Supervised Analysis (Control Case)
SUPERVISED ANALYSIS (CONTROL CASE)
Control analysis (also known as "supervised analysis" or "analysis under supervision") is a cure during which the analyst reports back the "material" and progress to an experienced colleague for discussion. Although supervised analysis is a mandatory stage for trainee analysts, it is not exceptional for an analyst to feel the need to discuss a difficult case with an experienced colleague even after the end of the supervised analysis.
The practice dates from the origins of psychoanalysis and we may even consider that it was present when psychoanalysis came into being, because Freud laid down the bases for it in his correspondence with Wilhelm Fleiss and in the course of their periodic "congresses." He then went on to institute the practice of open discussion with the analysts he trained, enabling them to discuss their cases during the Wednesday meetings of the Psychological Society, later the Vienna Psycho-Analytical Society (cf. The Minutes of the Vienna Psycho-Analytical Society 1962, 1967, 1975), and in the course of private conversations. These new analysts themselves continued this practice with their own students.
However, it was quite frequent in those early days for the same person to act as analyst and supervisor within a limited circle. The obvious drawbacks of such a confusion of roles precipitated a call for better regulation of the process. A first directive was adopted during the congress of the International Psychoanalytic Association (IPA) in Bad Homburg, Germany, in 1925. It was agreed that the training process, regulated and supervised by the societies comprising the IPA, or their training institutes, should include at least two supervised analyses, the supervisor being distinct from the analyst. (An earlier congress in 1918 had already established the necessity of personal analysis for candidates.)
These principles still apply. The IPA rules stipulate that only the body of training analysts of a regional society can authorize supervised analyses; that two adult analyses must be conducted, and that at least one child analysis is desirable in addition; that the supervisors must themselves be accredited by their society; that the supervision must be weekly; and that each of these supervisions must last at least two years (the analysis itself may obviously extend beyond this period).
Those are the general rules. They are compatible with differing approaches depending on the country or psychoanalytic group. In practice, admission to supervised treatment generally coincides with admission to training as a psychoanalyst (including, in addition, lectures, attending work groups, and seminars). Candidates may be admitted following personal interviews with several training analysts whose mission is to assess the state of progress of their personal analysis (whether applicable), as well as their potential as future analysts, and who report back to a commission in charge of making the actual decision. Several IPA societies exclude the candidate's analyst from this procedure (the Paris Psychoanalytic Society preferring to extend this exclusion to all stages of the training process, including final certification).
Supervision can have two formats: the weekly meeting may be personal, limited to the candidate and the supervisor; or a "group meeting," comprising several candidates (but never more than five or six) who may meet with a shared supervisor. Both systems have advantages and drawbacks. It is often stressed that group supervision has the great advantage of enabling candidates to compare their experiences and thus to avoid a too closely dyadic relationship with their supervisor. Individual meetings, on the other hand, facilitate more open discussion, free from the reserve and self-conscious attitudes to be expected in groups; also they facilitate discussion of counter-transference issues, more difficult in a group setting. There is a risk here, however, of reviving and importing transference effects from the candidate's personal analysis (which is often ongoing during supervision).
Generally speaking, the idea in supervisions is not to dictate to trainee analysts what they should do and say, even less to equip them with theoretical precepts or technical recipes. The aim is to help them detect the meaning of the material that is presented to them, its instinctual and affective charges, as well as the patient's defenses, all this with reference to the transference and counter-transference. This consideration is especially vital to the training of analysts. The supervisor's task is therefore a difficult one, because he or she must draw the attention of the supervised analysts to their own counter-transference without ever transforming the supervision into an analytic session.
The procedure raises many delicate questions, calling for continual work on the part of psychoanalytic institutions (Lebovici, Solnit, 1982). This has led certain groups to work out original formulas, such as the "fourth analysis," proposed by the Quatrième Groupe OPLF (France) as its foundation.
See also: "Analysis of a Phobia in a Five-Year-Old Boy" (Little Hans ); Association psychanalytique de France; Berliner Psychoanalytisches Institut; Fourth analysis; Hungarian School; Pass, the; Psychoanalytic filiations; Société psychanalytique de Paris and Institut de psychanalyse de Paris; Training of the psychoanalyst.
Fleming, Joan, and Benedek, Terese F. (1983). Psychoanalytic supervision: A method of clinical teaching. New York : Basic Books.
Lebovici, Serge, and Solnit, Albert J. (Eds.). (1982). La formation du psychanalyste. Paris: Presses Universitaires de France. Monographies de l'Association psychanalytique internationale.
Nunberg, Hermann, and Federn, Ernst. (1962-1975). Minutes of the Vienna Psychoanalytic Society. New York: International Universities Press.