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Differences and inequalities of class are not matters of which psychoanalytic theory and practice take much account, although in the actual experience of analysts and patients the discomforts of class positions and identities are often deeply felt. This is the paradox which Joanna Ryan’s welcome book sets out to explore.
She is able to demonstrate with many examples that the feelings and states of mind which arise from positions in class hierarchies are of real importance in psychotherapeutic relationships. Perceived inequalities of income or status between therapists and patients sometimes have to be worked through by either or both of them, in order to establish a relationship of trust within which psychotherapeutic work can be done. Where issues of class have been of great importance in a client’s life – experiences of social mobility are described by Ryan as sometimes traumatic in their meaning for personal identity – these may be important issues to be explored within a therapeutic relationship. Yet although this is plainly the case, Ryan’s contention is that the psychoanalytic field has mostly been reluctant to acknowledge the significance of these aspects of life, and that it offers little in the way of a theoretical language with which to do so.
These issues are somewhat parallel to those relating to racial and ethnic differences in psychotherapy, matters which have become difficult to ignore in an increasingly multi-cultural and multi-racial society such as modern day Britain. The similar difficulty in the arena of class is that these issues of social identities seem to be beyond the scope of a psychoanalytic mode of thought which has been focused principally, since its origins in Freud’s work, on the experiences of individuals and their primary relationships within families, located both in reality and unconscious fantasy.
Ryan’s diagnosis of this troubling situation is perceptive, and is the outcome of a great deal of thought and scholarly work. She describe