All Things Bright and Beautiful: A Revisiting of, and Response to, Richard Hoggart's The Uses of Literacy

From Hymns for Little Children

(Mrs) Cecil Frances Humphreys Alexander 1848

The Uses of Literacy was first published over 50 years ago in 1957 and has remained in print for most of that time. It is due to be republished in October this year with an introduction by the author's son, the journalist Simon Hoggart. I first read it in the 1970's and was moved and affected by it. I chose the title of this paper very straightforwardly, as the old children's hymn seems a perfect illustration of much that Hoggart is speaking about. It is a stark example of the ability of language to place people and to oppress them. Interestingly, the verse that I quote has disappeared from some copies of the lyrics, but I remember very clearly singing it myself.

Hoggart's book, of course, is not a psychoanalytic text, nor in many ways is it classic sociology; it could probably best be described as cultural studies. What has drawn me back to it is the phenomenological approach it has to the material. Hoggart uses the concept of ‘Us’ and ‘Them’ throughout the book, and I shall be comparing his use of the term with that of R. D. Laing in The Politics of Experience. As Hoggart does in his book, I shall be drawing on examples from popular culture rather than psychoanalytic texts. This is not merely a structural conceit on my part, but evidence that I agree with Hoggart that popular culture is a major factor in the way our place in the world is reflected back to us

and how we construct and shape it. In addition, one of my concerns is that of accessibility, and I have written this paper, as far as possible, in a style that will make it readable to the people that is written about.

Although Hoggart's title is about literacy, the book is as much about language in general. Psychoanalysis and psychoanalytic thought, in a phenomenological sense, exist only through language, and I want to consider how the language and setting of psychoanalysis could be excluding to working class people. For many working class people their only access to the talking therapies has been through the mental health services, and this has often been accompanied (not unjustifiably) by the fear of stigma. Added to this has been an institutional view that working class people are not eloquent or articulate enough to engage in the process. The preferred option would be a prescription of some sort of psychotropic drug. It is only now that the NHS in general and Primary Care Trusts in particular are tackling this inequitable state of affairs. The question of stigma is being addressed through the Time to Change campaign. The most visible manifestation of this is a television advertising campaign with a link to a website. Increase of provision of talking therapies is mainly through IAPT (improving access to psychological therapies). This is dominated by CBT, and one of its main stated aims is to reduce the bill for welfare benefits. As a matter of interest I looked at my current referrals from the GP surgeries I am attached to. Of the 50 referrals, the breakdown is as follows: 40 of them are women and only 10 are men. In class terms, of the women 10 could be considered truly working class, as they have remained close to their birth origins; of the 10 men, I would describe two as working class. This should be taken merely as a snapshot, since it only covers three surgeries and one of the surgeries is from a predominantly affluent area where the majority of patients are not working class. However, it does indicate that working class people are still finding it difficult to access the talking therapies. It also shows there is still a big gender divide in the take up of services.

Hoggart's book draws from his own experience of growing up in Leeds during the 1920s and 30s. This, and the time in which it is written, have resulted in the text being very male oriented. Consequently, my reflections will also tend to reflect this male dominance. However, as I stated previously, it is important to consider the disproportionately small number of men coming forward for psychotherapy. Hoggart describes

a world, much of which is long since vanished and had vanished by the time the book was first published. Similarly, Tony Warren, the creator of Coronation Street, has said that when he created it he was actually writing about the Salford that his grandmother used to talk about, not the Salford of the early 1960s. The world Hoggart writes about is white and devoid of ethnic and racial diversity and the tensions that are now present in a multicultural society. However, it is important to note that the people he writes about he describes as kind of second generation immigrants themselves, in as much as they are recent descendants of country people who moved into the towns for a so-called better life. So in some ways, their experience has relevance to more recent arrivals. It also appears to be a world of full employment after the second world war rather than the long-term unemployment that is more common today. It is also before the advent of mass electronic media when the world view was shaped more by newspapers, magazines and the radio. Nevertheless, I would suggest that much of this is like stage dressing and many of the attitudes and ways of being in the world remain as they are presented in the book.

I intend to concentrate on two chapters in Hoggart's text that I believe are relevant to the practice and theory of psychoanalysis today. These chapters are ‘Them and Us’ and ‘The Uprooted and the Anxious’.

In a famous sketch from the satirical television show The Frost Report, John Cleese, Ronnie Barker and Ronnie Corbett played an upper class man, a middle class man and a working class man. The point of the sketch was hammered home by their differences in height—Cleese being upper class and the tallest, Barker being shorter and representing the middle classes and Corbett, the shortest, representing the working classes. The final line of the sketch belongs to Corbett and it is, ‘I know my place’ (Feldman and Law 1966). Hoggart suggests that working class people do not necessarily think themselves not as good as people from the other classes, but he does imply that they know their place. The strength of the sketch, which I have to say is as funny now as it was when first broadcast, encapsulates this sense of place or even lack of it.

The categories of ‘Them’ and ‘Us’ can be affirmative, and strength can be derived from a sense of solidarity with others, as the civil rights, women's and gay movements have shown. All these movements have been powerful forces for change and have crossed class boundaries and

helped to break them down. However, they may have unintentionally obscured aspects of class as now being irrelevant. It is interesting to note that it is perfectly acceptable for a prospective patient to ask to see a therapist who is a woman, a person of colour or, in some settings, a lesbian or gay man, but in all the years I have practiced I have never known a patient to ask to see a therapist from a particular class. It could be argued that it is because it is irrelevant; or is it because all therapists might be seen to be at least middle class by the very nature of their position or place? This aside, could therapists come under Hoggart's definition of ‘Them’? So who does Hoggart describe as ‘Them’?

Hoggart cautions against generalisation but also recognises its inevitability, and I am very aware of this myself. ‘Them’ can often operate institutionally much more than individually, and indeed those who are ‘Them’ may be from a similar background. They may be acting as agents of ‘Them’. In most cases ‘Them’ are those who have power over you and can inflict sanctions or punishments upon you. Thus the police, social workers, housing officers, immigration officers, benefits officers, Members of Parliament, and employers would all fall into the category of ‘Them’ (Hoggart 1957: 72-74). Invariably, this creates a division along class lines. It could be seen as the threatening other. Middle class people can feel equally threatened by working class people. When we come to the medical profession and allied health care workers, the situation becomes a little more complicated and can be down to the personality and character of individual practitioners. However, mental health practitioners are invariably seen as ‘Them’, and much of this is down to the fear of madness and Stigmatisation. I would suggest that working class people have a much greater fear of being labeled as ‘mad’ and quite possibly justifiably so.

In my experience of working in the NHS, patients can be very reluctant to be referred on to secondary care where they may be more likely to receive some form of psychotherapeutic intervention. This is because of what it may say about them not only to their family and friends, but also to themselves. A common anxious plea is, ‘I'm not mad am I?’ or ‘Can't I just see you?’ This is not simply because they consider me to be approachable and doing a good job, but because of their fear of being put both literally and symbolically into another place. In psychoanalytic terms it could be argued that ‘Them’ represents an externalised

punishing and controlling superego. For once it is perfectly translatable as ‘over I’. This can inevitably lead to some patients entering into the therapeutic encounter with an already developed negative transference. It is not surprising therefore that some patients would prefer to be seen in the voluntary sector where they feel safer.

Working class people can often be very aware of their rights, but this is not the same as feeling entitled. This is not a new state of affairs and is illustrated by the Doolittles in Shaw's Pygmalion and by derivation Lerner and Loewe's, My Fair Lady. The Doolittles, father and daughter both, at various points in the script cry, ‘I know my rights’, but the weight of the onslaught from Professor Higgins reveals how little they feel entitled. Rights are a transaction of what is owed to one, whereas entitlement is about feeling in one's place. As a child I remember my mother often saying about social situations where she felt uncomfortable, ‘I felt so out of place’. She was really saying, ‘I'm not sure I was entitled to be there’. To put it simply, it is a disparity between knowing and feeling. The first barrier to entitlement, which is much more recognised now, is the way one speaks. English, as it is spoken in the United Kingdom, immediately places one in a social class. This is not so true anywhere else in the world. This of course is the premise of Pygmalion, the passing off of a working class flower girl as a lady. However, as Higgins discovers, elocution is only part of it. At a tea party with the Professor's mother, Eliza speaking beautifully reveals her origins by what she says and how she says it. Eliza is revealed to be well and truly out of place. Shaw is making a serious point about class difference here. Popular culture is strewn with examples of those who could be seen to be ‘getting above their station’; for example Mrs Slocombe in Are You Being Served? or Sally Webster in Coronation Street. These examples are not merely confined to the fictional world. Whatever one may think of John Prescott as a politician, I believe he has been particularly reviled for getting above himself. It is the class origins of him and his wife that are as much of a problem to the establishment as the man himself. For instance, there are far more disparaging jokes made about his weight and appetites than the equally portly Kenneth Clarke or Nicholas Soames. It is no wonder that, for most working class people, and maybe men in particular, it is safer to keep their heads below the parapet. Of course this disparagement goes both ways, and it is notable that greater derision

is meted out to middle class contestants on ‘Big Brother’ than working class ones.

R.D. Laing, in the chapter of The Politics of Experience entitled ‘Us and Them’, tries to give some psychoanalytic explanation for this. He sees this in terms of alienation from our experience and describes it thus:

Within this most vicious circle, we obey and defend beings that exist only in so far as we continue to invent and to perpetuate them. What ontological status have these group beings?

This human scene is a scene of mirages, demonic pseudo-realities, because everyone believes everyone else believes them.

and

We act not only in terms of our own experience, but of what we think they experience, and how we think they think we experience, and so on in a logical vertiginous spiral to infinity. (Laing1967: 66)

I believe a negative response to this construction amongst working class people is a greater tendency to feel shame. As a rather talkative and outspoken child, I well remember my mother saying, ‘You do show me up. I was so ashamed!’ when I had said something she felt was inappropriate. Shame, although sharing some characteristics with guilt and at times they are uttered in the same breath, is of quite another order. Guilt has the possibility of something transformative folded into it. It can offer the possibility of action, a desire to confess or to make amends. Shame, however, tends to make one wish to hide or to runaway, as in the phrase, ‘I wish the floor could have opened and swallowed me up.’ It is often accompanied by hyperbole, ‘I have never been so ashamed in all my life!’ There may also be a gender divide in the reaction to feeling shame. Working class women may be described as ‘plucky’, but this is not an epithet attached to men, thus leading men to be very reluctant to acknowledge even to themselves these emotions.

It may appear that in modern life the opposite is true, but I believe there is still a strong relationship with shame. Paul Abbot's masterly comedy drama Shameless in its title reveals this as a kind of paradox. The Gallagher family and the residents of the Chatsworth estate appear to have no shame. Yet isn't there an underlying suggestion that perhaps they ought to have? While I have been thinking about this paper, I have also noticed a class difference in the way comedians present their material. Working class comics tend to use self-deprecating humour about themselves and their social setting, whereas middle class comics are more likely to make jokes about what is other. For example, the Scottish comedian Frankie Boyle, who is known for this cutting remarks about the famous, in whatever field, inflicts his most scathing and scurrilous jokes upon himself, whereas the more middle class Michael McIntyre tends to locate his mockery away from his origins. The work of Alan Bennett is full of examples of shame. In his memoir, Writing Home, he writes:

I have had unfortunate experiences in hotels. I was once invited to Claridges by the late John Huston in order to discuss a script he had sent me. The screenplay was bulky (that was what he wanted to discuss) and looked like a small parcel. Seeing it and (I suppose) me, the commissionaire insisted I use the tradesman's entrance. (Bennett 1994: 30)

This is told as an amusing anecdote, but folded into it there is a sense of having been shamed because he was thought not to be entitled to enter through the front door of a grand hotel. He was certainly brought up with a highly developed sense of shame, which, while deftly exposing it, also reveals how pernicious it is.

‘Not washing one's dirty linen in public’ possibly owes its origins to the public laundries of days gone by and might also be linked to, ‘You didn't go out in that vest? What if you'd had an accident?’ My aunt was fond of recounting how my grandfather would say to her, ‘You'll end up in The News of The World you will!’ Today, popular culture seems even more than ever to be full of confessional and potentially shaming content. The granddaddy of these, I suppose, is The Jerry Springer Show, with the audience baying for more and more extreme confessions. Currently

running in the United Kingdom is The Jeremy Kyle Show, which broadcasts in the morning on weekdays. It is a particularly unpleasant experience to watch. The whole premise of the show is to expose members of the public to shame and disgrace. The participants are invariably and maybe entirely working class people. He encourages his audience to take the moral high ground towards his guests under the guise of being helpful. The worst aspect of this show and others like it is that they purport to have some transformative or therapeutic effect. As Tricia Goddard says on her show at the end of her guests' appearances, ‘Our counsellors are waiting for you backstage now’. The illusion is created that ten minutes of television exposure will put you right. This is not an attack on Goddard, who seems to genuinely care about the people she presents, but on the machinery behind these shows.

Rather as slasher movies and fairground rides enable us to experience terror safely, these programmes allow the audience to vicariously experience shame and being shamed. ‘There but for the Grace of God’, the audience thinks with relief. There is rarely an occasion or opportunity for the possibility that there might be no need for shame. The effect of all this, as Laing puts it, is to further alienate us from our own experience. Here he is speaking about personal interactions, but it could be about the experience of watching Jeremy Kyle:

Gossip and scandal are always and everywhere elsewhere. Each person is other to the others. The members of a scandal network may be unified by ideas to which no one will admit in his own person.

and

Each person, however, is a neighbour of his neighbour. It is indubitable and it is incontestable. The scandal group is a series of others which each serial number repudiates in himself. (Laing 1967: 68)

Thus those who might constitute ‘Us’ are not necessarily supportive, and the fear of ostracisation is very strong in working class communities. This is fueled and then stoked up by a tabloid journalism that purports

to be, ‘the voice of the people’. Hoggart called this phenomenon ‘palsiness’. It was exemplified in The Daily Mirror by a column called The Old Codgers, which was little more than a ‘letters to the editor column’. What marked it out were the little quips after each letter patting the correspondents on the back for their homespun common sense which the columnists seemed to endorse and share. This sense of the tabloids being part of ‘Us’ is fragile, as was vividly illustrated by the people of Liverpool's repudiation of The Sun following the Hillsborough disaster. On a more individual level is the fatalistic ‘Not for people like us’.

Hoggart quotes examples of this:

At the lowest is the acceptance of life as hard, with nothing to be done about it: put up with it and don't aggravate the situation: “what is to be will be”; “if y' don't like it y' mun lump it”; “that's just the way things are”; “it's no good kicking against the pricks”; “what can't be mended must be made do with”; “y've got to tek life as it comes—day in day out”. In many of these is a note of dull fatalism; life is always like that for people like us. (Hoggart 1957: 92)

What this illustrates is both a belief that change is impossible and a fear that change only makes things worse. It seems to me that the reluctance of men, and working class men in particular, to come for even short-term counselling is as much to do with this relationship to change as it is with being seen as at best weak and at worse mad.

This situation has probably got worse since Hoggart wrote his book. He was writing at a time of economic growth and growing prosperity. Now, with the downturn in the economy and the ever widening gap between rich and poor, there is more fatalism and a dwindling belief in the possibility of change. This as ever is projected outwards and blamed on the new arrivals into working class communities; most notably against Muslims and Eastern Europeans. Of course it has always been so; they are just the latest groups to suffer this kind of scapegoating. However, in the consulting room it is hard to encourage people to try to live in possibility when they are caught in the poverty trap of inadequate housing, long term benefits and poor employment prospects.

In the late twentieth century we witnessed the growth of celebrity culture and the accompanying plethora of magazines that recorded it. What is notable about this new development is that one can be simply famous for being famous. Ironically, this world of glamour, as with the National Lottery, seems to offer a way out to the hopeless. ‘I just want to be famous’ is a cry I have often heard from working class patients, even relatively successful ones. It is quite different from the old desire to be a famous sports person, pop star or actor that required a belief in one's abilities to get one out. It may always have been fanciful, but it did stem from self belief. Part of the sadistic pleasure derived from watching the auditions for The X Factor and Britain's Got Talent is that at least we are not that self deluded. We know we've got no talent and that makes us superior. Of course, these shows are hugely successful and not simply watched by working class people, but most of the contestants do seem to come from poorer backgrounds. As with Big Brother, the greatest mockery is reserved for middle class contestants, as if they should really know better. The Apprentice, whilst purporting to be about finding the best young business talent, is in fact a more middle class variant upon this theme. Except it dangles the carrot of a five-figure salary, but with the risk of Sir Alan Sugar's finger pointing, ‘You're fired!’

The Apprentice rather neatly brings me to the other chapter in Uses of Literacy that I should like to consider, ‘The Uprooted and the Anxious’. Of all the chapters in the book, perhaps this has the greatest resonance and relevance for psychoanalysis. It is also the one that has perhaps dated the least. It is this chapter that predominantly concerns itself with men, and although I would argue that it doesn't apply only to men, the widespread effects of the feminist movement of the 1970's onwards have made a significant difference to the way women feel about themselves. Some gay men of working class origins have been similarly affected by the gay movement.

The chapter opens with several quotes, including one from George Eliot's Middlemarch.

For my part I am very sorry for him. It is an uneasy lot at best, to be what we call highly taught and yet not to enjoy: to be present at this great spectacle of life and never be libcrated

Page 74

from a small hungry shivering self. (Hoggart 1957: 291)

Hoggart acknowledges that this was a difficult chapter to write because it is the most personal to his own experience, and I have to own that this is the chapter that I found painful reading. It combines both anger with and compassion for the people he is writing about. When I say people, I should say that Hoggart is writing almost exclusively about men. The title is self explanatory and the group of people are those that, these days at least, are the most likely to present themselves for treatment. Once again they can be identified within the theory and clinical examples of R. D. Laing. As Hoggart points out, not all people who are uprooted from their class origins will experience problems, but I would agree with him that many will exhibit some of the difficulties of ‘place’ that he describes.

The recently published white paper on social mobility, New Opportunities: Fair Chances For The Future, identifies that access to the professions has become increasingly difficult for working class people. The standard of education in comprehensive schools has been blamed for this, by the media and pundits at least. However, Hoggart problematises the uprooting of working class people within the old grammar school system. He identifies the psychological difficulties that can be experienced by those who move away from their roots. He sees these problems as primarily about anxiety stemming from an alienation from the family and the wider social culture. This was very stark in the days of the eleven plus and the splitting of children from their peers and indeed from their family cultures. I remember my own experience of this when at my small village school only two of us passed. We were instantly shunned by our classmates, who were all off to the local secondary modern, and they jeeringly called us ‘posh’. With our exam results, we were catapulted into the ‘Them’ from the previous security of the ‘Us’. That I can still recall this shows how powerfully it affected me. Of course there were working class children at the grammar schools, but the majority of pupils did come from more affluent backgrounds. I suspect that this is reflected in university admissions today. As Hoggart points out, not all children will be severely affected, but he does say at its most extreme it can result in psychosis. In a time of the comprehensive

system, the problems faced by the gifted child may not be so stark, but it doesn't mean to say they have gone away.

Obviously, in our work we are still seeing patients of working class origins who have gone through the selective education system, and the picture they paint of their early domestic life is remarkably similar to that of Hoggart's—doing one's homework on the table in the living room because bedrooms were unheated or shared; in the midst of family life, yet apart from it. It is at this point that anxiety begins to develop. This anxiety can be further increased by the ambivalence of the rest of the family towards the gifted child. It is in this ambivalence that we can identify examples of the double bind. This was first described by Bateson and then developed by Laing in The Self and Others.

I recently saw a young woman in the NHS who exemplified this problem. She was referred to me for anxiety because she was facing the prospect of being evicted from her home for non-payment of rent. This situation had come about because she was unable to fill in the necessary forms for Housing Benefit. It was not because she didn't have the capacity to fill in the forms, but because she was seized by a kind of paralysis that left her unable to engage with the task. It emerged that she was eldest in the family and had recently dropped out of a university course. She had been very bright at school and on the one hand had been encouraged to work hard at school, but then had been mocked for getting good results. She was her mother's confidante from an early age, and her mother would seek her advice but would then blame her if things subsequently went wrong. She saw her family's situation as one of failure, but if she had any success she would be ostracised for it. Her tutor at university had told her at the end of her first year that she could get a first. Rather than seeing this as a compliment, she became very anxious and felt compelled to fail the second year. Similarly, in a job she was doing with ease, she was asked to train up a new colleague who struggled with the work. She then found herself unable to carry on at the higher standard of work she had previously reached. For her it was the exclusion that success might bring that was forcing her to sabotage herself. Her younger brother, seemingly, had even more difficulties than her, having been diagnosed with some form of psychosis. When thinking about her, I am reminded of the saying ‘Too clever by half’, which has probably been said to many a gifted child.

Perhaps, as Hoggart suggests, it is those whose ambitions and achievements are more modest who suffer the most. It may be that those who do enter the professions are better able to achieve what Hoggart calls self adjustment, but it may be that being able to call oneself a doctor or a lawyer builds up enough self esteem from what one does to compensate for inadequacies about who one is. Nevertheless, with social mobility there is loss of original identity as well as gain, so there can be a profound sense of loss. This loss can lead to a feeling of not belonging anywhere of having no ‘place’ at all. Emmanuel Levinas, throughout his work, is concerned with the diaspora and sees it more than being about a return to Israel. He was, of course, not a Zionist and saw all mankind as subject to this yearning for a ‘place’ to call ones own or perhaps to belong. This is clearly illustrated by those who might be considered to be the uprooted and the anxious. The song ‘Somewhere’ from West Side Story opens with the line, ‘There's a place for us, somewhere a place for us’. It is undoubtedly a beautiful piece of music, but it is the Sondheim lyric that reaches out to so many.

In a series of masterly television plays written for LWT during the 1970s, including, Me I'm Afraid of Virginia Woolf, Alan Bennett has written extensively about the uprooted and the anxious. Although often very funny, these plays are always full of compassion and reveal the underlying tragedy of his characters' lives. His leading characters are living on the edge of their existence; a part of, yet apart from, all that is going on around them. It seems to me that Bennett himself knows only too well what it is to be uprooted and anxious. Hoggart could be writing about Bennett's characters or the patient I mentioned earlier when he describes the grammar school boy thus:

As childhood gives way to adolescence and that to manhood, this kind of boy tends to be progressively cut off from the ordinary life of his group. He is marked out early: and here I am not thinking so much of his teachers in the ‘elementary’ school as of fellow members of his family. “E's got brains” or “E's bright”, he hears constantly; and in part the tone is one of pride and admiration. He is in a way cut off by his parents as much as by his talent which urges him to break away from his group. Yet on their side this is

Page 77

not altogether from admiration. “E's got brains”, yes, and he is expected to follow the trail that opens. But there can also be a limiting quality in the tone in which it is used; character counts more. Still he has brains—a mark of pride and almost a brand; he is heading for a different world, a different sort of job. (Hoggart 1957: 294)

Hoggart goes on to identify another difficulty that could be seen in Lacanian terms as an absence of desire. I have observed this in a number of my patients who could be described in various ways as uprooted and anxious. This most commonly presents itself as an unfulfilling of potential and early promise. The women or, I have to say more commonly, men, who having completed their degree, haven't a clue what they might want to do with it and end up in jobs that they are overqualified for and are unhappy in. It can also spill into the sphere of sexual/emotional relationships where they may find it more difficult to form more committed relationships.

Hoggart sees the origins of this in the loss of the ability to be spontaneous under the pressure to achieve exam results. He likens this process to that of the circus pony being trained to do tricks. He notes that this pressure is more likely to come from the child than the parents. In my experience, their parents rarely say something like ‘Look what we have sacrificed for you to give you the chances that we never had’. They are far more likely to have said, ‘All we want is for you to be happy’. The child may nevertheless be acutely aware of the opportunity she/he has been given. This, I would say, is in stark contrast to the middle class child who may be under extreme parental pressure to do well. Hoggart sees this burdening of the working class boy as having a direct effect on the acquiring of knowledge, which becomes merely a means to passing exams. It never generates a genuine desire or enthusiasm for anything and produces a stifling compliancy and lack of creativity in the child or young person. They don't even consider that there could be pleasure in what they are studying and it becomes just a stepping stone to the final piece of paper at the end of school or university. It is at this point when they have graduated that they ‘drop out’. This is quite different from the middle class graduate who may do the same. In the case of the middle class student, it could be seen more easily as a possible act of rebellion.

An obvious example of this would be the seemingly dynastic nature of medicine where a child after following in his or her parents' footsteps then drops out and becomes an actor or comedian.

For working class graduates, it is that desire has been stifled and they have no idea what they want for themselves. It is almost as if the ability to dream has been cut out of them. It can be at this point that they present for psychotherapy, and often the presenting problem is one of anxiety. Hoggart observes how the anxious might internalise their world view as follows:

He is unhappy in a society which presents largely a picture of disorder, which is huge and sprawling, not limited and centrally heated: in which the toffee apples are not accurately given to those who work hardest nor even to the most intelligent: but in which disturbing imponderables like ‘character’, ‘pure luck’, ‘ability to mix’ and ‘boldness’ have a way of tipping the scales. (Hoggart 1957: 299)

Although this is a very concretised and totalised view, it does give something of the flavour of what has been brought to me in the consulting room. It does seem to play out differently among women and particularly older women, who may have had to fight not only their families but the school system itself to fulfill their potential. An example of this is an older woman I see within an NHS setting who is of working class origins but is highly educated and has had an extremely successful career. She is constantly plagued by anxiety that she is not wanted socially anywhere. She analyses any delay in response to phone calls or emails she has sent to friends and family in terms of worrying that she is not welcome. She is extremely confident in what she does, but is very unsure in who she is. This may have been exacerbated by her being sent for elocution lessons as a girl, which has resulted in her sounding different from her origins and indeed to the rest of her family. There is a sense of her not feeling she belongs anywhere socially or that anyone belongs to her. This only manifests itself in the private sphere of her life, as in her professional life she is extremely confident.

I would just briefly like to reflect that analysts are not exempt from being uprooted and anxious, although one hopes that training analysis

helps to dissolve its more severe manifestations. Here I can only reflect on my own experience of working with patients who, to me at least, I would perceive as middle class. An example of my own uprooted anxiety: shortly after completing my training I was seeing a middle class patient and we were in the midst of a difficult negative transference. In this particular session there had been long silences, and after one of these he angrily said, ‘I hate this room, it's so provincial!’ I had managed everything else that he had thrown at me quite calmly, but this hit me like a bullet. I was mortified. I felt found out and I felt ashamed. It opened up what no amount of education or training could shift. I was ‘common’ and ‘less than’. I realised later that what this represented was a return to my mother's anxiety when unexpected guests arrived. There would be a knock at the door and my mother would go into a complete fluster. ‘Oh this house is such a sight!‘, she would say and shake my father awake—he was more than likely asleep on the sofa, having worked a long shift. She would pull the table cloth off the table and look around at the decor in despair. She was actually extremely hospitable and always made people very welcome, but when it was a surprise it cost her dearly. As Hoggart points out, in earlier times working class people would not as a matter of course invite others into their homes and certainly not strangers. My patient in that moment awakened all my old fears of not being good enough. It did not reside in the professional but squarely in what I perceived to be the personal.

Perhaps, it is important to reflect that the therapist of working class origins may not feel entirely at home within a peer group, or not as confident of taking up a theoretical place, as those of a middle class background. This could remain largely hidden, as origins are not necessarily very obvious. Again, I am thrown back on my experience and, despite my willingness and desire to speak, this has probably been the hardest and most anxiety-producing piece of work I have ever written. The same conflict and anxiety seem to be folded within Hoggart's text.

It is somewhat ironic that an all pervasive media and traditional psychoanalysis, from very different perspectives can, by maintaining their individual status quo, compound class structures and attitudes. Despite our cynicism about what we read in the papers or see on television our world view is shaped by them. A simple example might be the automatic anxiety generated by the sight of adolescents in ‘hoodies’ or groups

of young people on the streets. From the other perspective of the metapsychology of psychoanalysis, whilst presenting itself as egalitarian, it in fact posits the specificity of social background and class culture as window dressing to the greater constructs of a universal theory. Ultimately, in their different ways, they are both refusing to acknowledge the Otherness of the Other.

Finally, I would like to return to the problem of engaging working class people in the therapeutic process, and in doing so I will focus on the NHS. I shall only consider those who might be considered as neurotic who, after all, represent the greatest number likely to be referred. Those who are experiencing psychosis present a different set of problems with which they have to contend. I would not purport to have the answer or, as is more likely, answers, to the problem of engagement, but I would like raise some questions.

In this brief examination I have identified the difficulties of stigmatisation, entitlement, the polarisation of ‘them’ and ‘us’, shame and social anxiety. By social anxiety I am speaking of something wider than the fairly common medical diagnosis of social anxiety disorder. These are not the sole property of working class people, but I would say that they occur more frequently in this group. Is it that, beginning with Freud, the theorisation and practice of psychoanalysis has been based upon the world view of people from more privileged backgrounds? Successful challenges have been made to these theorisations in terms of race, gender and sexual orientation. The same kind of fundamental challenge has not been made as successfully in terms of class. Perhaps an example of this might be the emphasis upon guilt as opposed to shame. Furthermore, in a culture where rights are at the forefront, does this mean that lack of entitlement can be relatively ignored? IAPT appears to offer the right to some form of therapy for all, but is the kind of therapy being offered appropriate for all?

The much-trumpeted notion of choice within the NHS does not extend to mental health services. Mental health services are completely postcode based. I have a patient who was admitted to a psychiatric unit following a suicide attempt. He felt safe and cared for there. He was then moved to another unit where the opposite was true, but that was the unit for his postcode. This was done despite attempts by his consultant to keep him where he had originally been admitted. The funded voluntary

sector, which previously has offered the possibility of an alternative, with the introduction of service level agreements is now being forced into becoming little more than another arm of the statutory sector.

However, increase of availability in a variety of services that may be more appropriate will not increase their uptake if the initial welcome or invitation is itself not considered. This is not solely the responsibility of the therapist as it relies on how the GP or other referrer presents it to the patient. At its worst, I have had patients referred as a kind of punishment. ‘If you don't go to counselling I won't sign your medical certificate’. It is perhaps the medicalisation and the reductive nature of the requirement to diagnose within an NHS setting that interferes with this invitation. Working class people can often have very concrete problems that can lead them to believe that talking doesn't change anything. Sitting in front of a single parent living on benefits and living in unsuitable housing, one can't help feeling some sympathy with this. ‘Actions speak louder than words’ is a phrase that comes to mind in the space between myself and the working class man struggling with crippling anxiety or depression in a world he can no longer make sense of.

In these situations the therapist can easily be placed as belonging to ‘them’, and perhaps Laing's acknowledged facility to connect with his patients was based on his ability to disrupt this. The invitation must always come with the possibility of disruption, which CBT does not always offer. It ultimately remains something that is done to the patient rather than with. It places the therapist in the role of scientist working towards preordained outcomes, not as one human being in free conversation with another. Laing in The Politics of Experience speaks of ‘alienation from the self’, but with that inevitably comes alienation from the other. Perhaps as the status of psychoanalysis becomes whittled away, there is an unconscious wish by the therapist to reinstate his or her expertise. This no doubt is of comfort to some but perhaps has the effect of further alienating others and particularly those of working class backgrounds. Maybe what we need to do is to find ways of extending an invitation that echoes that of Nancy to Oliver, ‘Consider yourself one of us’! Then perhaps we can really set the cat among the pigeons.