Psychoanalysis, Class and Politics

Encounters in the Clinical Setting

Lynne Layton, Nancy Caro Hollander, Susan Gutwill, Lynne Layton, Nancy Caro Hollander, Susan Gutwill

• Publisher: Routledge
• Year: 2006
• Print ISBN: 9780415379410
• eBook ISBN: 9781134181612
• Topic: Política y relaciones internacionales
• Subtopic: Política

Do political concerns belong in psychodynamic treatment?

How do class and politics shape the unconscious?

The effects of an increasingly polarized, insecure and threatening world mean that the ideologically enforced split between the political order and personal life is becoming difficult to sustain. This book explores the impact of the social and political domains at the individual level.

The contributions included in this volume describe how issues of class and politics, and the intense emotions they engender, emerge in the clinical setting and how psychotherapists can respectfully address them rather than deny their significance. They demonstrate how clinicians need to take into account the complex convergences between psychic and social reality in the clinical setting in order to help their patients understand the anxiety, fear, insecurity and anger caused by the complex relations of class and power. This examination of the psychodynamics of terror and aggression and the unconscious defences employed to deny reality offers powerful insights into the microscopic unconscious ways that ideology is enacted and lived.

Psychoanalysis, Class and Politics will be of interest to all mental health professionals interested in improving their understanding of the ideological factors that impede or facilitate critical and engaged citizenship. It has a valuable contribution to make to the psychoanalytic enterprise, as well as to related scholarly and professional disciplines.

Chapter 1: Working directly with political, social and cultural material in the therapy session

Andrew Samuels

What shall we do about politics?

I am going to explore how the practice of psychotherapy might become more sensitive to political issues as these affect therapists and their clients. The hope is that therapists and analysts who seek to work directly in a responsible way with the whole person, including the social and political dimensions of the experiences of their clients, may do so with greater confidence and clarity. I believe this detailed work has not really been done yet, though there is by now a major shift in awareness concerning the social, cultural and political aspects of the subject positions of both therapist and client.

In spite of an interest in how these differing subject positions evolve in practice and the consequent recognition that everyone, not just members of sexual, ethnic or economic minorities, belongs to a “culture” and has a subject position, I shall not focus much on the external and internal political dynamics of the therapy encounter itself (see Samuels 2002). Equally, I will say almost nothing about the politics of the profession, though this remains a concern of mine. Instead, I present some ideas about addressing politics in therapy practice. Although these ideas derive from work with individuals, they may be even more pertinent and useful in group analysis and psychotherapy. The group matrix may facilitate the politicization of the practice of therapy rather well (see Brown and Zinkin 1994: passim).

In referring to “politics,” I have in mind the crucial interplay to which feminism introduced us between formal and institutional economic power and power as expressed on the domestic, private level. One implication of this reading is that power is understood as a process or network as much as a stable factor. Political power is experienced psychologically: in family organization, gender and race relations, and in religious and artistic assumptions as they affect the lives of individuals.

Where the public and the private, the political and the personal, intersect, I think there is a special role for analysis and psychotherapy in relation to political change and transformation. The tragicomic crisis of our fin de siecle civilization incites clinicians to challenge the boundaries that are conventionally accepted as existing between the external world and the internal world, between life and reflection, between extroversion and introversion, between doing and being, between politics and psychology, between the political development of the person and the psychological development of the person, between the fantasies of the political world and the politics of the fantasy world. Subjectivity and intersubjectivity have some political roots; they are not as “internal” as they seem.

There is little point in working on the orientation of psychotherapy to the world of politics if its own basic theories and practices remain completely unaltered.

I support the continuing practice of therapy and analysis with individuals and small groups. This is because I do not agree that analysis and therapy inevitably siphon off rage that might more constructively be deployed in relation to social injustices. In fact, I think that it is the reverse that often happens: experiences in therapy act to fine down generalized rage into a more constructive form, hence rendering emotion more accessible for social action. Even when this is not what happens, the potential remains for a move from private therapy to public action - and I propose to discuss that potential in this chapter.

The idea is to develop a portrayal of the clinical setting as a bridge between psychotherapy and politics, rather than as the source of an isolation from politics. Critics of the clinical project of depth psychology (e.g. Hillman and Ventura 1992) have noted the isolation - and this is not a totally wrong observation. But I want us also to see the potential links and to create a truly radical revisioning of clinical work, not a simplistic huffing and puffing aimed at its elimination.

One of the most potent criticisms of therapy and analysis is that the client is encouraged or even required to run away from external concerns - for example, political commitments or actions - and focus exclusively on the “inner world.” This, it is argued, makes any statement about therapy engaging the whole person an absolute nonsense. Most textbooks of therapy and analysis continue to accentuate the introspection by making it clear that exploration of outer world issues is simply not done in “proper” therapy and analysis.

Over a period of time - from about 1980 to 1990-1 sensed that this professional consensus, derived from psychoanalysis, was collapsing and that therapists and analysts were indeed beginning to pay more attention to what could be called the political development of their clients (Samuels 1993:134-137). In my own practice I noticed that many clients seemed to be introducing political themes more often than they had before. Talking to colleagues confirmed that this was also going on in their work, so it was not all due to suggestion on my part. We tended to put it down to the fact that, since the mid-1980s, the pace of political change in the world appeared to have quickened. At times, I still felt that the usual formulation - that such material needs to be understood as symbolic of what is going on in the client - worked pretty well. At other times it turned out that the clients had a need to talk about some public issue, maybe to work out what their true feelings and opinions were. But the clients might also have learned that you are not supposed to do that in therapy or analysis. For example, during the first Gulf War there were certainly some clients who used war imagery to tell me something about their inner state. Yet, there were others who were hiding a profound need to talk about the Gulf War behind the flow of regular, ordinary clinical material.

I decided that what was needed was a large-scale investigation, by means of a questionnaire, to see if analysts and therapists were experiencing something similar in significant numbers. I therefore obtained the cooperation of 14 professional organizations with differing theoretical orientations in seven different countries and sent out 2,000 survey forms. I got a return rate of almost exactly one-third (quite high for a cold-calling survey on which the respondents had to spend some time and write fairly lengthy and thoughtful answers).

In the survey, I asked which themes of a list of 15 possibilities were the most frequently introduced by clients. This produced a worldwide league table as follows: (1) gender issues for women, (2) economic issues (e.g. distribution of wealth, poverty, inflation), (3) violence in society, (4=) national politics, and gender issues for men, (4=) racial or ethnic issues, (6) international politics.

There were some striking departures from the order. For instance, the German analysts placed “the environment” at the top of the list as the most frequently introduced issue, while for the British psychoanalysts economic issues came in seventh. This enables us to make all kinds of speculations about whether there is or is not something like a “national psyche” or “collective consciousness,” at least as evidenced in the political themes the clients of therapists and analysts bring to their sessions.

I asked the participants how they reacted to, handled or interpreted the material. Seventy-eight per cent of the respondents mentioned that they understood the material as referring in some sense to reality. For many, this was in conjunction with a symbolic interpretation or an exploration of why the client was interested in that particular theme at that particular moment. The replies - thoughtful and extensive - showed considerable struggle by the respondents as they endeavored to mark out their positions.

I went on to ask if the respondent “discussed” politics with his or her clients. Of course, I realized the explosive nature of the question and deliberately did not define what might be covered by the word “discuss.” Worldwide, 56 per cent said they did discuss politics and 44 per cent that they did not. American Jungian analysts do the most discussing (72 per cent) and British psychoanalysts the least (33 per cent). However, it is interesting to note that the implication of the one-third “yes” of the British psychoanalysts is that 43 of them admit to discussing politics with clients (one-third of the 129 respondents).

I asked the respondents the obvious question: “Have you ever been/are you politically active?” Sixty-seven per cent said they had been politically active at some time - a figure which, unsurprisingly, dropped to 33 per cent at the present time. My intuitive impression, just from talking to colleagues, that a good many of them had been politically active at some time was borne out. The stereotype of a profession composed of introspective, introverted, self-indulgent types was challenged.

So what might it all mean? In the most down-to-earth terms, it could mean that if a person is contemplating analysis or therapy, and if that person is interested in politics (however defined), it would be as well to explore with a potential therapist or analyst what they are likely to do if one brings political material to the consulting room. For the profession is clearly divided about it. Even if everyone who did not return the survey forms abhors politics in the consulting room, there is still a significant minority of practitioners who do not. This other, hitherto unknown, group of clinicians sees that involvement in and concern for the world is part of growing up, of individuation, and maybe even part of mental health. The split in the therapy profession is at its most destructive when it is between the public, apolitical, hyperclinical face of the profession - something that has quite rightly been criticized - and a much more politically aware, private face of the profession. Many therapists and analysts seem all too aware that they are citizens too, that they have political histories themselves, that they too struggle to find the balance between inner-looking and outer-looking attitudes. As a British psychoanalyst put it when replying to the questionnaire: “We are political animals. Everything we are and do takes place within a political framework. It is impossible to divorce this from the inner world of either our patients or ourselves” (see Samuels (1993:209-266) for a fuller account of the survey).

Politicizing therapy practice

When attempting to link psychoanalysis or psychotherapy with political and social issues, we need to establish a two-way street. In one direction travel men and women of the psyche, bringing what they know of human psychology to bear on the crucial political and social issues of the day, such as leadership, the market economy, nationalism, racial prejudice and environmentalism. Going the other way down this street, we try to get at the hidden politics of personal life as broadly conceived and understood: the politics of early experience in the family, gender politics, and the politics of internal imagery, usually regarded as private. The dynamic that feminism worked upon between the personal and the political is also a dynamic between the psychological and the social. It is so complicated that to reduce it in either one direction (all psyche) or the other direction (all sociopolitical), or to assert a banal, holistic synthesis that denies differences between these realms, is massively unsatisfactory. There is a very complicated interplay, and this chapter trades off the energy in that interplay. One hope is to develop a new, hybrid language of psychology and politics that will help us to contest conventional notions of what “politics” is and what “the political” might be. The aspirations of so many disparate groups of people worldwide - environmentalists, human rights activists, liberation theologians, feminists, pacifists and peacemakers, ethnopoliticians - for a reinvigorated and resacralized politics would gain the support of the psychological and psychotherapy communities (see Samuels (2001) for a fuller statement of this position).

It is worthwhile focusing on therapy and on clinical work for two main reasons - first, because the results of the survey show that this is a hot issue for practitioners; second, because exploring the politicization of practice might help to answer the awkward question: why has the political world not shown up for its first session with the therapists who are so keen to treat it? Freud, Jung and the great humanistic pioneers such as Maslow and Rogers truly wanted to engage with the institutions and problematics of society. But they, and even more their followers, did this in such an on-high, experience-distant, mechanical fashion, with the secret agenda of proving their own theories correct, that the world has been, quite rightly, suspicious. Objecting to psychological reductionism in relation to the political and social is reasonable - not resistance. But what if clinical experience were factored in? At the very least, there would be a rhetorical utility. For, without their connection to the clinic, to therapy, why should anyone in the world of politics listen to the psychotherapeutic people at all? What do we have to offer if it does not include something from our therapy work? Therapy is certainly not all that we have to offer, but it is the base.

The professional stakes are very high. In certain sectors of humanistic and transpersonal psychology, clinical work is becoming more overtly politicized so that the whole client may be worked with. But this is still very much a minority view in the psychodynamic and psychoanalytic sectors of psychotherapy. Politically speaking, most clinical practice constitutes virgin territory. The stakes are so high because what people like me are trying to do is to change the nature of the field, change the nature of the profession -that which we profess, believe and do. As the survey showed, this attempt is part of a worldwide movement in which the general tendency is to extend the nature of the psychotherapy field so as to embrace the social and political dimensions of experience.

If we do want to treat the whole person, as some of us do, then we have to find detailed ways of making sure that the social and political dimensions of experience are included in the therapy process regularly, reliably, and as a matter of course. We must try to achieve a situation in which the work is political always, already - not unusually, not exceptionally, not only when it is done by mavericks, but when it is done in an everyday way by Everytherapist.

I feel that we are at the earliest stages of this project, and are handicapped by the lack of a much-needed new language. These thoughts and speculations are my best shot. I want to discuss the politicization of therapy practice under the following headings:

1. 1 The therapeutic value of political discussion in the session.
2. 2 Exploring the political myth of the person in therapy.
3. 3 The hidden politics of internal, private imagery.
4. 4 Working out a socialized, transpersonal psychology of community.

However, as the project of creating a responsible way to work directly with political material has developed, I have found it useful at the outset to attempt to deal with, or at least discuss, the objections to what is being proposed. In this way, readers are alerted to my own awareness of the radical and often risky nature of these ideas. Moreover, dealing first with the objections resembles good psychoanalytic technique whereby resistance is analyzed before content. Of course, the objections are not only resistance and I am convinced that an ongoing engagement with objections (and objectors) to the politicization of therapy practice is enhancing for all sides in the debate.

The first objection is that removing the focus of the clinical enterprise away from the internal world and onto the political world constitutes bad clinical practice. The reply to that objection can be equally assertive. Foreclosure on politics, the privileging and valorizing of the internal over the external, may, as we stagger through the first decade of the new century, itself constitute bad clinical practice. From today’s perspective, maybe I do want or need to do some bad practice as I change my practice. Those who do not or cannot change their practices may, from tomorrow’s point of view, be the ones guilty of bad practice. What is or is not “on” in clinical technique has evolved strikingly over the first psychoanalytic century. These matters are not definitively settled.

The second objection concerns the problem of suggestion and undue influence on the part of the therapist. This is a sensitive issue these days, given the moral panic surrounding psychotherapy stemming from the notion of false memory syndrome. Is there a risk that a politicized therapy practitioner will foist his or her own political ideas, principles, and values onto the vulnerable, open-to-suggestion client? Would not that be a shattering objection to the politicization of therapy? In reply, I would ask if we are really supposed to believe that a practitioner who sticks to the way he or she was trained and keeps the political out of the consulting room is thereby devoid of the sin of ever suggesting anything to the client. Many studies show that an enormous amount of influencing by the therapist of the client goes on, and in fact may be essential for some kind of psychological movement to happen. At times, even Freud equates transference and suggestion, making a defensive point that also serves me well: you cannot suggest something into somebody unless they are ready for it, unless it “tallies” with what is already alive in them. I would use Freud against the objection. Suggestion is going on already. There is no reason to suppose that a politicized practitioner would necessarily be intruding his or her own values more than somebody whose interest was in object-relations, sexuality, aggression, spirituality or the soul.

Of course, there is always a risk of discipleship in the psychotherapy situation, as those who have had training therapy know. But I feel confident in saying that there is today a huge amount of uncritically accepted suggestion in clinical practice and that, from a certain point of view, the more “bounded,” “contained” and “disciplined” the behavior of the practitioner, the more suggestion is taking place in his or her practice. I think this is inevitable. The technical rules of analysis are not politically or culturally neutral; they do more than “facilitate” the unfolding of the self. They have themselves cultured depth psychology in a permanent way, and they have themselves done it to a certain extent by suggestion. On the basis of the replies received to the questionnaire on political material that is brought to the consulting room, it is clear that a good deal of rule-breaking goes on in ordinary therapy and analysis - probably much more than is revealed in supervision, wherein words like “discussion” are dirty words. If psychotherapists and analysts are already discussing politics with the client, then it is clear that the hygienic sealing of the consulting room from politics is a virginal fantasy on the part of practitioners.

The third objection concerns what is to be done when the therapist is confronted with somebody with political views he or she finds repulsive. Discussing my ideas at a meeting of the British Association of Psychotherapists, I was once asked: “what would happen if Hitler came into your consulting room?” Well, psychodynamically speaking, I think I have seen quite a few Hitler-types in my consulting room already. Although this point cannot settle the very real worries that working with somebody whose views you find repulsive creates, surely we can agree that, from time to time, every practitioner will meet a version of this problem. Moreover, politics is not the only source of repulsion.

A fourth objection concerns the alleged elitism of what I am proposing. Do I have some kind of fantasy that we are going to send a well-analyzed vanguard of the psychopolitical revolution out into the world? Of course I have had that fantasy from time to time but, in a more moderate vein, and in terms of developing an argument about changing the field, I do not for one minute think that a person who has had psychological analysis or therapy is in some kind of elite vanguard. However, as indicated, I do recognize that there is some strength in this objection, and I try to stay conscious of the problem.

The fifth objection is extremely subtle and hence difficult to deal with. This objector claims that he or she is carrying out a political therapy practice already. Sometimes I feel that this is undoubtedly the case. At other times, when I am told that the mere practice...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Contributors
• Acknowledgments
• Introduction
• Chapter 1: Working directly with political, social and cultural material in the therapy session
• Chapter 2: Money, love, and hate: Contradiction and paradox in psychoanalysis
• Chapter 3: That place gives me the heebie jeebies
• Chapter 4: The manic society
• Chapter 5: Despair and hope in a culture of denial
• Chapter 6: Class and splitting in the clinical setting: The ideological dance in the transference and countertransference
• Chapter 7: Attacks on linking: The unconscious pull to dissociate individuals from their social context
• Chapter 8: The normative unconscious and the political contexts of change in psychotherapy
• Chapter 9: Racism, classism, psychosis and self-image in the analysis of a woman
• Chapter 10: The beheading of America: Reclaiming our minds
• Chapter 11: Psychoanalysis and the problem of the bystander in times of terror
• Chapter 12: Is politics the last taboo in psychoanalysis?: A roundtable discussion with Neil Altman, Jessica Benjamin, Ted Jacobs and Paul Wachtel. Moderated by Amanda Hirsch Geffner
• Chapter 13: Response to roundtable: Something’s gone missing
• Chapter 14: Response to roundtable: Politics and/or/in/for psychoanalysis
• Chapter 15: Response to roundtable: What dare we (not) do? Psychoanalysis: a voice in politics?
• Chapter 16: Political identity: A personal postscript