Tuesday, March 5th, 2002, 8:00 PM

TRAINING CASE TRANSFERENCE FANTASIES: THE IMPACT OF SUPERVISION ON PATIENTS TREATED BY CANDIDATES

author: Grace Caroline Barron, M.D.
discussant: Christopher J. Allegra, M.D.

This paper will explore how and why a candidate’s silent experience of two supervisors emerged in patients’ fantasies about them. In these two cases, patient fantasies about the supervisor had a different quality than those about others in the candidate’s personal life. Four issues are examined in light of two control cases. (1) Patients divide, rather than split, the transference between supervisor and candidate, experiencing both ambivalently. (2) Even a patient with no knowledge of the supervisor’s identity may have a fantasy of the supervisor that is congruent with the candidate’s experience of the supervisor. (3) As the candidate identifies with his or her mentor and new professional traits emerge, the patient may attribute them to the invisible person in the room - the supervisor. The patient may intuit and be influenced by the candidate’s feelings about the supervisor as well. (4) By exploring a patient’s fantasies about the supervisor, one may have a chance to examine the reverse manifestation of parallel process -- that the patient discerns what is going on between supervisor and candidate through his or her treatment, as the supervisor normally does through the candidate’s reporting of the treatment. The supervisor can help a candidate understand how to create a safe environment in which a patient can speak freely if the supervisor creates such an environment with the candidate.