Psychoanalytical supervision of the treatment of suicidal patients

摘要

Psychoanalytic psychotherapy is an effective treatment for suicidal patients but can be intimidating for early career therapists and challenging for more experienced clinicians. Psychoanalytic psychotherapists are faced with complex transference/countertransference issues and the threat of potentially deadly violence. Supervision can help empower apprehensive therapists when they feel supported and accompanied by knowledgeable supervisors. Experienced therapists also may benefit from supervision for help in processing the patient's hostile and hopeless communications. The supervision experience requires the establishment and maintenance of a safe learning environment that provides a space for the supervisee to think about and take in the experience of working with the suicidal patient. Supervision also enables a review of psychotherapeutic interactions and interventions, which can counteract countertransference hopelessness and destructive communications. The process of supervision is complex and is influenced by several factors including the patient's psychopathology and suicidality, the supervisor's training and style as well as the match of the participants. This paper examines supervision of psychodynamic psychotherapy of suicidal patients, cross-cultural features on learning, and the experience of mutual supervision while meeting with colleagues at the Center for Therapy and Research of Suicidal Behavior (TZS) at the University Hospital Hamburg-Eppendorf.