The Gift of Vicarious Resilience in Supervision
The Sacred Role of Supervision
Supervision is a sacred space with trainees.
Of course, the main goal is to process cases and strengthen clinical skills, but supervision is so much more than reporting updates and being told what to do next. Ideally, it is a protected time and space where trainees can be vulnerable to share their strengths and weaknesses, supervisors can model what it’s like to be a human being and clinician, and the parallel process between client, clinician, and supervisor can come to life.
Being a supervisor is one of the best parts of my job as a psychologist and I am incredibly fortunate to work with psychology predoctoral interns as they are completing the last year of their training before earning their title as Doctor. This part of my work helps to diversify my practice, which for me is necessary to manage Vicarious Trauma in healthy ways.
Even more, though, it allows me to experience Vicarious Resilience with and through the work my supervisees are doing - so cool!
Each time we reach the end of the academic year, I find myself in a reflective place as I am working with my supervisees in saying goodbye to their clients while we are also saying goodbye to each other. This time of year is one of gratitude, as we make space to really sit with and acknowledge the work and growth clients and supervisees have made in the past 12 months.
For me, it’s a true honor to bear witness to these processes and I wanted to take time in this post to share how it impacts me as a clinician, leader, and human.
Supervision and the Parallel Process
I am privileged to experience Vicarious Resilience with and through my supervisees because of The Parallel Process of Supervision. This concept helps us understand how the work supervisees do with their clients can have an impact on the supervising clinician.
One way this process is often depicted is as follows:
At first glance, the above diagram can feel overwhelming, I know! Stick with me and we’ll get through it. 😉
Within the parallel process model, we first have to consider the client and the reasons they are coming to therapy (1). The therapist (4) uses this information to choose appropriate interventions (2), which plays a big role in establishing the therapeutic relationship (3). The therapist of course will also have a relationship (5) with their supervisor (6) and ALL of this exists within the larger external system (culture, current events, theoretical orientation, etc.).
There are lots of moving parts in this model! The main thing I want you to take away are the overlapping circles in the center. These circles demonstrate how the therapist is at the center of this process - they are working with the client, holding and understanding that work, and then sharing it with the supervisor.
The therapist is acting, then, as the messenger, the connection between the supervisor and the client. According to the concept of the Parallel Process, whatever is happening in the therapist-client relationship will then be replicated to a certain extent in the therapist-supervisor relationship.
What Does This Have to Do with Vicarious Resilience?!
Vicarious Resilience and Vicarious Trauma are two sides of the same coin - while VT consists of the stress and trauma we inevitably soak up in our work as trauma therapists, VR (not the headset kind 😉) is made up of the BIG and (mostly) small moments of success, empowerment, and resilience our clients also share with us.
While we get to receive these gifts from our clients directly, we can also receive them through our roles as supervisors. The Parallel Process of Supervision has allowed me to receive these gifts lately, and I want to share a recent one with you!
Please note that names and identifying information of the supervisee and client have been changed but the overall messages shared in the vignette remain the same.
Anna and the Heart Transplant
Anna sought out supervision with me because she wanted exposure to working with medically complex clients and one of my areas of specialty is working with clients who are pre- and post-transplant. Anna was assigned a case of a middle aged man who had recently received a heart transplant. Anna’s client was referred by his psychiatrist, and although he was compliant in attending therapy, he wasn’t super jazzed about the concept. 😊
There were certainly some struggles in the beginning of the therapeutic relationship - Anna really wanted to teach her client skills to manage symptoms of anxiety and depression but she was not speaking his language. A lot of our work in supervision was learning how to rephrase things so he could receive her interventions in meaningful ways.
A common theme when working with post-transplant clients is whether or not they are going to write a letter to the organ donor family. For much of the past year, this particular client was either not open to this or ambivalent so the topic was put on the back burner while Anna made incredible progress in strengthening the therapeutic relationship, building trust, and supporting her client as he worked towards his therapy goals in his way.
Fast forward to 2 weeks ago - Anna hadn’t seen her client for a couple weeks because he had been traveling so the session was a typical check-in, how was your trip, etc. vibe. Then, out of the blue, her client shares that he has written a (lengthy) donor letter and did she want him to read it to her?!
I hadn’t had a chance to read her note prior to our supervision session, so like Anna, this came as a total surprise (oh, hello parallel process)!
As she described what it was like to sit with her client while he read her the letter, which was full of powerful insights and emotion, we both began to tear up. We felt the warm fuzzies together and marveled at the progress this man had made in the past year. We were filled with hope, inspiration, and delight in the work she and the client had done together.
How Do We Hold Onto this Vicarious Resilience?
I am often asked what we’re supposed to do as trauma therapists to hang onto Vicarious Resilience because it’s such a valuable resource and something we don’t want to lose.
Reality check - Vicarious Resilience isn’t something we get to package up and save for a rainy day, sorry (not sorry). I encourage our community to Name Vicarious Trauma regularly because it is a regular practice to be cultivated in our work as trauma therapists.
Well, noticing and “tagging” Vicarious Resilience is also a practice we have to intentionally cultivate, which often requires an active slowing down in session with clients or supervision with trainees. This was my job with Anna - to state the obvious fact that we were both having strong feelings and reactions and to honor how the work she has done with this client was impacting us at that moment.
I then encouraged Anna to take some time after our supervision meeting to write about the recent session, to really give her brain and body time to soak in all the details, and to document it so she can return to it later when her cup is feeling less full.
The act of recording or documenting our moments of Vicarious Resilience is worth considering because when we are having a difficult day, week, month, our brain is probably starting to move more into our own survival mode. This is natural, and nothing is wrong with us when this happens, but it also means our prefrontal cortex isn’t working as well as it could be, making it more difficult to notice moments in our work that serve to refuel our own engines.
Next Steps
I’m going to encourage you to do the same thing I recommended to Anna - start writing down your moments of Vicarious Resilience! I really like to hand write these experiences, but you do you.
Decide on a dedicated journal or document where you will only write about your experiences of Vicarious Resilience (with clients or trainees)
Remember that VR is not only those big moments of progress/breakthroughs with clients, in fact it’s more often the little moments
Consider scheduling a time each week to write these experiences down, especially to get started in strengthening this as a regular practice
Keep the journal/document accessible so you can easily access it on those difficult days and remind yourself of the incredible resilience you get to witness alongside the heavy work you do (and love)
You might consider sharing some of your experiences of Vicarious Resilience with others to really strengthen the memories of these experiences and to inspire your fellow trauma therapists!
You’re always welcome to hop in the free Facebook group, The BRAVE Vicarious Trauma Community to share your own stories and to soak up VR experiences shared by our community!
