Intersectionality, Social Context and the Co-Creation of Clinical Experience

Fourth Year Adult Psychoanalytic Training (APT)
2020-21, 3rd Trimester — Fridays, 3:30-5:00pm


Intersectionality encompasses a number of dimensions including race, ethnicity, nationality, immigration status, gender and gender identity, sexual orientation, socioeconomic class, religion, ability, age and the way in which these aspects of the self are lived in a particular social context. In this six-session class, we have chosen to focus attention on current psychoanalytic ideas about race, ethnicity and the intersection of multiple aspects of identity in the United States. We are operating from the perspective that these dynamics are present in every clinical encounter, whether or not they are consciously experienced or addressed and whether or not the analyst and patient experience themselves as similar or different from one another (along multiple axes).

At the conclusion of this course, we hope that you will read and engage with theory, clinical material and our institute with a deeper understanding of racial trauma and a deeper curiosity about layers of identity – your own and those of your patients. We have chosen articles that we hope will spark discussion and engagement. We welcome you to talk with us about your experience in class as we proceed.

In a recent presentation to the New Center for Psychoanalysis, Anton Hart noted that the idea that individuals could eliminate “blind spots” is inconsistent with psychoanalysis. In his words, “we are all blind to aspects of ourselves and if we are able to become aware of our pervasive blindness and more receptive to the presence of our biases we will be better able to persist in deep and uncomfortable conversation and listen with less chance of inflicting our biases on others.” As instructors, our hope is to encourage self-reflection and genuine engagement. We also hope our discussions will allow us to be more conscious of how power arises and can be misused, whose experience tends to be centered, whose experience may be marginalized and how this affects how we relate as colleagues and with our patients.

Learning Objectives

At the end of this course, associates will:

  1. Have engaged with current psychoanalytic ideas about the relationship between the intrapsychic and intersubjective within our social and historical context.
  2. Understand more consciously the ways in which we defensively veer away from or foreclose interpersonal and clinical moments related to difference, power and social context, which will enhance treatment persistence and stimulate institutional change.
  3. Have explored ideas about racial/ethnic identity, normative unconscious processes and their clinical applications, which will decrease misrecognition and deepen analytic process.
  4. Have greater awareness of the intrasubjective and intersubjective dynamics related to racialized enactments and understand ways of responding clinically, which will increase clinical dexterity.
  5. Have applied contemporary theory to the effects of chronic racial trauma, how white guilt is an aspect of racial trauma and the potential uses of depressive or reparative guilt in facing the reality of the harm of racial trauma.

March 19, 2021 — Intersubjectivity and Listening/Relating with “Radical Openness.”

[23 pages]

Both the podcast and reading for today’s class ask us to consider what occurs intrapsychically and what gets enacted relationally when ethnic/racial subjectivities come into contact. Hart asks us to think about how we listen and advocates an ethic of taking the other into one’s care. He notes that listening with “radical openness” involves relinquishing what we think we know and an openness to what we might not know or recognize about ourselves. His ideas about safety, risk and recognition will guide our opening discussion.

Griffin, Echegoyén and Hyman are reflecting on their time together in training. They note how the transitional space created by their multiracial cohort often involved disavowal or dissociation of aspects of their subjectivity that reminded them of their differences from one another. They comment that this was both adaptive and came with “significant losses.” How do Hart’s ideas relate to their experience? How might your cohort attend to dynamics in your transitional space in order to create a sense of mutual recognition and reduce the kind of disavowal and dissociation they write about? How do we avoid topics we perceive will make the group anxious? Our psychoanalytic elders anxious? How do we call people into a dialogue? How can there be a living/dynamic relationship with theory and practice rather than a sense of indoctrination?

Mind of State Podcast, October 28, 2020, “The Case for Radical Openness” with Anton Hart, PhD

(The link also includes a transcript of the podcast if you would prefer to read it rather than listen.)

Griffin, C., Echegoyén, R. & Hyman, J. (2020). The Secret Society: Perspectives from a Multiracial Cohort. Contemporary Psychoanalysis, 56(2-3), 282-304.

March 26, 2021 — Subjectivity, social context and racialized enactment

[41 pages]

Suchet describes a clinical vignette in which she experiences “a psychic and social space” within herself that she had not wanted to inhabit. Both Suchet and her patient have their subjective sense of self disrupted, disturbed and transformed when current and historical trauma become vibrantly awake in the outside world and in their relationship. Suchet’s description of her internal experience and the external clinical process are related to Hart’s ideas of working with a “radically open” approach. In particular, Suchet seems to say that her unfolding openness to her own “internal otherness” or those parts of herself she wished to avoid knowing was the key to her work with Ara.

Obeid and Schoen write about Obeid’s painful experience of racial enactment in two supervisory dyads, and the institutional framework and dynamics that made these enactments difficult to address. They explore how power dynamics intersect with race/ethnicity to affect conscious and unconscious choices about what is said, what gets silenced and how power is experienced in the dyad. How do Suchet’s ideas relate to Obeid’s and Schoen’s experiences?

How have themes of race/ethnicity, diversities and power arisen or been absent from your discussions with clinical consultants? How have you experienced the dynamics of recognition or misrecognition in the clinical or consultation context? How has current and/or historic trauma awakened in your clinical work and how was it managed?

Suchet, M. (2010). Face to Face. Psychoanalytic Dialogues, 20(2), 158-171.

Obeid, N. & Schoen, S. (2020). Dangerous Dialogues: Racial Enactment as the Scene of Address , Contemporary Psychoanalysis, 56(2-3), 255-281.

April 2, 2021 — Normative unconscious processes, racial and ethnic identity and clinical process

[31 pages]

Layton addresses the issues of intersectionality and identity. She writes: “does it even make sense to speak of racial identities without simultaneously speaking of the way they intersect with class, gender, and other identity categories?” She calls our attention to normative unconscious processes that bias us to see our patient as a “kind of person,” rather than a person whose identity is complex and specific. She offers a clinical example to show how these issues are revealed and avoided, and how we may unintentionally collude with stereotyping in our work.

Yi notes that theories of racial/ethic identity “conceptualize racial identity in binary terms of the White oppressor and the injured racial other.” She sees it with more complexity and notes that while racial/ethnic identity develops in the United States in a context of the white dominant culture, this is far from the whole story. She gives a clinical example of a patient whose racial identity reflected an internalization of the relational and cultural context specific to her family and her experience of her post-war Vietnamese American community.

These articles encourage us to engage with our patients as individuals, being aware of the unique meanings that race, ethnicity, class, and gender have for different people. This seems like an obvious goal, but both authors note the ways in which they initially missed the complexity of identity in their clinical work.  What are your thoughts about Layton’s idea of the “normative unconscious process” and Yi’s  ideas about racial identity? How can we apply these ideas clinically?  What is the best way to address our preconceptions, and to think critically about these issues? How does the current socio-political moment affect how we work clinically with these issues – or does it?

Layton, L. (2020). Racial identities, racial enactments, and normative unconscious processes. In M. Leavy-Sperounis (Ed), Toward a Social Psychoanalysis: Culture, Character, and Normative Unconscious Processes. (Chapter 11, pp. 147-168). New York, NY: Routledge.

Yi, K. (2014). Toward Formulation of Ethnic Identity beyond the Binary of White Oppressor and Racial Other. In Psychoanalytic Psychology, 31, pp. 426-434

April 9, 2021 — Dynamics of identification, defense and dissociation in racialized enactment

[27 pages]

Tummala-Narra writes about racism and xenophobia in the context of immigration. She notes that these issues are inevitably part of the treatment dynamic and exact a toll on both members of the dyad. From her perspective, “Working with xenophobia and racism requires a willingness to witness and engage with sociocultural trauma and defensive reactions in intrapsychic and interpersonal conflicts.” She discusses the ways in which defense and dissociation leave xenophobia unmentalized and provides two case examples of how racism affects her, her patient and the therapeutic process. As she relates these two cases, she calls our attention to the clinical question of whose narrative is privileged moment by moment in a clinical process.

Leary’s article explores the ways in which transference dynamics are enacted in a racialized context. She highlights the intersection of race, class, and mobility and the possibility of misrecognition between two people who appear similar. She writes, “I think that the most common racial enactment has been our relative silence about racial issues.” She recommends collaborative methods of analysis of transference, particularly when racial material arises, though she notes that this needs to occur in a context of earned trust.

What does it mean to encounter the “other,” within ourselves, our patients, and the cultures that we share? When and how do we make the implicit, explicit? What do you make of Leary’s notion of collaborative exploration of transference?

Tummala-Narra, P. (2020). The fear of immigrants. Psychoanalytic Psychology, 37 (1), 50-61.

Leary, K. (2000). Racial Enactments in Dynamic Treatment. Psychoanal. Dial., 10(4):639-653.

April 16, 2021 — Silence, racialized violence and the generational transmission of trauma

[29 pages]

Mid-term evaluations should be conducted in the closing minutes of your classes today. This is a discussion that should be allowed at least 10 minutes, but no more than 30 minutes. No written records are necessary.

Midterm Class Evaluation Discussion Questions

Powell writes about the connections between racialized trauma and silence and the implications of collective silence in the face of our uniquely American genocidal history. Her use of pictures in this article (the lynching of Thomas Shipp and Abram Smith in Marion, Indiana in 1930 and Michael Brown killed in the street in 2014) intentionally disrupt this collective silence. As she considers how to work clinically with racial dynamics and generational transmission of trauma, she notes both the difficulty and importance of holding in mind both the reality of social context and the psychic meaning to the patient.

The video, History and Memory (1991), brings to life intergenerational transmission of trauma by exploring what is recorded, what is left unrecorded and what is imagined in our collective memory. The filmmaker, Rea Tajiri, uses photos, movie and propaganda film clips, writing and family interviews to explore an aspect of her family’s history that has haunted her despite her family’s silence and efforts to forget.

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

Tajiri, R. (1991). History and Memory.

(The 32-minute Tajiri video is available with a public or university library card, please let instructors know if you have a barrier to accessing and we will help).

April 23, 2021 — Persecutory and depressive guilt, splitting, breakdowns in thinking and the uses of ordinariness

[26 pages]

Caflisch uses contemporary Kleinian conceptualizations of guilt, and particularly persecutory guilt, to explore what gets in the way of white engagement with responsibility, concern and reparative action. She examines the ways in which white people’s self-idealization or romanticization of sorrow result in splitting and breakdowns in thinking. Depressive guilt, on the other hand, disturbs our sense of self, allows for what is disavowed to be integrated, softens defenses and allows for the possibility of repair.

Cyrus grounds the theoretical in the real by discussing Caflisch’s paper in the context of her lived experience and the severity of ongoing racial trauma in our society. By examining the real harm caused by the dynamics of white guilt and the trauma response in those harmed, she takes Caflisch’s ideas to the interpersonal realm. She calls into question Caflisch’s ideas about repair and presents instead the notion that harm reduction is the way to address the violence of whiteness and white guilt that harms both white people and people of color.

We are ending this class with a return to ideas about racial trauma, safety, harm reduction and the integration of disavowed self-states in the service of repair, recognition and true engagement. This often means letting go of mastery and knowledge as Hart referenced in our first class. Adrienne Harris’s struggle to relinquish her ownership of Haida art epitomizes this struggle. How can we apply these ideas clinically, in our understanding of racial trauma, in our engagement with psychoanalytic theory and in our relationships within the institute?

Caflisch, J. (2020). When reparation is felt to be impossible: Persecutory Guilt and Breakdowns in Thinking and Dialogue about Race. Psychoanalytic Dialogues, 30(5), 578-594.

Cyrus, K. (2020). When reparation is impossible: A Discussion of “When Reparation is felt to be impossible: Persecutory Guilt and Breakdowns in Thinking and Dialogue about Race.” Psychoanalytic Dialogues, 30(5), 595-603.