Saturday, April 1, 2017

Bad supervisor

I don’t have the clinical supervisor credential here in Nevada, and maintained it only briefly when I was in Ohio. I don’t mind the work of guiding a new counselor – with provisos. The coursework to become a supervisor, however, is so horrendously cold-oatmeal plywood boring and depressing and generically empty and ‘eurythmics on the greensward’* properness-heavy that I will never again glance in that direction.
I would be a terrible supervisor! To prove that, here are three dished-up scenarios with a neophyte counselor, based on composites of some past cases.

Therapist – I just saw a fourteen-year-old boy who is very bright, according to his parents, but he refuses to do any work in school. He bypasses homework in general, and when he does it, he often “forgets” to put it in his backpack and bring it to school the next morning. His parents are frightened, but they show anger more. They see him ruining his future and they don’t know how to get him to do the work. They’ve tried removing his electronics and grounding him from friends and school activities, but he seems indifferent to punishment.

Supervisor – How does he express or show this non-caring about consequences?

T – He just says to me, “I’m not concerned.” But it really goes beyond that. His mom said there are Christmas and birthday presents from years past that he’s never unwrapped, sitting on his shelves and in his closet. That seems to be more than just not caring.

S – I think you need to sit his parents down and say something like this to them: Your son is failing in school? Good! That’s exactly what he should be doing. Because that’s his way of being true to himself, to his feeling. This is his way of communicating to you, very clearly though indirectly, that he hurts, that his life is wrong in ways no one has seen. Why would he be this indirect? He has lost touch with his deeper feelings, or is afraid to give them to you. Ask yourselves why he can’t sit down and be himself – his real self – with you. Look inside yourselves to see if you know how to hear him as a separate person, as his own person, not as reflecting or disagreeing with your own expectations or agendas. Look inside yourselves to see if you even know what I am saying.

T – I’m not sure what I should do about this situation. I have a new client, a woman in her early thirties who brought her husband to the second session. My “countertransference” must be ringing off the hook because this guy really made me seethe. My client, Cheryl, complained that three or four times a week he drives off after work to spend the evening with his parents, who live about fifty miles away. This happens on weekend days, too. His parents don’t need him, they’re early sixties and not disabled, but he helps them with all sorts of things – mowing the lawn, figuring out the remote, even doing the dishes with his mother. He’ll sit around and play chess with his father. And his wife and two little girls are left alone at home! What’s so aggravating is that he seemed to me to be perfectly bland about this. He had this dreamy clueless look on his face when she described her grievance. When I asked him if he could address her concerns, he had a simple response: It doesn’t seem a big problem! How do you think I should approach this, without giving him a lecture or a steel-toed boot to the ass?

S – I think what you should give him is a toy or a bottle, because he’s a little boy. He never grew up. Many people never traverse the psychological developmental stages, never become actual adults. I mean this in every way except, possibly, looks, height, income, vocabulary and ripeness of cynicism. Your client married an infant. You might ask if he’ll come in by himself. Then you would present him with his problem: The umbilical cord is still attached, mother to baby. He is fooling himself into thinking he has a normal, grown-up relationship with his parents, when in fact they are still his masters, they are his home. Stare him down: This is not casual information, but the main problem of his existence. We can’t make him grow fatherly and husbandly feelings, but we can disturb him with his abort. Only then will he have a chance to feel what he still needs – what his parents never gave him and that he waits for in their home. You will have to talk to his wife. Can she live with this? Can she give him the fear of loss of his family? This is not a marital therapy issue, but the deepest intrapsychic stuff possible. You may have to face that this will result in failure.

T – I hate to say this, but a new client is making me feel totally incompetent. I’m fighting the feeling: Why the hell do I think I can be a therapist? He’s in his mid-forties, teaches computer science at Otterbein, has no financial stress, his marriage is solid, they’ve put their two children through college, and all seems well. He can’t tell me what’s wrong: He said, “I don’t know.” There’s never been any significant depression, but lately he’s found himself doubting the value of life. Suicidal thoughts are starting to pop into his head, like an academic question that feels legitimate. This is smacking me in the face like a problem with no answer. Growing-up years were “normal,” no abuse or trauma, just working parents, vacations, the standard. His siblings are adequately successful, though his sister has had a problem with prescription opiates. His parents are retired; everyone gets together for the holidays and they talk frequently. The man looks at me politely, expectantly, to figure him out, and I can’t even generate a question – much less answers. The fact is he makes me furious: the damned nerve of him to be so beautifully obtuse so early in my career! – is how it feels.

S – For one, I can tell you that you don’t need to panic, because the answers he seeks are entirely within him. Literally: The reasons, his nature, are buried in his history, and his history is in his words that he doesn’t know yet. He will find them in your room of truth. What feels intimidating to you is that he’s presented you a head question – the professor’s intellectual query – which pushes you into your head, where you want to find answers. But when you get into your own inner space, feel both of you as time-dwellers, touch your own grayer feelings that give you meaning that isn’t perfect and happy; when you even feel the connections between your present states and the underlying child – then you’ll be able to show him that deeper place.

Many people, maybe most, have a depression, an empty place they don’t see that comes from critical losses in their childhood. The emptiness is pushed to the side, redescribed, covered up by all the challenges of life – graduating from school, getting through college or maintaining a job, prosecuting a career, working a marriage, swimming rather than sinking, raising children. But at a certain point there’s going to be a plateauing effect: the challenges are accomplished or now appear less meaningful than the face of middle-age. On that destination plateau, feelings reappear, and if they are emptiness, they are the childhood and its losses. There are some losses that feel like death – thanks to our human psyche.

Ask him to get out of his head – he’s been there long enough. Ask him to feel what’s true. With time, and luck, and your instincts and your silence, he will find his depression, his losses. And then he can grieve them – a good thing.

My guaranteed failure as a supervisor would come from several directions. Supervision is supposed to help a new therapist find and error-correct his or her own approach. But I believe most counselors’ paradigms are shallow or wrong, and I would try to sell mine. Cognitive therapy is the ubiquitous theme of psychological help nowadays, and I would dispute it in most supervision conversations. Most new clinicians would need depth therapy to know who they are, avoid their own poisons, and to avail themselves of the best kind of empathy, which might be called “deep health empathy.” This is not normal kind-person’s empathy, or paint-by-the-numbers “unconditional positive regard,” or the sick symbiotic identification with the client that has no boundaries. It would be an arrived kind, benevolence to acorn and oak tree from one’s own loss, repair and part-redemption. But most new counselors are young, pre-arrived, and never have that therapy.

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*, sixth paragraph. Article by the ponderous deceased anarcho-capitalist libertarian economist Murray Rothbard.

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Comments are welcome, but I'd suggest you first read "Feeling-centered therapy" and "Ocean and boat" for a basic introduction to my kind of theory and therapy.