FORUM
Can We “Treat” Racism in our Clinical Practices? In a recent talk, Steve Portugues (2021) called on white psychoanalysts “to learn how to explore race and treat racism within ourselves and our patients and to do so with compassion for the racist in us all.” He urged that analysts set aside a false idea of neutrality in the interest of identifying oppressive ideologies that distort our and our patients lives, presumably in order to demystify and expunge them. Portugues’s call is in the spirit of a growing turn in psychoanalytic practice to attend to the social dimension of our patients’ lives and is given more urgency following the murder of George Floyd and burgeoning Black Lives Matter movement. Racism hurts us all, dividing Black from white, keeping us from joining in common interest, and in this way contributes to the largest context of whatever problems in living our patients present to us. Racism is at once an omnipresent feature of our social world, and an easy thing for many white people to ignore. I admire the intention behind Portugues’s project, as well as its ambition. As Beverly Burch (2020) notes, white people’s privileged ability to avoid dealing with race leaves us ill-prepared to talk about it; Portugues seems up for the challenge. The idea that we might use the clinical space to explore and perhaps challenge racism raises many conceptual and technical questions. For instance, outside of the rare circumstance in which a patient seeks therapy to address their racism, how to raise the issue when it doesn’t arise quote-unquote “organically.” Do we wait for some relevant context to bring it up, and what does it mean, to us and the patient, if we deviate from our usual practice of following the patient to raise it ourselves. The idea that in our clinical work we might set about “treating” racism—by which I take Portugues to mean identifying racist attitudes with the aim of changing them— needs to be subject to psychoanalytic scrutiny. My reservations about this undertaking break down roughly into three areas: The question of motive; the role of the analyst’s authority; and the effect of such an undertaking on the dynamics of the therapy process and the analytic couple. I’ll consider how these factors might pertain in a white-on-white therapy dyad, the configuration in which the issue of racism is perhaps least likely to come up explicitly. In the first place, let’s hold in mind all we’ve been learning about the systemic nature of racism, that is, how racism in our era operates largely “behind our backs,” an aspect of ideology, rather than as a result of the actions of individual racists. Attacking structural racism takes the committed work of conscious antiracists, as well as smaller actions on the
Steven BOTTICELLI
Janet Passehl is an artist and curator of the Lewitt Foundation.
part of everyone. But thinking about racism in its systemic aspects should cause us to approach with modesty the scope of what it will be possible to achieve in addressing racism on the individual level. Thinking psychoanalytically, we can’t assume our motives are transparent to us. We may believe we’re aiming to uncover underlying racist ideologies in the service of the patient’s and society’s enhanced well-being, but there could be more to it. Do we identify and explore and perhaps challenge the patient, as a way of managing our anxiety and discomfort at listening to racist speech? To attempt to relieve our own guilt about racism? Jane Calflisch (2020) has written of the unbearable burden of guilt white people may experience about historical and current racism given the magnitude of injury inflicted on Black people over centuries, injuries so great that in her words reparation may well be felt to be impossible. We may want to be seen as and experience ourselves as good for addressing racism with a patient, or to reassure ourselves that we are free of, or in the process of freeing ourselves, of the contamination of racism. 19
DIVISION | R E V I E W
SUMMER 2023
Might our intention to treat racism be a way of managing our disappointment at the ordinary results of our clinical work? Lynne Layton (2006) has written that too often our work only seems to produce “happier, healthier versions of narcissism” (p. 107); those of us with a developed political consciousness might wish to achieve something more. While the impulse to make our clinical work politically relevant is understandable, might we thereby inflate it with more significance than it can really bear? Then there’s the matter of the analyst’s authority. As analysts, we are not innocent of power. We analyze, but also participate in, power. If we are to set about analyzing power, including the social conditions and psychological operations that perpetuate racism in our patients and ourselves, we need to consider the sources and effects of the power that inheres in our professional roles. It’s easy as solo practitioners sitting in our private offices to feel that we encounter our patients simply one individual to another, but in fact we operate as representatives of an entire mental health industrial complex that depends for its
