Psychoanalysis in the Community

I am not yet an analyst. I am a pediatrician for urban public schools and state-regulated behavioral health facilities. In my current capacity, I address the medical needs of hundreds of minority kids and families who are excluded from traditional psychoanalytic culture but who could deeply benefit from this healing art. Every day, I witness both the need for psychodynamic applications on a programmatic scale and imagine possibilities for public health partnerships to enable this process.

Working as a civil servant for underserved populations forces me to think largely and collectively. The resources are limited, and the racial/cultural/ethnic disparities are painfully present. The mental distress can be as immense as the socioeconomic obstacles are formidable. Every encounter, every patient, every family represents thousands more in the system. Though the details may be personal, the needs are the same and can be multiplied exponentially. All are seeking a way toward a better future. This recognition of shared humanity is the basis for developing compassion.

Compassion lets me feel for other human beings. And empathy allows me to identify with their distress. These allow deep human connection. My supervisor describes the connection as a bidirectional effort, requiring investment from the analyst as much as the analysand to sustain the healed reality that can be co-created with this model. It transcends all our perceived differences. It allows us to truly see who sits before us.

As an analyst in training, I discuss these perceived differences of race, class, disparity, and economics and the role they play in making psychoanalysis inaccessible to the larger Black and Brown culture. The conversations revolve around privilege and identification—my patients do not have the means to engage in psychoanalysis, and its private-practice system at large is not set up to accommodate them. And there are cultural divides that are bidirectional barriers to care beyond the monetary i