Shame and guilt in psychotherapy supervision.

Abstract

Current interest in shame is examined in its relationship to psychotherapy supervision. Clinician/trainees are vulnerable to exposure and humiliation in the course of their training. This article examines the sources of shame in supervision and offers some suggestions for reducing the shame that might compromise the professional well-being of neophyte clinicians and their supervisors.As the pendulum swings around to more concern about affects in psychoanalytic theories, we have come to see shame and guilt as important byproducts of the uncovering analytic process. Psychoanalytic writers define shame and guilt in a variety of paradigms consistent with their theoretical emphasis. Shame is distinguished from guilt in the psychoanalytic literature by Piers & Singer (1953), who defined guilt as the painful result of a transgression of a superego boundary, and therefore a willful act; shame, on the other hand, is a defect in the self that prevents the person from living up to the ego-ideal. Whereas guilt leads to castration anxiety, shame leads to abandonment and hiding. Furthermore, whereas a person usually feels guilty or not guilty, shame can be experienced along a whole spectrum of discomfort, ranging from awkwardness and embarrassment all the way to corrosive humiliation and fear of disintegration.Freud (1912/1963) and other drive theorists place shame as emerging from the exhibitionistic wishes and fears of the individual. Later in development, anal impulses around the loss of control generate shame. Still later, guilt emerges around the wishes to overwhelm the competitor in the oedipal triangle.

What's not being said? Recollections of nondisclosure in clinical supervision while in training

“…Further research suggests that supervisees would feel less exposed and their confidence less threatened if supervisors were more open to appropriately disclosing their own challenges in the work, thus normalising the trainee's experience (Hess et al, 2008;Mehr et al, 2010;Worthen & McNeill, 1996). Errors and difficulties in the work need to be welcomed in supervision without these being evaluated as the sum of the supervisee's professional experience (Alonso & Rutan, 1988;Nelson, Barnes, Evans, & Triggiano, 2008). Hess et al (2008) propose that this would lead to fewer nondisclosures in supervision and would facilitate the development of a more open and effective dialogue within the supervisory relationship.…”

Predoctoral interns’ nondisclosure in supervision

“…From empirical data (Ladany et al, 1996), we know that supervisees sometimes do not disclose to their supervisors because the information is deemed irrelevant, they feel threatened or vulnerable, or they have concerns about the supervisory relationship (e.g., poor supervisory alliance, supervisor's perceived incompetence). Another plausible explanation is avoidance of shame (Alonso & Rutan, 1998;Farber, 2006;Yourman, 2003;Yourman & Farber, 1996), given that supervisees often struggle between wanting to appear competent and fearing that they will be found out as imposters (Harvey & Katz, 1985). Another possible reason relates to the evaluative nature of the supervision relationship (e.g., Bordin, 1983).…”

Perspectives on supervision in cognitive therapy

“…Indeed, self-disclosure can be an effective supervisory tool (Carifio & Hess, 1987;Alonso & Rutan, 1988;Albott, 1984;Pickering, 1987;Schmidt, 1979;Shapiro & Schiermer, 1993;Greben, 1991). When supervisors share their successes, rough spots, stuck points, and failures with their students, this disclosure paints a balanced view of professionals.…”

“…Numerous authors (Pickering, 1987;Berger & Buchholz, 1993;Friedman & Kaslow, 1986;Rodenhauser, Rudisill & Painter, 1989;Alonso & Rutan, 1988;Goguen, 1986;Hess, 1987;Kaslow & Deering, 1993) discuss the importance of relationship factors in supervision. The relationship between supervisors and trainees should facilitate a learning alliance (Berger & Buchholz, 1993).…”