You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
After 38 years, “Learning to Do Psychoanalytic Therapy with an Inner City Population” remains surprisingly current. It describes what is still the main patient population in most mental health clinics dedicated or zoned to serve persons who are poor, minimally educated, culturally diverse, from unstable families, exposed to chronic social and domestic violence, and with limited access to health care or adequate housing.
This article was groundbreaking at the time because the authors specifically recommended a treatment method that was then considered inappropriate for this target population. The authors acknowledged the reductionistic practice of stigmatizing psychotherapy patients as “good” or “bad.” At the time, trainees avoided working intensively and long term with this population because they were not “good psychoanalytic patients,” and these “bad patients” were considered chronic, untreatable, manipulative, and abusers of the system, as most were on welfare or social security disability, and would not offer much opportunity for the eager trainee to properly learn psychotherapy skills.
This article, enhanced with two clinical illustrations that still read current, teaches us that any individual with at least average intelligence and the ability to verbally communicate with a comprehensive flow of ideas, no matter how concrete their content can be, can be taught incrementally to verbally express interpersonal or intrapsychic affect-ridden experiences. In the current lexicon we would say that patients can be taught to mentalize or cognitively translate such experiences.
Many inner-city patients are receptive and able to tolerate intensive psychotherapy treatment. They are amenable to participate in a verbal interchange that links somatic complaints to their intrapsychic, interpersonal, or environmental crises. The therapist, while using a supportive approach, frames the interventions through the lens of a psychodynamic understanding. The therapist's goal, while unde