‘But things are always impossible, what of the possible and why the absence? Is the sea forgetting its epic tales?‘ asks Etel Adnan, poet and visual artist (1997, p. 19). Discourse on the topic of free clinics and the social mission of psychoanalysis indeed appears to be flourishing. Two contemporary examples are Psychoanalysis and History vol. 24 no. 3, the open access special issue of December 2022, and Elizabeth Ann Danto's (2005) Freud's Free Clinics: Psychoanalysis & Social Justice, 1918–1938. Another is Psychoanalysis in El Barrio, the 2016 PEP Video Grant Project Winner by Christopher Christian and Richard Reichbart, which shows the experience of psychoanalytic practice in some Latino communities of the United States. An excerpt of this documentary which features interviews with Latino residents, analysts, and students, on their thoughts about therapy can be read in the following dialogue:
Patricia Gherovici: One development of psychoanalysis in the US is to think that psychoanalysis will only work with people who are described as highly sophisticated, intellectually sophisticated […]. And that kind of thinking, at times, leads people to believe that someone who is poor could not benefit from psychoanalysis.
Carlos Padrón: And the argument goes that insofar as people are poor and pressured by the exigencies of poverty, they're externally driven […] only thinking about solving day-to-day problems.
Patricia Gherovici: I have my clinical experience to prove the contrary. I often say that, indeed, it's a little extreme, but poor people may be poor, yet they can afford to have an unconscious.
The call which was founded in Freud's appeal in the wake of World War I for a more socially responsible practice,1 and further elucidated upon in the above-mentioned documentary, in turn inspired the co-edited volume Psychoanalysis in the Barrios: Race, Class, and the Unconscious edited by Patricia Gherovici and Christopher Christian. This collection of essays is a compelling exploration of the practice of psychoanalysis with an eye on the barrio (i.e. working-class urban neighbourhoods with populations of Latinx origin), which challenges the notion that only time-limited, symptom-focused interventions are beneficial in impoverished areas. The volume features contributions from a range of clinicians, community activists and scholars, who offer insight into the potential of psychoanalytic interventions to address social and political issues, such as the impact of immigration on mental health and the ways in which race and psychoanalysis intersect.
The thirteen chapters of this interdisciplinary volume are divided into four sections, with the first section focusing on the impact of Freud on Latin American culture. What stands out as particularly pertinent for myself in this section, as someone who works in a similar setting, albeit in Cologne, is the clinical material presented by Ricardo Ainslie, Hannah McDermott and Crystal Guevara in chapter 3, ‘Dying to get out: challenges in the treatment of Latin American migrants fleeing violent communities’. This presents three clinical case studies which clearly examine the intersection between and consequences of forced migration and trauma, in which a psychoanalytic approach is shown to be highly beneficial in the work. In the second section, entitled ‘Pathology of otherness: diagnosis in the barrio’, the medical model and psychiatric diagnosis is assessed. Although psychiatric nomenclature is examined here in detail, and with very accessible examples, what I found especially striking in this section is Alfredo Carrasquillo's chapter 5, ‘The anxiety of citizenship or the psychotic as citizen’, in which an innovative treatment programme founded in 1982 in Québec City for people experiencing psychosis is described as 'an ethical choice to provide young people with psychosis access to a clinical treatment in a middle-class neighbourhood
in the city rather than in a hospital setting' (p. 89). The treatment here operates under the proviso that patients are acknowledged as citizens, with rights and responsibilities, so as to re-establish the social link. Dream work is mentioned as central to the treatment, as is a programme of art studies with local artists and musicians. The multidisciplinary clinical team works together on the treatment plan, and it is expected that each team member undergoes their own psychoanalysis (p. 92).
In the third section, which has contributions related to the Latino queer body, the reader is taken, for example, into the queer performance world of an iconic guaracha singer by Licia Fiol-Matta in chapter 9, ‘Chencha's gait: voice and nothing in Myrta Silva’. Drawing on Mladen Dolar's A Voice and Nothing More, the unattainable object of desire and the Lacanian psychoanalytic object a as embodied in the singer's voice is the focus of an evocative and intriguing read. The final section, ‘The Clinic is Political’, presents the intersection between race and psychoanalysis, as in Patricia Gherovici's chapter 13, ‘Psychoanalysis of poverty, poverty of psychoanalysis’. This contribution adds to the already rich compilation of clinical material in the book with a re-examination of so-called ‘Puerto Rican’ syndrome, a psychiatric diagnosis, characterised by what at the time seemed to be inexplicable symptoms closely resembling the somatic grammar of classic hysteria. Having previously encountered and written about this diagnosis in the Latinx community of North Philadelphia (Gherovici 2003), in this volume, Gherovici discusses a historical incident from the Korean War connected to Puerto Rican syndrome and the ensuing resistance to working psychoanalytically with low-income populations. The vignettes provided in relation to the caucho – her analytic couch in the outpatient clinic of Philadelphia's barrio – make an irresistible case for psychoanalytic work.
This collection is an indispensable read for anyone interested in the practice of psychoanalysis in economically oppressive circumstances across the world. It continues the line of social activism appealed to at the turn of the last century by Freud, an appeal which has largely disappeared from collective memory and psychoanalytic history. At the same time, this
book demonstrates how some things are possible nevertheless, and that the process of making them possible can actually be highly entertaining and enjoyable.
Psychoanalysis in the Barrios: Race, Class, and the Unconscious, edited by and , is published by Routledge (2018), .
‘[I]t is possible to foresee that at some time or other the conscience of society will awake and remind it that the poor man should have just as much right to assistance for his mind as he now has to the life-saving help offered by surgery; and that the neuroses threaten public health no less than tuberculosis, and can be left as little to the impotent care of individual members of the community’ (Freud, 1919, pp. 167–68).