Journal of Analytical Psychology, 2000, 45, 367–383

Some reflections on empathy

and reciprocity in the use of
countertransference between
supervisor and supervisee
James Astor, London

Abstract: Reciprocity refers in its general meaning to a mutual give and take. It is a
background feature of all productive supervisory relationships. In this essay I want to
bring it into the foreground. I will describe it by contrasting supervision and analysis.
For, in my view, that is exactly what reciprocity is in the supervisory relationship: it is
an attitude of mind in which the supervisor performs the task of differentiating internally
the supervisory from the analytic vertex, in the context of the asymmetry of the super-
visory relationship.

Key words: countertransference, empathy, Fordham, Jung, reciprocity, supervision.

Introduction
Empathy is a form of identification and as such is a perceptive process, Jung
described it as ‘a movement of libido towards the object in order to assimilate
it’ (Jung 1971, para. 871). It is a process influenced by reciprocity, a term which
refers in its general meaning to a mutual give and take. It is a background fea-
ture of all productive supervisory relationships. I think of it as an attitude of
mind in which the supervisor performs the task of differentiating internally the
supervisory from the analytic vertex, in the context of the asymmetry of the
supervisory relationship. I am borrowing the term vertex from Bion, to refer to
‘views with which I am identified. With myself as the vertex all these vertices
represent “other-people-as-seen-by-me” ’ (Bion 1965, pp. 145–6). So if I write
‘an analytic response …’ that’s one vertex, or ‘some people think’ is another,
or ‘Jungians generally …’ is yet another. In using the term vertex Bion was
getting away from the implicit confusion between the literal and the metaphor-
ical that a term such as ‘point of view’ with its emphasis on the visual system
gives rise to.
By way of orientation I will begin with Michael Fordham’s observation
about analysts and learning how to become an analyst.

0021–8774/2000/4503/367 © 2000, The Society of Analytical Psychology

Published by Blackwell Publishers Ltd, 108 Cowley Road, Oxford OX4 1JF, UK and 350 Main Street, Malden, MA 02148, USA.
368 James Astor

The analyst will know that every single statement he makes is an account of the state
of his psyche, whether it be a fragment of understanding, an emotion, or an intellectual
insight; all techniques and all learning how to analyse are built on this principle. It
is thus part of the analyst’s training experience to realise that he is often going to
learn, sometimes more, sometimes less, from each patient, and that in consequence
he himself is going to change.
(Fordham 1957, p. 69)

This is my starting point. I have in the back of my mind the principle which
Fordham enunciated, and the fact that both supervisor and supervisee are
going to learn something from the work together. This encourages mutuality.
The essence of supervision is that it provides a space for thinking (Rustin 1996).
It is therefore both clinical and didactic. It is a space which has a certain quality
of attention, not dissimilar to analysis, in that the communications are being
thought about from the position of multiple vertices (Rustin 1996). It is like
analysis too in that supervision leads to the internalization of a process and a
model, which enables us to monitor our sessions. Openness to different ways of
thinking about experience, absence of judgemental attitudes, benevolence and
analytic thinking in all its forms are features which characterize both super-
vision and analysis. But supervision is unlike analysis, in that the supervisee’s
transference to the supervisor is not systematically analysed or interpreted.
I acknowledge that as supervisor I am learning from the relationship with
the supervisee, and from their relationship with their patient. I proceed on
the basis that they are learning from their patient and from their relationship
with me. I recognize that there exists in their mind my relationship with their
patient, and that this can sometimes cause difficulties in their work with their
patient. I also demonstrate in my interventions that my relationship with the
supervisee is monitored from different vertices including the supervision itself.
I pay attention to what is being reported, the way it is being reported, and
what I experience while it is being reported. While this is happening I am con-
sidering and rejecting hypotheses about the material under consideration. I am
thinking about this in the context of what I know about the supervisee, their
characteristics, tendencies to understand the material in a particular way, and
their residual psychopathology as revealed in relation to me. Technically this
means that I often make use of questions, expressed ruminatively or tentatively.
This is because questions allow issues to be raised in an unthreatening way.
Most of us have had the experience of understanding something new about
our own material just from talking about it to a colleague. We can understand
this coming together of two minds as a form of parenting, in which the thoughts
and ideas we have about the supervisee’s patient are the children of the process.

‘Getting to know you’

This coming together of supervisor and supervisee, however, does not always
have this creative consequence; sometimes, usually at the beginning of the
Some reflections on empathy and reciprocity 369

relationship, this experience of the supervisor/supervisee couple can stir up in

the supervisee old sores, feelings only partially addressed in their own analysis,
feelings of exclusion, even of envy and hate. And this can then be destructive of
the work together. More usual, in my experience, however, has been the initial
struggle to understand where each of the parties is coming from. One super-
visee has referred to her early experience of working with me as one of strug-
gling to find a common language, when she felt I was talking mathematics and
she was talking intuition and passionate feelings. I was water to her fire. She
was getting caught up and needing time to think about her entanglement;
she thought of me as detached, schematic, and very English. She talked about
myths and I talked about the quality of the patient’s internal object. Little by
little she came to realize how much I appreciated her engagement with her
patients and she in turn found her own way to use what I understood and my
way of describing it.
Another complication at the beginning of a supervision is the added weight
of the supervisee’s historical relationships to their own internal objects and their
need to sort these out. The characterization of me as mathematical, detached
and very English might have a superficial plausibility but its significance is that
it is evidence of residual transferences to internal objects (in her case her father).
If the supervisee is not in analysis or not able to integrate these experiences
through self analysis then that can derail the supervision process. Only occasion-
ally have I found this insurmountable.
Caution too needs to be exercised should one be tempted too often to be
collegial and talk about one’s own cases to one’s supervisee as this can have
unexpected effects on their transference to their patient. Epstein gives a clear
example of this which I will quote:

During a session with his patient, the supervisee found himself unable to concentrate
on what the patient was talking about. His attention kept drifting away and he
found himself preoccupied with personal concerns. Unable to bring this process of
involuntary distraction to a halt, he decided to associate to the problem. He recalled
his experience of the last supervisory session in which his patient was discussed. At
a certain point in the session, his supervisor began to talk about his own work with
a similar kind of patient. The candidate remembered feeling slightly unsettled by
this but resolved the matter by thinking to himself as follows: ‘Oh that’s good. He’s
treating me like a peer’. It came to him, while associating, that he had actually
suppressed feelings of being emotionally abandoned by his supervisor, and he then
understood that he had been unwittingly and uncontrollably subjecting his patient
to similar mistreatment.

(Epstein 1997)

This example of how the supervision repeats itself in the session reveals how
important it is to be clear in one’s mind as a supervisor that mutuality and
reciprocity contain necessary asymmetries. Epstein restored the situation by
reverting to his supervisory function.
370 James Astor

1. The focus: the supervisee or the patient

If the supervisor focuses too much on the supervisee and not enough on his
patient, then the knowledge gained in the supervisory session can take on the
persecutory quality of the knowledge of hindsight. It can seem like wisdom
after the event as when in a legal context, encased in superiority and contempt,
the tone becomes ‘if you know that now, why didn’t you do something about
it then?’ In the context of my quotation from Fordham, however, wisdom
after the event is learning from reflection.
On the other hand if the focus is too much on the patient, then the effect can
also be demoralizing for the apprentice analyst but in a different way. There
was a supervisor when I was training who had a particularly evocative style
with emphasis on embodied interpretation of infantile fantasies. Those super-
vised by him would hear him reinterpret their material. His style was to focus
hardly at all on what the supervisee said but to say what he, the supervisor,
had understood. That could be inspirational, but it could also promote learn-
ing through imitation and that, in my view, is a sure way to trample on the
individuality of the patient and the supervisee. For if the supervisor does not
pay attention to the understanding of the supervisee but only to the uncon-
scious of the patient, the supervisee will find himself repeating the supervisor’s
formulations, without being able to follow them up, because they have not
been integrated. This has been described by Fiscalini as ‘analysis by ventrilo-
quism’ (Fiscalini 1985).

2. Obstructions to learning in supervision

Supervision provides a space to examine the power and strength of the ideas
which are informing our analytic practice (Rustin 1996). This is valuable at all
stages of our professional life but especially so when we become more experi-
enced and realize that we have for so long assumed the significance of certain
analytic truisms, theories and concepts, and need to re-examine them, to forge
them anew and give them a personal edge. This is important in the context of
Jung’s statement that we need to make a theory for each patient and Fordham’s
encouragement to us to make a theory for each session. Making theories, like
writing papers, makes us think out and find expression for our thoughts and
feelings. Sometimes, however, the problem which is brought to us as super-
visors reveals that the supervisee does indeed have what he thinks of as a
theory, but it is in fact a misconception about his patient which is imposed on
the material.

Example 1: Identifying the supervisee’s misconceptions which are not being

modified by the material
In this example the supervisee is reporting material to me which he has under-
stood as an example of an attack on an enviable object. He basically thinks
Some reflections on empathy and reciprocity 371

the material is an instance of penis envy. The background situation is that

the supervisee’s patient is in and out of the same building as he is. The building
in question houses an institute, which offers courses, training and treatment.
The material brought to me is that the patient has been attacking this analyst
(my supervisee) by telling him that she was in the building attending a seminar
at the same time as she knew him to be there, and she had seen that he had
left a note for someone at the front desk. The patient is angry about this note,
which is addressed to someone she knows, and she pours scorn on the small
size of the return address information which the analyst has stuck on the
envelope. She tells him that this small size indicates he is a wimp and just a
little man, just like her father. The analyst now reported that he interpreted
this as if from an identification with the patient’s father. He said that he spoke
to his patient as if with her father’s voice about her denigration and contempt
for him. He felt angry with her, he said. There are two points here: the theory,
namely that this material is about penis envy, and secondly that the way to
interpret this is by speaking out of identification with the denigrated object.
I did not agree either with the analyst’s conception of the material or with
his interpretative style. I thought it was unwise to speak out of identification
with the denigrated object, as to do so suggested that the analyst too was filled
with contempt. He would be experienced by his patient, in my view, as being
contemptuous of her intense feelings of hurt and anger. Rather I was concerned
that the significant other unconscious communication in the material, con-
cerning the analyst’s presence in the building and his involvement with others
there and the patient’s response to this, was not being addressed. I understood
her attack as a defence against something. I was interested in the two people
in the building who were not meeting (you could understand this as having
arisen from my countertransference realization that my supervisee and I were
not in harmony) and what effect I thought this was having on the patient’s and
the analyst’s internal world. As part of my monitoring the supervision I was
wondering whether the analyst was feeling at this point in the session with me
that I had an understanding of his patient which he did not have. This might
be making him less sensitive to an Oedipal interpretation because of feeling
excluded. At the same time I was aware that my supervisee was affected by his
patient’s contemptuousness and that he can easily feel flawed in both senses of
the word (floored and flawed). I was unclear why the analyst was made angry
by the patient’s contempt.
I began therefore to wonder out loud what the analyst thought the patient’s
anger was about. My supervisee replied that he did not know. I then suggested
my Oedipal theory about this session, namely that the patient is angry with
him for being in the building, seeing other people and doing interesting things
with them to her exclusion. My supervisee now told me that there was to
be a short break in the treatment and this is the session immediately prior to the
break. He continued with associations which deepened the understanding of
what we were now working on. He remembered that his patient had commented
372 James Astor

on the two planters on either side of the door when she had come to the
Monday session and had expressed her interest in the connections between
their contents. Now the supervision session is beginning to take shape. We
had an impasse, a patient who felt misunderstood, and an analyst who knew
something was not right because he had spoken out of his anger. Then we had
a way of thinking about the impasse, the Oedipal theory arising out of the
material, which was filtered through the knowledge and history of our relation-
ship. A fertile interaction could occur. The supervisee’s further reflection was
that his identification with the denigrated object (a bit of his own pathology)
prevented him from seeing the Oedipal dynamic. This I did not comment on.
I strongly disagree with supervisors who tell their supervisees to take such and
such a feeling to their analyst. We are analysts, so let us proceed analytically
not as traffic policemen. Apart from anything else this comment usually in-
dicates some rivalry or unexpressed hostility towards the supervisee’s analyst,
as if the problem would not have arisen if the analyst had done a better job.
In thinking about the supervisee’s contribution to that example, I recognize
that by being open and unguarded about the interaction with the patient
he enabled me to feel into it. By being receptive to thinking about my altern-
ative suggestion and how I had derived it, he both facilitated further asso-
ciative exploration of the idea and elaborated it. I, as the supervisor, needed his
response for me to be effective. He could quickly see, once we had started on
the Oedipal theme, that his previous position was not the significant dynamic
of the session we were discussing. It was as if he was employing last week’s
idea on today’s material. A further aspect of the reciprocity inherent in this
supervisory relationship concerns the question I have been developing further
with this supervisee: that is the meaning for his patient of embroiling him in
her drama in the way this material demonstrated.

Example 2: Projective identification and countertransference

A colleague who had a specific problem asked me for a few supervision sessions.
On the telephone he stated that he had difficulty getting his patients to come
more than once a week. In the event when he came he first of all told me
something of his biography and then gave an account of a patient who he felt
treated him disdainfully. This patient was, while seeing him, also having con-
sultations with someone else to see if this other person might be a more suit-
able therapist for her. He described her as rich and rather grand by marriage,
but ill at ease internally with her family of origin. My internal transference
commentary at this point was that this therapist was wondering whether if
he had a different analyst, for his own analysis, it would improve his work. He
was having difficulty thinking about the feelings stirred in him by this patient
and was looking elsewhere for the solution to the problem.
My hypothesis at this stage, based on the material he brought about his
patient, was that he had become identified with the projective identificatory
Some reflections on empathy and reciprocity 373

content of her material and that this was probably due to some difficulty
he had with envy. So my colleague now talked and talked, filling the whole
session with material. He was determined to get through the sessions he had
brought. No time was left for discussion or examination of the material. I
indicated that time was up and that we would have to return to this in a
fortnight. He said in a somewhat peevish tone of voice, ‘Is that all?’, meaning
was that the best that I could do. I was put in the position at that point of the
analyst/supervisor who was not able to produce enough, which was exactly his
dilemma, with his patient and within his practice. I was the recipient of the
feelings the supervisee had when with his patient, but which he was unable to
interpret to her satisfactorily. So I said that his comment ‘Is that all?’ sounded
like the sort of thing his patient said to him; this struck a chord with him and
he replied that, yes, that did seem to be the transference.
This pithy little exchange at the end of the session encapsulated the issue.
My colleague took it away and worked on it. When he returned two weeks
later he had digested it and internally elaborated it so that without the bound-
ary of our work being broken he could acknowledge the significance of our
exchange, and felt freer of his identification with his patient’s projections of
inferiority and anger. In consequence he was able to work with these feelings
inside himself and to work with the patient more productively, to interpret the
patient’s consultations with the other analyst as the potentially better one. It
helped him realize that deepening his work involved a process of working with
his own ambivalence as it was constellated in his transference to his patient.
I will formulate in relation to myself the question in this transference prob-
lem that was brought to supervision. If what I have written is making you pick
holes in what I am saying one of the questions you, the reader, might ask is:
Whose problem is this? Is this your own problem (your envy for instance) or
is it my problem (my envy) projected into you defensively as a way I might have
of protecting my own inner object from attack? My colleague was struggling
with just this dilemma.

Example 3: The use of reciprocity within the countertransference

of the supervisor as an aid to resolving impasse in the supervisee’s
work with a patient
This supervisee rarely brings process reports. She prepares for the supervision
by reading through her material before she comes and talks out of the re-
evoked experience. The reciprocity in her relationship with me is the essential
feature of our work together. The relationship is not analytic but it has analytic
features; in supervision, since the supervisee does not have an analytic relation-
ship with me, I think of these features as constituting a reciprocity.
The material is nearly always about how she is affected by the patient and
often about how she struggled to contain her anger or irritation or bewilderment
within her professional persona. In other words she is bringing a combination
374 James Astor

of unprocessed countertransference, projective identifications and a receptivity

to thinking about new ways of understanding them. The supervision has a
pattern. First she needs to be settled down; this happens partly from the initial
exchanges and her feeling that now she has my attention and partly from the
way she idealizes me in her transference to me. Then she describes what is on
her mind about her patient.
My colleague begins the meeting by saying how desperate she is feeling
about a borderline patient who is screaming at her in the session that she, the
therapist, is evading the big issue, which is that the patient insists on knowing
whether her therapist fancies her. ‘Do you fancy me? You have got to tell me!’
the patient shouts. My colleague tells me at this point that the patient was hos-
pitalized when she was three years old. Her parents did not visit. The patient’s
parents’ marriage was one in which father screamed at and physically assaulted
mother, usually when under the influence of alcohol.
At this stage I am proceeding analytically and am thinking that my super-
visee is having difficulty with how to convey to her patient that her patient’s
demand to know if she is fancied by her therapist is similar in feeling to her
patient wanting to know whether her mother loved her. The obstacle in the way
of the patient’s understanding is that any reference to her dependency needs is
greeted with scorn (because too painful) and, in consequence, any interpretation
which is precipitately reductive will not work. She needs an interpretation
which helps her overcome rather than defend against despair. So I comment
that the patient is screaming at her therapist, in a manner similar to the way
the patient’s father screamed at her mother. I add that the therapist is feeling
terrorized, like her patient did as a child, and that this identification on the
part of the therapist with the screamed at child paralyses her.
My colleague continues that the patient beseeches her to tell her that she is
special and writes her a letter between sessions telling her of her frustration
and rage. I comment that the patient’s frustration derives from a feeling that
she is not exclusively in possession of her therapist as if her therapist was a
mother and she was a child. My colleague now reports that the patient also
complains that she can hear other people in the therapist’s house and that this
is inhibiting. The tone of the complaint is threatening and the therapist com-
ments that she is frightened of her patient’s violent feelings. I comment that all
of this seems to be a complicated communication. In part the patient is anxious
about her warring internal parents while at the same time she is feeling enraged
that she is on the outside and wondering what she contributed to their fight-
ing. For the therapist this experience seems to be evoking feelings arising from
her identification with her patient as the unwanted, excluded child. What is
needed here?
What I notice as I am listening to this is that my colleague is anxious about
the insistence the patient makes that she should be her lover and refers to this
as the erotic transference. I did not think it was principally erotic as there was
nothing very erotic in the feelings between these two people. I thought this was
Some reflections on empathy and reciprocity 375

the dependent transference masquerading as the erotic, where what seemed

erotic was in fact primarily aggressive. I thought this patient was furious that
she needed her analysis and that the technical problem was to see the attack
on the therapist as a defence, to analyse it as a defence, and especially to under-
stand what was being defended against. I was thinking that she had never had
the illusion of possessing her maternal object; how then to make use of these
resulting intense feelings of injustice?
I was struck by the tyrannical nature of the patient we were discussing and
inquired after the imagined age of ‘the tyrant’ with my colleague. This initiated
a discussion about the difficulty of thinking when being yelled at. I recalled the
experience of containing ‘the tyrant’, of staying close but not giving in to
threats. As I knew this supervisee had brought up children herself, I con-
ceptualized this behaviour as emanating from a child-like part of the self and
described what I imagined a three year old would be feeling, when left in
hospital and not visited by her mother. I described a three year old whose fury
threatened to break her up inside. This brought relief to the therapist who could
now think about the nature of her patient’s insistence that she, the analyst,
should become her lover. I had in mind that the therapist’s problem with this
patient derived from a difficulty which she, the therapist, had as well, namely,
a difficulty with acknowledging vulnerable and childlike dependent feelings
and the way this expressed itself in her own unresolved Oedipal issues, though
I did not say that.
Why did this bring relief? Because we had conceptualized the material within
the transference. Which transference you might well ask? In this supervision
I was showing my colleague how she would like to analyse her patient but
also how she got invaded with the same feelings as her patient. By this process
these complicated feelings became more familiar and less threatening. They
were contained. What I had said had stopped the yelling voice in my colleague.
We could now consider how to speak to this very unhappy and vulnerable part
of her patient. We agreed that the patient’s feelings about her object were sub-
ject to fierce ambivalent pulls of love and hate, which were regressive. We agreed
she needed to create in the transference an idealized object as part of her
reparation, and I wondered to myself whether my colleague had realized that
this was what had happened here with me. We agreed that at some point the
patient’s denial of the loving aspects of the parents’ intercourse would have to
be examined in the context of the patient’s insistence that she could supply to
her therapist everything she needed. It was also clear to us that this fantasy of
hers was a reversal of what she actually wanted to happen, namely that she
wished for the exclusive maternal attention of the therapist, and that this would
at some point need to be interpreted.
But this could wait. The problem at the moment was that the patient was
feeling frustrated and excluded and this made her feel violent. What was the
quality of this violence? My colleague and I thought about that together. Was
it violence as a consequence of the deficiencies of her object or was it violence
376 James Astor

that had a sadistic relish to it? It seemed on examination to be the former.

Being excluded from an ideal object is what enraged her.
In the old days we might have thought of interpreting in terms of part
objects here. I used to think like that myself, and even wrote in one of my
papers apropos a dream that it was the thought of the mother’s nipples which
kept the baby’s mind in order after a feed (Astor 1989). Now I look at that
work and realize how it is functions, not part objects, which need emphasizing
and that embodied interpretation at a part object level can be distracting. I was
now thinking that what needed emphasizing was that this child needed some-
thing in her mind to hold onto that symbolized the creative and positive aspects
of the maternal couple and ultimately the parental couple. Focusing on part
objects, which represent only partial and incomplete meanings for the patient,
distracts from the purposive nature of their function. Today I would speak
more of the function of holding on in her mind to something which acted as a
conduit from the inside of her mother to the inside of her; something which
had a quality of firmness, perhaps masculinity and something which might
even conjure up the possibility that father had some part in the creation of the
supplies.
My colleague and I now started to speculate on how to phrase the thoughts
we were having about this patient. In doing this it emerged that my colleague
was playing a sort of verbal ping pong with her patient.
The patient said, ‘Well, you always say you have me in mind, but I don’t see
how you can, as you have all these other patients’.
The therapist replied in the same vein, ‘Well, I know that makes you angry
and we know something about where that anger comes from’.
Essentially a defensive statement.
The patient replied, ‘Yes, yes: I know all about that too, but what about
now, what about here?’
At this point I suggested to my colleague that what she was not hearing was
the statement the patient was making about the deficiencies in her object: that
she was very frightened of being left and that she was armouring herself against
the ending of the session by creating a retaliatory atmosphere, so that she
could storm out and protect herself from feeling bereft. We needed to consider
the unconscious assumptions behind the patient’s statements. What in part I
was trying to do here was to mobilize in my colleague a reflective process
which would enable her to wonder what was it in her that made working with
this patient difficult. And as you can probably tell from what I have described
there was an underlying meshing of the patient’s and my supervisee’s Oedipal
dramas. In this description I am following Klein in hypothesizing that there are
pregenital components of Oedipal fantasies.
I suggested that it was preferable, with the patient in this desperate state,
to convey what we had understood, initially by saying something like, ‘you
want me to understand that you are terrified you might be left, abandoned and
rejected’. I continued that depending on how this was received and assuming
Some reflections on empathy and reciprocity 377

that it had helped to diminish the yelling, gradually one could add a reference
to her rage and frustration and its effects on her inner world, namely that she
felt broken up by it. When in this state of mind the patient could not be inter-
preted to until her present emotional state was acknowledged. You could only
say, ‘I know you need an answer to your question, but I also know if I try to
talk to you about this in relation to your terrible losses as a child it is going to
make you even angrier because you feel this is urgent and this is now and that
was then’. This patient needed that to be recognized. That is what I understand
Jung to have meant when he wrote of the ‘real’ relationship which is necessary
in analytic relationships. Real means understanding that what you are hearing
is a memory in action but the patient does not know this yet, and so she needs
containing and not exposing. Feeling exposed is what can happen if a reductive
interpretation is made too soon. It can also sound accusatory. What I am
trying to demonstrate is that by responding in this way, the therapist stood a
better chance of engaging the patient’s imagination and interest in the analytic
process.
The interpretation phrased like that recognizes the unconscious meaning
within the transference of the patient’s demandingness and also the therapist’s
countertransference. What it conveys is that the therapist has understood what
the patient is feeling like. It is another matter whether the patient wants to under-
stand what the therapist has said. That is why I suggested delaying at this stage
the additional observations which are directed at the patient’s understanding
rather than just being understood (Steiner 1993, chap. 11).
The interpretative style here is aimed at the patient’s urgent demand for
love, and her intolerance of frustration. It is not aimed at making the patient
feel guilty for having these feelings. I am particularly keen not to make border-
line patients feel that their situation is entirely of their own making or due to
their own nature: in this instance, that she was put in hospital because she
was unliked, and not visited because she was so intrinsically unlikeable. Inter-
pretations directed towards these feelings are deeply demoralizing, ego weak-
ening and destructive of the development of resources within the patient to
cope with living in their own mind. (It is difficult enough for all of us to live
in our own minds without analysis making it worse.)

Reflections on the supervisee’s contribution to the supervisory process

In reflecting on this supervisee’s contribution to the process of developing this
analysis through the supervision I note that she uninhibitedly brings her feel-
ings and her difficulties in her thinking. She also listens and interacts with me.
There is a dialogue between us which has the characteristics of an inner dia-
logue, with my being able to articulate what she is preconscious of. Her trans-
ference to me reflects the transference in her patient. But at times she behaves
as if under the dominance of the patient’s feelings. Grinberg calls this projective
counteridentification to distinguish it from countertransference (Grinberg
378 James Astor

1997, pp. 16–17). These feelings stirred in the supervisee by her patient are
part of the supervisory discourse, whereas her countertransference muddles
arising from her own Oedipal difficulties are for her own analysis. This is
clearly understood between us. She lets me know whether what I am saying
is of any use to her and we proceed from this supervisory vertex. All this helps
me, in that I can wait and process the experience she brings and speak out of
my analysis of this experience. I do not have to know. She trusts me and the
unconscious and I trust her and the unconscious and out of this mutual trust
something usually happens.
Sometimes we both get stuck. On one occasion the therapist’s impasse
with the patient was enacted with me. She brought material which I could
not follow. I simply did not understand what she was saying. She spoke about
the patient having had a series of minor accidents and that these must be in
some way significant. She had no thoughts about this and neither did I. We
were both like the patient, unable to think. I became inattentive. The therapist
became increasingly fed up with her inarticulateness in the supervision, which
my response was highlighting, but significantly, she did not become fed up with
me. She realized she was having a difficulty in conceptualizing the problem
both emotionally and intellectually. She felt annoyed with herself. She left
feeling frustrated. She had understood during her supervision that the problem
with her patient centred round an impasse and, as in her relationship with me,
this had something to do with not being able to articulate intense feelings. I am
describing here as nearly as I can what I mean by reciprocity as an aspect of
countertransference. I am understanding at an analytic level what is going on
and comparing it internally to the supervisory vertex from which I speak to
my supervisee.
In the sessions with her patient following our meeting, she stayed close to
this bewildering feeling of impasse as she sat and listened to her patient. Into
her mind came the image of a huge dam. She thought of the dam as holding
back water from other dams and that the structure was defensive more than
containing. She began to speak out of this feeling. She described to her patient
how frightening it would be if there was a crack in the dam and her feelings
flooded out; would they ever stop, would they drown the very person she
wanted to hear them? The patient was receptive to this and together they
thought about the accidents as fissures in the wall, and that these fissures were
communications from the unconscious. The impasse was now defined in
outline. It formed the basis for further investigation of her defences. Out of an
apparently unproductive supervision came a reflection on the process which,
when thought about as the enactment of the transference, led to the problem
becoming more accessible. And the fear of being overwhelmed diminished in
both patient and supervisee.
Some reflections on empathy and reciprocity 379

Example 4: Empathy and the re-examination of the grammar

of interpretations in supervision

To illustrate this I am going to draw on Anne Alvarez’s thinking about her

work with a borderline patient. Anne Alvarez re-examined her work with this
patient in the light of what the patient showed her and she has produced a
thoughtful critique of her own work (Alvarez 1997), arising from her taking
her work to supervision. In this critique she distinguished between the grammar
of interpretation appropriate for neurotic patients, who have enough ego to
cope with the unmasking quality of interpretations intended to reveal the
depression behind the defence, and the approach necessary for the borderline
patient, whose defences are less manic and paranoid but carry elements that
are basic for development. In this case the defences seem more like attempts
on the patient’s part to recover from, and overcome, states of despair.
Alvarez’s approach is the fruit of her clinical experience, combined with her
absorption of the work of Rosenfeld, and Bion and supervision with Joseph.
Underlying this approach is the question: ‘What is the motivation for the com-
munication we have just received?’ When we have understood the motivation
of a boastful and manic assertion, thinking for instance, that it arises from a lack,
an absence in, or perhaps failure of, their object, are we then careful enough
to distinguish when talking to our patients between what is omnipotent and
what is the patient’s desire for potency?
She gives an example. Her child patient was painting, and there were painters
in the house which he had noticed when he came in. She interpreted that he
was perhaps wanting to show her how he would like to be able to paint like
the workmen (omnipotence). He corrected her ‘Yes I do, I do want to, but I do
work, that is what I do, you see!’ (potency). The therapist’s ‘what you would
like to be able to do’ has been restated by the patient as ‘what I do’. The con-
ditional has been removed. The therapist’s interpretation refers to loss and lack
and depressive feelings, to the patient’s absence of potency. It is an initially
ego-weakening statement. Alvarez notes that the patient’s correction refers
to the need for her to recognize that he has suffered a lifetime of humiliation
about his inadequacies and is pointing out to her that he has the potential to
become a competent painting man, potent and paternal, repairing the inside of
the house.
Here is another thought from Alvarez about understanding the patient’s
motivation for saying what he has said. When a patient speaks of wanting his
mother there forever, do you understand that as a defence against sadness or
as a statement about his urgent need for continuity of relationship with you?
In this formulation there is a continuity in the transference, which can repair
the internal object whose deficit is being referred to. In borderline patients it
is not unusual to encounter an object which feels to them irreparable. If you
interpret to these patients as you would to a neurotic patient (i.e., assuming
that they have more than one perspective on their inner world: for instance,
380 James Astor

that they can feel sad, and feel sad that this makes them sad), you do not take
account of the deficit in their object. The consequence is that the patient feels
accused ‘of being totally responsible for this state of affairs’ (Alvarez 1997,
p. 761): blamed, despondent and despairing, without hope of change. This can
prolong treatment, since it does not allow the possibility of an object that can
be repaired and of a person (the patient) who can repair it.

Reciprocal affectivity and the supervisor’s role

There are many ways a supervisee can use a supervisor, especially when the
supervisee’s material is very intense and painful. In the following example the
supervisee reports on a patient who is revealing something deeply shameful.
The atmosphere of the supervision is very intense. The supervisee is affected
by the material and upset by it. What happens is that what was projected into
her is now projected into me. My task is then to redescribe part of the analytic
meaning of the projected material.
The supervisee reports that her patient was talking about how affected she
had been by a friend of hers telling her that she locked her little girl in her bed-
room at night because she wanders about. The patient is upset and the super-
visee is upset too with this account. I am affected by the emotional atmosphere
as well. But my task is to bring out how the horrific nature of the story, which
we can all imagine ourselves into, of a frightened little girl being locked into
her room at night, so that she is not a nuisance to her mother, can distract us
from the analytic communication. For what I have understood from my
listening and my distress is that the patient is feeling locked out, frightened and
misunderstood in a vulnerable and childlike part of herself. In addition, she
wants her analyst, my supervisee, to know that she is ashamed to think that
she has been a damaging parent herself.
In the context of the transference in the therapy session I saw it as my job
to formulate this and point to where the supervisee has allowed herself to
become so emotionally involved in the horror story of the imprisoned child
(projective counteridentification) that she has been unable to hear the patient’s
communication. In my view the patient is telling the therapist both that she
feels that she, the patient, could have been a mother who did not understand
her child, and that she is frightened the therapist might not understand her
(the patient’s) own childlike terrors, which are related to her feelings of being
locked in and locked out. There is probably some terrifying primal scene
fantasy behind this material, but at this stage this hypothesis is awaiting more
information.

Rhythm in the supervisory exchange

The interactions between supervisor and supervisee have a rhythm to them which
is often closely related to the material (Rustin 1996). Thus when the supervisee
Some reflections on empathy and reciprocity 381

is very anxious about what is going on, the supervisor becomes more active in
trying to help him contain the experience and makes more proposals and
suggested formulations. If the patient is becoming less contained the supervisor
tries to be more containing to his supervisee, perhaps even directive, if the super-
visee is at a loss. At other times the main function of the supervisor is to be, what
Margaret Rustin calls, ‘the thinker of interpretative links’ (Rustin 1996).
I was listening recently to material from an experienced therapist who
was analysing an experienced patient. The links she was making were close to
the material and to the point. The patient was speaking about the difficulty
of living in two places, a house in the country and a little flat in town from
which her husband went to work and where she stayed three nights a week.
She described her behaviour in the language of performance and acting: ‘getting
my act together’ was how the patient described her move from the country
(no analysis) to London (analysis).
At first the therapist was interpreting this in terms of the different states of
mind in which she lived, relating it to the three sessions a week (analysis and
London), and the non-analytic time in the country. But then I began to realize
that there was considerable anxiety in the therapist about the falseness of the
patient’s description in terms of ‘getting her act together’ and that her efforts
to help her patient understand this were failing. This feeling the therapist
had about her failure to get through to her patient was not uncommon in our
experience of this patient. We had noticed that she had a way of not allowing
the truth to touch her. I was aware that I was not being an effective supervisor
at this point, and I was thinking about this and the material when I realized
what the problem was. ‘Getting her act together’, performing, and all that that
meant, was central to the whole process, especially the analytic endeavour.
I suddenly realized that the patient was experiencing the therapist’s inter-
ventions as just so much performance art. In this example the communication
inherent in the patient’s performance was its inauthenticity which matched the
therapist’s feelings of frustration that she was not getting through to her.
The problem, as I now understood it, was that the therapist was perceived
by her patient as playing at being a therapist while she played at being a patient.
So the therapist interpreted and the patient ‘ummed’ along and from the patient’s
point of view this was all that was necessary, each was in role and the truth
remained in the hands of an unseen author, who did not need to be consulted.
Nothing else had to happen. The therapist spoke and the patient responded,
not by letting the words, feelings, and images settle in her mind, not by savour-
ing or digesting, but by tasting and pushing away. The act of serving up the
interpretation was the therapy. The patient did not have to make any commit-
ment to what was said, just as she did not have to make any commitment to
her own feelings, nor any commitment to the consequences of recognizing what
the implications of certain truths were. Once I had grasped that, I elaborated
on it at length, becoming active and descriptive in response to my supervisee’s
inactivity.
382 James Astor

Concluding statement
In the clinical examples I have reported I have endeavoured to distinguish the
analytic from the supervisory vertex, with reference to reciprocity and empathy
as aspects of countertransference. In essence I have described emotional ex-
periences which were felt to be meaningful and which became the basis for
further thoughts about the process of supervision.

TRANSLATIONS OF ABSTRACT

Réciprocité est un terme qui se réfère, dans son sens général, à un donner/recevoir
mutuel. C’est un trait de base de toute relation de supervision productive. Dans cet
article je cherche à mettre au jour ce trait de base. Je le décris en différenciant super-
vision et analyse. En effet, de mon point de vue, c’est exactement dans cette réciprocité
que se situe la spécificité de la relation de supervision: il s’agit d’une attitude, d’un état
d’esprit dans lequel le superviseur s’applique à différencier à l’intérieur de lui l’axe
analytique et l’axe de supervision, dans le contexte de l’asymétrie de la relation de
supervision.

Reziprozität bedeutet allgemein ein gegenseitiges Geben und Nehmen. Es handelt sich
um eine Charakteristik im Hintergrund jeglicher produktiver Beziehung in der Super-
vision. In diesem Aufsatz will ich diese Charakteristik in den Vordergrund bringen. Ich
werde sie beschreiben durch eine Gegenüberstellung von Supervision und Analyse. In
meiner Sicht ist Reziprozität nämlich genau dies in der Beziehung in der Supervision: es
ist eine psychische Haltung, in welcher der Supervisor die Aufgabe vollführt, innerlich
den supervisorischen vom analytischen Vertex zu unterscheiden, und zwar im Kontext
der Asymmetrie der Beziehung in der Supervision.

La reciprocità nella sua accezione generale si riferisce a una reciprocità di dare e avere.
E’ una caratteristica di fondo di ogni rapporto di supervisione produttivo. In questo
saggio vorrei portarla in primo piano. La descriverò mettendo a confronto la super-
visione e l’analisi. Perchè, secondo me, ciò mostra esattamente cos’è la reciprocità in un
rapporto di supervisione: è un atteggiamento mentale per cui il supervisore raggiunge
lo scopo di differenziare internamente l’aspetto di controllo dal vertice analitico, nel
contesto dell’asimmetria del rapporto di supervisione.

La reciprocidad se refiere en un sentido amplio al intercambio mutuo. Es la caracter-

ística fundamental de cualquier relación productiva en la supervisión. En este ensayo
deseo traer este hecho a la luz. Lo describiré contrastando análisis y supervisión. Ello
debido a que, desde mi punto de vista, es ello lo que es la reciprocidad en la relación de
supervisión: esto es la actitud mental en la cual el supervisor realiza la labor de difer-
enciar internamente la supervisión del vértice analítico, en el contexto de la asimetría
de la relación de supervisión.
Some reflections on empathy and reciprocity 383

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[MS first received December 1998, final version March 2000]