Joanna Ryan was my supervisor during the second half of my training at the Philadelphia Association and for some time after that, and I am one of the people she interviewed during the preparatory work that would culminate in this timely, authoritative and comprehensive (yet concise) work. I gained much from our middle-class/working-class creative coupling and hope she did, too. She manages to pack so much into less than two hundred pages that I feel somewhat inadequate to the task of reviewing it. However, Ryan makes it easy for any reviewer – and this book is a gift to trainees and teachers in this respect – in that she takes the time-honoured yet currently oft-neglected approach of saying what she's going to say, saying it, and saying what she's said. Further, each term introduced is accompanied by ‘defs and refs’, i.e.: Ryan defines her terms and cites references where required (a delight to any academic supervisor!). However, she does so in a manner which is both reasoned and clear, yet unambiguously left-leaning. Moreover this is not achieved by means of sacrificing complexity and subtlety to the demands of polemic. The writing is characterised by an authorial modesty where Ryan is careful to avoid tendentious arguments, careful at all times not to overstate her case and to refer closely to her sources. If, after reading this review, someone might feel that Ryan has omitted an important issue in relation to class and psychoanalysis, then it is very likely due to the limitations of the reviewer: I would urge them to read the book and then form an opinion.
In her introduction, in addition to sketching out the ‘landscape’ of the book, Ryan introduces a key theme that runs throughout the work, which is the assertion that, in order to survive as a relevant discourse and practice, psychoanalytic ‘theorising’ (‘theory’ itself being a term which is under question, as far as I'm concerned) needs to be opened up to incorporate ways of seeing and lessons learned from other disciplines, principally sociology yet also philosophy and literature: an open system as
opposed to a sterile enclave. Along with this, consequently, would come an abandoning of the crass binaries that seem to be a chronic feature of Anglophone culture, including ‘inner’/‘outer’, psyche/social, individual/collective, clinical/political.
Another divergence from what Ryan characterises as traditional (British?) psychoanalytic (and academic) orthodoxy comes when she writes herself into the picture as a classed subject, thereby questioning the Great Foundational Myth of neutrality (i.e., one person's neutrality is another's specificity). Ryan's starting point is that ‘…class matters. It matters because it is a major source and consequence of inequality, often transmitted intergenerationally…Class is a prime example of the past operating in the present, and thus could be of great psychoanalytic interest…’ (6). In the following chapters she explores, variously, the early history of free and low-cost clinics in Germany and Austria, set up in many cases by the Founding Fathers and Mothers of psychoanalysis, who were often also active politically on the Left, and the ‘theoretical’ debates that underpinned these initiatives; the exclusion of class from early – and subsequent – theoretical discourse; the position of psychoanalysis in the public sectors of various countries; class as seen from the perspective of contemporary sociological thinking; social mobility within the psychoanalytic field; class dynamics within therapeutic relationships; contemporary psychoanalytic writing, and the central issue of money and therapy within a wider political and economic context. Ryan refers at a number of points to the currently dominant Western ideology of ‘neo-liberalism’ and how this has led to the privileging of atomistic individualism over collective narratives and solutions, a trend to which much contemporary psychoanalysis has arguably fallen prey. Due reference is also made throughout to the interwovenness of class with other positions – intersections in current terminology – and in particular ‘race’ (her inverted commas), gender and sexuality. Ryan describes British psychoanalytic culture as currently riven with inequalities, rivalries and snobberies, both in terms of access for clients and also trainees and therapists from working-class backgrounds.
As stated earlier, Ryan refers to a wide range of writers within the fields of sociology, psycho-social studies, psychoanalysis and journalism,
including the work of Reay, Layton, Hanley, Altman and in particular the psychoanalyst Jean Laplanche and the sociologist Pierre Bourdieu, applying and adapting their ideas in order to investigate the interrelationship between psychoanalysis and class, arguing for an externally-focused theory and practice which acknowledges the centrality and materiality of socio-economic experience in therapy, as opposed to the self-centred and atomised individualistic approaches that have dominated the field for much of the twentieth century.
I was left reflecting on which other currents within psychoanalytic discourse might also be helpfully put to use in a greater incorporation of socio-political realities in psychotherapy, and thought of the ‘phenomenological’, for example the conviction of Maurice Merleau-Ponty (among others) that we are ‘thrown’ into a world (a culture, a society) that pre-exists us, that there is never just a mother-baby dyad, there is always already the group, the world. Or a refraction of the Lacanian tradition (apologies for the violence of over-simplification), where the entry into the symbolic involves entry into language and therefore culture, society, politics (notwithstanding Lacan's own attitude to money and charging of fees, which Ryan discusses). Similarly ‘classical’ Jungianism, where collective ‘experience’ is also seen as foundational (although reference should be made here to Frantz Fanon's justified criticism in ‘Black Skin, White Masks’ of the cultural specificity of the contents of the ‘collective unconscious’).
Like all good books, the reader wants to continue the conversation with the writer – and others – after finishing it. Towards the end of the work, Ryan points out that ‘Many class-inclusive efforts have raised questions of whether psychoanalytic technique needs to be altered in different circumstances’ (174). This left me wondering what a working-class generated psychoanalysis might look like. Ryan, in discussing Reich's work, lists several characteristics for which working-class clients have historically been pathologised, including being ‘antisocial, uninhibited and instinct-driven’ (27). Sounds like me! This led me to reflect that I had often in the past tended to pathologise elements of my own character when they manifested themselves with clients: my quick temper, my impulsive warmth, my tendency to ‘self-disclose’ (a loaded term, if ever there was
one). Might these be elements, however, of a working-class psychoanalytic praxis on the part of the therapist? Or am I simply looking to excuse my ‘bad’ behaviour?
Finally, and thinking of a question raised recently at the Freud Museum event with Joanna in conversation with Site colleague Barry Watt, I am drawn back to the geographical metaphor contained in the book's title. As we all should know by now: it's all about ‘location, location, location’. Where are our consulting-rooms? What does the surrounding area look like, socio-economically? What do our rooms look like? What do they communicate to our clients about our class position? How welcome do clients feel in approaching our workplaces and ringing the doorbell? (And what fee do we charge them, and why?).
In conclusion, this book should be compulsory reading for every member of the British psychoanalytic community.