EMDR Therapy Quarterly

As ever, in this column, I am attempting to look at supervision from the supervisee’s point of view, as we all are (or should be) receiving supervision for our EMDR practice.

Rupture and repair

It is inevitable that, as with any other kind of relationship, things sometimes go wrong and ruptures occur. It is worth repeating that it is not the rupture that is so important as the way in which it is repaired. Let me start, as I often do, with a story:

My longest supervisory relationship has actually been with my wife, Jane Logie, since training together as clinical psychologists and starting to meet for peer supervision as long ago as 1982 – before EMDR was even invented! Now retired from her career as a clinical child psychologist, I still turn to Jane on occasion for help with children with whom I am working who have early attachment-related trauma, which Jane had specialised in. A few years ago, an uncharacteristic rupture occurred in our supervisory relationship, and we agreed to independently write an account of what occurred.

The rupture

Robin’s experience

I asked Jane for some supervision regarding Ben today. I thought it was just a straightforward question about a resource she might be able to recommend regarding ways to help him self-regulate.

My supervision question (SQ) was, “Can you recommend any resources (books or programmes) for parents to help a child learn ways of self-regulating?” I was instantly disappointed by her response as she started to do a sort of lecture about how children learn to self-regulate and how they miss out on this stage in their early development if they have early attachment-related trauma. “Yeah, yeah,” I thought. “I know all that, but how can we actually ‘teach’ Ben to learn to self-regulate?” I may have sort of expressed some of this out loud. Jane was starting to look a bit tense and seemed to be just repeating herself and saying the same thing in more detail. So, I asked what the parents should actually ‘do.’ I still felt we were on different wavelengths, so I asked her if she could give me an example. She declined to do this, so I gave her an example of a situation that might occur when Ben loses his temper. Jane told me that it wasn’t the time to be teaching him self-regulation and that he needs to learn it when he is calmer and hasn’t lost the plot. “But,” I said, “what do we actually do or say to Ben when he is calmer?” “Well, usually when I explain this to the parents, they understand what I am talking about, and we come up with an idea together.” I still didn’t understand what she was telling me, so off the top of my head, I came up with the following scenario:

So, for example, you might say, “Ben? Are you listening to me? Yes? Good. We are going to play a game of xxx in a few minutes, but I need to finish loading the dishwasher first. I want you to try really hard and stay calm and wait for me while I load the dishwasher. If you are still calm when I’ve finished, we will play the game.” Then just leave him to his own devices whilst you load the dishwasher. If he has been able to stay calm, say, “Wow, Ben, that’s amazing! You managed to stay calm. I’m really pleased with you. Now, let’s play that game.”

“Yes,” said Jane, “I think you are getting it now.” Aaagh! So why didn’t she tell me that in the first place? Well, maybe I had to work it out for myself.

Jane’s experience

Robin asked me for some supervision about Ben and his family. He said it was just a question and may only take a minute or so, or it may develop into a longer discussion.  

Robin told me that Ben’s parents are asking how they can help Ben learn to regulate his emotions rather than going from 0 to 60 when he is feeling angry. Ben does not want to be like this – how can they help him? Do I know of a book or manual?

I had a sinking, overwhelmed feeling that this was impossible for Ben to achieve and thought, “Where are we going to start with it?” I attempted some kind of answer about the learning process he has missed out on with examples. Robin stated that he didn’t understand. I continued, and the same happened again.

I then felt panicky – that I didn’t know what I was talking about. I recovered and, rather than giving suggestions, asked Robin what he thought Ben needed to learn in order to have more success at being able to regulate his emotions. It then felt that we started working together on some joined-up understanding and ideas about providing regular re-learning experiences. 

Thinking about it afterwards, our supervision seemed to reflect the experience that many adoptive parents have of thinking that there are ways of fixing these children if only they knew how – and other people know and it is being kept from them – like conception and having their own baby kept from them.

The repair

The rupture started to occur immediately when Jane recognised that the way in which my SQ was framed was actually getting in the way of me helping my client. She tried to reframe the dilemma, but I remained stuck in my way of thinking, and Jane therefore started to feel helpless. At this point, we both needed to take a step back and look at a new way of going forward that would work. Although we both needed to do this, it was Jane’s primary responsibility, as supervisor, to make the first move. When she had asked what Ben needed to learn in order to have more success at regulating his emotions, she was helping me to reframe the problem, rather like a cognitive interweave in EMDR therapy. At this point the repair began to occur, and the supervisory relationship began to run more smoothly. Both our levels of arousal came down to the point where we could subsequently reflect on what had happened between us and we could happily go away and write up what we had experienced.

“Moments of resistance or rupture occur in all authentic and meaningful relationships” (Corrie & Lane, 2015, p. 129). In fact, Lesser (1983) suggests that we should be wary of a supervisory relationship that appears too comfortable. Safran et al. (2008) discuss rupture and repair in supervision with reference to how this occurs in therapy. They state that the rupture will start when the client sees the action of the therapist as confirming their own expectations about relationships. The client will react by confronting the therapist or by becoming withdrawn. The therapist will then react either defensively or angrily, which will confirm the client’s expectations. Firstly, the therapist needs to notice the rupture and then stand back from it in order to discuss it with their client.

Here is a fictitious story about a rupture in EMDR supervision and how it was resolved.

Clare & Charles

Clare, the supervisee, has recently completed her basic EMDR training and has only met her supervisor, Charles, for three sessions so far. Clare is very competent and has a good grasp of the EMDR protocol but is also very anxious about working with this new model and, particularly, about the potential unpredictability of her clients’ responses to EMDR processing. When she raises her anxiety with Charles, he replies with comments such as, “Well, you are clearly an excellent therapist, and you know the protocol so well that I don’t see why you need to be so worried!” Charles presents himself as an experienced and skilled EMDR therapist who has never made any mistakes. He just hopes that by modelling himself in this way and telling Clare how good she is, she will gradually absorb some of his confidence and be able to start using EMDR with her clients. However, this approach causes Clare to feel increasingly de-skilled, and she copes by becoming withdrawn in supervision, telling Charles that everything is going fine and she has nothing much to bring to supervision.

Things come to a head when Clare mentions that she is seeking a new supervisor. At this point, Charles realises for the first time that there has been a rupture in the supervisory relationship and asks Clare to describe how she feels during supervision. She tells Charles that she feels very anxious during supervision and that this is becoming worse rather than better over time. She feels that Charles believes that she is pathetic and has a poor opinion of her. Charles reacts by saying that he is very surprised by this. He shares with Clare the fact that he felt very uncertain when he started doing EMDR himself but coped with this by pretending to his own supervisor that he was doing fine due to his feelings of shame at the time. Clare was equally surprised to hear this, as she assumed that Charles had been born super-confident. After this, Clare felt more able to show her vulnerability during supervision, and Charles also changed by sharing more of his own experiences and what he had learnt when things had gone wrong.

So, it is the process of repair that is most important and can, in fact, enhance, develop and strengthen a relationship, supervisory or otherwise.

Getting the level right

We all want our supervisors to be nice, supportive and accepting, don’t we? Well, according to Ögren et al. (2008), being nice and accepting is not necessarily appreciated by supervisees. Supervisors were appreciated more if they were “straightforward, expressed empathy, and held an autonomous position that conveyed their care about how things turned out for their students and their clients” (Ögren & Boalt Boëthius, 2014, p. 354-355). They added that being a “containing authority” was appreciated by supervisees. Fleming et al. (2007, p. 22) warn that supervision can become “devoid of critical reflection, mutate into backslapping and become part of what has been called the ‘tyranny of niceness’”. A study by Rieck et al. (2015) showed that client outcomes were better when low supervisor agreeableness was present.

However, Ögren and Boalt Boëthius (2014) also point out that becoming too authoritarian and proclaiming that only they know the “absolute truth” was also unhelpful to supervisees. In fact, it is all a matter of getting the level right for each supervisee. Whilst too much anxiety can affect what supervisees can notice and encode (Dombeck & Brody, 1995), just the right amount of anxiety in the supervision room will be optimal for effective supervision. As an undergraduate, I recall learning about Yerkes and Dodson’s (1908) famous hypothesis that both too little or too much arousal will reduce the ability to perform a task. I am reminded here of the “window of tolerance” concept we use in EMDR processing (Siegel, 1999). I have attempted to explain this in the Figure 1 below. I hope this is useful, although I accept that the lowest area, which I have named “too laid-back to learn,” does not quite equate with hypo-arousal.

Hopefully this column will have provided some help in relation to some tricky areas in EMDR supervision. But unfortunately, it will have provided no easy answers to some very thorny dilemmas about how to cope with things when they go wrong in supervision. This reminds me of the feeling I have during supervision when I believe I have been of little help to my supervisee. What might Jane say if I brought this to supervision with her? She would probably say, as she has done so many times before, “Robin, you need to accept that not every problem is solvable, and sometimes we just have to stay with it and share the discomfort.” In other words, just notice!

Robin Logie is a clinical psychologist, EMDR Europe accredited consultant and senior trainer. He is a former president of the EMDR Association UK, a current member of its Accreditation Committee and runs EMDR consultant training on behalf of the Association. His book, EMDR Supervision, was published by Routledge in 2023. Positionality Statement: "I am a straight, white, cisgender, male from a middle-class background. My mother was a Jewish refugee from Nazi Germany and my father was from a Christian family. Both were atheists and I was brought up with no religion. In writing about issues of diversity regarding EMDR supervision, I have recently become more aware of my position in society, the privileges it has afforded me and how it will affect those who relate to me who come from different backgrounds. I try to help this to inform my own clinical practice and how I consume research."