“Interpreting in the Dark”: Race and Ethnicity in Psychoanalytic Psychotherapy

In this article, I discuss the impact of race and ethnicity on the psychotherapeutic process of three patients in psychoanalytic psychotherapy with an African American therapist. The influence of race on the treatment process has been explored infrequently in psychoanalytic writing, despite consensus that it is conceptually and clinically relevant. This outcome stems from the complex web of attitudes attending talk about race in this country. Race and ethnicity remain topics that engender anxiety in social and clinical discourse. I selectively and critically review the psychoanalytic literature on race, which has been hampered by incomplete conceptualizations and overgeneralizations that often limit its clinical utility. I then explore, through clinical examples, the way in which attention directed at racial issues provided a framework for the treatment alliance and illuminated key transferences and resistances for these patients. Discussion of racial issues is most fruitful when racial themes are situated in bodily and social contexts and when the meaning that race has within the therapy dyad is negotiated by patient and therapist, apart from idealized or socially correct conceptualizations from outside of the treatment situation.