Recently, I had the opportunity to speak to Dr Alex Rowell on The Secure Start Podcast, on the topic of attachment informed supervision. Alex was a highly engaging and informed speaker on the topic of supervision, and I took a lot from him I hope you do too.
How Supervisors Create A Secure Base For Clinicians In Training
Clinical supervision is often treated like a technical handover: discuss the client, check risk, review notes, move on. But when we listen closely to experienced supervisors like Dr Alex Rowell, a different picture appears. Supervision is a relationship built around vulnerability, uncertainty, and performance pressure, which means attachment dynamics naturally arise. Attachment-informed supervision uses attachment theory as a guiding framework to understand how supervisees seek safety, how supervisors respond under stress, and how the supervisory alliance can become a secure base that supports learning, reflection, and ethical clinical decision-making in trauma-informed care settings.
Attachment theory also bridges schools of therapy instead of competing with them. Rowell links attachment-informed, psychodynamic, humanistic and existential practice to a core shift in psychology: moving from drive-based explanations towards comfort-seeking through people. That shift matters in mental health training because many supervisees arrive focused on “doing it right” rather than understanding what is happening between therapist and client. When supervision includes internal working models, emotional regulation, mentalising, and relational patterns, the clinician gains a deeper map of depression, anxiety, burnout, loss, and dysregulation. The work becomes less surgical and more human, without losing rigour.
In an attachment-based supervision lens, patterns can look familiar. An anxiously attached supervisee may seek frequent reassurance, bring repeated questions after sessions, or send late-day emails asking whether their documentation or intervention was acceptable. A more avoidant supervisee may appear competent and organised but minimise affect, avoid transference and countertransference, or keep supervision strictly intellectual and checklist-driven. Crucially, the supervisor is not outside the dance. A supervisor with avoidant tendencies might withdraw when they feel overwhelmed; an anxiously inclined supervisor might over-function and rescue. Naming these dynamics gently supports reflective practice and reduces reactive supervision behaviours.
The practical skills that create a secure base are surprisingly concrete: attunement, empathy, curiosity, and the capacity to notice ruptures and repair them. Ruptures might involve tough feedback, mismatched expectations, or a supervisee feeling blindsided by an assessment. Repair means checking the impact, inviting reflection, and re-establishing trust so learning can continue. This approach also respects context: developmental supervision models remind us that a first placement needs more scaffolding and structure, while advanced trainees can go deeper into parallel process and relational themes. Systems pressure, workload, and “voluntold” supervision can limit depth, so blending structure from CBT-style supervision with attachment-informed awareness helps supervisors stay both effective and humane.
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Transcipt
Welcome And Defining Attachment
Colby 0:00
Welcome to the Secure Start Podcast. Brought to you by the Secure Start Aura apps supporting trauma-informed care and practice at home and in school.Alex 0:17
Any relationship that has an element of vulnerability, of insecurity, of uncertainty is an attachment relationship. I have found in the supervision relationship from a supervisor to supervisee, those attachment dynamics do come out. Not just within the supervisee, but also within the supervisor. The supervisor serves as a secure base. It serves as this safe haven to explore different approaches, different parts of the training and whatnot. So the attachment, again, it gave me a framework to think about working with students, with trainees, with supervisees in a stage of their career. It will help them understand their clinical work and also themselves a little better. Certain environments, certain people may elicit certain types of attachment patterns. So when I think of attachment-based supervision, I think of it as a relational one where we discuss not only what’s going on clinically with cases, because that’s the focus of any type of supervision, but how is it coming alive between perhaps you and I?
Acknowledgement And Guest Background
Colby 1:26
Welcome to the Secure Star podcast. I’m Colby Pearce, and joining me for this episode is a highly experienced practitioner and psychology educator with overlapping interests with my own. Before I introduce my guests, I’d just like to acknowledge the traditional custodians of the lands I’m coming to you from, the Ghana people of the Adelaide Plains, and acknowledge the continuing connection the living Ghana people feel to land, waters, culture, and community. I’d also like to pay my respects to their elders, past, present, and emerging. My guest this episode is Dr. Alex Rowell. Alex is a practicing clinical psychologist in the United States and United Kingdom. He has a wide range of clinical and professional experiences that include working in inpatient, outpatient hospitals, nonprofit organizations, multiple college counseling centers, the National Health Service, higher education, and he currently works virtually in private practice. His areas of interest include clinical supervision, mood disorders, self-compassion, teaching, mindfulness, burnout, and gender awareness and education. Alex has presented on postpartum, mental health, multicultural awareness, clinical supervision, psychodynamic psychotherapy, and personality disorders at various conferences. He practices mainly from an attachment-informed, psychodynamic, and humanistic existential lens. He is also a certified supervisor through the British Psychological Society. Well, welcome, Alex, to the Secure Start Podcast. Now it’s interesting. I connected with you uh through LinkedIn and some LinkedIn posts that um that I saw from you, and and I I I continue to look at them and just think, oh, what an what an interesting person you are in terms of uh um the breadth, I think, of the of the work and the influences that you have, uh, and in including um uh attachment theory, a big interest and and big aspect of your practices, I understand it, attachment theory, which, if I’m pointing the right way, I did, um uh lines up a little bit with my own interests as well. So I’m really eager to talk about uh that. Maybe we just start uh with uh perhaps if you can tell us a little bit about the work that you do and how you came to be interested in attachment theory.
Why Attachment Guides Therapy
Alex 4:33
Yeah, yeah. Well, you know, Colby, thank you for having me on the this uh Secure Start podcast. So really excited to be here. And yeah, I’m glad we connected via LinkedIn, which is a really wonderful tool to connect people from all over the world. You know, here I am in you know, the US and you’re uh, you know, in Australia. So it’s really lovely to connect. And yeah, so so kind of my experience um has kind of taken me actually different parts of the world. So I’ve worked in the US and in the UK for a little bit in Northern Ireland. Um, so I’ve done a lot of clinical work, um, everything from working the NHS, which is my most recent post prior to what the one I’m at now. Um, but yeah, I’ve worked in university settings, I’ve worked in nonprofits, worked for some uh inpatient, outpatient hospital settings, and I have found it all really lovely, wonderful experiences. I’m working with people from various walks of life, very different cultural backgrounds, identity markers, suffering from certain and different mental health conditions. Um, so not only within the US context where where I was trained, um, actually in Southern California, but you know, I practiced a little bit in the middle of the of the US and then Oregon, which is a state above California, but then again to the UK, working in a different health system uh and at a university. I worked at Queen’s University for a couple of years prior to coming back to the US, is who where I am currently. But um to your question more specifically, yeah, attachment theory has always been something that has guided pretty much all of my clinical work, uh, some of my teaching as well, and some of my supervision, which you know, I hope we kind of get into in just a moment. But um, it’s always been an interest of mine. I think it applies to all different types of clinical work, working not with patients, but working with supervisees, working in systems, working in teams, working with, you know, organizations, all those types of things. I have found it very applicable to different aspects. So you could take a psychoanalytic lens, you can take a neurobiological lens, evolutionary lens, a social cultural lens. I just find it kind of covers quite a bit, like it really does, as far as different perspectives and ways to understand the person in front of you, um, whether it be someone with severe complex trauma, um, someone with EUPD, or maybe someone who’s just feeling quite anxious or dysregulated in that moment. So attachment theory has really guided kind of my clinical work and part of my professional identity. And I think what’s been, I was quite lucky in the program I went to, which was very psychodynamic, psychoanalytically focused, which I don’t know how this in Australia call be, but there are programs not as much anymore focused on orientation. What will happen is you have to do analytic training. So people are probably familiar with analytic institutes, not just you know, in the US or Australia, but all really all over the world. There’s institutes, but that’s usually postgraduate training. But my graduate program was lucky enough to have quite a bit of therapists, um, therapists, professors, teachers, mentors who are analytically trained uh in in San Diego, where I got my training. So I think, you know, kind of a very kind of narrowing down to narrowing down to the question you asked me originally. It’s just something that I feel like it really gets to what’s going on, um, and not just, hey, these are the symptoms, here’s the fix. It really gets to the core of all mammals, obviously, humans being included in that, and what they’re experiencing in the world, how they experience others, how they experience themselves, how they feel, um, whether they can trust people, whether they’re able to repair, whether they’re able to mentalize or empathize in some ways. So I I it’s just really a guiding principle um in a professional identity for me.
Colby 8:18
Yeah, yeah. Same. I think um I refer to it as a guiding framework, and it and similarly, I’ve often thought of it right back even early in my professional life, um, as as providing a really good framework and good, really good base for understanding the people in front of me, but also understanding the role that I have, the ta the tasks that I have as a practicing clinical psychologist with them. And um, yeah, you you you you wondered about what the situation is like in Australia. I suspect there’s even less psychoanalytic tra uh training opportunities here in Australia. And um I have had people like this um fellow called Peter Blake on the podcast who’s very who’s an Australian clinical psychologist author who but he yeah, he went to the UK to train at um and uh I think it was at the Anna Freud um training school training uh school or or or yeah. So yeah, and and I and that’s I think generally the the way it is here in Australia. Um interestingly, with attachment theory, I haven’t always thought it was you know very far into the camp of psychoanalytic thought, probably until I’ve become more and more exposed to psychoanalytic thought, including through this through this podcast. And uh yeah, because Balby Balbi was seen as a bit of an outsider at the time. Object relations was was the predominant um theoretical orientation amongst psychiatrists um in his neck of the woods. Um, but yeah, as I said, as I’ve um as I have learnt more about soccer dynamic work, because it wasn’t part of my training, I I see very much how it uh how it does fall under the umbrella.
From Drives To Seeking Comfort
Alex 10:23
Yeah, absolutely. I mean think of Balby and you know Fairburn and Maine, and you think about the shift, the shift became from drives, sexual aggression drives, to people or how they say it, object seeking. That instead of we are we want to discharge energy, sexually aggression energy, now we want to discharge or see comfort through other people, which I think probably people understand that, they get that, that people seek comfort in others. Um, I mean that that’s how mammals are. And yeah, there was a nice, I think a really helpful shift. So object relations, attachment theory, I I think really kind of shifted the direction a little bit from you know the section aggression, destruction, death drive to more of a um sort of object-seeking pleasure, object-seeking comfort.
Colby 11:13
Yeah. Yeah, yeah. And um I wonder you you’ve you’ve touched on um how you apply it as as guiding principles or uh an aid to understanding in your in various aspects of your work. I think I was particularly interested in um in the supervision work that you do and um how how you apply it. And are there any particular aspects of attachment? Because it’s quite a broad church attachment theory. For sure. It’s a large body of work now. But what what in particular or what parts of attachment theory do you think are parti are important, perhaps in each of those aspects of your work? Um, but we’ll and we’ll be we’ll move more into the supervision.
Building Attachment-Based Supervision
Alex 12:02
Yeah, yeah. So in regards to the clinical supervision from an attachment perspective, I really got interested in this when I was in the UK at Queen’s University doing some um training, some research of my own about supervision models. And my experience, you know, in the NHS system, um, it’s banded, there’s different band levels. So a band seven, a band eight A, band 8B. And what I experience is usually when providers, psychologists reach a band 8A, they are kind of expected to supervise. Then if you think of your graduate training, I know my graduate training and even graduate training in the UK, um, those are ones I, you know, most experienced with you know with myself in those systems, and you kind of, you know, booking in the Australian system. It’s you might get a class on it in graduate program if you’re lucky. Um, however, you’re being asked to do it. Usually for some banned A-day uh therapists in the UK, uh a couple years after, uh maybe even faster than that, depending on the pressures of the systems and whatnot. So what I’ve found is just like ACT, DBT, psychodynamics, CBT, uh there’s a framework how to work with people, patients with their depression, anxiety. And I was wondering how can we create a framework or at least a theoretical understanding of how to work with supervisees? Because people listen to this podcast, think about how many times they have either been supervised, which is probably every, you know, they have been supervised if they at least reach this stage of training, but more so how many times have they been asked to supervise? And what have their models looked like? So there are some out there, don’t get me wrong, there’s a seven-eyed model of supervision, there’s developmental model supervision, and how mainly therapists supervise is their own theoretical orientation, a CBT acts, psychodynamic. So when it came to attachment supervision, I just felt like as you highlighted just prior to SC’s question, um, that does cut across different orientations and understandings and approaches that I have found in the supervision relationship from a supervisor to supervisee, those attachment dynamics do come out, not just within the supervisee, but also within the supervisor. So, you know, the secure, anxious, avoidant, disorganized kind of approaches that what happens is that when we’re feeling kind of maybe a little scared, a little vulnerable, a little overwhelmed, those patterns come out in the supervision. Let’s say, for example, you struggle with a particular case, or you’re really nervous about, oh, did I do enough, you know, safeguarding or enough um uh did I do this intervention correctly? Those patterns kind of come out, like I said, not just with a supervise you, but with the supervisor. So I just felt that some of those patterns and some of the work I was doing as a supervisor, but also some of the research and some of the readings I was doing was coming out because there is a dynamic in there that that’s similar to therapy. Like we have a therapeutic alliance when working with patients. There’s such a thing called a supervisory alliance. Um, how strong is it? Will a supervisee, well, hopefully a secure supervisor, be able to maybe try out an intervention and then come back and report it. How was it? Did I do this okay? Was that all right? Can I explore this? You know, there is the supervisor serves as a secure base, a secure uh it serves as this safe haven to explore different approaches, different parts of the training and whatnot. So again, with the attachment piece, it’s not just with the supervisee, it’s also the supervisor. In my experience, the most helpful, and your listeners can reflect on the most profound supervision experiences have been in the ones that are the most emotionally attuned, reflective, not just come in, here’s a didactic, I’m gonna teach you this, or okay, okay, we have to talk about patient A, patient B, patient C. Those experiences I don’t think help guide clinicians to their full potential and growth when it comes to working clinically. So the attachment, again, it gave me a framework to think about working with students, with trainees, or supervisees in a stage of their career that will help them understand their clinical work and also themselves a little better.
Colby 16:22
I like the idea of um the supervisor as a secure base. And um I wonder also your thoughts about um what what are some of the because people bring their own attachment style or styles to supervision. And um one of the things that so I would one one of the ways I think about attachment is that people have a predominant attachment style, but they don’t always approach relationships under the influence of that style. It really depends very much on what’s happening in their contemporary circumstances, and uh so for example, just just quickly, uh, from my perspective, every the vast majority of adults in April 2020 were approaching life and relationships under the influence of what we would more you know, we we would uh identify as being some pretty problematic uh schema or uh internal representations of themselves, other people and their world, so that they’re they um you know themselves as as vulnerable, other people as dangerous as the world, the world is unsafe. And this very early in the in the covet pandemic. So I’m just wondering about what you see people bring to supervision in terms of an attachment style, and uh and whether that’s probably likely their predominant way of approaching life and relationships, or whether they’re moving on that continuum a bit, or or that spectrum a bit of attachment.
Alex 18:04
Yeah. You know, that’s a really good perspective and good points that you highlight there. Um, I you know, I think sometimes people think of attachment styles like you’re anxious, you’re avoidant, you’re secure, as is as if it’s this neat little chart. I kind of conceptualize it almost like um a percentage or or a pie chart that you might be 45% secure, maybe 20%, you know, avoidant times anxious, that you’re not you don’t just fit into one category. My experience re researchers do that. It’s because it’s easy to quantify, you know, put in a nice little category. Here we’ll make sure we’ll get it published, and here’s you know, make it simplistic in the sense that if it fits this quantifiable category. But clinically, when you work with patients, supervisees, certain environments, certain people may elicit certain types of attachment patterns. And my experience has been, like I said, maybe you’re 65% secure and then maybe 30% avoidant. When distress is quite salient or going on, there might be a little secure tendencies, but also some avoidant tendencies. So it’s not just one or the other black or white. So yeah, I you know, Kobe, I agree with that. Also, one thing, as you were talking, how does it come up in supervision? Now, you know, I like to ask the listeners to reflect on their own supervision experience or being a supervisor. Let’s say we have an anxious supervisee, you know, thinking about okay, attachment theory, what does anxious look like from a clinical perspective or with a child? But let’s kind of conceptualize it from a supervisee perspective. It may look like the supervisee who is always knocking at your door every time they finish a session. Did I do this right? I’m not sure if I did that correctly. Um, what do you think about this? Did I can you check my note? Can you double check it? That would it that’s an example might look like. It also may look like they’re calling you at you know 5 p.m., 5 30 after workday is ended. Is this okay? That I can again, can I complete this record? I’m really worried about this person. And the supervisor supervisor may feel a little smothered, overwhelmed. We’re using a kind of an analytic term, there might be some projective identification going on. Then their attachment style gets activated, like, oh, here we go again. I’m seeing this incoming call or this email again, or I got sent the note back again. And maybe their attachment style comes up. So, for example, if it’s a more avoidant supervisor, they may feel overwhelmed, may not pick up the phone, might not answer the door, might say that they’re busy. So that’s just an example of how it might look in a supervisee, a supervisor, or another one would be an avoidant supervisee. The avoidant supervisee may have trouble engaging with emotional content, transference, counter-transference. What is the emotion in the room? They may be hyper-focused on maybe certain type of cognitive intellectual approaches and have a difficulty going there or ask why do we need to go there? This is maybe what the uh self-report measure says, like, why do we need to talk about this? Um, they may be very checklist. Sometimes, especially with this type of supervise, the supervisor supervisor is like, ah, they’re great. They’re going, they’re they got everything, check it, but boom, boom, boom. But I have found with those supervisees, the emo there’s yeah, they’re doing everything right, like they’re passing the training, their practicum or the placement. But the supervisor’s like, yeah, there’s something missing here. Like, yes, they’re passing on the chart on the, you know, the I, you know, passing all the marks, I’ll go on to the next practicum replacement. But there’s something missing here. So, you know, it comes out in different ways and supervision, in attachment-based supervision. The supervisor and hopefully supervisor is supervise you are aware of these dynamics playing out in the room and what’s going on.
The Supervision Dance And Secure Base
Colby 21:44
As you talk, it sounds like a dance to me. And I’m not the first person to refer to the dynamic between an attachment figure and uh and a and uh what usually in the context of my work, a young person as a dance. Um yeah but but and and I think I wonder what what um others have also talked about it in it from from so uh singing perspective and you know the extent to which you’re singing the same song uh so to speak.
Alex 22:17
But but I like that the symbolism of a dance and um and I I I wonder what the you could skip right ahead get ahead to what is the optimal uh way of of dancing with between the two but I I what I I guess is I’m wondering about is um how that looks in terms of a progression stages towards you know dancing together in sync so to speak yeah yeah you know just like any dance there’s breakdancing there’s also ballroom dancing and what I mean by that we’re going with this kind of metaphor there’s inpatient work there’s outpatient work there’s nonprofit work there’s a pressure from a system work so for example if you have hey we have 10 sessions you know this is the work we’re gonna do that can influence the type of music and the type of movement we have you might not do long-term work or depth work in 10 session 10 sessions or if you’re an inpatient you might get one meeting or two meetings with someone other clinics you might get that there’s no treatment is open-ended so in regards to this dance I think it depends on the type of music is playing and the type of dance that you have so again getting to these more attachment styles would be getting more to unconscious content interpersonal content internal working models and whatnot so I think the ultimate kind of simplify it is to have a secure attachment relationship between the supervisee and supervisor whereas the supervisee I kind of talked about just a moment ago is a supervisee can come with some of their insecurities some of their failures some of their mistakes and bring that to supervision and have the supervisor hold that maybe co-regulate or regulate that explore that hey how do we try it this way or what was going on for you when you with this patient said this so they’re able to the supervisor able to contain and regulate the supervisee and then maybe kind of put it back to them let’s let’s try maybe this time or we let’s explore it a little more in depth there are certain settings where that is more um able to to be done in certain settings that are not so i i also want to understand the realities of some settings are are able to do that some stable some settings are not but it doesn’t mean it’s not prevalent um again thinking of some supervisions sometimes it’s just okay tell me about patient A, B, C, D. Okay, did you do this? Okay, did you fill out this paperwork? Did you do that? Sometimes it’s very um task focused or line manager focused but attachments yeah administrative for sure yeah and then but the the attachment piece of the supervision is not it it’s more the interpersonal working of what’s going on and it can be a parallel process of what’s occurring. So the dance is you know making sure that you both are kind of moving to the same music and same kind of rhythm. And yeah it’s hopefully the idea would be to more secure attachment. And like you said there are times where that may happen to supervision times that may not happen. But again is it consistent enough for the person the supervisee or trainee in this case feels safe enough to bring up some of their mistakes or insecurities because that’s you know for especially from a training perspective that’s where that’s done. I mean think about being qualified or licensed once you get qualified license with the state with the board with the whatever entity it is you you might not have to seek out supervision.
Colby 26:01
People do like I think it’s a good thing like I know I do myself but it it’s it’s one of these things that like who’s there to check in on you that you’re doing these things that maybe some of the things that even as you’re qualified that you’re maybe nervous about or anxious about yeah it’s it look it I’m I’m really enjoying listening to you talk about it and thinking about how I would also conceptualize it as um so you could you can take on the role of supervision with a with a particular supervisee.
Attunement Plus Rupture And Repair
Alex 26:36
There’s this dynamic between you that that kind of plays it plays out as what we might think uh is representative of different kinds of attachment style and a and and a relationship that exists between you that you know that may fit under the umbrella of those kind of classifications of secure uh avoidant ambivalent and uh and disorganized and supervision uh apart from the teaching and all the other aspects of supervision i is about a dance that comes more and more into alignment yeah with each other is and I’m I’m I’m I when I when I hear you talk about it as an attachment relationship I I wonder I wonder how what what’s been the reaction when you’ve when you’ve taught when you’ve spoken publicly or even if you’ve written about it uh supervision as an attachment relationship I wonder what the reaction has been yeah no that’s that’s quite a good question I I think for some people’s most of the time the reaction is like oh that makes sense like oh I you know that that that that kind of clicks that makes sense and I think most people are kind of receptive to it because again if you think about supervision models or trainings you know or trainings models orientations um there’s not a lot there um if I said you know like what’s your theoretical orientation you would be able to pull from that a little bit if I ask them what’s your supervision orientation or super theoretical orientation you would probably list your actual theoretical orientation so I think my experience so far is that most people are receptive to it and I I I will say this supervision there is a built-in power dynamic yes some some more than others in any attachment relationship there can be especially early attachment when we’re talking about children right there is a power dynamic there is a different issue now it’s different when we get married or have relationships there might be a power dynamic but not in the way of I’m the parent you’re the child I’m the supervisor you’re the supervisee in a training perspective that supervisor holds a lot of power they can fail them on the placement so we have to acknowledge that built-in power dynamic there’s also so there’s the built-in structural power there may be other uh power dynamics playing out in the sense that um for example they might have a certain identity marker maybe being you know kind of a white man working with someone who is not of a dominant identity or a gender so that is a cultural social built-in dynamic on top of the structural dynamic of supervision age is another example degree could be another example so in from an attachment perspective the earliest you know type of bulby and whatnot it would there was there is a power dynamic I’m the parent you’re the child the supervision has it’s a flavor of that there is a built-in power dynamic it’s it’s different from hey I’m yeah I can fail you on this placement because you didn’t meet you know these qualifications it may look a little different when hey I’m I’m already qualifying I’m seeking out supervision for professional development but regardless there there is a bit of a power dynamic so going back to your question how do people receive it I I think most of the time people can take a attachment theory take b supervision and combine it like oh that kind of makes sense like I I understand that perspective um because inherently in a supervision dynamic there is a power dynamic just like in attachment style at the beginning especially with children infants babies adolescents teenagers there is a power dynamic being played out yeah yeah and I I guess it it it also calls for people to be in addition to the work to be self-aware about the the relationship that is existing yeah um and I wonder there are there are relational behaviors um that the the attachment this the attachment figure um deploys that uses um in a in the context of raising a child for example yeah um and I I guess I’m I’m wondering what what are those what do those relational behaviors look like when you think of attachment uh as a well think of supervision from a an attachment point of view and what does what does the supervisor do to create this uh felt sense for the supervisee of a secure base and to is uh support and encourage um alignment with secure uh secure attachment behavior ultimately yeah no that’s a really weird question I think one thing that hopefully all supervisors or most supervisors at least strive towards is attunement and um attentiveness can they attune can they uh are they attempt are they attentive to what’s going on so tracking not just what’s going on for the supervisee clinically but you know in my context working in a training it’s like hey how are things going with your viva or your dissertation how are things going in your classes you’re attuning not just to the clinical work but because that shows the humanity that usually the supervisee the trainee student whatever is not just there existing in isolation at the practicum replacement right that what happens is is you’re attuned to all of those things that a supervisee brings to the experience. And I guess again kind of answer that question like what kind of behaviors do they they tune that are attentive that are empathic. I would also say another skill because I can any relationship switch from attachments is there’s going to be ruptures and ruptures are part of any relationship. You know I think maybe this is one of the my clinical hat on ruptures are going to happen between parents and children between partners ruptures happen. It’s not so much the rupture that could be the problem it’s the inability to repair um it’s it’s not the initial cut it’s maybe getting infected again gets infected again and again so example of a rupture a potentially a supervisee doesn’t give good get get good marks or a supervisee when they’re qualified get some really harsh feedback. So that could be potentially a rupture right and it’s how does a supervisor repair that for example I wonder if you have any thoughts about these marks being different from what you put down to compared to what I put down so that is something you know or you can even maybe a little more guiding hand would be like I would imagine maybe there’s some I don’t know feelings or maybe some disappointment or some curiosity around my scores being this and your scores being that or something hey I’m wondering how that feedback sat with you over this week when we met last time how what was going on for you so so again it it’s my guys’ experience in just kind of working with this kind of model is supervisees remember how you made them feel in your presence so if they and that’s that secure base safe base kind of thing you know uh safe haven they don’t really remember like wow they had they went to this prestigious university oh they have this many letters alphabet soup after their name they don’t just like patients they don’t really care about those things they care about are you safe? Do you hear me? If we have a rupture can we repair it um so supervisees trainees licensed qualified professionals are are similar. So so again it it it it’s how do we repair that relationship because ruptures do happen some more significant than others you know when when I when I’ve worked with supervise there have been some where like I don’t know if this person’s gonna pass this placement because they haven’t met these qualifications you know those those are the hard ones right like those are the ones that as a supervisor like oh I don’t know if we want to do that like it’s really hard. But there are also supervise that you get a lot of enjoyment out of like thinking about working with them and what you learn and whatnot. So it’s not just a one-way street we learn from our supervisees as well.
Colby 34:58
Absolutely yes yeah a couple of things going on in my mind yeah uh one I’m I’m gonna process um while I while I speak the first but I do I guess getting back to something I said a little bit earlier um I wonder I just wonder about I think I think everything you’re saying absolutely I’m completely aligned with what you’re saying. I do wonder though part of it kind of is suggestive of of the the supervisory alliance is like a therapeutic alliance yeah but it’s also like a a parent dynamic and I wonder I do I do wonder if there is if you’ve ever encountered any any pushback about in relation to likening the the supervisory relationship is a bit like a parent child. Um but even if you don’t liken it that I guess people think attachment theory that’s all about parents adults and children yeah yeah I was wondering about that.
Alex 36:08
Yeah yeah I think so yeah I think some pushback could be just to be quite honest is it feels very uh like you’re parentifying in in in infant infidelizing making infantilizing yeah yeah making the supervisee feel and some of them sometimes a supervisee is older and supervisor you know for example this second career coming back and whatnot so I I think it’s it’s again it’s not a perfect kind of model to put over it but I think the piece that I would highlight is there’s a power dynamic. Yeah and whenever there’s a power dynamic built in a relationship because there’s a just like a clinical relationship excuse me relationship there is a built-in power dynamic. Now how big that power dynamic is there’s so many factors to that can help hinder, strengthen, weaken that relationship like what does it look like? How is it used? How is it discussed in the room? So yeah I think there can be I I think that’s a fair kind of point to highlight because it’s not it’s not clinical work. It’s not you know you know you’re working with a patient or whatnot but I often found there’s a lot of clinical things that do come up in supervision.
Colby 37:17
Yeah. You are it is a nurturing relationship most a lot of people would think of supervision from a supervisory perspective I guess if they’re relatively new to that role or and maybe not maybe if they’ve just always practiced this way is that my my role is to teach and to guide. And whereas attachment theory is more about support nurture grow.
Alex 37:45
Yeah and and I think and that’s that there is that’s what a that what a supervisory relationship or supervisory role is uh from my point of view too and I think um and in some ways that’s that’s also what therapy is all about as well so and and it this probably goes to the the broad applicability uh of attachment theory as a the theoretical body of theory but also as a um a way of practicing and a way of being mm-hmm yeah I I mean there’s no there’s no question there are times where as a supervisor you have to be quite didactic or quite maybe hands-on instructional for example if there are maybe your supervise is working with someone and they didn’t do a thorough enough risk assessment you might be very instructive very like we need to do this we need to do that um there may be times where yes I felt I have to fill out this paperwork where there’s an administrative component to it as you highlight it’s also nurturing one and one that hopefully has a two-minute attentiveness you know as well because being in there being a therapist being in therapy working with people clients and whatnot is a vulnerable experience like it is and what can be more vulnerable than coming up to someone or going into a room with someone and saying like hey this is how I work with this person. What do you think? How can I grow? It’s you’re asking for feedback and hopefully you can get it in a constructive way. So excuse me so so yeah it’s it’s it it’s you you may find I know supervisors that I’ve talked to excuse me they’re wearing many different hats they’re coordinating with you know the university about this they are filling out these forms they are you know picking up this client because this person’s out sick like like they’re doing they’re wear wearing many different hats just like clinically we can sometimes wear different hats as well. Yeah yeah and I guess I I’m wondering about being more attachment informed in one’s approach to supervision professional supervision what what you experience and observe to be the the benefits of um adopting that that framework and that approach yeah I I think the people I have worked with from an attachment kind of supervision lens is the work feels more um um here and now it feels more emotional it feels more tangible it doesn’t feel as surgical it doesn’t feel as cold or as an exercise going through the motions in a way because we’re taught it’s relational yeah it’s a relational I I believe supervision is a relational um experience all sociotherist I believe therapy is a relational experience absolutely and there and there’s different modes again and that’s not to say there are different schools that have different approaches and that one is better than the other whatnot I guess my experience is going back to the roots I think of psychotherapy it was a relational one it wasn’t hey check these boxes fill up these worksheets do these things you know people people get hurt in relationships and people heal in relationships so think of people who come into your office or anyone’s office feeling depressed or anxious most of the time it’s not an isolation a breakup um an exciting thing they got a promotion the emotion attaches to in a relational experience so as we get hurt in relationships with disappointment breakups a loss we can heal in them so when I think of attachment based supervision um I think of it as a relational one where we discuss not only what’s going on clinically with cases because that’s the that’s the focus of any type of supervision but how is it coming alive between perhaps you and I, from the supervisor and supervisee. Is there a parallel process? I don’t know what the term would be necessarily but just how we have transference and countertransference when you’re in a room with the patient there is an element of transference and countertransference with a supervisor and supervisee. Some people might idealize a supervisor oh my gosh they’ve written this they’re like this they’ve wondered there’s so many some people might devalue them oh what do they have to prove oh they have this degree um I’m older than them this is my second you know so so those dynamics play out so my experience is when we’re able to get beneath the surface to internal working models unconscious dynamics attachment patterns that’s when people I guess really come alive the work comes alive and they’re able to think of the the depression anxiety the loss the separation in in a different way than just this is what’s happening to me as opposed to this is how I’m feeling about it.
Colby 42:47
Yes it encourages a perhaps a more humanistic and person centered approach to to the work um in our supervisees.
Alex 42:56
I’m thinking about what what’s it like what I’m thinking a little bit about challenges here and what would it be like um supervising uh someone um from an attached with an attachment um framework guiding framework who had experienced um relational trauma growing up with their with their parents one one or one or other or both of their parents yeah yeah yeah so so again there may be some similarities that come out just like they would come out in the relationship with their partner they come out with their classmates with their co-workers like it’s not in isolation just in this example give me with their parents with their partner it would also come out in the supervision supervise supervision process so so again I think as a supervisor it’s it’s to be aware of that dynamic as far as if there’s a rupture or disconnect or disagreement not a good parent relationship how is that maybe occurring how is that showing up in the room between potentially a Supervisor who could be seen as an authoritarian figure, as someone who is all-knowing, someone who has a they have a position of power. How could that play out with the supervisee? And it’s not necessarily like, I’m wondering if there’s a similar pattern with your parents. Wouldn’t it necessarily be that, right? Like, like you might stow that as a supervisor clinician. You might stow that and this, you know, take a mental note of that. But you wouldn’t name it necessarily like that, but you name it, you know, in the idea of just like, what do maybe other supervision processes look like? Has this occurred before? What is it like to receive feedback from me? What areas do you think maybe I’m not uh asking you about or not getting in our work together? So again, there’s a clinical aspect of it, but it’s not like you know, hey, is have do you recognize this pattern before? It sounds like something you do, it sounds like you’re parenting because that that feels like therapy to me. Like that that that feels, but it may be not naming that so bluntly, but like naming that here’s a power dynamic potentially, here’s a pattern. What do you think of this pattern? Because that pattern now may play out between the supervisee and a patient. Yes, of course.
Colby 45:14
And I think um and the other thing that you’ve mentioned, which I think is really interesting as well, is to is for the supervisor to be very aware of how their their own attachment patterns are brought to to therapy. I wonder if you’ve you might comment a bit about that as a challenge.
Alex 45:37
Yeah, yeah, you’re right. Because when I do when I’ve done these trainings before, it’s usually supervisors, right? So when I propose the idea that guess what, you’re also in this dance. It’s you’re not stationary, they’re not moving you around. You had need to be in the rhythm with them. I think there is now the the first step is reflection. Like, okay, what does that look like for me? And you know, some therapists have gone to therapy. The part some pro my program required it. We had to do, we had to do therapy before we can graduate. Some programs require it, some do not. I think it’s always helpful to be on the other side of the couch to relate what that experience is like. So, with the supervisor, 99.9% of the time they have been supervised. You know, you usually can’t finish a any type of program unless you get supervision to graduate. So when I’m asking, when I’m proposing this, is yeah, thinking about their own styles. And again, some people are quite reflective on it. You know, in my experience is especially with people, mental health therapists, maybe a little more anxious attachment style. They want to make sure that they help. They want, okay, oh, I’m going to make sure you do these. I want to make sure you pass, I want to make sure all these things to get through the program and whatnot. But that doesn’t mean necessarily mean everyone has that attachment style. Um, there’s disorganized kind of attachment style, which we haven’t talked about as much for supervisors and supervisees, and the avoidance style. So, so I think most therapists who are supervisors realize there is some element of they are contributing to the dynamic. Now, some supervisors are okay sitting with that and processing it, and some will be like, I’m the supervisor. This is how it’s done. I blah blah blah, or or they don’t care, or they’ve done it for 20, 30 years and they’re kind of like out to lunch in supervision, you know. So, so just like that, that’s what I’m saying. Sometimes there’s no oversight like there would be when you’re actually getting supervised. But but yeah, I it does encourage them to reflect. So I have found some supervisors are like, yeah, that makes sense. This is kind of my style, this is how it comes up for me, and then some supervisors who are resistant to it. And and that’s information as well, right? Like that’s data as well.
Colby 47:45
Yeah. I I I while you’re talking, uh one thought that comes back to me from what something you said earlier was um that is is a w wondering about the extent to which people even think about um how what guides their supervision. And um, you know, people can per perhaps practitioners in this space can can talk more easily about what guides their clinical work. But yeah, but then when when put into a supervis uh supervisory role, what yeah, what what is an overarching guiding framework that informs that yeah, that approach. Yeah. I think lot it’s it’s similar and different to therapy. A lot of people with good supervision, in my I’m hearing through this podcast and through direct experience, people will say that good supervision feels a bit like therapy in a in a sense, particular and particularly when talking about holding space for people, holding respective place spaces for people. And one of the one of the challenges that I encounter in my clinical work particularly, is that so in in clinical work, the clinical work that I do, the therapeutic relationship is a really enriched relationship. Yeah. And you what you’re ultimately wanting to be redundant in the life of your client. Yeah. But if not, if they if they’re not experiencing the same the same or similar similar levels of um enriched relationship with others, they can be quite resistant. In my case, with children and young people, quite resistant to the idea of um of making you redundant in their life, so to speak, and finishing it up. And and in supervision, it’s a bit like that too. Sometimes we have a time frame, sometimes, you know, if it’s for a university program, you’re supervising whatever, there’s a time frame. Um, and that, but then in you know, you talk about when super professional supervision for colleagues, they could that can often be open-ended. And I I I wonder whether a a relational, attachment-informed, even psychodynamically informed, in a more broader sense, uh, um supervision process. I I I wonder about challenges and your thoughts about how you how the supervisor also makes themselves, well, they make themselves both a secured base, but ultimately redundant in the life of the supervisee.
Alex 50:29
Yeah. Yeah, I mean that that’s a good point. I I think when I think of supervision or being supervised, my and I think a lot of people do who are in this space, they’re they’re mosaic of their supervisors. So think about your training, maybe professor. They take bits and pieces from their supervisors that they’ve worked with, they’ve trained with, and they just apply it to their style. So again, you know, to that point, it’s not to be redundant. I I guess just like in therapy, um, you are with the client, you know, again, I’m stereotyping here, maybe you know, 60 minutes um a week, once a week, therefore. Okay. So the idea is with therapy, it also with supervision, that that 60 minutes lasts longer than that. You actually take that person, that therapist, that supervisor with you throughout your day, throughout your work, throughout your life, that they not necessarily become a voice or become part of you, but they’re there, they’re accessible. Um, it’s are they able to integrate that um person into their internal working model, into their object relation? Are they able to kind of, yes, they’re not physically there, you know, a supervisee when they’re working with a client, the supervisor is not physically there most of the time, unless they’re observing or one-away mirror, whatever. But there may be like, what would my supervisor do in this moment? What in my what is the protocol? What did they say that they should do? So you, you know, seeing the redundance, yeah, that’s that’s true, right? It there is some of that, but it’s once the therapy or the supervision is over, how does that person still live within your professional identity? I mean, I think it’s with my supervisors, and there’s you know, a couple in particular that that, you know, if we’re talking 13 years ago now, that I often think about quite often how would they approach this, how would they think about that? So I haven’t spoken to him in years, but they’re with me. Just like attachment figures, internal working are yeah, yeah.
Colby 52:34
Yeah, I was thinking just like parents, you know, that process of growing up and individuation and and tolerance of separation. Yeah, yeah, yeah, yeah. Yeah. Because there’s a fear, I would say, because this this this also happens in the clinical work that I do is with children and young people, predomin predominantly children and young people who can’t safely be cared for at home at for a particular for a period of time, or maybe not through throughout their growing up years. So they’re in out-of-home care. And there’s always been this um fear of the therapeutic relationship fear of it becoming an attachment relationship and and and the child becoming dependent in you know in the way that a child does in an attachment relationship. And there was there’s been over the last 30 years, there’s been periods of my career where that’s been very much seen as a bad, a bad outcome. Yeah. But what we’re talking about here, and this is the way I guess I’ve always thought, is that they need a good attachment experience somewhere. Yeah. They they you know, if if if our supervisees come to us with a complex um attachment history themselves, as you say, they’re going to be practicing. They need they need a a model, they need a representation of what a what a secure being a secure and attachment figure looks like, feels like, what they project and what it feels like to have that. A secure attachment relationship.
Alex 54:16
Yeah, yeah.
Colby 54:18
Yeah. I yes, I’m I’m thinking and and talking at the same time, which um uh usually I do a lot of my my thinking while you’re while while I’m listening as well. Yeah, um juggling. You juggling. Yeah. So, you know, it there’s much uh food for thought here, Alex. And um I guess I’m also wondering about are there any cautions that you would would provide about who might um adopt this approach to supervision in terms of, you know, it could be in terms of their their knowledge and understanding of of dynamics and and the dynamics of relationships, um, their understanding of um yeah, uh of where that, how that is felt by supervisees or experienced by supervisees. And are there, you know, is it are there supervised, certain supervisees that you would say would actually benefit from different types of supervision approaches to an attachment-informed one?
Alex 55:27
Yeah, you know, I answer that like correct last question, yes. So one model of theoretical or theoretical model of supervision is developmental model. So, for example, your supervision style. So we’re putting attachment supervision to the side for just a moment. Your supervision model will be guided on where that trainee, supervisee, professional is in their career development. For example, a first-year doctoral student, master’s student in their first practicum replacement, you might do a be a little more hands-on. You might do a little more guiding, more didactic, you might be a little more involved, which again, if we were to put the spec attachment lens on, you’d be a lot more scaffolding. You would do a lot more guiding. The attachment relationship from an infant or even a six, 12 months, 18 months, 20, you know, 24 months, looks a little different from someone who’s 13 years old, right? So a first-year supervisee and their first placement, first training, your style might look a little different. You might not ask some of these deep questions into personal process, but it may look different from a fourth or fifth year doctoral trainee. Um, they would be at a very different different developmental stage of that. So there’s that piece, right? There’s another piece from the supervisor’s perspective is have they also done some work? Um, if the questions that are going to be asked of the supervisee, are they going to be comfortable with that answer? Um, if they say, Oh, yeah, I felt a little hurt, or I felt kind of blindsided when you gave me this feedback, you know. If the supervisor response is like, well, this is how I feel, this is, you know, I’ve been doing this for a while, I’ve compared training. That’s an intellectual response. That is, that is not that now you have shifted about from a relational dynamic and got behind the position of a supervisor, a power position. So the I would also encourage the supervisor to think of their own attachment style, what comes up when they’re really stressed or dysregulated. As you know, Australia, United States, you know, the UK and Ireland, health systems are under tremendous pressure. And often people are voluntold to supervise. So not only do they have their full caseload, but now they’re asked to take on a supervisee. So again, that’s when it goes back to can I do attachment force supervision if I’m so busy, so inundated with all the clinical work, and now I have to supervise because it’s part of my band A, band A requirement. That looks a little different from like, oh, I really want to supervise and um I can manage it in my caseload of my current patients. So, so again, so there’s the setting, there’s the supervisees developmental arc, and the supervisor’s own um, let’s call it, awareness of their attachment style. So, so it it’s there’s multiple pieces uh to it.
Colby 58:18
So that that then I guess suggests that there um there are it is not always the time and the place or the person to be, yeah, to be. And I’m I’m wondering, just kind of as a final um um question as such, what whether there are other particular types of um uh other theoretical traditions or approaches that you think are are very helpful for people who take on the supervisory role either voluntarily or they’re made to. Uh should be should be aware of, maybe be trained, get receive some training in. Um yeah, so that they they a bit like therapy, you you you can adapt your approach uh somewhat to the to the client in front of you and what their needs are.
Alex 59:12
Yeah. And and piggybacking off of that, you as a supervisor would adapt your needs to what the supervisee is. A third-year supervisee, as far as how much you observe them, you know, critique their clinical notes, may look very different from a first year, may look very different from someone who’s who’s redoing a placement. So, so yeah, I I mean there are certain times that a more, for example, a CBT structure supervision might be really helpful. So we’ve done this type of supervision before where every excuse me, every kind of supervision session, the supervisee will come in with three or four clients. There are different columns, different categories, presenting issue, work done, next appointment. And having that type of structure can be really helpful. Like there’s no doubt that can be really helpful. And again, just like a theoretical orientation, if you have maybe three to six sessions, maybe 10 sessions, you might not do psychodynamic work. That’s the the environment might not be there. Just like the other end of uh uh under the spectrum, let’s say you’ve been seeing someone for 20, 30, 40 sessions, maybe some of those cognitive approaches that you have been doing, you might find yourself sputtering and not, you know, where do I kind of go from here? So it’s all relative, like it is all relative to the setting, to who the supervisee is, who the supervisor is, their capability and ability. Um, so so yeah, there’d be times where it’d be harder to approach. I mean, most analytic programs or institutes have you have to be supervised. And you know, when we think of supervision back when, you know, it was kind of first kind of thought of how we kind of practice it today, there was a blend of therapy and supervision. You know, but now it’s that those things are a little more separated. So yeah, there are maybe times where you don’t, you know, talk about these ruptures, these repairs, attentiveness, because the supervisee is so dysregulated because they forgot to check something. You wouldn’t be like, Oh, you’re really upset right now. And it’s like, ah, maybe I need to do a safety assessment or I need to call this person back. Like that, excuse me, that would be an example of, yeah, maybe it doesn’t apply to this approach, or this is not the tool to use at this moment.
Closing Reflections On Vulnerability
Colby 1:01:22
Yeah. But notwithstanding all that, it it strikes me that the role of supervision is to enable the supervision uh supervisee to be able to launch into the world with confidence and with an understanding that they can come back to top up their cup when they need it. So even even though you might adopt a different style, the one of the primary gain gains of super uh primary aims of supervision still remains able to be articulated or understood from in in through an attachment lens.
Alex 1:02:04
Yeah, absolutely, right? That they can come back to you. Yeah, I’m sure there are times where maybe you or some of your listeners have consulted with supervisors that they’re not that placement anymore, blah blah blah, but it’s a difficult case, or the presenting issue, like, oh, this person is suffering from a disorder, eating or eating disorder, I don’t have them experience, but this other supervisor I used to work with has that. Maybe I’ll give them a ring. We might call professional consultation, you know, kind of thing. But but you go back just like a child would in a new environment, they’re exploring it. Who are these people? What are these objects? Oh, is mom or dad there? They’re there. I maybe I’ll go back to them, recharge, fill up a little bit, and go back out again.
Colby 1:02:44
Yeah. Yeah. Yeah. It’s a very it’s a very interesting way of thinking about it. Uh, as a again, notwithstanding my great interest in attachment theory and the use of it as a guiding framework, um, not not so much to my shame, but I I you know, I really probably haven’t always turned my my mind to um the atta the supervisory relationship, viewing it through the lens of attachment theory. Uh, I probably have done it, you know, like you know, you know how we sometimes we we often practice um in a certain way and uh and then we kind of the penny drops that we’re we’re we’re doing we’re doing this, but we’re we haven’t always attached that um that nosology to it or those those ideas to it. And and I think for me that part partly that’s because of um what you were saying, the thinking around, the prevailing ideas around um what a supervisory relationship is meant to be versus what a parent a parent-child relationship is is and is meant to be, and you know, you don’t, and and and a kind of an anti-patriarchal approach to practice as such. But uh but I I think this has been a really helpful and really um good conversation because no matter what what ideas we you know might might be put forward to say, well, you know, um you shouldn’t be um trying to be an attachment figure in the life of your trainee, you really are. You really are.
Alex 1:04:40
Any relationship that has an element of vulnerability, of insecurity, of uncertainty is an attachment relationship.
Colby 1:04:52
That’s a really good point to um to finish up on. Thank you, Alex, for for taking the time to appear on the podcast.
Alex 1:05:00
Yeah, thanks, Colby, for having me. Appreciate it.
Alex’s Bio:
Dr. Alex Rowell is a practicing clinical psychologist in the United Stated and United Kingdom. He has a wide range of clinical and professional experiences that include working in various inpatient/outpatient hospitals, non-profit organizations, multiple college-counseling centers, the National Health Service (NHS), higher education, and currently works virtually in private practice. His areas of interests include clinical supervision/supervising, mood disorders, self-compassion, teaching, mindfulness, burnout, and gender awareness and education. Dr. Rowell has presented on peripartum mental health, multicultural awareness, clinical supervision, Psychodynamic psychotherapy, and personality disorders at various conferences. He practices mainly from an Attachment informed, Psychodynamic, and Humanistic/Existential lens; he is also RAPPS (Register of Applied Psychology Practice Supervisors) certified through the BPS (British Psychological Association).
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Disclaimer: Information reported by guests of this podcast is assumed to be accurate as stated. Podcast owner Colby Pearce is not responsible for any error of facts presented by podcast guests. In addition, unless otherwise specified, opinions expressed by guests of this podcast may not reflect those of the podcast owner, Colby Pearce. Finally, all references to case examples are anonymised to the extent that the actual case could not be identified, or are fictional but based on real-life examples for illustrative purposes.
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