Physcoanalytic supervision and consultancy: Promoting staff support system in instit Issue addressed: The challenges involved in effectively integrating cross functional and multidisciplinary teams. In conjunction with personal analysis and theory/technique seminars, clinical supervision represents one of the three pillars of psychoanalytic training. Since several years, however, ‘supervision’ is also a term which describes consulting for staff groups in health and social institutions, a practice standing at the crossroad between training and consultancy, offered as a staff support system to teams more and more heterogeneous and involved in an often confused network of related tasks and services. The Authors develop their hypotheses by reflecting about their work as consultants and/or supervisors providing staff support and educationwithin various organizations in the public, private and voluntary sector. The first part of the paper focuses on similarities and differences between individual and institutional supervision, with particular attention to clinical supervision, experiential team building, organizational development, and the issues involved in the relationship, overlapping and conflict among training, support and administrative functions. The second part, drawing on Winnicott’s notion of “holding”, Pichon-Rivière and Bleger’s concepts of “deposit” and “context”, Bion’s theory of container/contained relationship, Menzies’ studies on “social defenses”, and Abadi’s paper on paradigm shift from the boundary to the network, examines how the notion of institutional container in healthcare organizations is increasingly involved in dealing with specific massive anxieties related to interprofessional work and diversity management. The last part, looking at the social analysis by Bauman and Sennett, discusses how the new scenarios created by the ‘managed care’ modify the containing function of institutions, lower their capacity to create links and deal with system anxieties, allowing primitive turbulent group, intergroup and leadership dynamics to impact on productivity and wellbeing. While organizations are progressively becoming boundaryless, networked and porose systems, relatedness and loyalty
become less important, and mobility and turnover are so fast to impede a healthy and mature attachment to work, people and the cultural values of one’s organization. Drawing on case studies, the AA formulate some working hypotheses concerning ambivalence, ambiguity, emotional pressures and social defenses implied in both the demand and the offer of institutional supervision; these could be related to a unique mix of concurrent elements including a resistence to learning from experience and fear of the responsibility for knowing (see ‘-K’, Bion), environmental insecurity, unsafe boundaries between person, role and organization, dilemmas involving control/support and professional/managerial interfaces, competition for care between staff and clients, inter-group or inter-professional conflicts, and leadership regression, against the new social challenges brought about by globalized networks and the problems of diversity, liquidity, complexity, uncertainty, turbulence, and rapid, sometimes catastrophic, change. Key words:
Supervision
Diversity
Staff support system
Container
Managed care | 
Dr Giovanni Foresti was born the November 13th 1957 in Domodossola (Italy). He is married and has two daughters. Graduated in Medicine in 1983, he has a degree in Clinical Psychiatry and a Ph.D. in “Scienze della Relazione”. Since 1994 and up to 2008, he was Medical Director of a psychiatric and geriatric institution. In 1999, he has become Member of the Italian Psychoanalytic Society (SPI) and of the International Psychoanalytic Association (IPA). Member of IL NODO group, he was in the staff of the Italian Group relations conferences (ALI: Authority, Leadership and Innovation) in 2005, 2007 and 2008. He lives and works in Pavia.
Franca Fubini lives in Perugia.She works as a psychoanalytic psychotherapist, group analyst and organisational consultant.
She has worked for many years within mental health institutions both in Italy and in the UK.
She has taught at Rome, Perugia and L’Aquila University in the field of Psychology and Human Resources. Senior Fellow of University College of London (UCL).
Member of the staff of the Italian Group Relations conferences (Autorithy, Leadership and Innovation).
Director of Social Dreaming Institute LTD (UK) and founder member of Socialdreaming.it (Italy).
Member of IL NODO group and of the Group Analytic Society, London (GAS).
Mario Perini, MD is a psychiatrist, a psychoanalyst and an organizational consultant. He is Chair of the Associazione IL NODO Group, Turin, a member of Italian Psychoanalytic Association, IPA (International PsychoAnalytic Association) and ISPSO (International Society for the Psychoanalytic Study of Organizations), and scientific advisor of the Italian Group Relations Conferences Programme (“Seminari di Arona”). After a 15-years career in mental health services, and a psychoanalytic education, he received a group relations training at the Leicester Conferences and elsewhere, and has been working since many years as a consultant in the public, private and voluntary sectors, and also as a trainer for professional and management education, a team supervisor, and a Balint group leader. He works in private practice as an analyst, a psychotherapist and a personal coach, and teaches group dynamics and team work at the Post-Graduate School of Health Psychology, Turin University. In 2007 he published the book “L’organizzazione nascosta” (“The hidden organization”) His interests refer particularly to psycho-social research, group relations and systems psychodynamic approach, organizational consultancy, issues of leadership, work safety and wellbeing, and the social applications of psychoanalytic thought.
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