In This Issue

The Psychology and Politics of Privilege

Lynne Layton examines how the problems of social and economic inequality in our culture permeate countertransference in ways that are often ignored.

By Lynne Layton, PhD

When I think about both political and psychoanalytic activism, one thing that comes to mind is the difficult but important work of becoming conscious of the ways in which we are situated in relation to privilege and lack of privilege. For me, this challenging task complicates the very question of what constitutes a political act. For example, one of the most pressing problems facing us today in the United States is increasing economic inequality. Despite the Democrats’ recent attempt to rectify this inequality by raising taxes on the wealthy--an attempt that, weak as it was, failed--my sense is that for years both political liberals and political conservatives have in fact colluded in sustaining the very cause of this inequality: free market fundamentalism. The problem that seems to have no name in mainstream discourse is neoliberalism--and that problem includes the money that in large measure determines both Democratic and Republican political positions. Not naming this is itself a political act, one that protects privilege.

Many of the political problems now facing us demonstrate clearly how social and economic inequality can be inextricably intertwined. Thus, when economic inequality goes unnamed, even calls for social equality that look progressive can subtly contribute to the “us versus them” politics that mark our era. For example, many of us who live in middle or upper middle class communities have adamantly opposed the kind of recent anti-immigrant legislation passed in Arizona, seeing in it a clear example of conservative “us versus them” racism. But as a colleague recently pointed out, it is not the privileged who live in the neighborhoods or work in the jobs that are most affected by illegal immigration. My colleague made me question whether asking those directly affected to be more tolerant is in some ways tantamount to asking them to solve the problems of neoliberal capitalism that the privileged won’t address (e.g., the desire for cheap labor). What I am trying to say is that I think it is often quite difficult for those of us who are economically privileged to recognize our implication in the struggles of those who bear the brunt of the contradictions of contemporary capitalism. But without such awareness our political acts may in fact only exacerbate the social divisions we currently find in the United States.

What does this have to do with psychoanalytic activism? The therapist is always in a position of privilege vis à vis the patient, and that positioning brings politics into the clinic in many different ways. In her excellent inaugural column on the subject, Diane Ehrensaft challenged the myth that therapists who are activists indoctrinate their patients. I’m well acquainted with that myth and well acquainted, too, with the corresponding and perhaps even more dangerous myth that it is possible for therapists NOT to bring their politics into the consulting room. Not bringing politics into the consulting room is itself a mode of bringing politics into individualist myth that the individual and the social are separable spheres—it can thus be considered a political act, one that further legitimizes the separation.

When I think about my own practice(s), I find that, although I am a psychoanalytic activist in writing and thinking, I often don’t allow the leftist “me” to enter directly into the consult-rable clinical sessions, sessions that broke new ground, were ones in which politics were explicitly discussed. In each of those cases it was clear that barriers-mine and the patient’s- had to be overcome before such a conversation could flow beyond an opening or closing remark. For example, “Can you believe Scott Brown won the election?” might be followed by, “No, it’s terrible,” and then a move on to the “real” psychodynamic issues. After the Brown election, a patient and I uncharacteristically lingered on discussing it, and we then moved on to talk about contemporary U.S. politics and culture. In the next session, I was stunned to hear the patient report that it was the first time he had come to analysis without a pit of anxiety in his stomach, a feeling he was only too familiar with from his years of being scapegoated as a gay boy in homophobic schools. He told me that it was the first time in analysis that he had experienced not being the pathologized other. For this patient, the frame of analysis itself, in which he talks about his problems and I don’t talk about mine, sustained his feeling of inferiority in relation to my privilege. In this case, talking politics not only brought more of our selves into the room, but also challenged the norm of healthy analyst/sick patient that in fact was contributing to a repetition for this patient. Breaking with two norms of the field by allowing myself to be in a place where the patient and I could engage with each other as “equals” led to analysis of the different ways in which each of us were implicated in creating and sustaining a particular kind of frame—and this analysis critically changed the treatment.

Alongside the fear of influence is also a fear, I think, of being “extreme.” In a book on sexual regulation and the limits of religious tolerance, Jakobsen and Pellegrini (2003) describe a dominant social subject position that they call the “tolerant middle.” They show how pleas for tolerance and moderation often conceal commitments to a particular value hierarchy and a conviction that normalcy lies on the side of the tolerant (as in the earlier mentioned immigration example). The “tolerant middle” values self-control and devalues strong displays of emotion, particularly within the political field; for the “tolerant middle,” political demonstrations, pro- and anti-abortion, for example, are labeled “extreme” and then dismissed as illegitimate forms of political action. I thought of this when contemplating what to write here because I think the mental health field shares some of the norms of the tolerant middle, particularly the norm of moderating/modulating emotion. But in instances in which people are suffering from various kinds of social and economic inequalities, perhaps what is required of us is less tolerance and more affirmation of our patients’ very understandable rage and “extreme” reactions.

Our angry patients know all too well that they have to function within the norms of the tolerant middle to get any recognition for their complaints at all; they simply can’t do it. An African American patient of mine feels she has to take Paxil to keep her anger in check, an anger that so often has made her lose jobs and become even more invisible than she already feels she is. When working with her, the tension I feel between what is just and what is possible given social realities is sometimes hard to bear. Will our work help her moderate her emotions so she can be heard? This may well be the best thing forher, but something about that solution makes me feel uneasy and complicit. I have been wondering whether and in what cases legitimizing the value of moderating emotion is a political act, one that, again, might protect the privileged and mark the non-privileged as “other.”

As the above suggests, politics enter the consulting room in many ways besides direct political discussions. Diane spoke of some of those ways, for example, supporting those patients who are despised for their difference -again, refusing to be neutral about the prejudice to which our patients have been subject. Another way, one that I have been engaged in writing and thinking about for awhile, involves how our own unconscious racism, sexism, classism, etc. show up in the clinic and how important it can be to bring those moments into the process and subject them to analysis. Many academics and analysts have drawn on psychoanalysis to understand cultural phenomena. But it is perhaps only in the wake of contemporary theory’s engagement with countertransference enactments and with the impact of the analyst’s subjectivity that analysts have begun to take a closer look at how we unconsciously “perform” particular cultural values like the ones addressed above, and how we sustain particular cultural hierarchies in the clinic. I have been interested in exploring what I call normative unconscious processes, that is, unconscious patient-therapist collusions that legitimize some of the very norms that have caused us and our patients pain in the first place (class wounds, the wounds of sexism, race wounds). The clinical literature that has taken up such issues in the past twenty years (much of which has been written by members of Section IX) shows how important it is to be alert to the ways we unconsciously enact cultural norms in the clinic such as those that legitimize separating the psychic from the social or that involve the splitting and subsequent gendering, racing, classing, and sexing of human capacities like dependence and independence. Here, too, the focus is on being aware of how we and our patients are differently but mutually implicated in the same cultural mess.

In conclusion, psychoanalytic activism, like political activism, is probably most effective and authentic when we are able to acknowledge and work with the multiple ways we are placed and have placed ourselves in relation to privilege and lack of privilege. For what we do and have done with those positionings are, in important ways, political acts that deeply mark both our identity commitments and our conscious and unconscious engagements with others.

- Lynne Layton, PhD


Jakobsen, J.R. and Pellegrini, A. (2003). Love the Sin. Sexual Regulation and the Limits of Religious Tolerance. New York: New York University Press.