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On the Radical History of Psychoanalytic Liberation: An Interview with Daniel José Gaztambide

To immerse yourself, as I did over the Christmas break, in Daniel José Gaztambide's new book, A People's History of Psychoanalysis: from Freud to Liberation Psychology is a thrilling experience indeed. It is a deeply fascinating book uncovering all sorts of links and connections, possibilities and prospects, some realized, some thwarted, some both. Above all, I walked away with a rejuvenated sense that the original psychoanalytical movement was indeed much more socially radical in its vision and hopes than many of its successor personages and institutions were and are, with their turgid, hide-bound bourgeois orthodoxies that have made so much of psychoanalysis and psychology alike the preserve of respectable middle-class white people. I also found a kindred spirit in the author who ranges clearly and comfortably over the borderlands between psychoanalysis and theology, seeing in both a vision of social liberation far more radical than reactionary apologists for both disciplines often realize. 

I contacted the author by e-mail about his book, and here are his thoughts:

AD: Tell us a bit about your background

DJG: I’m originally from San Juan, Puerto Rico, born and raised in the Hato Rey sector of the metro area. My father is a “Brown” Puerto Rican man, and my mother was a White Cuban refugee from the Cuban Revolution. They were both heavily involved in our church community, Un Ministerio Sanador por Una Iglesia Sanadora, “A Healing Ministry by a Healing Church,” where my mother worked closely with our pastors. Our church, which had a orientation of healing and restoration toward the community, was very psychologically minded. 

My mother would read me books on psychoanalytic diagnosis, including from a theological perspective. Although she barely had a middle school education, she, along with my pastors, were the first to introduce me to psychoanalysis. I bring that up because one of the first things I encountered when I came stateside was this strange idea that psychoanalysis, in its essence, was too “Western,” classist, racist, sexist, and culturally incongruent with the worldviews of global south and colonized peoples. Not so under the mango tree of my childhood, the roof of my church, or the care of my community. Psyche, per Freud’s use of the work seele, was the soul if not it’s expression. 

But aside from being introduced to psychoanalysis at an early age, was the function of psychoanalysis—to put the unspeakable into words. And there were many things that were unspeakable in Puerto Rico, because de eso no se habla, “we don’t speak about it.” And the Puerto Rican was wrapped in many silences—around race and the meaning of my father’s Brown body and my White body, around class and the brutal inequality of the colony, around sexuality and the invisibility of women’s sexuality, and LGBTQ people as human. How is it, for example, that Puerto Ricans are “three harmoniously integrated races” yet Blackness is perpetually erased? Putting those questions and unspoken realities into words, in the clinic and the streets, are the impetus of my work. In some ways, my existence.

AD: What led to the writing of A People's History of Psychoanalysis: from Freud to Liberation Psychology?

DJG: The first seeds of this work started in my time at Union Theological Seminary in NYC. I was in the Masters program, which was an academic as opposed to a ministry-oriented degree, studying the intersections of psychoanalysis and liberation theology and psychology. I had been introduced to Paulo Freire’s work, the Brazilian educator and contributor to critical pedagogy and one of the inspirations behind Ignacio Martin-Baro’s book, Liberation Psychology, and was in the seminar library trying to find Jessica Benjamin’s book Bonds of Love. I had noticed all of these parallels around intersubjectivity, the teacher/student and therapist/patient relationship, and social justice, and thought that might be the beginnings of a project integrating psychoanalysis and Liberation Psychology.

I literally stumbled over a stool! And that stumbling brought me eye level with a copy of Elizabeth Danto’s Freud's Free Clinics: Psychoanalysis and Social Justice 1918-1938, Reading that work along with Sander Gilman, and realizing that the first generation of psychoanalysis was predominantly left-oriented Jews marginalized as racial others within the turn-of-century European world, blew my mind. Maybe, I thought, there were more than parallels between psychoanalysis and Liberation Psychology.

Later, when I was a doctoral student in clinical psychology at Rutgers, I was connected to Dr. Danto via an adjunct lecturer and later professor at the Silberman School of Social Work at Hunter College. She was my supervisor there, so I had an opportunity to explore these themes in-depth as I was beginning to write the papers that would inspire the book. It was liberating in a way, to find a story of Freud not at this impenetrable “guru,” a bastion of White male European enlightenment, but as a man negotiating the complexities of race, class, gender, and sexuality—as a matter of survival.

As I was reading about Freud’s cultural context, I discovered a number of contemporaries of both Freire and Erich Fromm who noted the ongoing dialogues between the two of them. Freire’s and others’ account of how Ivan Illich connected Freire and Fromm in Mexico City was powerful to me. In particular the moment when Fromm remarks that Freire’s critical pedagogy was essentially a historical-socio-cultural psychoanalysis. Noting Freire’s repeating citation of Fromm’s books was striking, as it was the first suggest that, actually, psychoanalysis and Liberation Psychology did not just have certain parallels. One actually flowed into and gave roots to the other. Learning how Fromm had originally studied with Otto Fenichel, another leftist psychoanalyst from the second generation who wrote quite cogently about race and class, became the first tributary connecting Liberation Psychology to psychoanalysis. First of many others.

Once, I was sitting with Doris Chang, a mentor and colleague who is more Cognitive-Behavioral, for lunch. As I was sharing all these connections I was discovering she got excited telling me that “It sounds like you’re writing a people’s history of psychoanalysis!” A la Howard Zinn. That was the “aha” moment. The rest, pun intended, is history.

AD: I loved your passage from Freire about how it is not a matter of thinking for the oppressed, but with them. (pp.xxviii-xxix). And yet how quickly did much of psychoanalysis in this country especially seem to revert to a model of "doctor knows best," setting up the kind of over-under relationship between analyst and analysand. This, as you show, was especially contrary to what Ferenczi in particular was attempting. Tell us a bit about his contributions to a psychotherapy of the people, and why that seems to have had a hard time taking root in the USA.

DJG: Ah, this gets at the other tributaries flowing from psychoanalysis to Liberation Psychology! One of the things Fromm did, both prior to and after his coming to America and then Mexico, was read and aggressively defend Ferenczi against the character assassination that took place after his and Freud’s death.

Let me make a few general comments—Freud and Ferenczi, both in their personal correspondence and their writing, talked very openly and cogently about race and class. People often write about how Freud dissociated himself from Jewishness, especially in bringing up race in his writings. That is not true. The story is much more complicated and tragic than that. Freud and Ferenczi were very aware of their Jewishness in an anti-Semitic world, and very aware of how anti-Semitism intersected with anti-Blackness and capitalist exploitation—dynamics which found their way into psychoanalytic theory. 

Ferenczi’s first writings on introspection and internalization were not primarily about parental object-relations, but about the internalization of social class. In particular, the sense of guilt that accompanies “moving up” in the world, and the precarity that even the position you now reached can be easily lost, tumbling you back down to “the bottom.” Similarly, some scholars note that Freud did not interact with any Black people on his infamous visit to the U.S. And yet, Ferenczi and Freud wrote to each other—Do you notice how they treat Black people in America the way they treat us Jews in Europe? How can that be, if they didn’t interact with, or see any African-Americans during their stay? 

If we understand that what is fundamental to anti-Blackness is not only the projection of aggression and animality, but the erasure of Black people’s humanity—especially the capacity to have a mind—then the analogy they drew is obvious. As if to say, “Do you see how Black people are erased in America, the way that we Jews are erased in Europe?”

Freud and Ferenczi shared a theory of how society becomes internalized within the individual, and how those who are framed as enemies of society—working class gentile Whites, for example—can be turned into the very vehicles of society’s violence. How they theorized the internalization of oppression is key and foundation, including to Liberation Psychology. When these dynamics entered the analytic session, that is where they began to part.

Ferenczi considered the possibility that he, no matter how warm or empathic as an analyst, could eventually “commit an act of murder” toward the patient that enacted their original trauma. Thus, he inaugurated a whole new way of thinking in which the analyst is not just a passive recipient of parental, cultural, or societal projections, but an active participant with them. If the analyst could be open to the patient, and think through this repetition not for them, but with them, and take ownership of their contribution, then a real sense of trust could develop--specifically, a trust in the analyst’s mind. 

Fromm, in reading and learning from Ferenczi, was one source transmitting this very same ethic to Freire, who more fully expanded on how this process was not only healing, but emancipatory, bringing the social world itself into view. After all, Ferenczi wrote to Freud on how in their analyses they discover the real conditions of society, as they are mirrored in the individual.

This idea, that the analyst could be vulnerable and open up their mind to the patient, was anathema to Freud. Although we know he was capable of being very warm and caring toward his patients, he was allergic to the thought of real vulnerability with them. We know, for example, that he found patients’ maternal transference to him to be disorganizing. Freud, a caring mother? Perish the thought! This belied an ambivalence toward vulnerability, but everything else associated with it in the social unconscious—femininity, homosexuality, Jewishness and Blackness.

Ferenczi, and Lacan himself recognized this to an extent, representing the best of what psychoanalysis could be—a process of open exploration where the patient, perhaps for the first time, could interrogate their relationship to the Other including the analyst, and discover new limits within which their freedom could be actualized. Not freedom in the sense of “liberty,” or participation in the market, but the freedom to choose in a new way. Freud, Ferenczi, and Lacan exemplify this ethic at different points—Thou art that. 

America wasn’t having any of that! The refrain from American analysts was always, yeah, but aren’t we supposed to educate the client? Give them a new moral framework? Make them good citizens of society? No, said Freud, Ferenczi, and Lacan. Not if that means imposing the analyst’s will as a vehicle for the will of society. They would have been in agreement, I think, with Martin Luther King’s address to the American Psychological Association. Not adjustment to an unequal society that pathologizes “maladjustment,” but the pursuit of “creative maladjustment” should be the north star of our field.

In brief, the ego psychological turn toward adaptation to an “average expectable environment,” the destruction of the psychoanalytic left and trauma of the Holocaust, the pressure in American medicine at the time toward assimilation to Whiteness, and the “Red Scare” all created conditions that turned Freud’s ambivalence toward Whiteness and Blackness into a disciplinary boundary. American psychoanalysis became White. Whiteness and toxic forms of masculinity, as ideologies that stress invulnerability, perfection, and autonomy, do not mesh well with a psychoanalytic stance that stresses vulnerability, humility, and our fundamental connectedness to each other, and the Other’s desire. 

In that sense, Freud and Ferenczi died twice.

AD: The 1918 Budapest congress is, you show in detail, a pivotal moment in the move of psychoanalysis out "into the streets" as it were. Tell us a bit about those developments at and after the congress.

DJG: Absolutely critical. There were a number of intersecting issues here. One was the aftermath of the First World War, and the exigencies of social democracy in rebuilding devastated economies and communities. The other was the proliferation of technical approaches to psychoanalysis, adapting treatment to working with war veterans and multiply traumatized working people. In essence, the war pushed psychoanalysis to define and re-define itself.

On the one hand you had folks like Ernst Simmel, who used “cathartic” technique in ways reminiscent of contemporary exposure therapy, and Ferenczi who, under Freud’s supervision, employed techniques we would today recognize as behavioral activation, exposure and response prevention. Both found that far from “corrupting” the psychoanalytic process, such “active” interventions—active not because the analyst was active, but because the patient engaged in new activity—freed up unconscious material that could be processed in the transference. Freud himself recognized you could only talk about a phobia for so long. Eventually, the resistance against approaching the phobia needed to be addressed--often through what was essentially “homework.”

This conference blew the doors open on a whole new world of technical experimentation which included brief psychotherapy. Also on Freud’s mind was how social democratic states could support psychoanalytic treatment to make it accessible for all. His “psychotherapy for the people,” can be read a “psychotherapy for all.” Public policy, clinical technique, theory, and social justice intersected in fascinating ways in Freud’s speech. Much of this innovation, however, was functionally destroyed by the “Aryanization” of the psychoanalytic free clinics, the Americanization of psychoanalysis—White supremacy on both sides of the Atlantic—and Freud and the other early analysts attempts at survival. In the end, Freud and others chose to “Whitewash” psychoanalysis, betraying the spirit of the theories they had developed, while enacting the very problems they were trying to solve.

Psychoanalysis went from a discourse that challenged social oppression, into becoming its vehicle.

AD: I have several beloved colleagues who describe themselves as Adlerians, and I have always understood Adler to have been much more focused on socioeconomic questions than those in Freud's early circles were often said to be. Yet he is absent in your narrative, as are Melanie Klein (echoes of whom I hear on p.153 in your treatment of splitting objects) and most of the British object-relations and "Middle" schools. Have your researches come across any significant contributions by Adler and British-based analysts to a liberation psychology?

DJG: To be clear—there’s no question about many other veins, tributaries, and roots connecting psychoanalysis to a social justice perspective. That would not only include Adlerians, but also Black psychoanalysts in America who developed new and revolutionary ways of thinking about race, psychoanalysis, and social justice--for example, Margaret Lawrence, one of the first African-American women to graduate from Columbia Psychoanalytic as an analyst. My project with this book focused on the "connective tissue," in both people and ideas, connecting psychoanalysis and Liberation Psychology, from Freud to Martin-Baro. Another project might explore other tributaries connecting psychoanalysis and social justice, whether they touch on Liberation Psychology or not.

This doesn't mean that Adler, Winnicott, A. Freud, or Klein aren't incredibly useful for thinking about these issues, only that they were not the focus of this book. There is some writing, for example, connecting Winnicott and Anna Freud's work in particular with the welfare state during and after WWII. Winnicott's discussion deprivation and delinquency, A. Freud's exploration of defenses, both took place in a context when British children were being literally deprived and their defenses literally bombed by the Nazis.

On the one hand, the theoretical constructs are incredibly relevant--not just parents but societies should provide a facilitating, "holding" environment. However, what Winnicott, A. Freud, Klein, or Fairbairn for that matter did not elucidate is how the broader societal environment, war or not, is not facilitating or holding for working class, immigrant, or ethnic minority populations. One's holding environment can be built upon another's depriving environment.

Neil Altman, for example, has drawn on Kleinian theories of the paranoid-schizoid position to talk about race, class, and splitting. James W. Jones has used Fairbairn and Winnicott to talk about transformative versus oppressive forms of religion.

AD: Your reading of Future of an Illusion brings out, as you say, a "complex, nuanced, proto-postcolonial psychoanalysis of oppressor and oppressed" (p.73) and thus begins laying the groundwork for a liberation psychology. This is not a reading of Future I have anywhere encountered before. Tell us how you came to it, and whether Freud's reputed hostility to "religion" made it more difficult for people to appreciate his liberating potential?

DJG: I've probably read Future of an Illusion ten times throughout undergrad, Masters, Doctoral school, and beyond! There's a bit of a game of telephone at play here--if the general consensus is that this is Freud's "religion book," and that the singular thesis is "religion is an illusion," you can wear that consensus as a lens and find that book and that thesis. But once I had made Freire, Fanon, and Martin-Baro a steady part of my literary diet, and being exposed to Danto's very different take on Freud and psychoanalysis, it's almost like I read Future of an Illusion for the first time. 

Once you read, for example, that for Freud society includes "control the forces of nature and extract its wealth for the satisfaction of human needs, and, on the other hand, all the regulations necessary in order to adjust the relations of men to one another and especially the distribution of the available wealth" (p. 6), that these two functions are interrelated, that "an individual man can himself come to function as wealth in relation to another one," that institutions "aim not only at effecting a certain distribution of wealth but at maintaining that distribution" (p. 7) you simply can't unread that! 

If, as Marx said, the "critique of religion is the beginning of critique," and that the critique of religion leads to the critique of ideology, then Freud is in good company here. My fantasy is Freud might have read Marx and not credited him! This is what is at stake in talking about religion.

To your point--most psychoanalytic critiques of Freud on religion have not picked up on the relationship he draws between religion, race, and the ideological apparatus that protects capitalism. Freud essentially is saying, "Religion is an illusion that fixes our desire on another world in heaven, in exchange for our exploitation. Maybe we don't need oppression and can create the Kingdom of God on Earth." The response, essentially, has been, "Yeah, but good religion gives us meaning, helps us get in touch with primary process and beta elements, access transitional space, have a corrective experience with a benevolent God," etc, etc.

It's not, mind you, that religion doesn't do those things. It's that the critique is almost never placed in the context of political economy--save of course, works like Carrette's Religion and Critical Psychology: Religious Experience in the Knowledge Economy. What would it be like for the psychoanalytic study of religion to "return to Freud" not only as a critique of patriarchal, idolatrous religion (per Jonte-Pace and Jones's great works), but as a specifically White and capital-informed idolatrous form of religion? Freud is clear on this--he's critiquing religion, but specifically White Christian Civilization, and how it upholds the political economy. 

In that sense, it's less about Freud's hostility to religion, and more about the desire to recuperate religion as a technology of self-actualization, which fits within a capitalist, White Supremacist mode of production. Freud and the Liberation Theologians would, interestingly, agree--this form of religion promises us mana in heaven, rugged individualism on earth, and "socialism" for the pharaohs, pharisees, and caesars of the world.

AD: Towards the end of ch.4 you note the ambivalence of Freud's legacy and recognize that while anti-Semitism and anti-Marxism blunted and destroyed the more "radical" inclinations to social justice, Freud himself also undermined the liberating program of psychoanalysis by reverting to being (in Fromm's view, as you show, which I think correct) an authoritarian figure demanding loyalty and subservient disciples. As a result, the tradition has both "emancipatory possibilities and bourgeois anti-Blackness." Tell us a bit more about that latter reality in light of "black psychoanalysis from Harlem to Algeria," the subject of your fourth chapter.

DJG: Absolutely. I think Claudia Tate's classic "Freud and his negro: Psychoanalysis as ally and enemy to African Americans" was really instrumental to my thinking here. She talks about a racist joke Freud would often repeat, "12 o'clock and no negro," referring to one of his American patients. With this joke, Tate argued, Freud evoked the anxiety provoking associations between Jewishness and Blackness on the one hand, and their contradistinction with Whiteness as the standard of the human. He evokes the association, in order to then cut it, finally collapsing it into the antagonism of Black and White. In so doing, he performatively assimilated Jewishness into Whiteness. The joke was a portable "Ellis Island" through which he could become White. 

Psychoanalysis in many respects is a theory about such transformations and displacements. While Jewishness could become Whiteness, this required Blackness to remain the fundamental antagonism facilitating this becoming as such. Blackness, in Freud, was as much a metaphor for the Unconscious, the uncanny double, and primitivity. If the work of analysis is to make the "unconscious," the "unheimlich," conscious and heimlich, and if, as Annie Lee Jones has recently written, Freud considered the preconscious between both as akin to a mischling, or mixed, "half-breed" race, then the traumatic project of at least one form of analysis becomes obvious. 

What Fenichel, Ferenczi, and others began to realize--and I think Freud began to approximate this in Moses and Monotheism--is that the call of Whiteness, "turn White or disappear," need not be the only way. What does psychoanalysis entail when you are the abject defined as non-Human, cast into a "zone of non-Being" that makes being for others possible? 

This is what Fanon wrestled with in his critique and use of psychoanalysis.  For Fanon, ultimately, to make conscious the very desire to make the Black subject become White, insofar as this betrayed a different formula, "turn White and disappear." To look beyond two options which are equally unattainable, to weep between "nothingness and infinity," means to take a leap. A leap into the abyss. A leap without faith or the possibility of arrival. A leap, which, by its radical vulnerability, introduces "invention into existence."

To put it succinctly, what becomes emancipatory about psychoanalysis for Fanon is that it leads us to question the contingencies that rule over our lives. "If you become White, then you will live," and "If you remain Black/Brown/Jewish, then you will die." But the psychoanalytic lens leads Fanon to notice that the Black subject is bound within an "omnipresent death," which renders such "If/Then" contingencies absolutely barren. Whether you become White or not, you are always already not-Human. If there is no "If/Then," then the only term that matters is "I," as in "I want," "I love," "I am," irrespective of the outcome. 

Black Theology, and here I'm thinking of James Cones' The Cross and the Lynching Tree, captures this ethic. Jesus on the cross does not look up at God, wink, and say, "We got this. I know this is part of the plan." No. Instead he says: "My God, my God, why have you forsaken me?" which gives way to a final act of surrender, "Into your arms I commend my spirit." Jesus dies. He is pierced on the side, even though he is already dead. And though dead, rose on the third day. No matter the heavy hand of empire, no matter its brutality and erasure, death has no hold over us. And why did Jesus endure that pain? Because he loved, irrespective of the outcome. 

When you're existence is a perpetual twilight, to demand that one "hopes" for tomorrow becomes an act of violence. The Fanonian ethic, psychoanalytically inflected, simply wants tomorrow, fights for it, demands it, takes a leap for it, regardless of whether it arrives. That is a level of vulnerability Freud flirted with and shied away from. A vulnerability that got Ferenczi buried. A vulnerability that made love not an assurance, but a possibility, for Fanon.

AD: David Pavón-Cuéllar's Marxism and Psychoanalysis: In or Against Psychology is rather scathing in its view that much, perhaps most, of American psychology has hopelessly sold out any interest in social justice to become a totally bourgeois institution concerned with protecting its own power and prestige. Do you see figures in American psychology today who would not be guilty of such a thing, who would be, in your terms, active in or at least supportive of liberation psychology?

DJG: Yes and no. On the one hand, there are those who truly take a consistently decolonial perspective in their work. On the other, to put it bluntly, are those who simply want a more diverse elite. Let me be clear--this not about people being perfect, or some unreachable notion of ideological purity. 

There is a very dangerous alliance between a White liberal desire for a performance of diversity and social justice, and a very specific, professional-managerial group of people from marginalized backgrounds who use that desire to climb up institutional structures, and then kick the ladder behind them. To paraphrase the late activist and podcaster Michael Brooks, a world in which White liberals can simply say "I acknowledge my privilege, now can I keep my money?" is a world that leaves rampant inequality virtually untouched.

The answer, of course, isn't just more ladders, but seriously questioning and deconstructing--here I mean literally tearing down--structures of power. 

If the best possible world we can imagine is one in which Puerto Rico is still a colony under the U.S. in which those Puerto Ricans who are wealthy and White--or can pass, or are light enough--can have, but the overwhelming majority have-not, with egregiously high levels of unemployment and underemployment, poverty, community violence, food insecurity, ecological precarity, and so on, but hey, here's Daniel Gaztambide. He made it, and so can you if you work hard enough and have resilience, optimism, and grit! The silent signifier here is, of course, and if you didn't make it, what's wrong with you? 

That is an extremely dystopian and fatalistic reality. We don't have to jockey with one another for position and status. When we do, the only ones who suffer are ourselves and our communities. When we are divided in this way, our mind shuts down, focused on the question of "Who am I?" and "Where am I in the hierarchy?" It would be great if the outcome was the realization that the hierarchy itself is itself. But more often than not, we become obsessed with climbing the very hierarchy that hurts us. No sense of solidarity is possible.

This brings us to Asad Haider's discussion of "insurgent universality," which I read through Liberation Theology's preferential option for the oppressed. It's not that I, being Puerto Rican, have access to some essence or special knowledge that should be privileged. It's that when I look at my experience, and my community's experience, of colonization I realize, wait a minute, Europeans came to Puerto Rico looking to conquer and accrue wealth. 

The indigenous Taino people and African people kidnapped from Africa fought back, furiously and at times creating free nation states. When free Black people, enslaved Black people, and the growing multiracial population all realized that the creole White and Spaniard class were full of shit, they rebelled. In each of these instances, the colonized constructed and weaponized notions of race and Whiteness to cripple slave rebellions and worker uprisings. Stories like these, although particular to Puerto Rico, have been enacted in some fashion throughout history. The history of the United States is a case in point.

It is not that I have to discover some hidden particularity to set against universality. Nor that I need to "surrender" my particularity in favor of an abstract universal. It is that within my particular story lies a universal story. When I state, for example, that I stand for the liberation of Puerto Ricans, built into that statement is the specificity of Afro-Puerto Ricans, of LGBTQ Puerto Rican Women, of working class Puerto Ricans. How is the Puerto Rican struggle, then, not also at the same time a workers struggle? A Black struggle? A struggle for women's rights? A struggle for trans revolution? My debt is both to Haider, and historically to the work of the Combahee River Collective. It was the ethic I heard in the halls of Union Theological Seminary: we are not free if we are not all free. And all must of necessity, the center the fight against anti-Blackness in said struggle. To learn from Freud's hubris, in a way.

If mentalization, simply put, is our ability to reflect on 1) the thoughts, feelings, and behaviors of the other in context, and 2) recognize the opacity and unknowability of the other, then political mentalization is our ability to reflect on self and other in a political context. As Freire argued, when we conscientize, we become able to read to the world. Because language also fails us, we begin to ascertain the world's indecipherable otherness. We begin to dream a new world that is not promised and is fundamentally unknown. We simply, in dreaming, want and demand a better one.

AD: Sum up your hopes for the book and who especially should read it.

My hope is people will get a different take on what psychoanalysis fundamentally is, and how it can inform how we think about power and politics in and outside the consulting room. 

I would say primarily graduate students, as my graduate school experience is really where the book came from. But also those interested in how the relationships between psyche and politics was conceived, from Freud to Martin-Baro.

AD: Having finished the book, what projects are in the pipeline now?

DJG: Currently writing a lot about anti-Blackness in psychotherapy, and racial identity among Puerto Ricans. I'm working on a treatment guide on working with race in complex trauma and personality disorder treatment, which is more of a clinical application of the ideas in A People's History of Psychoanalysis.

The Ethical Visions of Psychotherapy

I have just finished a short but fascinating book by K.R. Smith, The Ethics Visions of Psychotherapy (Routledge, 2020), 112pp. Imagine, if you will, Charles Taylor teamed up with Alasdair MacIntyre and Smith to write this book. It explores crucial philosophical issues that Taylor and MacIntyre have been rightly celebrated for over the last several decades, but which mainstream psychology and psychotherapy have all but totally ignored. Smith unpacks those issues, and the costs of their neglect, and the promises and prospects of exploring them in the years ahead by and for psychotherapists. To do all this in short, accessible, polemic-free book is a masterful achievement. It is the sort of book that belongs on the bibliography of every introductory psychology and psychotherapy course. 

Here is the publisher's blurb:

The standard view of psychotherapy as a treatment for mental disorders can obscure how therapy functions as a social practice that promotes conceptions of human well-being. Building on the philosophy of Charles Taylor, Smith examines the link between therapy and ethics, and the roots of therapeutic aims in modern Western ideas about living well.

This is one of two complementary volumes (the other being Therapeutic Ethics in Context and in Dialogue). This volume explores the links between therapeutic aims and conceptions of well-being. It examines several cognitive-behavioral and psychoanalytic therapies to illustrate how they can be distinguished by their divergent ethics. Smith argues that because research utilizing standard measures of efficacy shows little difference between the therapies, the assessment of their relative merits must include evaluation of their distinct ethical visions.

A key text for upper level undergraduates, postgraduate students, and professionals in the fields of psychotherapy, psychoanalysis, theoretical psychology, and philosophy of mind.

I will have more to say about the book in due course, when I also hope to have heard back from Smith with some questions I sent to him for an interview on here. Stay tuned!

Louis Cozolino on the Making of a Therapist

I don't remember exactly how I came across Louis Cozolino's The Making of a Therapist: A Practical Guide for the Inner Journey, but I am very glad and grateful that I did. He has written an extremely useful book in a cogent and accessible fashion. I would be very tempted to use it if I ever teach a course on, say, introductions to counselling and therapy. 

He begins by noting that would-be therapists need to be encouraged not to "stay above the neck" in how they relate to their patients: "the more fearless we become in the exploration of our inner worlds, the greater our self-knowledge and our ability to help our clients" (xvi). Such inner exploration is necessary because that world is a crucial tool: "the private personal world of the therapist is, in fact, one of our most important tools" (xviii). The fact that this is so little taught today, Cozolino says, is a great loss to all concerned. And we mustn't resist doing this, for, as he says a little later, "to accept our clients, we have to first learn to accept ourselves. This can be the biggest challenge of all" (15).  

His first chapter reiterates what I have seen so often, and recently written about, in Nina Coltart: the therapist, for much of the time, must live with not knowing, not being certain, not having clear ideas of what is going on. This is not to be shunned or feared. 

Arranging the Consulting Room:

Chapter II has some very practical tips on getting centred in order to get started. He says that one must pay attention to one's consulting room and its set-up to ensure a comfortable, calm, mindful environment for you as well as your patient. I wrote rather at length about such matters here. He says it's best not to have chairs directly facing one another, and to give people options for sitting, asking them from time to time about how they feel being in the consulting room with you. He also says there's nothing wrong with modifying arrangements if people need or request it.

Communicating:

As you are going about your day, schedule yourself to allow for breaks and to ensure you are not rushing. Equally or even more important: do not rush to fill in gaps, but allow for silence. When you do talk, keep it simple and short. This good advice, much confirmed by my recent supervisors, led me to adapt something I heard in another context:

  • Be blunt
  • Be brief
  • Be quiet. 

Maintaining the Tension:

Good therapy, Cozolino says, is always going to find itself stretched between several poles:

  • Nurture and Challenge
  • Comfort and Stress
  • Affect and Cognition

In addition, it should have the goal of increased affect regulation and the creation of new narratives about the self. 

Treatment Plans:

These will flow out of your theoretical orientation, he says, and are constructed backwards, from goals to interventions. Keep them clear, straightforward, and open to revision in dialogue with your patient.

Notes: 

Keep them very short and say nothing critical that you would not want the patient to read.

Loving Defenses, Patiently:

What Cozolino writes about appreciating the role of resistance and defenses puts me in mind of Auden's poem "In Memory of Sigmund Freud," which I love, especially these lines:

he would have us remember most of all 
to be enthusiastic over the night,
     not only for the sense of wonder
   it alone has to offer, but also

because it needs our love. With large sad eyes
its delectable creatures look up and beg
     us dumbly to ask them to follow:
   they are exiles who long for the future

that lives in our power, they too would rejoice
if allowed to serve enlightenment like him.

One thing I have realized over the past year is that we must come even to love the defenses for they once served a useful purpose that has since become maladaptive. Cozolino says that if patients see your appreciation of their defenses, they "will be more wiling to explore alternative ways of being" (76). All this will be slow-going with, he says, some "backsliding." 

Resistances, too, have their rewards, not least because they often point quite clearly and directly to what is most painful and difficult that might hitherto have been closed off to and hidden from us. This may also be true of conflicts in the therapy. Don't be defensive about defenses, about conflicts, about resistances. That will serve nothing and nobody. To launch a frontal attack on defenses is to ensure they deepen. 

Negative Therapeutic Reaction and the Death Drive:

Cozolino has clearly been influenced by the psychodynamic traditions, but he wears them very lightly. He raises "the very success of therapy" will unsettle some people and cause regression, or even destruction and early departure. All this is, he says, a "common occurrence" (119). (Freud certainly saw it, not least in Beyond the Pleasure Principle.)

Counter-Transference and the Desire to Sack:

Cozolino offers some helpful advice in sorting out the desire to fire or sack a patient. This may be legitimate--you are a bad fit, or lack the skills for this particular disorder, or are in an impasse. But it might also be caused by the patient who needs to try to get you to fire him or her, creating, yet again, their past experience of abandonment. This requires careful discernment on your part, and perhaps some supervision if necessary.

In his ninth chapter, he introduces the very useful image and concept of shuttling. This is "up into your head, and down into your body" as you monitor counter-transference reactions. You shuttle from mind to body, and then from you to your patient and back again. He offers very concrete guidance here, saying you should do this if you've felt disconnected, or been tuned out, confused by what the patients is said, or fearful or anxious. He often shares the results of these shuttlings, especially if a particular strong feeling or image surfaces. Sometimes these can provoke really stunning responses; at other times they miss their mark. In any case, he allows the patient to "accept, reject, modify, or ignore" the results of the shuttling, saying that if it is rejected, just let it go because hanging on to it will not serve any purpose.

Dreams: The Royal Road to Whose Unconscious?

Cozolino has a brief section on the use of dreams, noting that patient's dreams are of course useful and important, but so are the therapist's. He gives a compelling example of how one dream of his enabled him to pick up on a deeply buried part of his patient's life, endlessly denied, and eventually nudge this trauma out into the open.

Wordiness Should Make You Wary:

Patients will try to recreate other relationships in the therapeutic relationship. One such will be the excessively wordy person who appears to be describing things--even feelings, or traumatic memories--in great, and greatly wordy, detail. This can be a trap and so Cozolino says we must not "mistake a barrage of words for openness and vulnerability" (143). 

The Vocation and its Enjoyment:

Cozolino ends this excellent book where he began, saying that your self-acceptance (and self-care, which he stresses in the penultimate chapter) will be key to your flourishing in the vocation of therapy, which must not be allowed to become all drudgery but should be an occasion (as Coltart and before her Winnicott above all said) where patient and therapist can enjoy one another (at least some of the time). 

Healing Sexually Betrayed Boys and Men

Last year I reviewed a manuscript for Routledge and in exchange for my labours took my remuneration in books, including a copy of this book: Richard B. Gartner, Healing Sexually Betrayed Men and Boys: Treatment for Sexual Abuse, Assault, and Trauma (Routledge, 2018). 

It is the second volume, a companion to Understanding the Sexual Betrayal of Boys and Men: The Trauma of Sexual Abuse (Routledge, 2017).

I have not read the 2017 volume, but on the strength of the second, I will be doing so.

Healing Sexually Betrayed Men and Boys is a very rich collection, only some of which I can hope to convey here. It certainly belongs in the hands of every man or boy who has been victimized, but will be equally valuable to their partners and family members, and of course to clinicians of all traditions. There is a great deal of solid research conveyed here as well as some pioneering programs, and reflections of those pioneering clinicians themselves. 

The book is divided into four sections, with a total of fifteen chapters. Most are written by US clinicians, but several are written by clinicians in Canada, including one, Rick Goodwin, based in Ottawa, where I did my initial training in psychology and underwent psychoanalysis. So his chapter was of special interest to me.

The first section looks at general and global issues in treating men who have been abused. The second looks at focused treatments, including a new program, Weekend of Recovery, and a resource-rich website to which it is connected, MaleSurvivor.org. The third section, "Women in the Picture," looks at female therapists working with male survivors as well as female partners of the same; there is also a section on same-sex partners and their unique challenges. In this section also is a chapter on covert seduction, about which more in a moment. 

The fourth and final section is a rare look at perpetrators who are also survivors/victims, and the very great difficulties that arise when trying to find placements for such men to be treated. I will return to this again later. Each section, and nearly every chapter, also contains often harrowing case material of patients the authors have treated over the years. 

Let me just highlight three chapters while, again, encouraging all those with interest in this area to read the whole book. 

The fourth chapter, co-authored by Howard Fradkin and Jim Struve, "Empowering Male Survivors to Heal through Community and Peer Connections," contains a new model that I have found fascinating. Based on their belief that group work is a crucial adjunct to individual psychotherapy, the authors proposed, plan, and have helped host Weekends of Recovery around the world since 2001. "While not considered therapy, the weekends often have therapeutic benefits," the authors say (102). In this regard, A good bit of the underlying philosophy, they say, comes from that landmark book we all know and love, The Theory and Practice of Group Psychotherapy by Irvin Yalom and Molyn Leszcz; their sixth edition was published just a month ago. There is much here, it seems to me, that would lend itself to Catholic churches borrowing and adapting for similar purposes as parishes and victims try to heal from the never-ending abuse in their midst, which I have addressed at length elsewhere

Chapter 11, "Covert Seduction and its Effect on Boys and Men," by Kenneth Adams is deeply interesting, raising a concept I have never heard before: covert seduction, where boys are used emotionally and sexually without actual physical sexual contact in most cases: "you can be sexually abused without being sexually touched" (214). One example of this he focuses on later in the chapter is exposure to pornography, especially at an early age. Other examples include bathing and toilet rituals as well as expecting boys to fulfill emotional and sexual needs of their mothers in the absence, or as rivals to, husbands and fathers. 

The damage this can leave is very real, serious, and long-lasting in many cases, resulting in guilt, schizoid-like detachment, shame, ongoing struggles to detach from the covertly incestuous family member, etc. In therapy, Adams cautions several times, these victims will often be the ideal patients--docile, compliant, reporting positive effects and results. All this is in fact a sign of their pathology: they have learned compliance, docility, and the importance of manifesting positive results as a result of their abuse. 

The last section is useful in highlighting some of the challenges that come from men who were themselves victims before going on to be perpetrators. The authors cite research indicating that this number is much lower than is sometimes portrayed, suggesting it is around 12% of abuse victims who go on to become perpetrators (a number borrowed from Anna Salter's very useful groundbreaking book Predators). Additionally this section contains a helpful typology of abusers, and a section of female abusers as well. 

All told, Richard Gartner and his contributors to Healing Sexually Betrayed Men and Boys: Treatment for Sexual Abuse, Assault, and Trauma have given us many insights (each chapter's lengthy bibliography is very valuable indeed) in this rich and helpful book. I know I shall be returning to it regularly.