Editorial

There is a continuing question over psychotherapy's social and cultural place. The idea of the typical ‘yavi’ patient (young, attractive, verbal, intelligent) has worn thinner over the years; as well as the image of white, self-indulgent, middle-class, WoodyAllen-followers cracking at the seams. Particularly with the development of NHS psychotherapy - outside London as well as within the M25 web -class constraints have been eroded. However, the cultural divide remains fairly impervious. The proportions of black patients in psychotherapy does not seem to be commensurate with the size of that population; and certainly the number of black psychotherapy is tiny compared with the indigenes.

In this issue a number of aspects of race have been considered; and social bars are examined from various points of view. Barbara Fletchman Smith has noted the link with abuse. Carribean culture was founded in the abuse of the slave trade, and she argues that it has retained a central place, a ‘cultural introject’ as it were. It hovers as a focus both in the treatments of individuals and in the cultural influences which determine referral of people from that culture. Using an empirical method, Paul Gordon tests the openness of the profession to would-be trainees - we keep them white, he finds. He requires that in common with other professions we should adopt a formal policy of equal opportunities, and a monitoring system.

Being psychotherapists we have a ‘binocular vision’; in addition to social causes and constraints we like, maybe prefer, to examine internal factors. It is anyway our special area of expertise. Richard Tan has gone back to clinical work to look at those factors at work in the psychotherapeutic setting. He argues that when therapist and patient are from different cultures primitive mechanisms sustain an unspoken racial context which, uninterpreted, can lead to impasse. He stops short of saying that racism simply comes out of internal factors. However it is common enough