supervisor als gleicharti-ge gestufte Transformationsbereiche verstehen wobeider Supervisionsbereich dazu dient die Rollen die derSupervisandAnalytiker durchlaumluft zu halten und zuverstehen Mithilfe von ausfuumlhrlichem klinischem Ma-terial von einem gestoumlrten 7-jaumlhrigen Maumldchen unter-suchen die Autoren die miteinander verbundenenProbleme und Schwierigkeiten die Aumlngste undStoumlrungen in der analytischen und der Supervisionssi-tuation zu containenldquo Wenn emotionales Contain-ment adaumlquat gehandhabt wird hilft die Supervisiondie Verwendung der Persoumlnlichkeit des Supervisandenals Behandlungsinstrument zu verstehen und zu ent-wickeln wie es F leming und Benedek vor Jahrzehntenvertraten Die Supervisionssitzung hilft auf diese

Weise klinische Probleme durch Symbolbildung auf-zuloumlsen wobei therapeutische Sitzungen und Supervi-sion gleichartige Bereiche zur Erfassung und zumVerstehen emotionaler Entwicklung sind

Las autoras enfocan el proceso de la supervisioacutencomo una experiencia de aprendizaje tanto para elsupervisado como para el supervisor la cual se lleva acabo sobre la contencioacuten de las ansiedades incon-scientes Se sostiene que lo esencial de la funcioacuten de lasupervisioacuten psicoanaliacutetica es contribuir a contener laturbulencia emocional y las ansiedades inconscientesque surgen y evolucionan en dos terrenos que inter-actuacutean entre siacute el de las sesiones de anaacutelisis y el de lassesiones de supervisioacuten Desde esta perspectiva lasinteracciones analistandashpaciente y supervisado-supervi-sor pueden ser consideradas como espacios abiertoscon gradas gemelas y cambiantes estando el espaciode la supervisioacuten al servicio de sostener y apuntalar elque las funciones del analistasupervisado sigan ade-lante ya que son parte del proceso analiacutetico Partien-do de un material cliacutenico expuesto en detalle yrelativo a una nintildea de 7 antildeos que presentaba muchosconflictos las autoras estudian algunos puntos inter-relacionados y las dificultades para contener las ansie-dades y los conflictos tanto en la situacioacuten analiacuteticacomo en la de supervisioacuten Cuando los contenidosemocionales son manejados de un modo adecuado lasupervisioacuten contribuye a la comprensioacuten y tambieacuten almejor uso de la misma personalidad del supervisadoacomo instrumento del tratamiento tal como fue de-fendido por F leming y Benedek hace algunas deacutecadasEs de este modo como las sesiones de supervisioacuten con-tribuyen a la solucioacuten de algunos aspectos cliacutenicos atraveacutes de la formacioacuten de siacutembolos ya que las sesionescliacutenicas y la supervisioacuten son terrenos gemelos pararegistrar y comprender la evolucioacuten emocional

R EF ER ENCES

ARLOW J (1963) The supervisory situation JA mer Psychoanal A ssn 11 576ndash94

BION W R (1962) L earning from ExperienceLondon Heinemann

F LEMING J amp BENEDEK T (1964) SupervisionA method of teaching psychoanalysis Psycho-anal Q 33 71ndash96

G RINBERG L (1970) The problems of supervisionin psychoanalytic education Int J Psychoanal51 371ndash82

SOLNIT A J (1970) Learning from psychoanalyt-ic supervision Int J Psychoanal 51 359ndash62

Virginia R U ngar and Luisa Busch de Ahumada Copyright copy Institu te of Psychoanalysis London 2001Dr U ngarBillinghurst 2533 1425 Buenos Aires(Initia l version received 1698)(F irst revised version received 19799)(F inal revised version received 14600)

78 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

to say that the analyst herself might have cor-rected the patient telling her that what she haddrawn was not a moon but a cloud

Since the analyst had decided not to andthat it would be best now to see the effects onthe session of keeping to the mooncloud con-fusion her impression was that by not cor-rect ing her patient and taking to the role ofpupil the analyst had helped sustain the pro-jection of the role of lsquothe girl who does notunderstandrsquo This seemed to lead to some-thing that the girl in the role of analyst stuckon pieces of paper and then lsquoassembledrsquo a con-tainer around it We agreed that keeping to theconfusion in the session might have allowedsome element related to the cloudmoons toshow up upon the analystrsquos taking the role oflsquothe girl Valeria who does not knowrsquo Thesupervisor remarked that compared to thisgirlrsquos usual evacuative outbursts these inter-changes would seem nicely to fit Bionrsquos (1962)idea of thought involving alpha-functionwhich requires an object containing the pro-jections and returning them in more organisedmanners with some anxieties processed Suchan objectrsquos reverie function seemed to havepermitted Valeria to put herself together andturn on her own alpha-function

The clinical narrative shows that the analystpartly grasped what had happened Readingthe session again and talking about it it grewmore articulated in her mind It is notable thatfor the first time in all these months the ana-lystsupervisee asked for correction she firsttook this event to be a simple react ion of with-drawal in the face of what took place but at asecond view and as is again apparent in thefollowing paragraphs this request for correc-tion would seem to correspond precisely to anenactment in the supervisory session of therole of the lsquogirl that doesnrsquot knowrsquo or the lsquogirlin the wrongrsquo which Valeria consistently pro-jected into her in the sessions

Valeria said lsquoAll right now wersquoll carry outanother lit tle assignment Write this downCopy it out This is a story which Irsquoll tell youlaterrsquo (She named each let ter while writingthem down) lsquoAnd here it says ldquopipipirdquorsquo (She

drew rays emanating from it) lsquoAnd now draw aspring flower (spring had started just five daysbefore this session) and write ldquopri-ma-ve-rardquorsquo(lsquospringrsquo in Spanish she spelled the word outthough with mistakes) As she said this shewrote the word on her own sheet of paper (F ig2) while I had to do the same on anothersheet lsquoVery good Now make two hearts gotogether like this (she drew lines linking them)and two balloons Remember that you areValeria the girl and Irsquom Luciacutea the teacherYou are 7 years old and Irsquom 40rsquo She wrotedown 7 and 40 and drew a square aroundthem Then she linked each by a line to thedrawing of the hearts

Faced with the girlrsquos drawing the supervi-sor noticed that for the first time she had writ-ten a word lsquopimabrarsquo The analyst hadrealised this as it happened and then wasfrightened by the idea that the parents mightpull the girl out of treatment as soon as shelearned to write so she felt ambivalent aboutthis development The supervisor remarkedthat it would seem that when the analyst man-aged to accept the identificatory projection ofan infantile aspect of the self that misunder-stood and felt misunderstood the girl man-aged to write her first word She added thatbesides feelings of mutual love the two linkedhearts might point also to two minds workingtogether and also that the drawing wouldseem to appear as a sort of blend of a familytree and a family organisational introductorychart with the ages of each Luciacutea the 40-year-old teacher and Valeria the 7-year-old pupilAt that point the supervisor realised that theword Luciacutea contained almost the same letter swith just one misplaced vowel as Luisa theanalystrsquos first name and asked if the girl andher family called her this or her more usualnickname She said surprised that they calledher Luisa not knowing her nickname

To the supervisor this seemed to supportthe notion that the word lsquospringrsquo so obviouslylinked to budding birth and flowering pointsto a creative link-up of two heartsmindsworking together Perhaps also the budding ofthe ability the development of which would of

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 79

course demand some lengthy work of learningto share with others mainly her peers

We went on with the session Valeria askedordered me to continue working lsquoAnd we putldquoChrdquo of cheese ldquocherdquo ldquocheerdquo2 and draw anapple with the little stick and five fingers(counts up to five) It has eyes and a mouthand two different feetmdashthatrsquos wrongrsquo She cor-rected one of the feet on my sheet She gave mea small piece of shiny paper and assignedanother to herself lsquoAnd now write on ldquoprimav-erardquo and the flower and you and mersquo Sheasked me to draw two squares with the ages 40and 7 She continued lsquoM ake a house and atreemdashdonrsquot worry just do it as well as you canEveryone does it as well as they canrsquo I inter-preted lsquoWhen we do lit tle assignmentstogether and you are the one who knows andyou teach me you get everything rightrsquo

Valeria looked attentively and said lsquoYeswersquore right arenrsquot we N ow write the headlineand underline it N ow Irsquoll tell you the story(Pretended to read) Once upon a time therewas a mother and a daughter and the motherwould tell the father ldquoYou go to the shoppingmallrdquo The mother and the children went outfor a while and went to M cDonaldrsquos and hadsodas and then went to the park and the fatherwas at the mall and then they came back homeand thatrsquos the end of the storyrsquo

It was the end of the session Valeria put thematerial in her box including the drawingwhich was stuck on the door

As the supervisory session also drew to itsend the supervisor mused on the effects of theanalystrsquos intervention on this last lsquostoryrsquo nar-rated by Valeria which might restate thecourse of the work carried out together withthe ages in a little square The flagrant demiseof the father whom the mother lsquoordersrsquo to theshopping mall while she and their children gofor an outing drives the girlrsquos felt experience(most likely related to a denial of the primalscene in the link to both therapist and mother)that for the time being the father has beenrejected

CONTAINMENT AN D TEACH ING IN THE

APPR OACH TO TH E SUPERVISORY PROCESS

We find the supervisory experiencedescribed has been apt for containing anxietiesand for thinking out the events of the sessionsupplying a frame for the emotional develop-ments leading to the patientrsquos first writtenthought-out word pimabra as distinct fromthose drawn from memory The analyst beingpart of the ongoing process was aware of somebut only some dimensions of what went onwhich illustrates the various levels encom-passed by lsquomaking the unconscious consciousrsquoAs her final interventionmdashlsquoWhen we do littleassignments together and you are the one whoknows and you teach me you get everythingrightrsquomdashshows she clearly perceived how andwhy roles were allotted in the actual contextbuilt by the evolving anxieties allowing thechild-analysand free use of the denial implicitin her demand that in the play context theyswitch their identit ies She was not howeverfully aware of the ongoing advances in theprocess of symbol-formation As the sayinggoes one cannot write history while making it

The supervisory session transcribed illus-trates containment at two transformationallevels On the one hand at that of the patientwho after putting together in her maquette herown experience of emotional containmentdrew two linked hearts along with her firstwritten word The result of an evolving emo-tional containment stands represented by thisaccomplishment of symbol-formation thejoint initials of patient and analyst with theirsupposed (but reversed) ages enclosed withina box The second level of transformation cor-responds to the supervisorsupervisee link Toput it in Arlowrsquos terms this has to do with thefact that being target to the unconscious anxi-eties of the analytic process the supervisee feelsand knows more than what she has managedto lsquothink throughrsquo and can become apparent inthe record This is the sphere of transforma-tions at the level of psychoanalytic awareness

2 lsquoQue Qui Quorsquo in Spanish

80 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

It must be surmised here that the supervisorrsquosgreater distance from the emotional scenehelped quite a bit It allowed her to grasp thehomology Luciacutea-Luisa illuminating the activeidentificato ry processes in the ongoing reversalof identities in the session

The clinical example presented demon-strates the difficulties inherent in emotionallyframing and instancing creative symbol-for-mation difficulties resulting from the emo-tional turbulence falling upon both membersin the analytic sessions Containment of theongoing anxieties and the opportunities itopens up for an emerging creativity in the ses-sion has required in the case of the analysanda domain of action to be shared with an analystwho can somehow be both lsquooutsidersquo andlsquoinsidersquo the psychic turbulence involved This isalso valid for the handling of the clinical mate-rial in supervision Session and supervisionthus turn into coexistent arenas for recordingand grasping emotional developments

The supervisory approach presenteddeparts as much as circumstances allow fromdirect lsquoteachingrsquo and it privileges the contain-ment and disclosure of the superviseersquos una-voidable anxieties that are part and parcel ofthe course of her analytic task In the Janus-likedilemma of the supervisor a dilemma whichparaphrasing F leming and Benedek can bethought of in terms of containment versusteaching it is our belief that the converse direc-tive teaching approach on the part of the super-visor tends to increase the paranoid anxieties inthe supervisory situation at the expense of con-tainment

It is a main tenet of this presentat ion that theactual learning process within the supervisoryexperience can be better obtained by the super-visorrsquos facilit ating attitude This facilitatio n canonly take place when a sufficient degree ofholding to and grasping of the vicissitudes ofthe superviseersquos involvement in the analyticprocess itself is achieved The supervisorymaterial presented documents the superviseersquostendency to fall into the role of the pupil at thetime when she asks to be told whether she actedcorrect ly H owever the supervisory stance

described may well have helped the analystbear the role of lsquopupilrsquo her patient so stronglyforced her into It may foreseeably have beentoo hard on her to bear the brunt of beinglsquopupilrsquo on both sides in which case we can sur-mise our stance which approaches the supervi-sorrsquos role somewhat to the side of the holdingfunctions of the analyst in session has helpedmake proper place for our little patientrsquos needto assign roles to her analyst and have themsustained The dangers of an overzealoussupervisorteacher pushing the superviseeana-lyst in the pupilrsquos place has been previously andto our mind duly stressed by Solnit (1970) Aswe envision it supervision furthers the recon-sideration of the therapistrsquos clinica l task pro-moting the examination of the evidence thesharing of doubts and the harbouring of evolv-ing ideas

Bearing the solitude of our psychoanalyticwork is in the best of cases problematic evenseasoned analysts need to talk over informallywith colleagues the events in their consultingrooms and have them help think these out Wehope our paper allows the reader to share inwhat supervisee and supervisor learned fromthis difficult but rewarding analytic experience

TRANSLATION S OF SUMMAR Y

Les auteurs illustrent une approche du processusde supervision comme une expeacuterience drsquoapprentissagepour le superviseacute et le superviseur qui est construite surla capaciteacute de contenir les angoisses inconscientesElles montrent qursquoune des fonctions centrale de la su-pervision psychanalytique est drsquoaider agrave contenir lrsquoagi-tation eacutemotionnelle et les angoisses inconscientes quisurgissent et eacutevoluent dans les deux domaines interac-tifs de la seacuteance analytique et de la seacuteance de supervi-sion Dans cette perspective lrsquointeraction analyste-patient ainsi que celle du superviseacute et du superviseurpeuvent ecirctre comprises comme des espaces de trans-formation superposeacutees jumelles lrsquoespace du supervi-seur eacutetant au service de contenir et de comprendre lesrocircles agrave travers lesquels va lrsquoanalyste superviseacute en tantque partie du processus analytique Agrave partir du mateacute-riel clinique deacutetailleacute drsquoune fille troubleacutee de 7 ans lesauteurs explorent les problegravemes relieacutes entre eux et lesdifficulteacutes preacutesenteacutees pour contenir les angoisses etlrsquoagitation preacutesentes agrave la fois dans la situation analyt-ique et en supervision Lorsque la capaciteacute de contenir

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 81

les eacutemotions est adeacutequate la supervision contribue agrave lacompreacutehension et au deacuteveloppement de lrsquoutilisationpar lela superviseacute(e) de sa propre personnaliteacute en tantqursquoinstrument du traitement ainsi que lrsquoont montreacuteF leming et Benedek il y des deacutecades de cela La seacuteancede supervision favorise donc les reacutesolutions des pro-blegravemes cliniques agrave travers la formation de symbole lesseacuteances cliniques et la supervision eacutetant des domainesjumeaux pour enregistrer et comprendre lrsquoeacutevolutioneacutemotionnelle

Die Autoren stellen einen Zugang zum Supervisi-onsprozess dar der ihn als eine Lernerfahrung fuumlrSupervisanden und Supervisor ansieht die auf demContainment von unbewussten Aumlngsten beruht Sieargumentieren dass es eine Hauptfunktion psycho-analytischer Supervision ist dazu beizutragen dieemotionale Verstoumlrung und die unbewussten Aumlngstedie in den zwei interagierenden Bereichen der ana-lytischen und der Supervisionssitzungen auftauchenzu containenldquo Aus dieser Sichtweise lassen sich dieInteraktion zwischen Analytiker und Patient und diezwischen Supervisanden und Supervisor als gleicharti-ge gestufte Transformationsbereiche verstehen wobeider Supervisionsbereich dazu dient die Rollen die derSupervisandAnalytiker durchlaumluft zu halten und zuverstehen Mithilfe von ausfuumlhrlichem klinischem Ma-terial von einem gestoumlrten 7-jaumlhrigen Maumldchen unter-suchen die Autoren die miteinander verbundenenProbleme und Schwierigkeiten die Aumlngste undStoumlrungen in der analytischen und der Supervisionssi-tuation zu containenldquo Wenn emotionales Contain-ment adaumlquat gehandhabt wird hilft die Supervisiondie Verwendung der Persoumlnlichkeit des Supervisandenals Behandlungsinstrument zu verstehen und zu ent-wickeln wie es F leming und Benedek vor Jahrzehntenvertraten Die Supervisionssitzung hilft auf diese

Weise klinische Probleme durch Symbolbildung auf-zuloumlsen wobei therapeutische Sitzungen und Supervi-sion gleichartige Bereiche zur Erfassung und zumVerstehen emotionaler Entwicklung sind

Las autoras enfocan el proceso de la supervisioacutencomo una experiencia de aprendizaje tanto para elsupervisado como para el supervisor la cual se lleva acabo sobre la contencioacuten de las ansiedades incon-scientes Se sostiene que lo esencial de la funcioacuten de lasupervisioacuten psicoanaliacutetica es contribuir a contener laturbulencia emocional y las ansiedades inconscientesque surgen y evolucionan en dos terrenos que inter-actuacutean entre siacute el de las sesiones de anaacutelisis y el de lassesiones de supervisioacuten Desde esta perspectiva lasinteracciones analistandashpaciente y supervisado-supervi-sor pueden ser consideradas como espacios abiertoscon gradas gemelas y cambiantes estando el espaciode la supervisioacuten al servicio de sostener y apuntalar elque las funciones del analistasupervisado sigan ade-lante ya que son parte del proceso analiacutetico Partien-do de un material cliacutenico expuesto en detalle yrelativo a una nintildea de 7 antildeos que presentaba muchosconflictos las autoras estudian algunos puntos inter-relacionados y las dificultades para contener las ansie-dades y los conflictos tanto en la situacioacuten analiacuteticacomo en la de supervisioacuten Cuando los contenidosemocionales son manejados de un modo adecuado lasupervisioacuten contribuye a la comprensioacuten y tambieacuten almejor uso de la misma personalidad del supervisadoacomo instrumento del tratamiento tal como fue de-fendido por F leming y Benedek hace algunas deacutecadasEs de este modo como las sesiones de supervisioacuten con-tribuyen a la solucioacuten de algunos aspectos cliacutenicos atraveacutes de la formacioacuten de siacutembolos ya que las sesionescliacutenicas y la supervisioacuten son terrenos gemelos pararegistrar y comprender la evolucioacuten emocional

R EF ER ENCES

ARLOW J (1963) The supervisory situation JA mer Psychoanal A ssn 11 576ndash94

BION W R (1962) L earning from ExperienceLondon Heinemann

F LEMING J amp BENEDEK T (1964) SupervisionA method of teaching psychoanalysis Psycho-anal Q 33 71ndash96

G RINBERG L (1970) The problems of supervisionin psychoanalytic education Int J Psychoanal51 371ndash82

SOLNIT A J (1970) Learning from psychoanalyt-ic supervision Int J Psychoanal 51 359ndash62

Virginia R U ngar and Luisa Busch de Ahumada Copyright copy Institu te of Psychoanalysis London 2001Dr U ngarBillinghurst 2533 1425 Buenos Aires(Initia l version received 1698)(F irst revised version received 19799)(F inal revised version received 14600)

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 79

course demand some lengthy work of learningto share with others mainly her peers

We went on with the session Valeria askedordered me to continue working lsquoAnd we putldquoChrdquo of cheese ldquocherdquo ldquocheerdquo2 and draw anapple with the little stick and five fingers(counts up to five) It has eyes and a mouthand two different feetmdashthatrsquos wrongrsquo She cor-rected one of the feet on my sheet She gave mea small piece of shiny paper and assignedanother to herself lsquoAnd now write on ldquoprimav-erardquo and the flower and you and mersquo Sheasked me to draw two squares with the ages 40and 7 She continued lsquoM ake a house and atreemdashdonrsquot worry just do it as well as you canEveryone does it as well as they canrsquo I inter-preted lsquoWhen we do lit tle assignmentstogether and you are the one who knows andyou teach me you get everything rightrsquo

Valeria looked attentively and said lsquoYeswersquore right arenrsquot we N ow write the headlineand underline it N ow Irsquoll tell you the story(Pretended to read) Once upon a time therewas a mother and a daughter and the motherwould tell the father ldquoYou go to the shoppingmallrdquo The mother and the children went outfor a while and went to M cDonaldrsquos and hadsodas and then went to the park and the fatherwas at the mall and then they came back homeand thatrsquos the end of the storyrsquo

It was the end of the session Valeria put thematerial in her box including the drawingwhich was stuck on the door

As the supervisory session also drew to itsend the supervisor mused on the effects of theanalystrsquos intervention on this last lsquostoryrsquo nar-rated by Valeria which might restate thecourse of the work carried out together withthe ages in a little square The flagrant demiseof the father whom the mother lsquoordersrsquo to theshopping mall while she and their children gofor an outing drives the girlrsquos felt experience(most likely related to a denial of the primalscene in the link to both therapist and mother)that for the time being the father has beenrejected

CONTAINMENT AN D TEACH ING IN THE

APPR OACH TO TH E SUPERVISORY PROCESS

We find the supervisory experiencedescribed has been apt for containing anxietiesand for thinking out the events of the sessionsupplying a frame for the emotional develop-ments leading to the patientrsquos first writtenthought-out word pimabra as distinct fromthose drawn from memory The analyst beingpart of the ongoing process was aware of somebut only some dimensions of what went onwhich illustrates the various levels encom-passed by lsquomaking the unconscious consciousrsquoAs her final interventionmdashlsquoWhen we do littleassignments together and you are the one whoknows and you teach me you get everythingrightrsquomdashshows she clearly perceived how andwhy roles were allotted in the actual contextbuilt by the evolving anxieties allowing thechild-analysand free use of the denial implicitin her demand that in the play context theyswitch their identit ies She was not howeverfully aware of the ongoing advances in theprocess of symbol-formation As the sayinggoes one cannot write history while making it

The supervisory session transcribed illus-trates containment at two transformationallevels On the one hand at that of the patientwho after putting together in her maquette herown experience of emotional containmentdrew two linked hearts along with her firstwritten word The result of an evolving emo-tional containment stands represented by thisaccomplishment of symbol-formation thejoint initials of patient and analyst with theirsupposed (but reversed) ages enclosed withina box The second level of transformation cor-responds to the supervisorsupervisee link Toput it in Arlowrsquos terms this has to do with thefact that being target to the unconscious anxi-eties of the analytic process the supervisee feelsand knows more than what she has managedto lsquothink throughrsquo and can become apparent inthe record This is the sphere of transforma-tions at the level of psychoanalytic awareness

2 lsquoQue Qui Quorsquo in Spanish

80 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

It must be surmised here that the supervisorrsquosgreater distance from the emotional scenehelped quite a bit It allowed her to grasp thehomology Luciacutea-Luisa illuminating the activeidentificato ry processes in the ongoing reversalof identities in the session

The clinical example presented demon-strates the difficulties inherent in emotionallyframing and instancing creative symbol-for-mation difficulties resulting from the emo-tional turbulence falling upon both membersin the analytic sessions Containment of theongoing anxieties and the opportunities itopens up for an emerging creativity in the ses-sion has required in the case of the analysanda domain of action to be shared with an analystwho can somehow be both lsquooutsidersquo andlsquoinsidersquo the psychic turbulence involved This isalso valid for the handling of the clinical mate-rial in supervision Session and supervisionthus turn into coexistent arenas for recordingand grasping emotional developments

The supervisory approach presenteddeparts as much as circumstances allow fromdirect lsquoteachingrsquo and it privileges the contain-ment and disclosure of the superviseersquos una-voidable anxieties that are part and parcel ofthe course of her analytic task In the Janus-likedilemma of the supervisor a dilemma whichparaphrasing F leming and Benedek can bethought of in terms of containment versusteaching it is our belief that the converse direc-tive teaching approach on the part of the super-visor tends to increase the paranoid anxieties inthe supervisory situation at the expense of con-tainment

It is a main tenet of this presentat ion that theactual learning process within the supervisoryexperience can be better obtained by the super-visorrsquos facilit ating attitude This facilitatio n canonly take place when a sufficient degree ofholding to and grasping of the vicissitudes ofthe superviseersquos involvement in the analyticprocess itself is achieved The supervisorymaterial presented documents the superviseersquostendency to fall into the role of the pupil at thetime when she asks to be told whether she actedcorrect ly H owever the supervisory stance

described may well have helped the analystbear the role of lsquopupilrsquo her patient so stronglyforced her into It may foreseeably have beentoo hard on her to bear the brunt of beinglsquopupilrsquo on both sides in which case we can sur-mise our stance which approaches the supervi-sorrsquos role somewhat to the side of the holdingfunctions of the analyst in session has helpedmake proper place for our little patientrsquos needto assign roles to her analyst and have themsustained The dangers of an overzealoussupervisorteacher pushing the superviseeana-lyst in the pupilrsquos place has been previously andto our mind duly stressed by Solnit (1970) Aswe envision it supervision furthers the recon-sideration of the therapistrsquos clinica l task pro-moting the examination of the evidence thesharing of doubts and the harbouring of evolv-ing ideas

Bearing the solitude of our psychoanalyticwork is in the best of cases problematic evenseasoned analysts need to talk over informallywith colleagues the events in their consultingrooms and have them help think these out Wehope our paper allows the reader to share inwhat supervisee and supervisor learned fromthis difficult but rewarding analytic experience

TRANSLATION S OF SUMMAR Y

Les auteurs illustrent une approche du processusde supervision comme une expeacuterience drsquoapprentissagepour le superviseacute et le superviseur qui est construite surla capaciteacute de contenir les angoisses inconscientesElles montrent qursquoune des fonctions centrale de la su-pervision psychanalytique est drsquoaider agrave contenir lrsquoagi-tation eacutemotionnelle et les angoisses inconscientes quisurgissent et eacutevoluent dans les deux domaines interac-tifs de la seacuteance analytique et de la seacuteance de supervi-sion Dans cette perspective lrsquointeraction analyste-patient ainsi que celle du superviseacute et du superviseurpeuvent ecirctre comprises comme des espaces de trans-formation superposeacutees jumelles lrsquoespace du supervi-seur eacutetant au service de contenir et de comprendre lesrocircles agrave travers lesquels va lrsquoanalyste superviseacute en tantque partie du processus analytique Agrave partir du mateacute-riel clinique deacutetailleacute drsquoune fille troubleacutee de 7 ans lesauteurs explorent les problegravemes relieacutes entre eux et lesdifficulteacutes preacutesenteacutees pour contenir les angoisses etlrsquoagitation preacutesentes agrave la fois dans la situation analyt-ique et en supervision Lorsque la capaciteacute de contenir

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 81

les eacutemotions est adeacutequate la supervision contribue agrave lacompreacutehension et au deacuteveloppement de lrsquoutilisationpar lela superviseacute(e) de sa propre personnaliteacute en tantqursquoinstrument du traitement ainsi que lrsquoont montreacuteF leming et Benedek il y des deacutecades de cela La seacuteancede supervision favorise donc les reacutesolutions des pro-blegravemes cliniques agrave travers la formation de symbole lesseacuteances cliniques et la supervision eacutetant des domainesjumeaux pour enregistrer et comprendre lrsquoeacutevolutioneacutemotionnelle

Die Autoren stellen einen Zugang zum Supervisi-onsprozess dar der ihn als eine Lernerfahrung fuumlrSupervisanden und Supervisor ansieht die auf demContainment von unbewussten Aumlngsten beruht Sieargumentieren dass es eine Hauptfunktion psycho-analytischer Supervision ist dazu beizutragen dieemotionale Verstoumlrung und die unbewussten Aumlngstedie in den zwei interagierenden Bereichen der ana-lytischen und der Supervisionssitzungen auftauchenzu containenldquo Aus dieser Sichtweise lassen sich dieInteraktion zwischen Analytiker und Patient und diezwischen Supervisanden und Supervisor als gleicharti-ge gestufte Transformationsbereiche verstehen wobeider Supervisionsbereich dazu dient die Rollen die derSupervisandAnalytiker durchlaumluft zu halten und zuverstehen Mithilfe von ausfuumlhrlichem klinischem Ma-terial von einem gestoumlrten 7-jaumlhrigen Maumldchen unter-suchen die Autoren die miteinander verbundenenProbleme und Schwierigkeiten die Aumlngste undStoumlrungen in der analytischen und der Supervisionssi-tuation zu containenldquo Wenn emotionales Contain-ment adaumlquat gehandhabt wird hilft die Supervisiondie Verwendung der Persoumlnlichkeit des Supervisandenals Behandlungsinstrument zu verstehen und zu ent-wickeln wie es F leming und Benedek vor Jahrzehntenvertraten Die Supervisionssitzung hilft auf diese

Weise klinische Probleme durch Symbolbildung auf-zuloumlsen wobei therapeutische Sitzungen und Supervi-sion gleichartige Bereiche zur Erfassung und zumVerstehen emotionaler Entwicklung sind

Las autoras enfocan el proceso de la supervisioacutencomo una experiencia de aprendizaje tanto para elsupervisado como para el supervisor la cual se lleva acabo sobre la contencioacuten de las ansiedades incon-scientes Se sostiene que lo esencial de la funcioacuten de lasupervisioacuten psicoanaliacutetica es contribuir a contener laturbulencia emocional y las ansiedades inconscientesque surgen y evolucionan en dos terrenos que inter-actuacutean entre siacute el de las sesiones de anaacutelisis y el de lassesiones de supervisioacuten Desde esta perspectiva lasinteracciones analistandashpaciente y supervisado-supervi-sor pueden ser consideradas como espacios abiertoscon gradas gemelas y cambiantes estando el espaciode la supervisioacuten al servicio de sostener y apuntalar elque las funciones del analistasupervisado sigan ade-lante ya que son parte del proceso analiacutetico Partien-do de un material cliacutenico expuesto en detalle yrelativo a una nintildea de 7 antildeos que presentaba muchosconflictos las autoras estudian algunos puntos inter-relacionados y las dificultades para contener las ansie-dades y los conflictos tanto en la situacioacuten analiacuteticacomo en la de supervisioacuten Cuando los contenidosemocionales son manejados de un modo adecuado lasupervisioacuten contribuye a la comprensioacuten y tambieacuten almejor uso de la misma personalidad del supervisadoacomo instrumento del tratamiento tal como fue de-fendido por F leming y Benedek hace algunas deacutecadasEs de este modo como las sesiones de supervisioacuten con-tribuyen a la solucioacuten de algunos aspectos cliacutenicos atraveacutes de la formacioacuten de siacutembolos ya que las sesionescliacutenicas y la supervisioacuten son terrenos gemelos pararegistrar y comprender la evolucioacuten emocional

R EF ER ENCES

ARLOW J (1963) The supervisory situation JA mer Psychoanal A ssn 11 576ndash94

BION W R (1962) L earning from ExperienceLondon Heinemann

F LEMING J amp BENEDEK T (1964) SupervisionA method of teaching psychoanalysis Psycho-anal Q 33 71ndash96

G RINBERG L (1970) The problems of supervisionin psychoanalytic education Int J Psychoanal51 371ndash82

SOLNIT A J (1970) Learning from psychoanalyt-ic supervision Int J Psychoanal 51 359ndash62

Virginia R U ngar and Luisa Busch de Ahumada Copyright copy Institu te of Psychoanalysis London 2001Dr U ngarBillinghurst 2533 1425 Buenos Aires(Initia l version received 1698)(F irst revised version received 19799)(F inal revised version received 14600)

80 VIRG INIA UN GAR AND LU ISA BUSCH D E AH UM AD A

It must be surmised here that the supervisorrsquosgreater distance from the emotional scenehelped quite a bit It allowed her to grasp thehomology Luciacutea-Luisa illuminating the activeidentificato ry processes in the ongoing reversalof identities in the session

The clinical example presented demon-strates the difficulties inherent in emotionallyframing and instancing creative symbol-for-mation difficulties resulting from the emo-tional turbulence falling upon both membersin the analytic sessions Containment of theongoing anxieties and the opportunities itopens up for an emerging creativity in the ses-sion has required in the case of the analysanda domain of action to be shared with an analystwho can somehow be both lsquooutsidersquo andlsquoinsidersquo the psychic turbulence involved This isalso valid for the handling of the clinical mate-rial in supervision Session and supervisionthus turn into coexistent arenas for recordingand grasping emotional developments

The supervisory approach presenteddeparts as much as circumstances allow fromdirect lsquoteachingrsquo and it privileges the contain-ment and disclosure of the superviseersquos una-voidable anxieties that are part and parcel ofthe course of her analytic task In the Janus-likedilemma of the supervisor a dilemma whichparaphrasing F leming and Benedek can bethought of in terms of containment versusteaching it is our belief that the converse direc-tive teaching approach on the part of the super-visor tends to increase the paranoid anxieties inthe supervisory situation at the expense of con-tainment

It is a main tenet of this presentat ion that theactual learning process within the supervisoryexperience can be better obtained by the super-visorrsquos facilit ating attitude This facilitatio n canonly take place when a sufficient degree ofholding to and grasping of the vicissitudes ofthe superviseersquos involvement in the analyticprocess itself is achieved The supervisorymaterial presented documents the superviseersquostendency to fall into the role of the pupil at thetime when she asks to be told whether she actedcorrect ly H owever the supervisory stance

described may well have helped the analystbear the role of lsquopupilrsquo her patient so stronglyforced her into It may foreseeably have beentoo hard on her to bear the brunt of beinglsquopupilrsquo on both sides in which case we can sur-mise our stance which approaches the supervi-sorrsquos role somewhat to the side of the holdingfunctions of the analyst in session has helpedmake proper place for our little patientrsquos needto assign roles to her analyst and have themsustained The dangers of an overzealoussupervisorteacher pushing the superviseeana-lyst in the pupilrsquos place has been previously andto our mind duly stressed by Solnit (1970) Aswe envision it supervision furthers the recon-sideration of the therapistrsquos clinica l task pro-moting the examination of the evidence thesharing of doubts and the harbouring of evolv-ing ideas

Bearing the solitude of our psychoanalyticwork is in the best of cases problematic evenseasoned analysts need to talk over informallywith colleagues the events in their consultingrooms and have them help think these out Wehope our paper allows the reader to share inwhat supervisee and supervisor learned fromthis difficult but rewarding analytic experience

TRANSLATION S OF SUMMAR Y

Les auteurs illustrent une approche du processusde supervision comme une expeacuterience drsquoapprentissagepour le superviseacute et le superviseur qui est construite surla capaciteacute de contenir les angoisses inconscientesElles montrent qursquoune des fonctions centrale de la su-pervision psychanalytique est drsquoaider agrave contenir lrsquoagi-tation eacutemotionnelle et les angoisses inconscientes quisurgissent et eacutevoluent dans les deux domaines interac-tifs de la seacuteance analytique et de la seacuteance de supervi-sion Dans cette perspective lrsquointeraction analyste-patient ainsi que celle du superviseacute et du superviseurpeuvent ecirctre comprises comme des espaces de trans-formation superposeacutees jumelles lrsquoespace du supervi-seur eacutetant au service de contenir et de comprendre lesrocircles agrave travers lesquels va lrsquoanalyste superviseacute en tantque partie du processus analytique Agrave partir du mateacute-riel clinique deacutetailleacute drsquoune fille troubleacutee de 7 ans lesauteurs explorent les problegravemes relieacutes entre eux et lesdifficulteacutes preacutesenteacutees pour contenir les angoisses etlrsquoagitation preacutesentes agrave la fois dans la situation analyt-ique et en supervision Lorsque la capaciteacute de contenir

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 81

les eacutemotions est adeacutequate la supervision contribue agrave lacompreacutehension et au deacuteveloppement de lrsquoutilisationpar lela superviseacute(e) de sa propre personnaliteacute en tantqursquoinstrument du traitement ainsi que lrsquoont montreacuteF leming et Benedek il y des deacutecades de cela La seacuteancede supervision favorise donc les reacutesolutions des pro-blegravemes cliniques agrave travers la formation de symbole lesseacuteances cliniques et la supervision eacutetant des domainesjumeaux pour enregistrer et comprendre lrsquoeacutevolutioneacutemotionnelle

Die Autoren stellen einen Zugang zum Supervisi-onsprozess dar der ihn als eine Lernerfahrung fuumlrSupervisanden und Supervisor ansieht die auf demContainment von unbewussten Aumlngsten beruht Sieargumentieren dass es eine Hauptfunktion psycho-analytischer Supervision ist dazu beizutragen dieemotionale Verstoumlrung und die unbewussten Aumlngstedie in den zwei interagierenden Bereichen der ana-lytischen und der Supervisionssitzungen auftauchenzu containenldquo Aus dieser Sichtweise lassen sich dieInteraktion zwischen Analytiker und Patient und diezwischen Supervisanden und Supervisor als gleicharti-ge gestufte Transformationsbereiche verstehen wobeider Supervisionsbereich dazu dient die Rollen die derSupervisandAnalytiker durchlaumluft zu halten und zuverstehen Mithilfe von ausfuumlhrlichem klinischem Ma-terial von einem gestoumlrten 7-jaumlhrigen Maumldchen unter-suchen die Autoren die miteinander verbundenenProbleme und Schwierigkeiten die Aumlngste undStoumlrungen in der analytischen und der Supervisionssi-tuation zu containenldquo Wenn emotionales Contain-ment adaumlquat gehandhabt wird hilft die Supervisiondie Verwendung der Persoumlnlichkeit des Supervisandenals Behandlungsinstrument zu verstehen und zu ent-wickeln wie es F leming und Benedek vor Jahrzehntenvertraten Die Supervisionssitzung hilft auf diese

Weise klinische Probleme durch Symbolbildung auf-zuloumlsen wobei therapeutische Sitzungen und Supervi-sion gleichartige Bereiche zur Erfassung und zumVerstehen emotionaler Entwicklung sind

Las autoras enfocan el proceso de la supervisioacutencomo una experiencia de aprendizaje tanto para elsupervisado como para el supervisor la cual se lleva acabo sobre la contencioacuten de las ansiedades incon-scientes Se sostiene que lo esencial de la funcioacuten de lasupervisioacuten psicoanaliacutetica es contribuir a contener laturbulencia emocional y las ansiedades inconscientesque surgen y evolucionan en dos terrenos que inter-actuacutean entre siacute el de las sesiones de anaacutelisis y el de lassesiones de supervisioacuten Desde esta perspectiva lasinteracciones analistandashpaciente y supervisado-supervi-sor pueden ser consideradas como espacios abiertoscon gradas gemelas y cambiantes estando el espaciode la supervisioacuten al servicio de sostener y apuntalar elque las funciones del analistasupervisado sigan ade-lante ya que son parte del proceso analiacutetico Partien-do de un material cliacutenico expuesto en detalle yrelativo a una nintildea de 7 antildeos que presentaba muchosconflictos las autoras estudian algunos puntos inter-relacionados y las dificultades para contener las ansie-dades y los conflictos tanto en la situacioacuten analiacuteticacomo en la de supervisioacuten Cuando los contenidosemocionales son manejados de un modo adecuado lasupervisioacuten contribuye a la comprensioacuten y tambieacuten almejor uso de la misma personalidad del supervisadoacomo instrumento del tratamiento tal como fue de-fendido por F leming y Benedek hace algunas deacutecadasEs de este modo como las sesiones de supervisioacuten con-tribuyen a la solucioacuten de algunos aspectos cliacutenicos atraveacutes de la formacioacuten de siacutembolos ya que las sesionescliacutenicas y la supervisioacuten son terrenos gemelos pararegistrar y comprender la evolucioacuten emocional

R EF ER ENCES

ARLOW J (1963) The supervisory situation JA mer Psychoanal A ssn 11 576ndash94

BION W R (1962) L earning from ExperienceLondon Heinemann

F LEMING J amp BENEDEK T (1964) SupervisionA method of teaching psychoanalysis Psycho-anal Q 33 71ndash96

G RINBERG L (1970) The problems of supervisionin psychoanalytic education Int J Psychoanal51 371ndash82

SOLNIT A J (1970) Learning from psychoanalyt-ic supervision Int J Psychoanal 51 359ndash62

Virginia R U ngar and Luisa Busch de Ahumada Copyright copy Institu te of Psychoanalysis London 2001Dr U ngarBillinghurst 2533 1425 Buenos Aires(Initia l version received 1698)(F irst revised version received 19799)(F inal revised version received 14600)

SU PERVISION A CONTAINERndashCON TAIN ED APPROACH 81

les eacutemotions est adeacutequate la supervision contribue agrave lacompreacutehension et au deacuteveloppement de lrsquoutilisationpar lela superviseacute(e) de sa propre personnaliteacute en tantqursquoinstrument du traitement ainsi que lrsquoont montreacuteF leming et Benedek il y des deacutecades de cela La seacuteancede supervision favorise donc les reacutesolutions des pro-blegravemes cliniques agrave travers la formation de symbole lesseacuteances cliniques et la supervision eacutetant des domainesjumeaux pour enregistrer et comprendre lrsquoeacutevolutioneacutemotionnelle

Die Autoren stellen einen Zugang zum Supervisi-onsprozess dar der ihn als eine Lernerfahrung fuumlrSupervisanden und Supervisor ansieht die auf demContainment von unbewussten Aumlngsten beruht Sieargumentieren dass es eine Hauptfunktion psycho-analytischer Supervision ist dazu beizutragen dieemotionale Verstoumlrung und die unbewussten Aumlngstedie in den zwei interagierenden Bereichen der ana-lytischen und der Supervisionssitzungen auftauchenzu containenldquo Aus dieser Sichtweise lassen sich dieInteraktion zwischen Analytiker und Patient und diezwischen Supervisanden und Supervisor als gleicharti-ge gestufte Transformationsbereiche verstehen wobeider Supervisionsbereich dazu dient die Rollen die derSupervisandAnalytiker durchlaumluft zu halten und zuverstehen Mithilfe von ausfuumlhrlichem klinischem Ma-terial von einem gestoumlrten 7-jaumlhrigen Maumldchen unter-suchen die Autoren die miteinander verbundenenProbleme und Schwierigkeiten die Aumlngste undStoumlrungen in der analytischen und der Supervisionssi-tuation zu containenldquo Wenn emotionales Contain-ment adaumlquat gehandhabt wird hilft die Supervisiondie Verwendung der Persoumlnlichkeit des Supervisandenals Behandlungsinstrument zu verstehen und zu ent-wickeln wie es F leming und Benedek vor Jahrzehntenvertraten Die Supervisionssitzung hilft auf diese

Weise klinische Probleme durch Symbolbildung auf-zuloumlsen wobei therapeutische Sitzungen und Supervi-sion gleichartige Bereiche zur Erfassung und zumVerstehen emotionaler Entwicklung sind

Las autoras enfocan el proceso de la supervisioacutencomo una experiencia de aprendizaje tanto para elsupervisado como para el supervisor la cual se lleva acabo sobre la contencioacuten de las ansiedades incon-scientes Se sostiene que lo esencial de la funcioacuten de lasupervisioacuten psicoanaliacutetica es contribuir a contener laturbulencia emocional y las ansiedades inconscientesque surgen y evolucionan en dos terrenos que inter-actuacutean entre siacute el de las sesiones de anaacutelisis y el de lassesiones de supervisioacuten Desde esta perspectiva lasinteracciones analistandashpaciente y supervisado-supervi-sor pueden ser consideradas como espacios abiertoscon gradas gemelas y cambiantes estando el espaciode la supervisioacuten al servicio de sostener y apuntalar elque las funciones del analistasupervisado sigan ade-lante ya que son parte del proceso analiacutetico Partien-do de un material cliacutenico expuesto en detalle yrelativo a una nintildea de 7 antildeos que presentaba muchosconflictos las autoras estudian algunos puntos inter-relacionados y las dificultades para contener las ansie-dades y los conflictos tanto en la situacioacuten analiacuteticacomo en la de supervisioacuten Cuando los contenidosemocionales son manejados de un modo adecuado lasupervisioacuten contribuye a la comprensioacuten y tambieacuten almejor uso de la misma personalidad del supervisadoacomo instrumento del tratamiento tal como fue de-fendido por F leming y Benedek hace algunas deacutecadasEs de este modo como las sesiones de supervisioacuten con-tribuyen a la solucioacuten de algunos aspectos cliacutenicos atraveacutes de la formacioacuten de siacutembolos ya que las sesionescliacutenicas y la supervisioacuten son terrenos gemelos pararegistrar y comprender la evolucioacuten emocional

R EF ER ENCES

ARLOW J (1963) The supervisory situation JA mer Psychoanal A ssn 11 576ndash94

BION W R (1962) L earning from ExperienceLondon Heinemann

F LEMING J amp BENEDEK T (1964) SupervisionA method of teaching psychoanalysis Psycho-anal Q 33 71ndash96

G RINBERG L (1970) The problems of supervisionin psychoanalytic education Int J Psychoanal51 371ndash82

SOLNIT A J (1970) Learning from psychoanalyt-ic supervision Int J Psychoanal 51 359ndash62

Virginia R U ngar and Luisa Busch de Ahumada Copyright copy Institu te of Psychoanalysis London 2001Dr U ngarBillinghurst 2533 1425 Buenos Aires(Initia l version received 1698)(F irst revised version received 19799)(F inal revised version received 14600)