Yale Psychiatry Grand Rounds: January 27, 2023
January 27, 2023Karasu Psychosocial Lecture: "Decolonizing Psychoanalytic Theory and Practice"
Pratyusha Tummala-Narra, PhD, Research Professor in the Department of Psychological and Brain Sciences; Director of Community-Based Education, Albert and Jessie Danielsen Institute, Boston University
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- 9418
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Transcript
- 00:00Much. Thank you so much Doctor Steinfeld
- 00:04and Doctor Crystal for these introductions.
- 00:06I really appreciate it.
- 00:09I am really honored to join all of you today
- 00:13on this very significant and meaningful day,
- 00:17the Holocaust Remembrance Day.
- 00:20I I also am especially grateful to to
- 00:26provide this lecture that honors Dr.
- 00:29T Byram Karasu, and I'll tell you a
- 00:32very short story about why actually,
- 00:35Doctor Karasu has meaning in my life I.
- 00:39Actually had a very dear supervisor of mine,
- 00:42Robert Webber and at Cambridge Health
- 00:44Alliance when I was a psychology intern.
- 00:47And back in 1996 when I completed
- 00:50my psychology internship,
- 00:51my supervisor gave me a book by an author and
- 00:56it is Doctor Karasu and he gave me a book.
- 00:59It was a parting gift and it was called
- 01:02wisdom in the practice of psychotherapy,
- 01:04which was published in
- 01:061992 and I have to say.
- 01:09I have cherished this book and
- 01:11it's wisdom over the years and
- 01:13find it very meaningful to deliver
- 01:15a lecture honoring this author.
- 01:17And I want to share something that
- 01:19he wrote in this book that I found
- 01:22especially relevant to my talk today
- 01:24in a in a chapter that he titled
- 01:27Diagnosis and psychotherapy means
- 01:29understanding human conditions that
- 01:31are both unique and universal.
- 01:34That was the IT was really a sentence,
- 01:36but that was the the title of the chapter.
- 01:39And he wrote the following in this chapter,
- 01:41he said accentuating neurotic or
- 01:44psychotic symptomology takes the
- 01:46psychotherapist away from a broader
- 01:48and deeper look at the individual,
- 01:50which is necessarily more flexible
- 01:53and demanding.
- 01:54Moreover,
- 01:55because such a stance is skewed towards
- 01:58towards preconceived categories or
- 02:00prototypic standards of behavior,
- 02:02it can be dehumanizing to the
- 02:04extent that it fails to regard the
- 02:07complex and subtle nuances of the
- 02:09whole person whose psychodynamics
- 02:11are intricate and infant.
- 02:13Infant.
- 02:13I can never say this word,
- 02:15but infinitesimal on one level,
- 02:18broad and boundless on another,
- 02:21and you'll see why this particular.
- 02:25Excerpt from the book is relevant to
- 02:27what I'm about to share with you today.
- 02:30So this topic of decolonizing a
- 02:32theory and practice like analytic
- 02:34theory and practice is so broad.
- 02:36My focus is going to be particularly
- 02:38in the area of race and culture,
- 02:40and I come to this talk as a researcher,
- 02:43as a clinician and as an educator,
- 02:45and as an immigrant,
- 02:46as an Indian American immigrant.
- 02:48My family and I immigrated to the United
- 02:51States when I was seven years old in 1977.
- 02:54We lived.
- 02:54We first arrived to New York City.
- 02:57We lived in the Bronx.
- 02:58We moved around to New York,
- 03:00from New York to New Jersey to Michigan and,
- 03:04you know,
- 03:05other places since then as an adult.
- 03:08But I want to start with a personal anecdote,
- 03:11and I'm going to be shifting
- 03:13sort of from the personal to the
- 03:15academic and to the clinical.
- 03:17So please bear with me as you see me
- 03:19sort of move through these different
- 03:21spheres throughout my talk today.
- 03:23But let me begin with a personal. Anecdote.
- 03:25After immigrating to the United States,
- 03:28it was striking how my family and I had
- 03:31so quickly begun to absorb American
- 03:34cultural norms and expectations,
- 03:36most often unconsciously.
- 03:381 Evening a few months after
- 03:41we arrived to New York,
- 03:43we had been eating our dinner,
- 03:45which almost always consisted of
- 03:47traditional South Indian curries and rice.
- 03:50We mix the rice with the curries,
- 03:53the delicious curries that my
- 03:54mother would make, and.
- 03:56Ate the food with our hands.
- 03:58This is customary.
- 04:00We had not learned to eat our Indian
- 04:02meals with Western utensils until we
- 04:04moved to the US that particular evening.
- 04:07The doorbell to our apartment rang and all
- 04:10four of us immediately got up from the table,
- 04:14washed our hands at the sink
- 04:16before my father opened the door.
- 04:18No one had instructed us to
- 04:20get up and wash our hands.
- 04:23Nevertheless, we knew to do so.
- 04:25We never spoke about this afterward.
- 04:28And since that time,
- 04:30I've thought about how we each
- 04:32knew to wash our hands without ever
- 04:34having a conversation about it.
- 04:36I was aware, however,
- 04:37that people at school and on TV
- 04:40would comment that's gross when
- 04:42they saw anyone eat food with their
- 04:44hands other than sort of pizza or
- 04:46a hamburger or something like that.
- 04:49This notion of eating with one's
- 04:51hands as gross was difficult for me
- 04:53to reconcile with the reality that
- 04:56eating Indian food with my hand was
- 04:59essential. To how the food tasted.
- 05:01To me it doesn't taste the same
- 05:03when I eat with a fork. Or a spoon.
- 05:07These memories raise questions
- 05:08about what we learned implicitly
- 05:10and explicitly about the presumed
- 05:13superiority of a culture and a
- 05:15nation that both allowed you to enter
- 05:18and demanded that you leave parts
- 05:20of yourself somewhere in transit.
- 05:22Enters.
- 05:23Interestingly,
- 05:23in more recent times,
- 05:25eating Indian food with one's
- 05:27hands has shifted towards a blend
- 05:29of acceptance and exoticizing,
- 05:31as many non South Asian people now
- 05:34enjoy eating Indian food with their hands.
- 05:37The change in attitudes in at least
- 05:39some regions of US or some parts
- 05:42of US culture raises questions
- 05:44of who decides which practices
- 05:46shaping development are acceptable,
- 05:48desire desirable and civilized.
- 05:52Narratives on what's normal and what's
- 05:55pathological are steeped in early childhood,
- 05:57within families,
- 05:58Community Schools,
- 05:59social media,
- 06:00and just the broader context that
- 06:02we all live in.
- 06:03These narratives persist even while
- 06:06we're exposed to new conceptualizations
- 06:08of normality and abnormality.
- 06:10And in my view,
- 06:12colonization strives to strip
- 06:14subjectivity of the colonized
- 06:15and requires a narrative written
- 06:18and spoken by the colonizer to
- 06:20be fixed and unchanging.
- 06:22For racial minorities in the US,
- 06:24our narratives are too often defined
- 06:27and codified without our presence.
- 06:29Existing psychological and
- 06:31psychoanalytic theories of development
- 06:34and psychopathology most often
- 06:36rely on fantasies of who we are,
- 06:38who racial minorities are,
- 06:40rather than our diverse and
- 06:42complex subjectivities.
- 06:44These theories also have
- 06:46profound implications for people
- 06:48within and beyond the clinic.
- 06:50Juxtaposed against mainstream psychological
- 06:52theories are postcolonial theories
- 06:55that counter theoretical concepts
- 06:57rooted in Euro American context.
- 07:00These theories aim to decolonize
- 07:03psycho psychological theories by
- 07:05reclaiming the subjectivity of
- 07:07colonized people and their descendants.
- 07:10So in this presentation today,
- 07:12what I do is I will explore
- 07:14the the juxtaposition between
- 07:16psychoanalytic and postcolonial
- 07:18perspectives concerning development.
- 07:20And I will focus specifically on the
- 07:24concept of dependency and why I think
- 07:27that's such a core issue and concept
- 07:29in our theories of psychopathology
- 07:33and our psychotherapy approaches.
- 07:35So let me begin with city of
- 07:38psychoanalysis and colonized approaches
- 07:39to development and then describe some
- 07:42this issue of dependency and postcolonial
- 07:45perspectives that challenge these views.
- 07:48And I will wrap up today by sharing
- 07:51with you some some of my ideas
- 07:54on on how we might begin to move
- 07:57towards decolonizing theory,
- 07:59practice and training.
- 08:02Umm so first,
- 08:04colonization within psychoanalytic theory.
- 08:06Dian Powell recently has written about how
- 08:09psychoanalysis and clinical psychology
- 08:11have contributed to racism in the US.
- 08:13She specifically points to the problematic
- 08:17use of psychological terminology like,
- 08:19for example,
- 08:21drapetomania,
- 08:21which is literally translates
- 08:24to flight from home madness.
- 08:26This concept or this term was
- 08:28used to describe an affliction of
- 08:30slaves who attempted to run away
- 08:32from their masters to gain freedom.
- 08:35This type of terminology illustrates
- 08:37how analysts and psychologists use
- 08:40pseudoscience to subjugate people of color.
- 08:43She further notes the importance of
- 08:45recognizing the insidious quality
- 08:47of racism in early psychoanalysis,
- 08:49beginning with Freud,
- 08:50who referred to people of African
- 08:53descent as primitive and less
- 08:55and less evolved and ongoing.
- 08:56And also the ongoing reluctance
- 08:58to fully engage with race and
- 09:01psychoanalytic institutes and circles.
- 09:03As Freud aimed for his meta psychological
- 09:06conceptions of development and
- 09:08psychopathology to be universal,
- 09:10he dismissed the the sociocultural
- 09:13particulars of human experience,
- 09:15especially when they contradicted
- 09:17what he understood as more evolved
- 09:19behavior or civilized behavior.
- 09:21His correspondence with Gurinder
- 09:23Shekhar Bose illustrates this point.
- 09:26Gurinder Shekhar Boaz was an Indian
- 09:28psychiatrist who received the first
- 09:31doctoral degree in psychology in 1921.
- 09:33The first ever to be awarded
- 09:36in British occupied India.
- 09:38In 1921.
- 09:39Both began a correspondence which with Freud,
- 09:43which would last until 1937.
- 09:47And while the tone of the
- 09:49correspondence was polite,
- 09:50Freud would largely dismiss the cultural
- 09:52particulars of of the psychoanalytic
- 09:54theory that Bose had presented to him.
- 09:57Both,
- 09:57in fact,
- 09:58had been developing psychoanalytic
- 10:00ideas that integrated Hindu and
- 10:03Indian philosophy with Western
- 10:05understandings of the unconscious.
- 10:07For example, for both,
- 10:08the delineation between the masculine
- 10:11and feminine were far less rigid,
- 10:13as he wrote about boys unconscious
- 10:15desire to be female,
- 10:17in contrast to Freud's conceptions
- 10:19of castration,
- 10:20fear among boys and penis envy among
- 10:24girls in honor of Freud's 75th birthday.
- 10:27Both sent Freud an ivory statue of Vishnu,
- 10:31who is the God,
- 10:32the Hindu God who is known as
- 10:34the preserver of life.
- 10:36And Freud responded to to boast
- 10:38by writing the following as long
- 10:41as I can enjoy life,
- 10:43it will recall to my mind the progress
- 10:46of psychoanalysis and the proud conquest
- 10:48it has made in foreign countries.
- 10:51Freud's response clearly marks
- 10:52a curiosity of the foreign,
- 10:54but one that's embedded within
- 10:56and constrained by the wish to
- 10:59to align with the colonizer.
- 11:01He seemed more interested in other
- 11:03words and contrast in conquering
- 11:05the minds of foreigners than an
- 11:08understanding their experience.
- 11:09Paradoxically,
- 11:10it's been widely recognized that
- 11:12Freud himself was an outsider in
- 11:15an anti-Semitic Viennese society.
- 11:17anti-Semitism among Europeans
- 11:19promulgated notions of Jews as castrated,
- 11:23oriental, black, racially,
- 11:25socially and psychologically
- 11:27inferior and primitive.
- 11:29And a major consequence of the colonial
- 11:32underpinnings of psychoanalytic
- 11:33theory was the separation of
- 11:35the psychic and the social,
- 11:37and even more aptly,
- 11:38the dissociation of the social
- 11:40from the psyche.
- 11:41And I would argue that the most traumatic
- 11:44aspect of the social remain the most
- 11:47associated in our theories even today.
- 11:49The effects of split and dissociation
- 11:51can be seen in psychotherapy
- 11:52approaches to racial minorities
- 11:54in the US and in the applications
- 11:56of psychoanalytic theory,
- 11:58and I would say broadly
- 11:59psychological theories.
- 12:00To development across the world.
- 12:02So for example,
- 12:03cross cultural approaches have most
- 12:06often framed psychological experiences
- 12:07of people and quote developing
- 12:10countries by separating the east from
- 12:13the West and uncritically imposing
- 12:15psychoanalytic concepts like the
- 12:17Oedipus complex rather than asking
- 12:20people what they actually think and feel.
- 12:23I remember growing up with Hindu myths
- 12:26in my home and the myth of Ganesha,
- 12:29the elephant headed God in Hinduism
- 12:32and he is known to be the remover
- 12:35of obstacles and how that story,
- 12:37which has deep spiritual significance,
- 12:40has been interpreted in psychology
- 12:43and psychoanalysis by many authors
- 12:46as akin to the Oedipus complex with
- 12:49no real research into how Hindus.
- 12:53Actually feel about this myth.
- 12:55So there's this history that we
- 12:57have around imposing these ideas.
- 13:00And together with disciplines
- 13:02such as personality,
- 13:04cognitive and developmental psychology,
- 13:06psychoanalysis has had a global
- 13:08impact on conceptualizations of
- 13:11development and psychopathology.
- 13:13Let me give you another example.
- 13:15And this was brought forth in a
- 13:17in a beautiful paper written by
- 13:19Sunil Bhatia and Kumar Priya,
- 13:20they explored Erik Erikson's theory
- 13:23of identity to illustrate the use
- 13:26of theory to mark certain cultural
- 13:28groups as less evolved in particular.
- 13:31Erikson's theory of identity formation
- 13:33and wide you're American adolescence as
- 13:36assuming responsibility in maintaining
- 13:38a nation's growth contrasted with his
- 13:41views of nonwhite adolescence as passive,
- 13:44dependent,
- 13:44and submissive.
- 13:45Kumar Priya noted Erickson further
- 13:48maintains that non whites are
- 13:50doomed to have a submissive identity
- 13:53because their parents corporeal
- 13:55and bodily socialization practices
- 13:57prime the child to develop a
- 14:00set of primary sensory behaviors
- 14:02reflected in the child's language
- 14:04and interpersonal interactions.
- 14:06And as we know,
- 14:08Erikson's theory of identity has
- 14:10deep influence in our understandings
- 14:13of development and identity.
- 14:16The emphasis of the cultural
- 14:18assumptions of psychoanalysis that
- 14:20are consciously and unconsciously
- 14:22absorbed and yet unintegrated by
- 14:24non white people and communities
- 14:26also cannot be overstated.
- 14:28So let me share with you a personal anecdote
- 14:31that provides an illustration of this issue.
- 14:34Just before I began my doctoral program,
- 14:37I had shadowed an Indian
- 14:39psychiatrist who trained as a
- 14:41psychoanalyst in the United Kingdom.
- 14:44He he this was in India.
- 14:46So I had taken a summer um and gone to India
- 14:49between college and and Graduate School,
- 14:52and I had shadowed him this summer.
- 14:55He had been he had finished his training
- 14:58in the UK, and then he led a very busy,
- 15:01psychoanalytically oriented practice
- 15:02in a in in Hyderabad in India.
- 15:05That's where I'm I was born.
- 15:08One of the first patients whom I observed in
- 15:11this practice was a woman in her early 20s.
- 15:14And the suchiate Christ had
- 15:16diagnosed with diagnosed her with
- 15:18obsessive compulsive disorder.
- 15:20The patient had been washing her
- 15:22hands compulsively for over three
- 15:24years and she coped with her
- 15:26intense anxiety through prayer.
- 15:28The psychiatrist prescribed medication to
- 15:29help her with her hand washing compulsion,
- 15:33but in private shared with me that
- 15:35he found it difficult to conduct
- 15:37psychotherapy with her as he was not
- 15:40able to understand her religiosity
- 15:42and he commented that.
- 15:44She's a product of Indian society that is
- 15:47quote hyper religious and quote backward.
- 15:50And he went on to tell me that her
- 15:53parents had poisoned her mind by
- 15:55telling her that if she prays enough
- 15:57that she would find a good husband.
- 15:59So when I asked him to tell me
- 16:01more about the patient's family,
- 16:02he said the family was from a low
- 16:05income and low caste background.
- 16:07Later that same day,
- 16:09just a few hours later,
- 16:10the psychiatrist told me how much he missed
- 16:14living in India while he was in the UK.
- 16:16He spoke about how he missed the
- 16:19landscape and climate of India,
- 16:20the beautiful colorful clothing,
- 16:22and the bustling noises of Indian cities.
- 16:26And I left these interactions on one hand.
- 16:29Very confused.
- 16:30And on the other hand,
- 16:32also I would say at the same
- 16:33time kind of apprehensive about
- 16:35psychology and psychoanalysis.
- 16:36I thought to myself,
- 16:38I have no idea what I've gotten myself into,
- 16:41you know,
- 16:41as I was anticipating starting a doctoral
- 16:45program just a month or two later.
- 16:47And at the time I didn't understand.
- 16:51His contradictory statements about India
- 16:53or his negative views of the patients
- 16:55and her family's religious beliefs,
- 16:57especially since these beliefs are
- 16:59not uncommon in Indian society,
- 17:01not to mention within my family.
- 17:04Since then,
- 17:04I've learned more about the impact
- 17:06of colonized thinking that's
- 17:08that's integral to Euro American
- 17:10psychology and psychoanalysis,
- 17:12and how the internalization of
- 17:14a colonial mentality leaves us,
- 17:17those of us whose ancestors were colonized,
- 17:19in despair.
- 17:20In particular,
- 17:21many people who are victimized by
- 17:24colonization questioned their own
- 17:26cultural or indigenous narratives
- 17:28as legitimate and powerful,
- 17:30even while we deeply value our.
- 17:33Emotional connection to our families,
- 17:36cultural,
- 17:36religious communities and heritage culture.
- 17:40Notably,
- 17:40this ambivalence makes us question
- 17:43whose narrative,
- 17:44that of the colonizer or that
- 17:46of the colonized,
- 17:47is in fact the legitimate 1.
- 17:49Which, of course, has important implications
- 17:52for the therapeutic relationship.
- 17:54Maybe even more significant on a
- 17:56global scale is the impact of this
- 17:59ambivalence on who holds power
- 18:01in developing and disseminating
- 18:03theoretical concepts of development,
- 18:05health and psychopathology.
- 18:07Within the US, this ambivalence and despair
- 18:10are evident in mental healthcare systems,
- 18:13as racial minorities continue to
- 18:15struggle with how much of their stories,
- 18:17indigenous to their families, communities,
- 18:19and at times countries of origin
- 18:22will be legitimate and considered
- 18:24civilized in the mind of the therapist.
- 18:27For example, my my patient Jacqueline,
- 18:30who's an African American sis woman.
- 18:32She's in her 40s.
- 18:35She had told me in one in
- 18:37actually in our first session,
- 18:38that she's not sure how
- 18:40psychotherapy could help her.
- 18:41She had met briefly with a
- 18:43therapist prior to working with me,
- 18:45and she said that while she
- 18:47expected her white therapist to
- 18:49not fully understand her family,
- 18:50she was disappointed by having to
- 18:52pay to see a therapist who doesn't
- 18:54really know what it's like to be
- 18:56black in one of her sessions when
- 18:59she described a family gathering.
- 19:01To this therapist,
- 19:04the family gathering included her
- 19:06former husband and his children and.
- 19:09And so the client, Jacqueline,
- 19:11was describing this family
- 19:13gathering and session.
- 19:15That therapist remarked that she
- 19:17needed to have better boundaries
- 19:18from her former husband.
- 19:20And Jacqueline then told me that
- 19:22she was not concerned about the
- 19:23presence of her former husband or
- 19:25his children at the Gathering,
- 19:27but that what had upset her at
- 19:29the gathering was that she missed
- 19:30the presence of her mother,
- 19:32who had died the previous year,
- 19:34Jacqueline said.
- 19:35I just stopped going to see her
- 19:38because I didn't want to have to
- 19:40explain black families to her.
- 19:42Jacqueline,
- 19:42in conveying this in this
- 19:44particular incident to me,
- 19:46was of course implicitly asking me if
- 19:49I too could understand black families.
- 19:53So let me shift a bit here to talking
- 19:57about post colonial challenges
- 19:59to some of this colonization,
- 20:02the colonized pieces that I'm talking about.
- 20:06In an effort to challenge the imposition
- 20:09of traditional paradigms on people of color,
- 20:11the discipline of psychology since
- 20:13the 1980s has supported unique
- 20:15therapeutic approaches for racial
- 20:17and ethnic minority patients.
- 20:19These efforts have resulted in a
- 20:21growing visibility of experiences
- 20:23of people of color.
- 20:24However, expanding the visibility of culture,
- 20:29race and other social locations and
- 20:31oppression faced by racial minorities,
- 20:33in my view,
- 20:34has not culminated in a deeper
- 20:37understanding of heterogeneity
- 20:38within racial minority groups or
- 20:41more complete understandings of
- 20:43subjectivity of racial minorities.
- 20:45The effort to expand psychological
- 20:48theories towards multiculturalism has
- 20:50inadvertently dismissed the importance
- 20:52of exploring individual subjectivity.
- 20:55As shaped by multiple social contexts and
- 20:58by conscious and unconscious dynamics,
- 21:01more recently,
- 21:02culture has been increasingly
- 21:04recognized as dynamic,
- 21:06contextual and transnational.
- 21:09Some postcolonial scholars have
- 21:11interestingly turned to using
- 21:13psychoanalytic concepts to
- 21:15challenge colonized thinking about
- 21:17development and psychopathology.
- 21:19In other words,
- 21:20psychoanalysis has been used as a framework
- 21:22for understanding the colonial mind and the
- 21:25effects of colonization on people of color.
- 21:27So let me share with you.
- 21:31Some some more depth around this concept
- 21:35of dependency which I mentioned earlier.
- 21:38The concept of dependency is a critical
- 21:41feature of psychological theories of
- 21:43development and typically dependency
- 21:44is seen as a subjective experience that
- 21:47one we sort of gradually move away
- 21:50from in the course of development,
- 21:51as as noted in ideas like separation
- 21:56and individuation.
- 21:57Now, while it's certainly the case
- 21:58that in many cultural contexts,
- 22:00psychological separation is a very
- 22:02typical process in development,
- 22:04the ways in which dependency and
- 22:07separation and individuation are
- 22:08constructed vary across contexts.
- 22:13There there's been a growing criticism
- 22:15in fact, over the last two decades of
- 22:18how euroamerican ideas around attachment
- 22:20and separation individuation have
- 22:22been applied non discriminately to
- 22:25non euro American cultural contexts.
- 22:27And and and there's also been a
- 22:30call for Indigenous studies that
- 22:32focus on local observations.
- 22:34In particular,
- 22:35these criticisms underscored the
- 22:37the the variations in parenting
- 22:39behaviors and that these variations.
- 22:42Don't necessarily mark a quality
- 22:44of relationship and attachment
- 22:46between a caregiver and a child,
- 22:49or how much a parent or a
- 22:51caregiver loves a child.
- 22:53But despite these criticisms,
- 22:55family dynamics that diverge from what
- 22:58I would say is is a Euro American middle
- 23:01class value system continue to be viewed,
- 23:04either consciously or unconsciously,
- 23:07as pathological or underdeveloped.
- 23:10So let me draw in Frantz Fanon's work here.
- 23:13Umm Fanon,
- 23:14in his landmark book black Skin,
- 23:16white masks,
- 23:17and which was published in 1952,
- 23:20challenged the notion of the dependency
- 23:23complex that was thought to compose the
- 23:26unconscious mind of colonized people.
- 23:28And specifically,
- 23:30he critiqued the work of Oktav Manoni,
- 23:35a French psychoanalyst who lived
- 23:37in Madagascar for about 20 years,
- 23:39over 20 years.
- 23:41Manoni's drawing on Adler's concept
- 23:44of the inferiority complex concluded
- 23:47that a dependency complex existed
- 23:49among the Malagasy prior to the
- 23:52French colonizing Madagascar.
- 23:54Because their culture was supposedly
- 23:56centered on the worship of
- 23:58ancestors and patriarchy,
- 24:00So what Manoni did was he he assumed
- 24:02that that the submissiveness of the
- 24:05Malagasy was a trait inherent to
- 24:08their culture that was redirected to
- 24:10new paternal rule of the Europeans.
- 24:14Fanone proposed an alternative to
- 24:16this idea of the dependency complex.
- 24:19That is the colonies,
- 24:21colonization and racist structures are
- 24:23the things that produce inferiority.
- 24:26And he stated inferior lization is
- 24:29the native correlative correlative to
- 24:32the Europeans feeling of superiority.
- 24:35Let's have the courage to say it is the
- 24:38racist who creates the interiorized.
- 24:40So in phenoms view,
- 24:42psychoanalysis should address
- 24:43the real source of conflict.
- 24:45That drives feelings of inferiority,
- 24:47which is the social structure.
- 24:50In the US today,
- 24:51we can certainly see how this colonial
- 24:54mentality is enacted in rhetoric and
- 24:57violence against racial minorities,
- 24:59immigrants and indigenous people.
- 25:01In my view,
- 25:02it's unconscionable that we have a
- 25:05well established understanding of the
- 25:07importance of secure attachment and
- 25:09yet we've allowed migrant children
- 25:11to be separated from their parents,
- 25:13be placed in cages.
- 25:14This is not a new thing, of course.
- 25:17In U.S.
- 25:18history,
- 25:18the separation of children has been
- 25:21used over and over again as a form
- 25:24of violence against people of color.
- 25:26Only a colonial mentality,
- 25:28though, can justify that.
- 25:30Secure attachment is only a valid human
- 25:33right for some children and not others.
- 25:36Along with the disregard for the humanity
- 25:39and subjectivity of the colonized,
- 25:41there's a prevalent belief that
- 25:43the colonized wannabe white.
- 25:45For example,
- 25:46we hear repeatedly that immigrants
- 25:48are dying to come to the US and
- 25:51not just take what we have,
- 25:53but also want to be like us.
- 25:55And so it's important to clarify
- 25:58what racial minority immigrants
- 25:59actually want, and that is the rights
- 26:02that whites have bestowed to themselves.
- 26:04We don't want to be white.
- 26:06We simply want the right
- 26:08to resources and humanity,
- 26:09which whites have consciously
- 26:12and unconsciously assumed belongs
- 26:14primarily or solely to them.
- 26:16Additionally,
- 26:17expressions of justified anger
- 26:19and outrage against racism and
- 26:22xenophobia within a colonized
- 26:24framework are often perceived to be
- 26:26further indications of pathology.
- 26:29So dependency and colonial mentality
- 26:31mentality is complicated in that it not
- 26:34only requires the superior racial group.
- 26:37The so-called Superior Racial Group
- 26:39to provide protection for those
- 26:41so-called inferior racial group,
- 26:43but also the belief that any
- 26:45autonomy asserted by the colonized
- 26:47is an attack on the colonizer.
- 26:52So I want to say a few things about the
- 26:57impact of colonized colonization and
- 27:00racial trauma on racial minorities.
- 27:05Dependency and inferiority are attributes not
- 27:07just projected towards racial minorities,
- 27:10but they also become internalized
- 27:13psychic experiences.
- 27:14Umm and so, like, for example,
- 27:18there's a high prevalence of skin
- 27:20bleaching and lightening creams and
- 27:23skin products both among racial minority
- 27:25groups in the US and in African,
- 27:27Asian, South Asian countries.
- 27:31And all of these,
- 27:32if you look across diaspora,
- 27:34this has become not a a problem that's
- 27:38declining but actually increasing and
- 27:40industries making a lot of money off of this.
- 27:44And to me, when you look at this,
- 27:46you know, simple, very simple but
- 27:48powerful example of these skin bleaching,
- 27:51lightening products and procedures,
- 27:53intravenous interventions to
- 27:54lighten your skin, which is,
- 27:56you know, becoming more and more
- 27:58prevalent around the world.
- 28:00To me, this is one way,
- 28:02one reflection of an internalization
- 28:04of white beauty ideals.
- 28:06It's worth noting,
- 28:07however,
- 28:08that many people of color internalize
- 28:10these kinds of white beauty ideals,
- 28:13and at the same time.
- 28:14Proudly identify with cultural values and
- 28:17norms distinct from euroamerican values.
- 28:20This type of paradox embedded in
- 28:23colonial mentality is a common experience
- 28:25where there's both an adaptation
- 28:28to the demands of white society
- 28:31and a rejection of white society.
- 28:33Therefore,
- 28:34projections of dependency and inferiority
- 28:36are met with ambivalence and resistance.
- 28:41Nonetheless, the devaluation of indigenous
- 28:44narratives on development has significant,
- 28:46lasting effects on intrapsychic life.
- 28:50Including psychological alienation,
- 28:52ambivalence, distortions about the self,
- 28:55sense of trust, safety and belonging.
- 28:59Colonial mentality among some people of
- 29:02color largely develops unconsciously,
- 29:04resulting in a sense of cultural inferiority.
- 29:07Also an uncritical rejection of a
- 29:09heritage culture in some cases,
- 29:11and discrimination among members
- 29:14of 1's own sociocultural group.
- 29:17There's a analyst,
- 29:19Chris Yee in Los Angeles,
- 29:21who's written very beautifully and has
- 29:24described a concept called cultural
- 29:27dissociation, and this is when an.
- 29:29Immigrant or racial minority
- 29:31person is traumatized within one's
- 29:33family and community,
- 29:34and traumatic stress and one's heritage,
- 29:37culture or community are merged.
- 29:39In this case,
- 29:41one distances oneself from heritage,
- 29:43culture, traditions,
- 29:44and language and similar ethnic people and
- 29:47feels more connected with mainstream norms.
- 29:50Yet the experience of cultural
- 29:53dissociation is actually a disruption
- 29:55in one's ability to stand in the spaces
- 29:59between disconnected or dissociated.
- 30:01Health states,
- 30:02reflecting heritage and mainstream cultures.
- 30:05So Chris would say that this,
- 30:10this experience of cultural dissociation
- 30:12poses an impossible dilemma for racial
- 30:15minorities coping with both traumatic
- 30:17stress within their families and our
- 30:20communities and at the same time,
- 30:22racism outside of their families
- 30:25and communities.
- 30:26Umm,
- 30:27the development of it.
- 30:30When we think about this issue of colonial
- 30:33mentality and cultural dissociation,
- 30:35it's also important to me to consider
- 30:39our existing diagnostics systems is
- 30:42there's a way in which racial trauma
- 30:45and colonization have remained largely
- 30:48disassociated from our diagnostic thinking.
- 30:51So our diagnostic systems like
- 30:53the DSM and I CD,
- 30:55still do not recognize racial
- 30:57trauma as a precipitant to PTSD,
- 30:59falsely suggesting that there's not
- 31:01enough empirical evidence for the
- 31:03negative psychological effects of racism.
- 31:06We have ample evidence in in
- 31:09several fields at this point of
- 31:12this the impact of racism.
- 31:14Cycle analytic formulations of psychic
- 31:17trauma have also not included racial and
- 31:20sociocultural traumas as precipitants.
- 31:22I would argue that it's now a critical
- 31:25time to explicitly recognize racial
- 31:26trauma as a form of psychic trauma.
- 31:29In doing so,
- 31:30we can finally recognize the ongoing
- 31:32traumatic effects of colonization and
- 31:35begin working through our dissociation
- 31:37from the effects of colonization
- 31:39on our theories of development and
- 31:41psychopathology and our practice.
- 31:46So I want to just move towards.
- 31:50Maybe a very last section of what I want
- 31:55to share how do we sort of move from?
- 31:59This colonization,
- 32:00the position of colonization towards
- 32:03a decolonized theory and practice,
- 32:06and this is again a very large topic
- 32:09and and I do believe that the task
- 32:12of decolonizing theory and practice
- 32:14requires multiple perspectives
- 32:17and interdisciplinary work.
- 32:19But I want to just ask us
- 32:22to consider four areas.
- 32:23One has to do with humanizing
- 32:27versus colonizing.
- 32:28Decolonizing theory and practice
- 32:30requires humanizing cultural narratives.
- 32:33Knowing and seeing a whole person,
- 32:35with all of the intertwined complexity
- 32:38of intrapsychic, interpersonal,
- 32:40and sociocultural aspects of life
- 32:43is 1 antidote to colonize theory.
- 32:46Specifically,
- 32:47we can reexamine our understandings
- 32:49of attachment and dependency as
- 32:52experiences that are fluid across
- 32:54and within sociocultural groups.
- 32:56We can expand our analysis of attachment.
- 32:59Beyond caregiving relationships or
- 33:01romantic or sexual relationships,
- 33:04integrating relational life
- 33:06involving friendships, social media,
- 33:08broader communities, schools, and workplaces.
- 33:13Let me give you a brief example of this.
- 33:16There's typically we in psychology.
- 33:19We ask many,
- 33:21many questions in our intakes
- 33:23around developmental history
- 33:25about a person's family.
- 33:27Which of course is very critical,
- 33:29but very seldom do we ask,
- 33:31as a part of our developmental
- 33:34history experiences that relate
- 33:36to sociocultural traumas.
- 33:38Like, for example,
- 33:38what was it like to go to school?
- 33:41What was it like to live
- 33:43in your neighborhood?
- 33:43Tell me about the social
- 33:45media platforms you use.
- 33:47What's going on in there?
- 33:49What's the composition,
- 33:50the racial composition,
- 33:51the religious composition of
- 33:52people who you grew up around?
- 33:55These are the kinds of
- 33:56questions that are critical.
- 33:58Corolla Suarez Orozco,
- 33:59who is a phenomenal researcher
- 34:02of immigrant children.
- 34:03She has she back in the early 2000s.
- 34:08Conducted a series of.
- 34:12I would say it's very
- 34:14psychoanalytically oriented research,
- 34:15but she conducted a studies with 3rd and
- 34:184th grade students who are immigrant
- 34:21children from Mexican American,
- 34:23Haitian American and Chinese
- 34:26American backgrounds.
- 34:27And she gave them sentence completion tasks.
- 34:30And so I'll give you a couple
- 34:33of examples of the sentences.
- 34:35The first sentence would read people
- 34:37in my family think that I'm blank.
- 34:40The second would read most
- 34:42Americans think that I am blank.
- 34:44And the kids, these are,
- 34:46you know, 9 year olds,
- 34:48typically 8910 year olds,
- 34:51they would,
- 34:52they would respond to the first sentence.
- 34:54People in my family think that I am funny.
- 34:57People in my family think that I'm silly.
- 34:59People in my family think that I'm smart.
- 35:02You know,
- 35:02all the kinds of descriptors you
- 35:05might imagine children to say about
- 35:07what their families think of them.
- 35:11The second sentence most
- 35:12Americans think that I'm blank.
- 35:14The children would say things like.
- 35:17Most Americans think that I am bad,
- 35:20that I am stupid,
- 35:22that I'm lazy, that I smell.
- 35:27All of the descriptors that these
- 35:30kids shared exactly matched with the
- 35:32stereotypes of their racial groups,
- 35:34their ethnic groups.
- 35:37So what she does then,
- 35:40Corolla, is she develops.
- 35:42She extends Winnicott's concept
- 35:44of mirroring in the in the
- 35:47caregiving relationship to the
- 35:48concept of social mirroring,
- 35:49the importance of understanding
- 35:51what is happening in the House and
- 35:54outside the House for children.
- 35:56Starting the moment they leave the House,
- 35:59preschool and beyond.
- 36:02So this is a critical step in
- 36:05what I'm talking about when I
- 36:08say humanizing versus colonizing.
- 36:10Relating to the whole self of the
- 36:13patient is inherent to humanizing.
- 36:15In contrast to relating to a partial
- 36:19object that characterizes colonizing.
- 36:21So here's another example.
- 36:23My patient,
- 36:24rose is a second generation
- 36:27Chinese American SIS woman.
- 36:29She came to therapy to to cope with
- 36:32her depressed mood and isolation,
- 36:34she told me in one session.
- 36:37People don't know me at work,
- 36:38or really most places.
- 36:39They see a Chinese person and think,
- 36:42oh, she must be smart,
- 36:43but you can't trust her.
- 36:45So I guess I show them what they expect.
- 36:48This way I don't have to deal with them.
- 36:51Rose is speaking here.
- 36:53To her colleagues perception of her
- 36:55as a partial object 1 steeped in
- 36:59colonized perceptions of Chinese
- 37:01and Chinese American people.
- 37:03She proceeded in the session to
- 37:05tell me that no one in her workplace
- 37:07really knows anything about the
- 37:09kind of music or food she enjoys,
- 37:10even though these are frequent topics
- 37:13of conversation among her colleagues.
- 37:16And she said no one sees how I suffer,
- 37:19only what I can offer them.
- 37:21They don't know that I lost
- 37:23a relative recently.
- 37:24And in the context of the pandemic,
- 37:26she's made even more efforts to
- 37:28keep herself hidden from others
- 37:30while bearing microaggressions.
- 37:32As some white colleagues comment on how
- 37:34the pandemic was spread by Asians, rose,
- 37:37feeling resigned in another session,
- 37:39shared.
- 37:40They will never really know me or my family,
- 37:42and they don't care.
- 37:44The powerlessness that rose experiences
- 37:48is unfortunately not uncommon.
- 37:50However,
- 37:50in psychotherapy she starts to
- 37:52reveal other aspects of herself,
- 37:54including what she loves and despises
- 37:57about her Chinese American family,
- 37:59her Chinese American church,
- 38:01the Chinese government,
- 38:02and the United States.
- 38:05Psychotherapy becomes a space in which
- 38:07she can re examine stereotypes and
- 38:09assumptions projected towards her and
- 38:11the ones that she has internalized
- 38:13and directed towards people of other
- 38:15racial and cultural backgrounds.
- 38:16In the session later in our work together,
- 38:19she said it's strange that
- 38:21seeing a therapist,
- 38:22such a white thing to do is
- 38:24what has been helping me,
- 38:25but it doesn't feel like a white thing,
- 38:27you know? It's like my own thing.
- 38:30Understanding.
- 38:31When I think about Rose's comments,
- 38:33I think about this shift where
- 38:36she was moving away from being
- 38:39experienced only as a partial object.
- 38:42Umm,
- 38:43a second area of consideration
- 38:44has to do with humility and psych.
- 38:47And I know that cultural humility
- 38:49has been written about and talked
- 38:51about quite a bit.
- 38:52And I think about what does
- 38:54it mean in in psychoanalytic
- 38:56psychotherapy in particular and
- 38:58and I I think part of it I loved.
- 39:01There was a paper written by Salman
- 39:03Akhtar that came out in 2018,
- 39:05which I highly recommend on
- 39:08psychoanalytic humility.
- 39:09But one of the things he talks about.
- 39:12Is listening with Attunement for
- 39:14multiple determinants of all psychic
- 39:16material and being comfortable
- 39:18with diverse theoretical models.
- 39:20This shows humility.
- 39:22The the ability to recognize one's
- 39:25mistakes and apologize for mistakes,
- 39:27and understanding that mistakes with
- 39:30our patients are are inevitable.
- 39:32This is another component of humility.
- 39:35Umm.
- 39:37Trying to think about what what we
- 39:40feel fragile emotionally about what
- 39:43what what is our type of what do?
- 39:46What do we feel discomfort with?
- 39:48Which aspects of our identities
- 39:50or other people's identity make
- 39:52us feel uncomfortable?
- 39:54This is all humility.
- 39:55The concept of cultural humility has
- 39:58actually been questioned in the case of
- 40:01racial minority therapists specifically,
- 40:03Sarah Moon and Steve Sandige called for
- 40:05an elaboration of cultural humility.
- 40:07Was asking racial minority therapists
- 40:10to be culturally humble might contribute
- 40:12to their own retraumatization.
- 40:14And so they ask an important question.
- 40:16They say,
- 40:17how does the therapist of color
- 40:19express ones authentic feelings of
- 40:21anger without shaming the patient?
- 40:23And they're pointing out that
- 40:25even while concepts like humility
- 40:27are critical for decolonizing,
- 40:29these concepts can hold significantly
- 40:32different meanings and implications for
- 40:35minority and majority status therapists,
- 40:37whatever that.
- 40:38Positionality might be whether we're
- 40:40talking about race or sexuality,
- 40:42gender, disability, and so on.
- 40:46Umm,
- 40:46I'll quickly mention the last
- 40:49couple of considerations.
- 40:50One the the third I want to
- 40:53mention has to do with working
- 40:55in the depressive position.
- 40:57Glasser Levi suggested that reparation
- 41:00involves a movement from a paranoid
- 41:02schizoid position to a depressive position.
- 41:05And he noted that it's in the
- 41:08depressive position that objects
- 41:09which have been split into good
- 41:11and bad may be united as whole
- 41:13objects that maintain the qualities
- 41:15of goodness and badness.
- 41:16So in other words,
- 41:18the depressive position allows for
- 41:20mourning a necessary process for a
- 41:23racial reparation and decolonization.
- 41:26Anna Ornstein has written
- 41:27beautifully about this,
- 41:28too.
- 41:28The essential step in mourning
- 41:30involves the capacity of the
- 41:33therapist and patient to remember
- 41:35past collective traumas and engage
- 41:37with ongoing collective traumas.
- 41:39So part of the working in the
- 41:42depressive position also includes a
- 41:44capacity to recognize the limits of our
- 41:47relationship with our our our patients,
- 41:50our own frustrations.
- 41:51Our own limitations of
- 41:53therapy sits alongside.
- 41:55Our desire to want to do good and
- 41:58feel good with regard to injustice.
- 42:02Lastly. And I think about decolonizing.
- 42:06I think about training and
- 42:07sort of where we begin.
- 42:09And I mentioned to you some things
- 42:12relevant in my own training earlier.
- 42:15But there's a way in which we can
- 42:17think about troye's elaboration of
- 42:19melancholia to better understand
- 42:20the ambivalence that we might have
- 42:23around structural change in our
- 42:25current psychotherapy training.
- 42:26Melancholia was described by
- 42:27Freud as a form of
- 42:30pathological unresolved warning
- 42:31where a person is unable to.
- 42:34Resolve their ambivalence towards a
- 42:37lost loved object and therefore has
- 42:40trouble investing in new relationships.
- 42:43So maybe that concept could help
- 42:46us understand our own collective
- 42:48reluctance and sometimes refusal to
- 42:51engage in narratives that hold multiple
- 42:54truths regarding race and culture.
- 42:56So I think there's a way.
- 42:59What I do want to emphasize here is that
- 43:02rethinking what we do does not mean that
- 43:05we erase euroamerican models of development,
- 43:08but rather that we identify common
- 43:10ground and distinctions across
- 43:12cultural narratives of development
- 43:15and recognize each perspective as
- 43:17equally valuable and relevant.
- 43:20So in my view, this is a call to move away
- 43:23from all or none thinking with regard to the.
- 43:26The inclusion and exclusion of people in
- 43:30dialogues about race and colonization,
- 43:33so I'm going to stop there.
- 43:37And um. Happy to.
- 43:39Hear from all of you.
- 43:41I've been talking for a very long time.