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As I wrote some years ago (Croce E. B. 2000) I think that supervision and control
are two “bad words” because of their visible institutitionalization, the unquestionable superiority of a well defined summit in relation with the clinical work, while expressions such as “working about the case”, “sensitization to listening” seem to me too vague and a little ambiguous. But seeing that, as much as I can know no better solution has been found yet I have just decided to overcome this terminology block and use here the traditional term of supervision. I am confident of
the reader’s good will so that he/she will be able to follow me easily enough.
The case
Marianna is awfully worried because Nicola , a nine year old boy inserted into a psychodrama group, she has been the conductor of for some months with a colleague, Valeria (who is working about the case in another group of supervision.) Marianna is worried because every time after the beginning of the session, automatically, Nicola falls asleep and wakes up some minutes only before the end.
“ What shall or can we do in such cases?” That’s the problem which seems to monopolise Marianna’s interest in this moment. In addition, Valeria, the colleague I had hint at, according to Marianna , intervenes in an absolutely wrong , unsuitable ant-analytic way. In fact, when Valeria is conducting she tries over and over again to wake him up in an active way and, every time Nicola closes his eyes and gets back to sleep with a sweet smile of forgiving tolerance. On the contrary, when she is attending as an observer she fires at the boy’s behaviour with sharp criticisms imbued with moralistic rage.
The problem of the supervision group perplexes everyone a little for a moment, then
suggestions and proposals are given: discussing deeply with Valeria (already experienced), asking Nicola to speak about his sleep (already experienced) and he falls asleep soon after without saying anything, proposing him an individual session or instead waking him up and let him go out of the room if he tries to fall asleep again ...etc.
The supervisor asks Marianna who is Nicola, which diagnosis had been given about him by the team how he appeared in the preliminary talks, what sort of questions she asked him and what sort of reaction he had to the proposal at taking part in the psychodrama group...etc.
Nicola isn’t psychotic according to the psychiatrists who visited him. As it often happens to children and first of all to those who are still in the age of latency, it seems
that Nicola isn’t aware to have problems. Instead his problems are seen “clearly” or imagined by his mother, a furious overbearing absolutely unable to listen both to others and to herself creature. She doesn’t want to accept in any way that his son’s progress at school is rather poor (he is very good at Maths only) and he has no friends: When he is at school Nicholas never speaks to anybody and at home he spends his day on his own, using his computer. It follows that the boy’s father is absent both as matter of fact and in his mother’s speech.
During the two preliminary talks occurred at his mother’s presence, the lady went wild according to the terms already described, while Nicola was listening to the woman’s rage by assuming a “paternalist” attitude made up of indulgence and understanding and demonstrated an irony full of superiority but without expressing practically anything about himself.
In the following session, an individual meeting, Nicola immediately accepted the proposal to enter the group, but even in this case, it was not possible to get the manifestation of any personal feeling. He continued playing silently with chess pieces, in spite Marianna’s kind requests. At this point the supervisor propose to play the interview scene at his mother’s presence. Marianna chose the auxiliary ego who should act as Nicola and his mother.
They started the play.. Marianna claimed that the auxiliary ego members coped moderately well but it was her who felt surprised and was stuck on exchanging roles she was stuck on playing Nicola’s role and didn’t succeed in recreating the boy’s ironic attitude, a mixture of superiority and understanding towards his mother. Then, when she returned to her location she was overwhelmed by a terrible unexpected anguish quite different from the sense of hypercritical inadmissibility and the worries about her efficiency she felt before the play.
The supervision session was over.
In the following session of his psychodrama group , Marianna was the conductor and when Nicola woke up towards the end of the session, she asked him kindly and with
a smile : “ What did you dream of? it’s the early bird that catches the worm but sometimes it catches dreams!”
Nicola was disabled, but the other group members (2 boys and 2 girls who were between 9 and 10 years old ) didn’t permit him to recover and each of them rushed to tell his/her own dreams in a situation of enthusiastic competition. And the session was over without that Nicola was able to say nothing.
In the following session Nicola didn’t sleep at once and said he had to tell a dream : “I was fishing … a fish swallowed the bait but I threw it back into the river because it
was too small”.
We can’t stop here telling Nicola’s story because our aim is another one in this short
assay and that is stopping reflecting on a specific side of the supervision work in a setting of analytic psychodrama.
Talking about Nicola we have to speak that starting from that session he started falling asleep less and less and the fact he found himself in a small group of boys and
girls who were as old as he was, involved him in a network of relationships which were quite different from the one with his mother, so that it permitted him to leave his
defensive “morph-adult” attitude of planned detachment and “understanding”. But it is first of all the therapist’s emphasis about the chance of dreaming when one sleeps and therefore doing something that might be interesting for others. All that approached him by degrees, in the course of therapy, for the possibility of experiencing something which has to see with desire and demand , something very difficult if not impossible when someone who has never been listened to, and who is
compelled to play the role of “complete” adult without achieving his/her needs or desires.
Mother’s reverie and therapist’s reverie as a cradle of the capability of thinking and “build up”
It appears obvious to me that whoever is involved in clinical work from a psychoanalytic perspective cannot think that the aim of a supervision is only to provide with models, suggestions or expedients fit for building correctly the problems we meet with our patients and solve them .But may be we never emphasise enough the importance to promote in the therapist what Freud (1937) called the capacity “to build” and above all we don’t emphasise the necessity that the construction rises and feeds in a state of reverie . This state is necessary not to find oneself in a state of paranoid vision or in one of those feverish manifestations which Freud alluded to on that occasion, thus comparing them with the analyst’s work. Reverie isn’t dream but like dream permits signifiers to fluctuate freely detaching them from their usual meanings more or less predictable and enabling so a richer change of metaphors in repetitive relationships pointing out summits before impossible up to the point of leading to a pre-chosen fact. This isn’t the result of logic or common sense or of more or less fixed valuations. Instead, it is a specific event caused (like the play described by Marianna ) by a little “catastrophe” driving the individual to be in mourning about all that is given as certain and enables to light the emerging material laying the foundations of the possibility of a new construction of both internal and external reality.
In fact the state of reverie as has been said so many times implies a work of mourning on the mother’s side (when we speak of the relationships between mother and child ) which is not only mourning of a mother’s illusion about a symbiosis and a fusion with her own child but it is also mourning on the side of a mother herself of her own internal illusory identity, her own certainties and her trust that her own appeals meet in the other a guaranteed availability.
On the other hand, because the child can learn to think it is necessary an external contribution to his/her competence and also the results of his/her mother’s rêverie (words, gestures, rhythm and tone of voice) in their material consistence that making them besides perceptible relatively constant and identifiable so to attract from time to time specific libidinal investments, which are just indispensable because the child has the possibility of “mentioning” and organising, at least, temporarily his/her own
sensations connecting them with something external and steadier and, at least, potentially perceptible even by others. It’s a communication of alpha objects from
mother to child.
Besides, it is useful for this reason not to forget what Bion claimed (1962) and that is
in the mother’s reverie the child can get possession not only of the contents, which have become reassuring by now but even from time to time he/she can get possession of something which has to see with the same functions of beneficial metabolism which every mother is able to exercise. These constructions are just derived from the context of reverie which offers new conditions to the necessity of a choice which cannot be postponed , it is so insistent in human existence to be able to survive so that we cannot be completely overcome by our conflicts in order to find, at least, a moment of agreement with our fellows. At worst., we are compelled to the necessity of choosing to not choose , but as matter of fact it is always, however, a choice and as such it is a moment of subjective division. On the other hand, reverie enables us to tolerate in a less tearing way the portion of unavoidable uncertainty which is at the basis of these choices of ours. It trains us to interpose between the rise of the stimulus and the motor discharge or the action itself a suspension where behaviour schemes are borrowed from memory or from the identification sometimes with motherly behaviours or anybody else who replaces her.
You can remember the anecdote about the three prisoners (so many times quoted by Lacan)They must take a decision to save their own lives without having at disposal all the data relating to the context where they are compelled to have to chose.
I think that one can say that something like this happens to the child when a “good enough” mother is able of reverie The same thing may happen to our patients when the analyst or therapist who works in a psychoanalytic is able to maintain a correct attitude in the course of the fluctuating attention.
Specificity of the play in analytic psychodrama
In the play one experiments positively and more or less symbolically the malleability of matter (visual, sound, tactile) and the flexibility of space and, then, the play can be regarded as a leading mediator between inner psychic life and the articulation more or less unexpected of external world. In other words, the play act provides up to a certain point, the possibility of controlling the external world, without risking too much at narcissistic level and one can say that it constitutes a hypothetical form of dominion of a world previously dominator. This reversal of the situation (from passivity to activity) is at the basis of the process of symbolisation which is therefore a process of play connotation of the external world.(Privat e Quelin- Soulingoux 2000)
But the psychodramatic play is a play which we can consider a little particular: as what matters, first of all, in order to use it for all that cannot be represented , (just like in free associations) and that is what is wrong , the moments of awkwardness, all that
seems , in some way, to contradict the situation just exhibited by the player.
More than a representation the play in psychodrama is then an tool of the fragmentisation of those previous performances of the external and internal world. They coincide for each member more or less with his/her prevailing phantom. In this way, the psychodramatic play offers, in o protected context , a proof that the player isn’t omnipotent, but through this mourning opens the possibility of recognising and using the modest real power each of us is endowed with and so it offers just in the articulation of horizontal and vertical transference a ortion which isn’t contemptible of narcissistic reassurance.
In this way, each of us trying to realise his/her own prevailing phantom in a hypothetic way and moving his/her own elements around the external space in which
even others are involved in a certain sense, he/she builds up it and lays the foundations to the possibility of crossing it
On the other hand, the fact that he/she can play instead of limiting himself/herself to speak, contributes through the succession of “disasters” we have already alluded to, in a visual and sound space which is more significant at perceptive level to trigger those abilities of reverie which is the basis of fundamental constructions in every correct analytic work both for the therapist and his/her patient because they are able to free , at least this latter from the fetters of his more expensive defences.
Importance of rêverie in the treatment of subjects in the latency period
These specific characteristics of psychodramatic play result particularly useful and significant when one works with children in the age of latency, whose Ego , as many authors claim, is particularly fragile even if not rarely it can create the impression on being rather disposed to adaptation and a certain conformity. (M.Klein 1965, D.W. Winnicott 1958, M. Bernabei 2000).
On the other hand, even who is writing, has already noticed how nearly always , in children in the age of latency, their problems don’t succeed in assuming the structure
of real symptoms, but much more often they present themselves as inhibitions or acting passages more or less evident.
I think that even Nicola’s “sleep” (up to which point real or simulated? we have no tools to verify it) presents itself with modalities suggesting inhibition and a little even to a passage to an action showing a “lightly” perverse colouring and lacking the wealth and metaphoric dynamism of a symptom, all that needs that the doors of a transitional space of mediation opens between it Self and others which can encourage the patient to try sooner or later the adventure of desire and demand.
This could happen in the case described here because the psychodramatic play had
in this way an effect on Marianna.
In fact it moved her attention from her worries about her efficiency and enabled to emerge something which led her to give room to what Nicola offered ( his sleep) not
certainly a speech but something which inserted in the speech of another (in this case
the therapist’s) could present as signifier or, at least , what Lacan defined “letter” and gives rise sooner or later to a chain or a bundle of chains embodied in images, dreams, words that the other and the Other can perceive and can answer or can’t.
The therapist’s listening in fact isn’t more or less directed attention in the sense of efficiency, nor more or less affectionate form of receptivity but permits to play freely
with our own signifiers and the patient’s up to the point in which the signifier and “letters” of the patient can be reversed and moved to a new perspective to allow to emerge what left to itself could continue to poison or paralyse.
References
Bernabei M. (2002) – Presentazione all’edizione italiana di “il bambino in psicotera in psicoterapia di gruppo” di Privat e Quelin-Soulingoux – Borla, Roma
Bion W. R. (1962) – Apprendere dall’esperienza (Learning from Experience) – trad. it. Armando Roma, 1972
Croce E.B. (1985) – La realtà in gioco – ed. Borla Roma
Fedida P. (1985) – Le constructions: introduction à une question sur la memoire en psychanalyse in “Revue Français de psychanalyse” n. XLIX luglio-agosto 1985.
Freud S. (1937) – Costruzioni nell’analisi (Constructions in analysis) – trad.it.OSF vol XI –Boringhieri Torino 1970.
Klein M. (1959) – Psicoanalisi dei bambini (Infant Analysis) – trad.it. Martinelli Firenze 1970.
Privat P. e Quèlin-soulingoux D. (2000) – Il bambino in psicoterapia di gruppo – trad.it. Borla Roma 2002
Winnicott D.W. (1958) – dalla pedagogia alla psicoanalisi (Trough Paediatrics to Psycho-Analysis) trad.it. Martinelli Firenze 1975. |