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Although The Analyst in the Inner City is indeed about the subject indicated in the title, its scope is far greater, as is its importance for any practicing clinician. With thoroughness, wide-ranging curiosity, and an impressive capacity for self-reflection, Altman leads us through matters of theory and technique as understood within the inevitable social, cultural, and racial contexts within which all clinicians work. Altman's thorough consideration of countertransference extends the topic far beyond most discussions of this crucial and yet often simplistically described phenomenon.
Altman begins this second edition of his book with the frank acknowledgment that while an increasing number of psychoanalytically informed clinicians are prepared and willing to use their skills creatively in the inner city, there are fewer and fewer public clinics in which they can do their work because of the decline in public and private funding for such endeavors. He makes an impassioned plea for those who have analytically oriented training to be open, by way of consultation, to the needs of other professionals, such as case managers, who would benefit greatly from their expertise as they try to address the urgent needs of their clients. However, he also notes that in spite of the discouraging trend toward decreased funding, there are encouraging examples of community-based clinics that offer psychotherapy in the face of considerable odds.
Altman explains that “psychoanalysis has developed as an exclusionary discourse, after deciding that those who do not fit easily recognizable social, class, and racial categories are deemed unanalyzable… my project is, thus, to contribute to bringing social class, culture, and race into the psychoanalytic domain” (p. x1x). Altman wants to encourage the presence of psychoanalytically informed practice in the inner city and to be of help to those clinicians who attempt this challenging and very rewarding work. Second, and no less important, he wants