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Psychoanalytic theory and practice, until recently, have reflected a Western, white, and upper middle class bias. While holding its postulates to be universal in application, it has ignored, if not subtly derided, psychological concerns of the Eastern, the “colored,” and the poor people. The following statement by Rose Marie Perez-Foster acknowledges this prejudice of our profession in a point blank and pithy manner:
Our hidden shame is that psychoanalysis has a very defined view of life and how it should be lived, and it is this perspective that determines who is to be treated, who is analyzable, who has adequate ego strength, who can meaningfully relate to objects, and who is capable of exploring his or her deep inner self. We see those who do not fit into our life program as “simpler people” who have limited or narrower life goals, “poor people” who are too consumed with the reality-based problems of daily survival, or “foreign people” who come from alien cultures or alien neighborhoods and simply do not fit the picture of self-actualization as we define it in our psychoanalytic culture. (1996, p. 3)
Fortunately, notions regarding the non-applicability of psychoanalysis and psychoanalytically derived psychotherapies to poor, ethnic minority, and culturally diverse immigrant patients are coming under increasing challenge. Arguments previously forwarded that such patients lack sufficient individuation, do not have the capacity for self-reflectiveness, subscribe to animistic belief systems, and are enmeshed with their families of origin are now either deemed invalid or regarded as not constituting major contradictions to psychoanalytic treatment. An increasing recognition of the ethnocentric biases of psychoanalytic developmental postulates and treatment methodology (Moskowitz, 1996; Perez-Foster, 1996; Rendon, 1996; Roland, 1988; 1996), as well as an emergent theoretical and technical pluralism in psychoanalysis are together responsible for a greater spirit of clinic