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Book Review   |    
Supervision of Psychotherapy and Counselling: Making a Place to Think • More Than a Mirror: How Clients Influence Therapists' Lives
John P. Bair, Ph.D.
Psychiatric Services 1998; doi:
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edited by Geraldine Shipton; Buckingham, England, and Bristol, Pennsylvania, Open University Press, 1997, 159 pages, $29.95 • edited by Marcia Hill, Ed.D.; New York City, Harrington Park Press, 1997, 145 pages, $24.95

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Publications on theory, practice, and research in psychotherapy have proliferated in recent years. In contrast, only modest new work in the closely related fields of psychotherapy supervision and the interaction between clients and psychotherapists has appeared. The two books reviewed here are bold and creative pioneering efforts that contribute to the expansion and deepening of the understanding of psychotherapy supervision and the therapist-client interactional field.

Supervision of Psychotherapy and Counselling: Making a Place to Think grew out of two British conferences on the Sheffield model of supervision, with its focus on the exploration of the psychotherapist's own reaction to patient and client material. Geraldine Shipton is a lecturer in psychotherapeutic and psychoanalytic studies in the Centre for Psychotherapeutic Studies at the University of Sheffield, England. Ms. Shipton brings together articulate contributors who share in the freedom of expression of psychoanalytic work. Indeed, Shipton achieves her goals of inviting the reader "to step outside of his or her usual way of thinking about supervision of clinical work and to entertain a few novel ideas" and to "stimulate fresh ideas or enthusiasms" in this area.

As the book progresses, new ideas are fashioned and used to integrate historical perspectives. Curiosity management is considered a primary theme for supervisors. This concept is detailed and advanced with new object relations formulations and lexicon to describe the positioning of the supervisor's self in the relationship between patient and therapist. The scrutiny and description of the space for thinking that is essential for supervision is this book's contribution.

Woven into the descriptive fabric of supervisory space are conceptualization and linkage of Bion's "reflective thinking," social constructivist views of inhabiting a neutral reflexive text, Freud's "evenly-suspended attention and love of truth," Klein's "fantasy-dreaming-aesthetic reaction and unconscious wish fulfillment," Hillman's fantasy images as a privileged mode of "access to knowledge of soul," Jung's "active imagination," Coleridge's "primary imagination," Wittgenstein's "image as a form of life," and Baar's "global workspace." A metaphor with fresh imagery used to describe the overall space of supervision is Foucault's garden and heterotopia. The term heterotopia refers to the garden as a microcosm, at the same time the smallest parcel of the world and the totality of the world.

Shipton states that defining the boundary area of supervision as a public or private space "beats a rhythm throughout this book" and that "the tension between predatory gaze and respectful regard enter into the supervisory relationship and create an optimal climate for thinking about and learning from experience." Several chapters are more traditionally concrete in discussing in detail the history of psychodynamic supervision, the use of audiotaping in supervision, Kagan's technique of interpersonal recall, and the need for sensitivity to issues of race and culture in supervision.

Marcia Hill is a feminist therapist in private practice in Montpelier, Vermont. She is past chair of the Feminist Therapy Institute and editor of More Than a Mirror: How Clients Influence Therapists' Lives. In this unusual book, the goals for the volume are not clearly stated. The implication is that personal accounts of the all-female contributors model the examination of how deeply and personally the practice of psychotherapy and the interaction with clients can affect one as a therapist and as a person.

Twenty-one brief personal and moving disclosures by female therapists follow. These personal narratives include situations of treating a patient who has a history of physical and sexual torture, stresses of a therapist in training, treatment of the dying, the impact of a therapist's pregnancy on the treatment of an inmate charged with infanticide, a therapist's wish to have children while treating patients who are mothers, a therapist's response to a man who appears to be psychologically tormenting his wife, mandatory reporting of suspicions of abuse in minors, merger and unconditional love between therapist and client, and other difficult therapist dilemmas.

Clearly, this volume of therapists' revelations is courageous in entering the difficult terrain of how clients influence therapists' lives. But however moving these stories may be, there is a danger of stark reporting without depth analysis. Accounts that may stimulate learning for some readers may be underformulated and underdiagnosed for others. Vignettes that inadequately model the use of supervision, consultation, or knowledge of professional traditions and literature have been included. This volume would benefit from a title more descriptive of the contents and a foreword that better explains the very serious goals of the book and the complexity of the clinical situations described.

Certainly both Supervision of Psychotherapy and Counselling and More Than a Mirror make a contribution to the in-depth exploration of supervision and the influence of clients on therapists. The experienced psychodynamic clinician and supervisor will be delighted by Supervision of Psychotherapy and Counselling, while More Than a Mirror raises issues that may be valuable for the less experienced therapist to consider.

Dr. Bair is assistant clinical professor of psychiatry at the Chicago Medical School and director of the dual diagnosis program at the Veterans Affairs Medical Center in North Chicago.




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