Community Transference Reviewed: With Notes on the Clinic-Community Interface

“Democratic institutions awaken and foster a passion for equality which they can never entirely satisfy.”

“One of the reasons why we have made so little progress in curbing and eliminating discrimination, exploitation, violence, and war lies in our refusal to recognize and acknowledge that all human beings depend heavily on paranoid processes throughout their lives. Most persons are too narcissistic to conceptualize themselves as primitive and irrational in thinking and behaviour.”

Paranoid mental mechanisms are universal amongst human beings and an important determinant of their coming together into small and large groups—even into societies and civilizations. The thesis of this paper is that these paranoid mechanisms are an essential ingredient of the relationship between the mental health clinic and the community it serves—indeed of the relation between any individual or treatment team attempting to understand neurotic and psychotic processes and the objects of their study.

The fundamental postulates of psychodynamics (I would add also sociodynamics) are two: the existence of unconscious mental processes; and the observation that the therapist and the patient influence each other in the course of discovering and understanding them (Sloane 1969).