What is psychoanalytic activism?

Richard Ruth, PsyD, of George Washington University sat down with Ruth Fallenbaum to share his thoughts about training the next generation of activists.

RF:  Richard, tell me how you would describe psychoanalytic activism?

RR:  Let me answer with a vignette of the May 1968 protests in France.  A group of analysts felt bad that they were not more involved in what was happening, so they showed up at a march with a banner that read, “The Psychoanalysts Are With You.”  Someone took a photo.  In my opinion, there’s no fun in that.  We need to be in the thick of things. 

So began my interview with Richard Ruth.  The George Washington University PsyD Program in which he teaches operates the largest community mental health clinic in Washington D.C.  In addition to his private practice in clinical psychology and psychoanalysis in Wheaton, Maryland, Ruth  is a steering committee member, faculty, and supervisor with the Child and Adolescent Psychotherapy Program at the Washington School of Psychiatry, a member of the Board of Division 39, and a long -time member of Section IX.  He was trained as a psychologist in Argentina, moved to Washington D.C., worked in community mental health and, in the late 1980s, “reconnected with the psychoanalytic community.” 

RF:  How do you see yourself as a psychoanalytic activist?

RR:  There is a memoir by Gillian Slovo *, the daughter of two leaders in the A.N.C. Her mother was murdered during the struggle.  Later her father became a minister in the post-apartheid South Africa.  She was deeply wounded by how her parents were forced to raise her.  Many progressive movements leave damaged people in their wake.  Some analysts work with those people, or use their money to donate to causes.  Alternatively, you can  be there for people who find the political work they are doing makes extraordinary demands on them.

Another very realistic issue speaks to me: You and I are both old.  There has to be another generation of people able to do this work.  There was no golden age of psychoanalysis.  It was homophobic, sexist, and hegemonic.  We mostly don’t want to return to that. The question is, what kind of training are we providing?  In our program at George Washington students train in the middle of downtown Washington, D.C.  Our clinic is the largest community clinic in D.C.

RF:  How does your academic curriculum address your mission of training students to treat the underserved?

RR:  In every course we integrate what we are trying to do through case examples.  For instance, when teaching about the WAIS, I might ask, “What do you do if the child’s first language is not English?”

RF:  Well, what do you do in that situation?

RR:  Technically, first I’d find out what the child’s first language is and when he uses it.  Then I’d add to the battery receptive language batteries and the Peabody test in the child’s language if it is available.  I like it when psychoanalysts have a technical comfort with these tests, which are not hard to learn and come in several languages.  We had a case a few years ago of a child who was bilingual in Spanish and English, referred by a non-bilingual therapist.  Our student was monolingual but sensitive to these issues.  She said, “I’m not the best person to do the evaluation.”  The supervisor went to the clinic supervisor, who suggested the student go ahead and do the evaluation, with an attitude of ‘we’ll see.’

Well, the student was not comfortable with that decision and came to me.  I was worried, too.  I suggested we have a second student, bilingual, use the Peabody test and determine which language was dominant. It turned out the boy was English-primary, but  his emotional life was primarily encoded in Spanish.  The second student administered a Rorschach in Spanish.  In the Spanish testing, this child showed psychotic features which did not appear in the English protocol.  So the therapist needed to hold that information in mind.  For the administrators, for me, and for the students that was an ‘aha’ experience.

RF:  Are there other ways in which you prepare the students to be psychoanalytic activists?

RR:  It’s a work in progress.  They need and want a stronger scientific base than my cohort had.  The typical student is neuroscientifically literate.  They need those tools to be able to talk back to insurance companies and health care systems, and to be able to read journal articles with a critical mind. Our program is big on assessment for many reasons.  When the students assess a traumatized child, with a damaged but resilient brain, we want them to be able to see the resilience in the data and to be able to narrate that resilient piece for the caregivers and therapists.  Also, pragmatically, for many students, being able to do assessments will provide a means for paying back their student loans.

RF:  You mentioned earlier that you would not want us to retreat to a false “golden age of psychoanalysis.”  Can you give us an example of how your training program has moved forward from what you described as “homophobic, sexist, hegemonic” psychoanalysis?

RR:  I’ve been supervising students facilitating a transgender affirmative group.  These clinicians are bisexual, gay, etc., they come in knowing a lot about life.  But graduate students read a lot, and much of the old theory about gayness as pathological is not true, but it’s in a book.  How do we make space for an understanding that what they’ve read is a dangerous lie?  We’re writing the theory as we go.

RF:  Are you able to maintain a diverse group of students in your program?

RR:  The makeup of the students is not perfect due to inadequate scholarship support, which disproportionately affects some of the most talented minority and working class college graduates.  But we have significant numbers of ethnic minority and international students who seem to find out about the program on the internet. 

One piece that is important to me is that this is a very comfortable place to be out as a legally married gay man, so it’s great to see the population of LGB, and hopefully T, therapists growing.  When I was in graduate school and came out, my most memorable encounter was with a faculty member who looked me in the eye and said, “No, no you’re not.”  That won’t happen with our students.  Right from their interviews they sense they are walking into an affirmative environment.

Also, not all our students are of European descent.  We have many languages available in our clinic.  We can have a student doing therapy in Arabic and get them supervision in Arabic.

RF:  I would imagine that in trying to open up training to a diverse and heterogeneous group  while you are “still writing the theory,” tensions must come up among the students around those differences.  How does the faculty respond?

RR:  We take a clear stand.  We value diversity and competence in treating multicultural  issues -- and that means all the diversity within the community.  For instance, we have many religious students.  It is an ethical requirement to convey respect.  The same holds true with students who choose careers in police work, the military, etc.  People need to feel included.  When that happens, learning takes place.

RF:  I heard that you had an interesting experience when you attended the APA convention in New Orleans following Hurricane Katrina?

RR: One of my personal quirks is that I like talking to folks and am particularly curious about where the Latin American community is in any city I happen to be visiting.  To get to the hotel for the meetings, I had to walk through a semi-deserted mall where I noticed a couple of Latino guys.  I got into conversation with them and learned that after the dislocation of whole sections of the African-American community, the African-American workers were not welcomed back to do the rebuilding, partly because there wasn’t housing for them. However, migrant workers came to do the work for far less than the former impoverished residents would earn, and lived in beyond make-shift conditions.  I consider this conversation of a piece with running a clinic in D.C. for the people of D.C. 

In other words, conversations are best not had in bubbles or we risk creating psychoanalytic apartheid. 

By a fluke I ended up using my psychological training in the 2012 election.  In Virginia there are red areas and blue areas.  In the blue areas it was taking up to three hours for people to vote.  Shortly before the polls were scheduled to close, the state government faced a dilemma: whether or not to keep the polls open to let people in line vote.  They turned to social scientists, so I wrote about statistical issues that indicated they should keep the polls open, and hit the “send” button.  Who knows if it was a waste of time?  But subsequent media analysis showed that the number of votes by which Obama won Virginia equaled the number of voters who were able to vote after the polls were kept open.

Reference

* http://www.amazon.com/Every-Secret-Thing-Gillian-Slovo/dp/1844085996