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Psychoanalysis as Counter-hegemonic Practice
from Division Review
by 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.
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.
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- sions of social experience, which I argue frame and lend meaning to unconscious processes (Hoare and Nowell-Smith, 1971). Gramsci’s ideas were the basis of French Lacanian philosopher Louis Althusser’s conceptualization of the paradoxical feature of our integration into culture, which he called interpellation. He argued that we are hailed by ideological apparatuses that, while providing the necessary process by which we are constituted as subjects, do so by imposing a socially constructed pre-existing identity through which we become intelligible to ourselves (Althusser, 1994). Unlike Althusser’s depiction of interpellation as eternal, Gramsci was focused on our capacity to resist and challenge it. He posited that people’s inchoate recognition of the contradiction between their real-life experiences and hegemonic ideology could, with the help of socially conscious intellectuals, mature into counter-hegemonic ideologies and political movements that challenge the oppressive hierarchical social relations in capitalism.
We might think of psychoanalysis as one component of an ideological state apparatus, which Foucault called the psi professions that have, from his perspective, facilitated adaptation to neoliberal capitalist values of individual responsibility, self-reliance, self-discipline and competitiveness as strategies for personal success. In capitalism, Foucault asserted, the psi professions’ ideological function is to develop patients’ capacities to adapt to neoliberal ideology and social structures rather than to provide opportunities to understand and contest the systemic sources of class, gender and racialized inequality (Foucault, 1977; also see Hook, 2007). Recent scholarship analyses how psychoanalytic theory and clinical principles have historically been shaped by Eurocentrism originating in Freud’s convictions of the superiority of Western cultural institutions and values. Moreover, psychoanalysis was born amidst 19th century European colonialism, and Freud adopted its racialized discourse in his conceptualization of the unconscious, still evident in our theories of “primitive states of mind” and in concepts like regression, pre-Oedipal dynamics and analyzability (Brickman, 2003). Concepts like these reflect an unacknowledged association between early mental states and non-European cultures, including black and brown psyches and bodies. Primitivity in Freud’s theorizing was also aligned with femininity, referred to as the dark continent. This orientation has been challenged by subsequent generations of critical psychoanalysts in light of their understanding of social oppression and in response to social movements, including feminism, gay rights, the recognition of multiple genders and sexualities, and most recently, the Black Lives Matter movement for racial equality. Some psychoanalysts have turned to critical social theory to contextualize in the specificities of history and culture their interpretations of the dynamics of individual and group fantasies, affects and defenses (see Aibel, 2018). Most recently, psychoanalytic research has examined how we in the U.S. emerge as subjects within a settler colonial society that since its origins has been characterized by racialized capitalism within which the dominant classes have used White supremacy to undermine multiracial uni- ty and struggles for social equity (Dadlani, 2020; Kita, 2019). This rich literature has not yet been integrated as core components of didactic training programs in psychoanalytic institutes, nor does it inform enough supervision of candidates’ clinical work. Thus, the bifurcation between psychoanalytic-informed social theory and clinical practice too often remains unchallenged.
Moreover, while White supremacy and racism in our profession have become a preoccupation of many colleagues, the ideology of class has yet to attract serious curricular attention within our institutes (Ryan, 2017). I suggest this lacuna is linked to the privatized nature of our profession within capitalism, in which we have traditionally functioned as entrepreneurs selling a service to consumers. Our own class identities and location, our incomes and lifestyles, have been based in part on our upper and middle-class patients’ abilities to pay our fees, leaving access to psychoanalytic treatment for those with limited resources dependent on practitioners’ personal ethical commitments to provide reduced fees. This relationship between psychoanalysis and its middle-class patient population has too often been ideologically justified by claims that the poor and people of color are burdened by so many daily pressures and problems that they do not have the free attention for a self-reflective engagement, requiring instead symptom-focused short-term cognitive behavioral treatments instead (see Gherovici and Christian, 2019). Moreover, our own privileged class location as professionals, (regardless of our class origins), may contribute to a reluctance to address class when considering transference/countertransference treatment dynamics. Perhaps most salient, when both analyst and patient are White and middle class, ideologies of race and class can be comfortably invisible—dissociated—as legitimate objects of psychoanalytic inquiry.
Let’s return to the clinical vignette I began with. Recall that I chose to say nothing when my politically progressive White upper middle-class but downwardly mobile patient, Liza, described having crossed a picket line of striking Black and Latinx working-class women. I believe that my decision to remain silent was an anxious reaction to my transgressive wishes to contest the ideology of psychoanalytic neutrality, the very principle I believe represents the transmission of hegemony in the clinical setting. Liza had crossed the workers’ picket line, and I had not dared to cross the ideological neutrality line. However, if I had called attention to Liza’s having said nothing about what it felt like to cross the picket line, many themes that had emerged previously in the treatment could have been reexamined, lending additional insight into Liza’s conflicts about her history and current life. Not only would familial pathology have been analyzed, but social pathology as well. For example, Liza’s childhood conflicts had revolved around her overweight and histrionic mother, experienced and depicted as endlessly greedy by her father, whose preferential love for Liza had been contingent on her ability even as a child to control her own appetites and to practice self-constraint in many areas. This oedipal configuration, in which my patient had been her father’s favorite because, unlike her mother, she could inhibit her own clamorous impulses, undermined her ability to identify with the raucous female picketers, whom she experienced as greedy -- for more wages, more health care, more recognition and more support from the public. In fact, we would later learn that my silence had been a communication, one that Liza had translated as approval of her disidentification with the assertive, demanding picketers. Thus, my silence had constituted an intervention that was anything but neutral. So, we lost a possible exchange that might have potentiated her ability, in fantasy if not in action, to combat one instance of her chronic feelings of isolation through an identification with a group of people collectively fighting for the very things she had longed for: a livable wage and quality health care. And we lost the opportunity to explore my conflicts between my White middle-class positionality and my leftist politics.
In subsequent sessions that followed the birth of her baby, Liza and I took up the issue of what crossing the workers’ picket line represented. We came to see that it involved not only unresolved familial childhood traumas, but her internalization of neoliberal ideology as well. In other words, she acted exclusively based on individual self-interest rather than in solidarity with others to challenge this society’s asymmetrical class and racialized power relations.
Moreover, we came to understand how Liza’s denigrating feelings toward the poor and people of color learned in her youth through parents, schools, friendships and the media persisted despite her progressive political views acquired as an adult. In this context, her insensitivity to the striking women workers represented a dissociative process that enabled her to assert her difference from rather than her similarity to their class and racialized plight.
Together Liza and I evolved an understanding of some of the ideologically infused meanings of her having crossed the picket line that had been previously eclipsed from our mutual inquiry. In the process of revisiting this issue, we both came to see more profoundly how ubiquitous racist and prejudiced beliefs and fantasies are, embedded in our minds in ways often unknown to us. Racism is created by the interface between external societal structures intra-psychic mechanisms, both acting together to shape and mobilize each other. Indeed, conscious and unconscious racist fantasies often organize our relations to one another through encounters with difference and the unknown Other. As we explored these themes stimulated by this clinical encounter, Liza came to resignify the striking women, now not only as the victims of poverty and exploitation, but as protagonists of their own lives who were assertively fighting against the social forces -their corporate bosses - responsible for their precarious conditions. And I, her analyst, learned about my own dissociated anxieties that in part had motivated my decision to obey the psychoanalytic neutrality rule. My conscious political alliance with the strikers and my participation in the solidarity movement supporting their strike had provoked my anger at Liza’s action. I became conscious of how in my countertransferential enactment, at least in part, my affectively infused critical attitude toward Liza represented a projection of my own disavowed fear of identifying with the desperate plight of socially denigrated, impoverished and disenfranchised working-class people of color. Ultimately, as two white cisgender middle-class women, both Liza and I were able to employ the psychoanalytic process to become more conscious of the psychological impoverishment imposed by identification with, rather than interrogation of, the hegemony of class and racial oppression.
I have used a single incident in a years-long complex psychoanalytic treatment to highlight my perspective on an important theme emerging within contemporary psychoanalytic theory and praxis on how to understand and treat the social in the psyche. I have attempted to illustrate with this clinical example the ubiquity of ideology in psychoanalysis, first in its function as interpellation and then in its potential as a counter-hegemonic engagement.
References
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Ryan, J. (2017). Class in Psychoanalysis: Landscapes of Inequality. Oxford: Routledge.
