IJSP Number 4, 2022

80 certain degree - a normal phenomenon in therapy) and to educate the supervisee regarding the psychotic patient’s need for concrete and substan tial help, in order to be able to manage the unstructured world she lives in. Supervision must support the psychotherapist in thinking about own meta- cognitive processes, as she thinks about the patient’s meta -cognitive processes [25]. The supervisor has to investigate the way the psychotherapist perceives the patient’s experience and the degree to which her image about the patient actually fits the patient’s behavior. In other words, supervision a kind of a parallel process [24] On the other hand, the pat ient’s fragmentation may disorient the psychotherapist, who may think that her own meta-cognitive skills are impaired. The psychotherapist also has the task of empathizing with the patient and working with her at an emotional level. Psychotherapists who work with psychotic patients may also have countertransferential feelings, like despair, hopelessness, anger and frustration [26]. In addition, psychotherapists in need of validation will feel inadequate, bored or impatient [14]. The psychotic cannot communicate in a way other than projective identification, and the schizophrenic’s fragmentation projects onto others a strange, odd and bizarre world. As a consequence, when working with psychotics, the psychotherapist frequently feels fear, horror and anxiety, may have the sensation that absolute evil is lurking around or feels she loses control and therefore the world becomes disorganized, similar to the way she may feel inside the world of a very small child [14]. Another common fear among psychotherapists is the fear of failure or of hurting the patient, who might commit suicide because of the therapist’s lack of competence. Other psychotherapists feel the psychotic’s intense sadness, the tragedy of the situation in which the patient does not have a normal life and has no chance for a normal life. Therefore, supervision must address the emotional difficulties of the supervisee and fears connected to own professional competence. Last but not least, the psychotherapist must connect the patient’s delusions and hallucinations to potential traumatic content. This is another difficult intervention for most psychotherapists, who feel lost in the patient’s lack of structure and coherence. Supervision must, therefore, address the supervisee’s capacity to tolerate this lack of structure, without feeling unstructured herself. Actually, psychotherapists working with schizophrenic patients often over-estimate or under- estimate the degree of integration the patient is capable of and as a result do not accurately perceive the patient’s experience of fragmentation [24]. Still, probably one of the most important interventions in supervision remains encouraging the supervisee regarding the potential success of psychotherapy. Prognosis in schizophrenia is still thought to be bad, with very few remissions, although, contrary to this pessimistic point of view, most psychotics do not have a severe impairment for the duration of their entire lives [27]. Consequently, it is necessary to educate the supervisee regarding this aspect, so she in turn may be hopeful that psychotherapy is going to be successful REFERENCES [1] Weinberger, D., & Camic, P. M. (2011). Schizophrenia . Wiley.