The problem of thinking in black and white: race in the South African clinical dyad

Abstract

This thesis explores the assumption that race, as an inextricable dimension of subjectivity, is ubiquitous in the clinical encounter, shaping the intersubjective overlap between patient and therapist, fundamentally impacting the passage and integrity of the therapeutic task. Whilst the thesis considers race against the backdrop of psychoanalytic thinking globally, its particular focus is on the South African psychoanalytic environment, taking into consideration the moulding influence of context on the idiosyncratic ways in which race is insinuated into the clinical space. The study progresses through four core papers, the first of which offers commentary on, and a critique of the relationship between mainstream psychoanalytic thinking and race. It contends that the absence of a consideration of race in the forces which shape the psyche, betrays an avoidance of the potency of race, and its capacity to destablise the mainstays of psychoanalytic thinking, including analytic neutrality. Drawing on the experience of a working group of clinicians grappling with race, the second paper engages with the interpersonal violence of race and racism, considering the iterative cycles of rupture and repair which inevitably accompany engagements margined by race. Through the use of clinical vignettes, the third paper investigates the subjectivity of racialised encounters in the intimacy of the consulting room, considering, in particular, the impact on the therapist’s capacity to think when race enters the room. Qualitative in nature, the thesis is intentionally self-reflexive throughout. This reflexivity is foregounded in the fourth paper wherein the researcher/clinician’s subjectivity, and the way in which it has been disrupted by race, and indeed by the progression of the thesis, is engaged with. This subjectivity, and the influence of the researcher’s particular lens, is intrinsic to the passage of the research, and to its outcomes.