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Spiegel, R. (1968). Supervisory Collaboration in the Treatment Strategy for Masked Depression. Contemp. Psychoanal., 5(1):57-61.

(1968). Contemporary Psychoanalysis, 5(1):57-61

Supervisory Collaboration in the Treatment Strategy for Masked Depression

Rose Spiegel, M.D.

AMONG THE ELEMENTS involved in the help given by the supervisor is the perception of the patient through the medium of the reporting psychoanalyst, as the basis for understanding both the difficulties that the patient is suffering and those the analyst is encountering in his therapeutic endeavor. This communication of the quality of a person through the experience reported both verbally and nonverbally by another, is in itself, when one comes to think of it, an astonishing process. In this particular supervisory collaboration, Dr. Cooper's transparent portrayal of the patient and the treatment situation, including his own responses, was par excellence such communication.

Another requisite for the supervisor as clinician is alertness to the present-day variations in the classical clinical entities—and it is the classical ones that are, of course, taught first. We have become familiar with the shift from the preponderant incidence of the hysterias as they were described by Breuer and Freud, to that of the obsessions. But the parade of change has not stopped. The case of this young woman illustrates an increasingly frequent present-day variety of depression—the modern mask overlying the profound depression, a gargoyle of wry cynicism, flippancy, alienation, particularly cultivated by those despairing young people who become dropouts from life.

It is such clinical attunement to variations in the classical entities that is to be communicated to the supervisee and cultivated in him.


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