FORUM
Psychoanalysis as Counter-hegemonic Practice
Nancy CARO HOLLANDER
Presented at APsA, September 2021 Roundtable: Ideology and Psychoanalysis We are living in a period of great upheaval. The psychological significance of multiple social crises is increasingly the subject of psychoanalytic research and a focus in clinical practice. As we consider how social structures and ideologies are core components of mental life and sources of mental suffering, a social psychoanalysis challenges ideological tradition within our profession. I want to begin my comments today with a brief clinical vignette to show the tenacity of the psychoanalytic politics of neutrality, which I believe sabotages our ability to engage patients in exploring how we are implicated subjects in the reproduction of asymmetrical relations of power, based on class, race and gender and sexuality. Some years ago, Liza, a cis-gender White social worker in her late-thirties, then six months pregnant, came to our session still upset about her experiences the previous evening at a good friend’s birthday party. Liza had grown up with this group of women, having shared the privileges of an upper middle-class life. While these women had all married wealthy men and were stay-at-home moms, Liza had a history of failed relationships and a lower middle-class lifestyle resulting from her employment at a financially strapped community mental health agency. Her feminist politics and social conscience had been undermined by her envy of her privileged female cohort and what she saw as her personal inadequacies. These states of mind had constrained for a time her ability to act on her wish to have a child. After several years of treatment, however, Liza had decided to become a single mom by choice. In this session, she bitterly complained that after an exhausting day’s work she been obliged to stop at a market on her way to her friend’s party to purchase a needed last-minute item. As I listened, I realized that she had crossed the much-publicized picket line of militant grocery workers, the majority of whom were Black and Latinx women on strike for a livable wage and health care benefits. Given Liza’s social conscience, I was dismayed at her having crossed the line and shocked that she did not comment on it, especially since the strikers’ demands paralleled her own discontent with her employer’s anti-labor policies. I said nothing, fearing that if I did, I would be breaking the psychoanalytic prohibition against imposing my own concerns on my patient, especially when her attention was directed elsewhere on her regret about not having a partner with whom she could share the excitement of her pregnancy and anticipated parenthood.
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I’ll return to this vignette in a moment, but I want to point out that my reluctance to speak represented an ideological psychoanalytic enactment, one stemming from the neutrality principle that in this case foreclosed our exploration of our respective and overlapping identifications and social locations related to race and class. From my perspective, this moment represents the limits of psychoanalysis when its goal is construed as helping patients achieve increased efficacy and gratification in their personal lives with little consideration for their – or our-- status as implicated subjects in a class-stratified and racialized social order. I suggest that this is a significant ideological problem, especially when the analytic pair is white and middle class. It also signifies the impossibility of operating outside the state of implication. What I hope to show is that neutrality is an illusion, that what we say and don’t say, what we do and don’t do, always communicates something that for the patient is permeated with psychosocial meaning. 22
DIVISION | R E V I E W
SUMMER 2023
Ideology has been theorized historically from a number of perspectives, but I want to mention several theories I find useful for our discussion today. Italian Marxist philosopher Antonio Gramsci conceptualized ideology as a component of hegemony and postulated that the ruling classes govern by securing consent from those they subjugate through the latter’s internalization of the dominant social symbols that permeate civil society. These symbols are transmitted through social (state) apparatuses, including the family, religious groups, the legal professions, civic organizations, the media and so forth, all of which generate an allegiance to the predominant social institutions. Within each ideological apparatus, Gramsci argued, intellectuals – like us—articulate and transmit the discourses of hegemony. He emphasized that hegemony is composed of a variety of ideologies in contestation with one another, just as together they serve to solidify the existing system. He saw ideology as not just a system of ideas but a lived, habitual social practice that encompasses the unformulated dimen-
