Supervision and the Problem of Grandiosity in Novice Therapists

The authors observe a heightened vulnerability to grandiosity in novice therapists, but one which is not usually associated with narcissistic personality pathology. Using vignettes from clinical supervision, they illustrate the view that anxielies particular to early stages of training are often responsible, at least in part, for evoking grandiose modes of experience. Anxiety over not-knowing and an mability to tolerate uncertainly are dissociated through grandiosity, which is often manifest as rescue fantasies, overly ambitious therapeutic goals, and strong feelings of inferiority in response to the supervisor's display of knowledge. The authors stress the benefits of at times challenging grandiose attitudes, at other times supporting nascent feelings empowerment, and at all times tolerating usually uncomfortable feelings of not-knowing.