Making Connections: Developing Racially and Culturally Sensitive Psychoanalytic Psychotherapy in NHS Psychotherapy Departments

This paper looks at some of the problems concerning access of black people to NHS Psychotherapy Departments. It examines some of the clinical issues that can arise in offering treatment to black patients, including racism. It argues that in addressing these issues improvements could be made to services, so that black people have a better and more equal chance (as compared to their white counterparts) of specialist psychotherapeutic help.

The term ‘black’ is being used in a broad context to signify different from white and to include African-Caribbean, Asian and mixed race people. These issues are inevitably emotionally charged and difficult to write about without stirring up uncomfortable feelings in the reader. As Bion (1962) understood, thinking is an emotional experience and, in thinking about race and inequalities in psychotherapy services, minus K can come into force - it can feel easier not to know. A clinical example is used to illustrate awareness of racism as an internal reality and that working with these issues helped to prevent the premature departure of a black patient from therapy.