Theory: Diversity and Intersectionality of Identity

Adult Psychoanalytic Psychotherapy (APP)
2019-20, 1st Block — Mondays, 6:30-7:45pm


In our work as therapists, we bring ourselves - our feelings and reactions - to our daily sessions with our patients. We are faced with and grapple with our patients’ “otherness” including for example, our reactions to those who are of a different gender, sexual orientation or gender identity, race, ethnic background, age, social or economic class, or who are differently abled.

This course is intended to offer us opportunities to explore and reflect on our reactions to “difference” — to become more curious about what we don’t know or understand about “others” including our misperceptions, defenses and other biased views which may be uncomfortable and disturbing.

Having the chance to listen to the stories and life experiences of a diverse group of guest lecturers is a chance to think together and talk about experiences we have with our patients. We hope this will allow you to feel more comfortable being curious and open to important differences between your patients and yourself.

In addition we’re introducing the broad concept of intersectionality to help us recognize and think about “the complex, cumulative way in which the effects of multiple forms of discrimination (such as racism, sexism, and classism) combine, overlap, or intersect especially in the experiences of marginalized individuals or groups.

“Kimberly Crenshaw introduced the theory of intersectionality, the idea that when it comes to thinking about how inequalities persist, categories like gender, race, and class are best understood as overlapping and mutually constitutive rather than isolated and distinct.”
— Adia Harvey Wingfield  (definition: Merriam-Webster Dictionary)

Learning Objectives

  1. At the end of this course, students will be able to recognize ways in which “difference” of both therapist and patient can impact the work
  2. At the end of this course, students will be able to identify areas or situations when discomfort is experienced related to “difference”
  3. At the end of this course, students will be able to develop increased curiosity about “difference” and the impact on both the therapist’s and patient’s ability to engage.

September 9, 2019 — What’s So Scary About Race?

Presenter: Sandra Walker, MD

[52 pages]

This class will be based on thought exercises intended help participants identify areas of uncertainty, discomfort or vacancy in the experience of race as well as ways in which this might impact alliance, transference, and counter-transference in the clinical situation.

Prior to the class, Dr. Walker encourages you to watch the feature film Sankofa (1993), a film by Haile Gerima. (embedded below)

Powell, D.R. (2018). Race, African Americans, and Psychoanalysis: Collective Silence in the Therapeutic Conversation. J. Amer. Psychoanal. Assn., 66(6):1021-1049.

Stephens, M. (2018). “Playing Out” Our “Playing in the Dark”: Racial Enactments and Psychoanalytic Institutions. J. Amer. Psychoanal. Assn., 66(5):941-950.

Apprey, M. (1999). Reinventing the Self in the Face of Received Transgenerational Hatred in the African American Community. J. Appl. Psychoanal. Stud., 1(2):131-143.

Akhtar, S., ed. (2012), The African American Experience: Psychoanalytic Perspectives, Jason Aronson, UK.

Includes: Character Studies — Martin Luther King, Malcom X, Muhammad Ali, Oprah Winfrey, Barack Obama; Contributors include — Jan Wright, Dionne Powell, Salman Akhtar, Shawn Blue, Clarence Watson, David B. Campbell, Glenda Wrenn, Kimberlyn Leary, Forrest Hamer, Carlotta Miles, Christin Drake, Samuel Wyche, Cheryl Thompson, Dorothy Holmes, Jennifer Bonovitz.

Akhtar, S.; Kramer, S., eds. (2004), The Colors of Childhood, Roman and Littlefield, MD.

Contributors — Selma Kramer, MD; Daniel Freeman, MD; Calvin Settlage, MD; Carlotta Miles, MD; Salman Akhtar, MD; Purnima Mehta, MD; Jennifer Bonobitz, Ph.D; Henri Parens, MD.

September 16, 2019 — Gender feels

Presenter: Ezra Gotzen, PsyD

In “Gender feels” we will discuss how our own gender/gendered feelings, concepts, limitations, cis/transness influence what is possible between our clients and us. We will explore how the positionality of our intersecting identities inform what we can see and what our clients have to force us to see.

Instead of providing an article, I would like class to review and think about the following questions:

  1. When and how did I know I was the gender I identity with?
  2. What my gender told me about the world I live in?
  3. How do I relate to my body based on my gender ( possibilities, limitations)?

September 23, 2019 — Presenting Autism

Presenters: Micah Levenson, MSW LICSW, Rebecca Levensen, MSW LICSW

A psychotherapeutic clinician diagnosed with Autism/Autistic Disorder will share a brief soliloquy before engaging students in a question and answer seminar for the remainder of the class duration. If you have ever had a question about autism, the autistic experience, neurodevelopmental disorders, or related topics, this class will be your opportunity to ask it and receive a direct, honest answer.

Presenting Autism: Micah Levenson, MSW LICSW and Rebecca Levenson, MSW LICSW

September 30, 2019 — I Can’t Hear You

Presenter: Jacqui Metzger, MSW

[27 pages]

This class will look at disabilities, both visible and invisible and focus on the impact of hearing loss on both patient and clinician.

Hertel, R.K. (2003) Analyzing the Traumatic Impact of Childhood Visual Impairment. JAPA, 51(3):913-939.

October 7, 2019 — My People Are Not Your People

Presenter: Flaviane Ferreira, MD LMHC

This class will explore difference in culture, religion, language , national origin, and experiences of immigration or dislocation.

Akhtar, S. (2016) Salman Ahtar on “A Third Individuation: Immigration, Identity, and the Psychoanalytic Process”.  PEP/UCL Top Authors Project, 1(1):17

Please watch this 20 minute video  in preparation for this class.

Optional Reading

Akhtar, S. (1995). A Third Individuation: Immigration, Identity, and The Psychoanalytic Process. J. Amer. Psychoanal. Assn., 43:1051-1084

Akhtar, S. (1999). The Immigrant, the Exile, and the Experience of Nostalgia. Journal of Applied Psychoanalytic Studies,1:123-130

Salman Akhtar on The Trauma of Dislocation,

Choksi, K. (2003). Children of Immigration. By Carola Suarez-Orozco and Marcelo M. Suarez-Orozco. Harvard University Press, 2001. J. Appl. Psychoanal. Stud., 5(3):371-374.

Saroop, S. (2004). Children of Immigration, by Carola Suarez-Orozco and Marcello Suarez-Orozco, Harvard University Press, 2002, 206 pp.. Am. J. Psychoanal., 64(2):219-222.

October 14, 2019 — Homelessness In Seattle

Presenters: James Basinski, MD, Ashley Proto

[16 pages]

We will consider psychodynamically informed approaches to understanding and working with homeless individuals. We will provide specific case examples individuals to illustrate issues around homelessness in contemporary Seattle, while facilitating discussion of class participants’ reflection of this topic and their own work with socioeconomically disadvantaged individuals.

(Possible) Discussion Questions:

  • How has American homelessness changed with demographic and socioeconomic trends from mid-20th century to contemporary times?
  • Who is affected by homelessness in Seattle?  What are some contributing root causes?
  • What are the three dynamics that Farrell theorizes contribute to perpetual homelessness?
  • How can clinicians apply psychodynamic theories/skills to working with people with homelessness in mental health settings?
  • What does the ‘Psychoanalyst in the Community’ look like for helping more socioeconomically disadvantaged and underserved populations?
  • Your Questions/Associations!

Farrell, D.C. (2010) The Paradox of Chronic Homelessness: The Conscious Desire to Leave Homelessness and the Unconscious Familiarity of the Street Life, Journal of Human Behavior in the Social Environment, 20:2, 239-254.

Optional Reading

May 2019 News Release - Homelessness in Seattle/King County

A news release from the last homelessness count in Seattle/King Country from this year.

Count Us In Report - 2019

Pages 8-12 of the 120 page report of the Count summarize the place, forms of homelessness, and various demographics of the very diverse homeless population in our area.

Crosscut, Sept 2, 2019: "Seattle is addicted to bad narratives about homelessness."

Crosscut, Sept 26, 2019: "What seems like an intractable crisis doesn't have to be. Here are ways to solve homelessness."

These are links to brief Crosscut articles that address some root socioeconomic causes (and potential solutions) for homelessness in our area.  We will likely not be addressing this much, but understand that analytic oriented therapists frequently like to think of ‘root’ causes of any problems!

October 21, 2019 — Talking With A Dying Patient

Presenter: Píyale Cömert, PhD

[13 pages]

Allan, M. (2017) Working with a dying patient and the power of the patient analyst bond. Psychoanalysis, Self and Context, 12:131-143.

By discussing the Margaret Allen article, we hope to have a deeper understanding of how to work with a dying patient (or an elderly patient who is contemplating their eventual death) and how the experience impacts the analyst as well as the patient. Please give some thought to elderly patients you have worked with or patients who have stayed in therapy for a long time whose aging (as well as your own in relationship to the patient) you have witnessed. Please consider sharing these experiences so that we can have a richer understanding of:

  •  special therapeutic needs of elderly patients
  •  the impact of aging on our patients,
  •  the impact of aging on us as human beings and as mental health providers,
  •  the impact of aging on our work.

Optional Reading

Gawande, A. (2014). "Letting go" in Being Mortal, Medicine and What Matters in the End. New York: Henry Holt and Company. pp149-190.

Atul Gawande’s chapter is informative and thought provoking. It is not required reading. However, if you are able to read it, it would provide a valuable angle for our class discussion.

October 28, 2019 — Reflection And Discussion

This class will be an opportunity for us to consider together the meaning of this experience for your development as clinicians.

Has this course impacted you personally and/or professionally? How?

What has been useful?

Do you have other comments, suggestions?