Negative Capability, Heuristics and Supervision

Abstract

While struggling to construct the meaning of their patients’ experiences, therapists often feel confused by their patients’ communications, driving them to elicit patterns of knowledge and intuitive rules, drawn from previous experiences, and to restore a sense of control. However, what is already known might affect the unknown, biasing the meaning of patients’ communications, hence Bion's recommendation of therapists’ attunement without memory and desire. The present article describes how supervisors can enhance their supervisees’ ‘negative capability’, their tolerance of ambiguity and doubts, by illuminating specific countertransferential reactions in the form of heuristics that interrupt this capability. Heuristics, presented in the literature as potentially helpful mental devices, are examined in this article as possible disruptions to therapists’ meaning‐making processes. However, heuristics in and of themselves are not negative or pathological phenomena. They are natural and spontaneous mechanisms, capable of temporarily reducing the anxiety of supervisees faced with ambiguous clinical situations. It is suggested that understanding the meaning of these phenomena might liberate supervisees from the need to respond impulsively and facilitate internal processes of metabolizing patients’ experiences.

A Psychoanalytic Perspective on Supervision in Field Education: Reflective and Containment Space for Supervision Interns

“…The descriptions in this study support Shulman's idea (Shulman, 2016;Sewell, 2018) that field education in social work should focus on exploring, moment by moment, supervision process and practice, with each participant influencing and being influenced by the others. Similarly, supervision in psychoanalytic training has been described as the opportunity for detailed and in-depth scrutiny of the analytical work in a process that develops over time (Dulsster &Vanheule, 2019;Yerushalmi, 2019aYerushalmi, , 2019bZachrisson, 2011). The supervisor's methodological practice involves containment, mentalizing and making sense of unconscious processes, such that they may inform the therapeutic process with the patient (Collens & Van Hout, 2017).…”

“…Thus, the unconscious minds of three people are involved in what is being listened to. Adequate ability to listen to this complex material is a core part of a supervisor's competence (Yerushalmi, 2019a;Zachrisson, 2011).…”

Observing and interpreting clinical process: Methods and findings from ‘Layered analysis’ of parent–infant psychotherapy

“…Exploring therapists’ conscious narratives of sessions and attempting to discern unconscious processes in both patients and therapists is of course a key element of psychoanalytic practice and supervision (e.g. McWilliams, 2021; Yerushalmi, 2019). However, our focus on the therapists’ embodied responses in combination with their conscious clinical narratives is a relatively new focus in both psychotherapy and parent–infant research.…”