by Rita Teusch, PhD

Gaztambide, D. J. (2019). A People’s History of Psychoanalysis: From Freud to Liberation Psychology. Lexington Books. 270 pp.

Daniel Jose Gaztambide is assistant professor in the Department of Psychology at the New School for Social Research. He has written numerous articles and book chapters on cultural competency, social justice and psychodynamic practice, as well as race and class in the treatment of borderline personality disorder. He is currently an analytic candidate at the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis. He is also a member of the Puerto Rican poetry troupe, The Titere Poets. He was featured in the documentary: Psychoanalysis in el Barrio (Winograd & Christian, 2015). 

Dr. Gaztambide’s timely, fascinating, scholarly, and highly readable book
A People’s History of Psychoanalysis: From Freud to Liberation Psychology (Lexington Books, 2019) revives an aspect of the history of psychoanalysis that seems to have been forgotten: i.e. the involvement of psychoanalysis in the fight for social justice.  The author has unearthed the works of several early psychoanalysts and analytically informed clinicians whose ideas were instrumental in the formation of psychoanalytic theory and practice, but who are infrequently discussed in our field.  In addition, Gaztambide introduces clinicians and scholars from multi-cultural backgrounds who discovered and studied psychoanalysis on their own because they found psychoanalytic ideas relevant to explaining situations of social, racial and economic injustice and the psychic effects on oppressed, marginalized, and colonized peoples. Many of these clinicians are probably unfamiliar to most analysts in the United States. Gaztambide writes in his introduction: “A People’s History of Psychoanalysis emerges from a particular philosophical and social vantage point…, inspired by Howard Zinn’s (2005) own historiographic classic, A People’s History of the United States” (p. xxxviii). Zinn had written “the lines are not always clear….The oppressor may also turn out to be a victim of the same destructive system, while the victim, “themselves desperate and tainted with the culture that oppresses them, turns on other victims… The cry of the poor is not always just, but if you don’t listen to it, you will never know what justice is” (p. 10).

Gaztambide wants us to listen to and learn from these clinicians, teachers, and scholars whose intellectual and socio-cultural influences on the development of psychoanalytic theory we have excluded from the current psychoanalytic canon because we have devised a split between our concern with “the individual psyche” and “social issues”.  Gaztambide reminds us that the practice of psychoanalysis is always also political in that we all exist as parts of a larger society, and, if we remain unaware of, and unconcerned about systemic racial and economic injustice and inequality around us, psychoanalysts contribute to its perpetuation. 

Gaztambide also reminds us that Psychoanalysis was created by a historically oppressed ethnic minority group.  In contrast to the current psychoanalytic focus on individual psychopathology and transference/countertransference issues arising in a dyadic relational context, many early psychoanalysts thought cogently about issues of culture, power, race and economics, as well as the psyche and its relation to society. They elucidated important psychic mechanisms about the relations between the individual and society, such as the identification with the aggressor, internalized oppression, splitting of love and hate to maintain important object ties, and horizontal violence. Gaztambide emphasizes that psychoanalysis has been a relevant and powerful tool for social healing and political activism among many scholars and clinicians of color, both in the US and South America, and, most importantly, has provided the foundational thinking of Liberation Psychology (1994).

Liberation Psychology rooted in Latin American psychology, was developed by the Spanish Jesuit priest and social psychologist Ignacio Martin-Baró, who was born in 1942 and assassinated in 1989 by the US backed military government during the social upheaval of the Salvadoran Civil War. Liberation Psychology is widely recognized as an inspiration and foundation for North American Multicultural Psychology. Multicultural Psychology refers to a broad interdisciplinary network of scholars, clinicians and researchers committed to addressing the mental health needs and social conditions of historically marginalized and underserved communities. There is general skepticism in multicultural psychology about the applicability and relevance of psychodynamic and psychoanalytically oriented treatments for diverse populations, due partly to the historical exclusion of ethnic minorities, people of various genders, and the poor from psychoanalytic treatment.   Also, psychoanalytic training was based for a long time on certain criteria of “analyzability”, which emphasized an explicitly verbal mode of communication, the capacity for insight and impulse control, and these criteria have acted to reinforce negative stereotypes by White middle-upper class therapists toward minority and working- class patients. Gaztambide, however, shows in his book that “psychoanalysis in its inception was neither unavailable nor exclusive of the poor and racial ‘other'” (Danto, 2005, p. xxiv), and it, in fact, provided the theoretical underpinnings for liberation psychology, next to liberation theology and the political writings of Marx. Freud’s writings with the focus on creating consciousness and awareness, his emphasis on an investigation of the patient’s mind through dialogue, and the centrality of the relationship (therapeutic alliance) were highly influential in Martin-Baró’s thinking when he developed liberation psychology. Martin- Baró wrote that “Concientization”, i.e. Critical Consciousness, “assumes an escape from the reproductive machinery of the relationships of dominance and submission, for it can be realized only through dialogue” (Martin-Baró, 1994, p. 42). Gaztambide elaborates this concept: “It is through a relationship that is grounded in dialogue, in negotiation and moment to moment responsiveness between subjects– not objects—that critical consciousness can occur” … Just as oppressive relations between the self and the world lead to distortions in the self, so, too, do affirming, empowering relations lead to repair, rejuvenation and new self-states” (p. xxxii).

This 270- page book is divided into 6 chapters, and includes an illuminating introduction and a conclusion with suggestions as to how psychoanalysis can be made more relevant for our contemporary multi-cultural society. 

Chapter One is titled: “A Tool to Achieve Power”: Colonialism, Anti-Blackness, and Anti-Semitism.  In this chapter Gaztambide discusses Freud’s ambivalent relationship to his own marginalized identity as a Jew. Gaztambide intends to complement Brickman’s (2003) reading of Freud, which, he states, has unintentionally contributed to a narrative in which Freud’s work is seen as disinterested in matters of race and culture, or even as hostile to the struggles of people of color and other non-dominant groups. Gaztambide discusses how Freud’s own early experience of extreme poverty and marginality as a Jew informed the development of psychoanalysis and his reflections on culture, race, and society.  Gaztambide gives numerous examples from Freud’s own personal history, correspondence, clinical work, and writings on humor that show Freud taking different positions in relation to the signifiers Whiteness, Jewishness, and Blackness. Freud repeatedly referred to his “Moorishness”, made associations between Jewishness and Blackness, and discussed with colleagues the relationship between anti-Semitism and anti-Black racism –revealing his identification with Blackness as a Jew. At the same time, Freud showed an identification with Whiteness, and a repudiation of his Jewishness positioning himself as “a devouring, dominating power toward Blackness.” (p. 29).  Gaztambide writes: “An analysis of his (Freud’s) work yields both an enactment of racialized dynamics and an analysis of them….Freud’s own struggles set in motion a series of antagonisms and dialogues that, through various routes, flowed into his descendants in Harlem, the Caribbean, and Latin America, ultimately setting the foundations to liberation psychology.” (p. 29).  He argues that “the social-historical context of colonialism and slavery which created discourses of anti-Blackness was fundamental in forging not only psychoanalysis, but the centrality of social justice to the psychoanalytic project” (p. 1-2).

In Chapter Two, “A Sort of Inner Revolution”: Freud, Ferenczi, Fenichel, and Fromm – Gaztambide reminds us that the first generation of psychoanalysts was comprised of politically left-leaning Jews who formed part of a persecuted and marginalized minority community.  Erich Fromm, Otto Fenichel, Wilhelm and Annie Reich identified as Marxists, whereas Ernst Simmel, Bruno Bettelheim, Grete Bibring, Helene Deutsch, Siegfried Bernfeld, and Sandor Ferenczi were Socialists. Edith Jacobson and Marie Langer were Communists, while Eduard Hitschmann, Paul Federn, Karen Horney, and Sigmund Freud were Social Democrats (Danto, 2005, pp. 18-19, 21).  “From these disparate left and center-left positions, they had regular, ongoing, and theoretically rich discussions about the relationship between psyche, culture, and society that deftly maneuvered between an analysis of class-structure, socio-economic inequality, and racism, alongside an analysis of the construction of gender and sexuality” (p. 31). Psychoanalysis lost touch with progressive thinking during the Nazi era when analysts concerned with social justice became refugees in the United States. The relevant socio-political writings of Ferenczi, Fenichel (1897-1946), and Bernfeld (1892-1953) are important here because they were influential to the following generations of socially conscious analysts, such as Erich Fromm, Frantz Fanon, Harry Stack Sullivan.

Ferenczi began his clinical work in hospitals devoted to the poor and those excluded and persecuted due to their sexual orientation. He wrote articles calling on the medical community to recognize the humanity of LGBTQ- patients, and drew attention to the power-dynamics in a therapeutic relationship with trauma patients, which could exacerbate the patient’s trauma. He advocated for the analyst’s empathy and receptivity to the patient’s negative feelings about the analyst and emphasized the analysts’ need to be aware that they were perceived as a representative of a hypocritical society which has victimized such a patient.  Ferenczi thought that the analyst needs to assist the patient in exposing inner prohibitions taken into their psyche from a society marked by injustice, prejudice and inequality, and liberate the patients’ critical faculties and their identifications with those who have committed acts of aggression against them.  He thought that psychoanalysis could bring about “an inner revolution” (p. 35), and serve as a source of enlightenment to free mankind from unnecessary internal and external repression. Ferenczi’s focus on empathy, the relationship and the curative factor of validation of the patient’s external reality became essential factors in the development of liberation psychology.

Fenichel is mostly known in the US for his “orthodox” defense of Freudian Analysis, i.e.  “The Psychoanalytic Theory of Neurosis” (1945). His writings on ‘psychoanalysis and politics’ are generally not known. Gaztambide gives several reasons for this: When the Jewish Immigrants became refugees in the United States during WWII there was pressure on them to adjust and also conform to the more conservative US society.  Already in 1909 the American Medical Association had imposed severe quotas on admissions for women, African Americans and Jews (Danto, 2009). Also, the FBI was involved in surveying Jewish immigrants who they suspected having Socialist and Marxist backgrounds. The IPA had also become increasingly conservative leading up to WWII and had clamped down on its progressive members. Fenichel had been removed as the editor of the Journal “Zeitschrift”, and Wilhelm Reich’s work was rejected without explanation. Fenichel and also Ernst Simmel were never able to feel comfortable with their American peers. They found that their colleagues reified Freud, reducing him to a monadic biologist instead of placing his theory of somatically derived affects- the drives- in a dialectical relationship to one’s relational and material conditions. (p. 56).

An important political paper by Fenichel was: “Anti-Semitism: A Social Disease” (1940), which explicates a theory of horizontal violence (how poor white people find an outlet for their aggression from their own oppression by victimizing another marginalized group). Gaztambide writes: “The “true culprit” for Fenichel lies in two domains- the ruling class who manipulates the working class into redirecting their aggression and the very repressed instincts of the working class” (p. 50). Another important paper by Fenichel which was written in the 1940s but only posthumously published in American Imago (1967) was titled: Psychoanalysis as the nucleus of a future dialectical-materialistic psychology”. This paper reveals Fenichel’s conviction that psychoanalysis is not a mere abstract, idealistic exercise, but a method for revealing the imprint of the realistic conditions of society upon individuals, their relationships, and their communities inscribed upon the body” (p. 52).

Gaztambide’s exploration of Freud’s first public call for social justice focuses on Freud’s keynote address at the Budapest Psychoanalytic Congress in 1918. In this speech Freud spoke to the “vast amount of neurotic misery which there is in the world, and perhaps need not be (155a, p. 165). Freud (1919) envisioned a future in which 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…..When this happens, institutions or outpatient clinics will be started, to which analytically trained clinicians will be appointed”  and where “treatments will be free.  At such clinics analysts would “be faced by the task of adapting (psychoanalytic) technique to the new conditions” (155a, p. 167). Freud suggested that clients who lack formal education should be provided appropriate psycho-education, demystifying psychoanalysis and making them active participants in treatment. He further intuited that for such treatments to be successful it would be necessary to address the client’s economic as well as psychological needs.  Freud ended his speech by saying: “whatever form this psychotherapy for the people may take, whatever the elements out of which it is compounded, its most effective and most important ingredients will assuredly remain those borrowed from strict and untendentious psychoanalysis. (pp.167-168).

Gaztambide quotes Danto (2005) who has chronicled the remarkable effect of Freud’s speech at the Budapest Congress in 1918 on the psychoanalytic movement. In the period between 1918 and 1938 twelve co-operative mental health clinics were established, in Zagreb, London, Berlin, Vienna, Paris. Psychoanalysts across Europe offered pro bono or sliding scale psychosocial relief for the poor, developed new treatment methods and participated in various feminist, gay, and Socialist-Marxist movements seeking social change in post-WWI Europe. Psychoanalytic practitioners used time-limited treatments and active interventions to serve a broader range of people (Franz Alexander, Max Eitington, Ernst Simmel, Sandor Ferenczi), and used these techniques also in the treatments of more traditional patients. Psychoanalysts contributed a portion of their income (about 4% at the Berlin Polyclinic- see Aron and Starr, 2012, p. 88) and dedicated at least one-fifth of their clinical hours to treating low income clients, making analysis accessible to students, craftsmen, artists, laborers, farmers, domestic servants, factory workers, office clerks, unemployed people and public school teachers.

In Chapter Three: “For Justice, For Equal Treatment of All”: Freud as Proto-Postcolonial Theorist” – Gaztambide focuses on “Freud’s Cultural Texts” Totem and Taboo (1913), Group Psychology and the Analysis of the Ego (1921), The Future of an Illusion (1927), Civilization and its Discontents (1930) , Moses and Monotheism ( 1939), in which Freud laid down his psychoanalytic exploration of society, oppression, and power, which reverberates through liberation psychology.  Gaztambide elaborates on the main ideas in each of these texts, focusing on Freud’s mythology of how human beings came to acquire taboos as an internalized mechanism of control, and how individual psychology is always also “social psychology”.

“He articulated how the oppressed internalize their aggression through an identification with the values and ideals of the oppressor. The oppressed will often identify with the position of the oppressor and fetishize the will to power” (p. 75).

Freud’s vision of social justice and power was hardly a utopian one. He rejected the idea that if economic inequality is resolved this will, by itself, quell humanity’s inclination toward aggression. He argued that our capacity for hatred, aggression, social division and haves and have-nots would simply go elsewhere. Human culture and society at its best for Freud “is a process in the service of Eros, whose purpose it is to combine single human individuals, and after that families, then races, peoples and nations, into one great unity, the unity of mankind” (Freud, 1930. p. 122). Culture and society attempt to tame the rage and hatred of individuals and groups by setting up the superego within them. This internalized sense of guilt, whose aim it is to prevent the repetition of violence, serves a pro-social function in that it helps with the recognition that “the other” is also a human being, like the self – deserving of love and should not be killed. Gaztambide writes that “while Freud addresses explicit social contradictions between the ruling wealthy classes, the “masses” excluded from the distribution of wealth, and the relationship between this economic inequality and Whiteness, he does not fully unpack the role of the “excluded third”. (p. 77). For example, in Totem and Taboo, he discussed the father and the band of brothers, but left the role of women as passive objects observing the patriarchal drama played out before them.

In Chapter Four: “The Possibility of Love”: Black Psychoanalysis from Harlem to Algeria” – Gaztambide traces the routes through which psychoanalysis became a tool of anti-racist, post-colonial theorizing, beginning with the liaisons of black intellectuals and novelists, psychiatrists  and psychoanalytic practitioners, such as Otto Rank and Harry Stack Sullivan, during the Harlem Renaissance, and how these relationships , along those with existentialist and Marxist psychoanalytic thinkers then flowed into the life and work of Frantz Fanon. Gaztambide introduces the writings of several well- known African-American novelists, Ralph Ellison and Richard Wright, who were deeply influenced by psychoanalytic thinking. Ellison (1913-1994) and Wright (1908-1960) argued in 1946 that psychoanalysis “was the most effective methodology available to interpret and explain the prevalence of mental illness and social deviance within black communities (Ahad, 2010, p. 83). These authors, in collaboration with German-American psychoanalytic psychiatrist Fredric Wertham (1895-1981), who had visited Freud and, on Freud’s recommendation, chosen psychiatry as his specialty, opened the Lafargue Mental Hygiene Clinic in Harlem in 1946, when mental health services for African Americans were uncommon due to racialist psychiatry. Echoing the spirit of Freud’s free clinics, treatments were provided at a low fee or for free. Wertham continued to write psychoanalytic commentary on segregation, anti-Black and anti-Puerto-Rican racism and participated in the landmark Brown vs. Board of Education Supreme Court decision in 1954.

Gaztambide concludes this chapter with a presentation of the life and work of Frantz Fanon (1925-1961), a psychiatrist and Intellectual, originally from Martinique, West Indies, who, during his psychiatric residency in Lyon, France, was influenced by several psychoanalytically oriented Spanish and Cuban born clinicians and authors, such as Francois Tosquelles (1912-1994) , Emilio Mira y Lopez (1896-1964) , and Nicole Guillet who had worked with August Eichhorn (1878-1949; 1925 “Wayward Youth”; analyst of Heinz Kohut and Kurt Eissler),  and Sandor Ferenczi who were politically engaged in the fight against racism. After residency Fanon worked as the chief of staff in a hospital in Tunis, Algeria and continued his study of psychoanalysis by reading Freud, Melanie Klein and Ferenczi, and using the principles and goals of a psychodynamic encounter:  building self-awareness by putting thoughts and feelings into words, having an empathic other explore one’s internal mental state and increasing one’s capacity for action . Fanon wrote several books Black Skin, White Masks (1952/2008; 1963), in which he states that only a psychoanalytic perspective can shed light on the distortions of self, affect and Other that maintain racist, colonialist systems. In his later works, Fanon expressed the view that violence may be necessary for oppressed peoples, “confronting the violence that impedes being, appropriating it in an act of de-subjugation, and turning it against the oppressor, especially when the historical conditions were such that the space of language had been obliterated” (Cherki, 2006), p. 183). Gaztambide discusses Fanon’s position critically and thoughtfully in the context of expressions of rage ultimately needing a humanizing response. Fanon died from leukemia at age 36 and was not able to fulfill his wish to have a psychoanalysis.

Chapter Five is titled: “A Loving Encounter of People”: Freud, Marx, Freire, and the Afro-Latinx Origins of Concientizacao”.  In this fascinating chapter, Gaztambide elaborates on the dissemination and influence of psychoanalytic ideas in South America.  Psychoanalysis was used both as a tool of liberation by progressives and also as a weapon of control by the political Right, i.e. as a “civilizing instrument” to control and dominate a multi-racial population, whose existence evoked anxieties about Brazil’s history of slavery. By the time slavery was abolished in Brazil in 1851, Brazil had imported more black slaves than any other country in the Americas (Lange, 2008, p. 10). Mainstream psychiatry in the 1920s Brazil was very conservative and dominated by the ideology of eugenics and White Supremacy. The Brazilian League for Mental Hygiene was founded in 1922 and psychoanalysis was used to cleanse a “diseased and illiterate country”. Several dissenting psychiatrists resisted this “purified” use of psychoanalysis and stressed Freud’s ideas on the need for introspection, accepting once heritage, and social injustice as a cause of neurosis. Arthur Ramos (1903-1949) became one of the foremost critics of theories of racial inferiority. As Chief of the Mental Hygiene Service in 1933, he conducted research identifying childhood trauma and deprivation as a source of adult misconduct. “Using Freud’s writings, Ramos argued that the perceived “criminality’, “primitivity”, and “mental atavism” projected onto indigenous and Black populations were instead the product of trauma, poverty, racial inequality, and marginality” (p. 129).

Gaztambide introduces other Brazilian and Argentine psychoanalytically oriented or trained psychiatrists (Mira y Lopez, Porto Carrero) and psychoanalyst refugees from Europe who based their own works on Freud’s writings on culture and society and the writings of Erich Fromm, Otto Fenichel, Herbert Marcuse, Wilhelm Reich.  In this context, I will mention two influential psychoanalysts who are not well known among US psychoanalysts, who were deeply committed to fighting for social justice and against racism and anti-Semitism.

Afro-Brazilian psychiatrist Juliano Moreira (1873-1932) was the first psychiatrist to disseminate Freud’s work outside Vienna. Moreira started using Freud’s theory and psychoanalytic treatment in 1899, even before Freud had published the Interpretation of Dreams (1900). In the 1920s and 1930s, he had Freud’s Complete Works translated into Spanish and Portuguese. Moreira reformed Brazilian psychiatry and instituted more humane treatments for the mentally ill. He fought against racism and arguments of Black inferiority.

Marie Langer (1910-1987), born in Vienna but barred from training as a psychiatrist in 1935 due to structural anti-Semitism, was accepted by Anna Freud for psychoanalytic training. However, with the rise of Nazism the Vienna Psychoanalytic Institute, a couple of years later, enacted a policy of “neutrality” and barred members from belonging to “activist organizations”.  Langer objected to this policy and went to practice in Spain, and in 1939 she and her husband fled the Nazis and eventually they settled in Argentina, where Langer became an influential member of the Argentine Psychoanalytic Society, which had become a hotbed of psychoanalysis.  Langer taught and researched there and was involved in leadership positions.  She published extensively for 30 years on issues of female sexuality, sterility, eternal fantasies, rationales for war, group psychoanalysis, anti-Semitism, methodological problems related to how psychoanalysis is taught, and some technical problems raised by the training analysis. The military’s rise to power in 1966 placed Langer and other Argentine psychoanalysts on a death list, and Langer fled to Mexico in 1974, where she continued her political activism.

Gaztambide ends this chapter with a description of the life and work of Paolo Freire (1921- 1997), a Brazilian educator and philosopher, deeply influenced by psychoanalytic thought, who is known for the creation of a critical pedagogy, which saw education as a political act. Freire’s work “The Pedagogy of the Oppressed” (1972), which is considered his response to Frantz Fanon’s book The Wretched of the Earth (1963) became the cornerstone of Liberation Psychology and Multi-cultural psychology. Freire delineates his theory of the relations between oppression and liberation:  the main task of the oppressed is to de-colonize the mind from an identification with the aggressor.  Freire believed that achieving one’s full humanity through recognition (humanization) is a central need in life. The oppressed person vacillates between fatalism (no rights, lack of confidence, magical belief in the oppressor) and fanatism (explosion of aggression, including horizontal violence, and the seductive nature of power). The latter is not true liberation, because true liberation involves also seeing the humanity of the oppressor, (p. 130).

The concept of concientizacao (critical consciousness) is central to Freire’s educational model. The stages of Critical Consciousness are: 1. Semi-transitive consciousness (a stage of fatalism, including resignation and hopelessness). 2. Naïve transitivity (its completed form is fanatical consciousness, i.e. the existing reality is problematized, which leads to political and psychological engagement. This is a necessary stage for achieving full critical consciousness.

3. Transitive or Critical Consciousness proper. The person becomes able to mentalize how the power relations in society work. There is now a capacity for reasoned argument and dialogue, and dialectic communication becomes possible. In the end, both the oppressed and the oppressor need to be recognized as subjects. The transformative relations are grounded in love, hope, mutual trust, vulnerability.

Freire’s work was quickly internationally recognized and fundamentally changed the way of teaching around the world. Freire was offered a visiting professorship at Harvard in 1969. Gaztambide states: “ Reading critical consciousness through a contemporary lens suggests that Freire is talking about a capacity for mentalization in which we are able to represent: 1. A sense of self, with our own interiority, selfhood and feeling states, 2. A sense of “the other” as harboring their own intentionality, and 3. The broader relational and social system that contextualizes the two” (p. 142).

In his final Chapter Six: “To Recognize ourselves in our Reality: Liberation Psychology as Political Mentalization” – Gaztambide further clarifies the relationship between psychoanalysis and liberation psychology and presents “a broader meta-theory that explains how oppression generates trauma, humiliation and political polarization that maintains different groups entrenched in a reactionary politics that circumvents true liberation”, (p. xxxvii). Gazambide presents compelling research and theoretical conceptions, including psychodynamic conceptions of the relationship between shame, humiliation and anger/violence to show how an emancipatory psychology needs to undermine the oppressor-oppressed dialectic through dialogue. (Jones, 2008; Dalal, 2006). Structural and systemic racism and poverty hurt both the oppressor and the oppressed. Trauma and systemic humiliation and shame due to poverty, communal violence, and deprivation of education is the cause of horizontal violence, i.e. displacing anger on other marginalized and disempowered groups. Gaztambide outlines how marginalized poor and uneducated Whites will become “sub-oppressors” as a result of identifying with their white oppressors and the racist explanations provided by them, that are put forth to divert attention from the actual cause of the problem, i.e. massive income and social inequality.  

In a second part of this chapter Gaztambide discusses and analyzes contemporary attachment theory using Fonagy’s research on attachment theory, mentalization and trauma (Lorenzini, Campbell, and Fonagy, 2018) to explain how victimized and marginalized minorities internalize systemic racism, which results in a loss of “epistemic trust”, i.e. the extent to which our mind is open to the other, and able to mentalize them as a safe and reliable source of knowledge, (p. 159).

Both the dominant and the victimized groups lose epistemic trust in societies with significant wealth inequality, because wealth inequality heightens one’s social evaluation anxiety, corrupts social relations and creates social polarization.  People become less caring of one another, there is less mutuality in relationships, everyone has to fend for themselves and there is less trust. Mistrust and inequality reinforce each other. This creates a prime environment to ask: who has taken my job, my opportunity, my partner, my future? In an environment of epistemic mistrust, the voice of the powerful answers: It was “the other”! They have humiliated you and taken what is rightfully yours. But do not fear: be like me and all will be restored. You will be great again! (p. 161).  Gaztambide writes: ”When we become mired in this inability to trust the other, and explore the various centripetal and centrifugal ways we enact positions of victim and perpetrator, oppressor and oppressed, we also become unable to mentalize about our position in the socio-political system, how the political economy operates, and how the powerful enact divisions of oppressor and oppressed which serve to maintain the system of inequality itself,” (p. 163).  The ability to mentalize about our own affective and political experience as well as the Others’ and how the broader socio-political system necessitates and produces this distinction between self and other is what Freire referred to as concientizacao, or Critical Consciousness, and what Gaztambide, following Fonagy et al. defines as political mentalization, (p. 163).

Gaztambide presents different models of how political mentalization can be achieved in our current political situation that divides us. He outlines one successful model called Racial Intergroup Dialogue, which is based on Intergroup contact theory (Pettigrew & Tropp, 2008), which involves building relationships within and across groups historically marginalized and privileged, developing a critical consciousness of group-identities and inequality, and increasing a commitment to social justice action. Facilitators need to be skilled at helping to normalize the intense expression of emotion, support members in reflecting back the feelings and thoughts of others, i.e. they are helped to mentalize politically. Gaztambide writes: “Political mentalization entails surviving the dominating other’s attack and still being able to reflect about their feelings, fears and circumstances without retaliation. In doing so, the dominating other is functionally disarmed and then challenged to reconsider their earlier impressions, put into a position where now they must mentalize” (p. 196). At the end of racial intergroup dialogues group members’ emotional engagement, awareness of racial privilege and inequality, and ability to engage in empathic perspective taking increased while their avoidance of difficult dialogues decreased.

Psychoanalysis is fundamentally a theory of the Unconscious, of what is and what is not allowed within the bounds of conscious awareness.  Gaztambide urges us to bring the dimension of “the social third” back into our psychoanalytic dialogue. He wants us to recognize that it has always been there, hidden in plain sight. He quotes Lynn Layton (2006) who has argued that the function of normative unconscious processes is to destroy attempts to link intrapsychic, relational, and intersubjective dynamics in psychotherapy with the broader political, economic and racial crises of our world. He argues for an emancipatory ethics which pushes the practice of solidarity, which yearns for transformative change. The premise of this book is that only dialogical methodologies that humanize all parties of a social antagonism are capable of reaching toward true liberation and transformation.

In his concluding remarks Gaztambide reiterates that, “psychoanalysis has made multiple and resonant contributions to multicultural psychology, post-colonial theory, and cultural studies. Recognizing this history and these contributions does not, by itself, “wipe the slate clean”, the sins of psychoanalysis are many and they should continue to be counted” (p. 181).

Gaztambide draws several important lessons from this people’s history of psychoanalysis:

  1. A clear distinction between a clinical psychoanalysis and an “applied” or “socio-political” psychoanalysis is not supported in the original works of the first and second generations of psychoanalysts, let alone their descendants in the genealogy explored in this book. Rather the relationship between clinical observations and social and cultural critique was dialectical in nature. Gaztambide submits that patients and therapists/ psychoanalysts function and relate within a broader socio-political world. He recommends that analytic clinicians need be trained “to think with their heart”, and their feet marching in the streets advocating for social justice and equity. p. 202. We should actively advocate for comprehensive healthcare reform in which all can have access to mental health care, including long-term treatment.
  2. There does not seem a firm distinction between “Freudian” and “Relational” analysis. Many of the thinkers discussed in this book borrowed liberally from Freud, Ferenczi, Fenichel, Fromm, Klein and others. They did not seem to distinguish between a one-person or two-person psychology, but the whole of psychoanalysis was drawn upon as sources of inspiration for anti-racist, anti-capitalist, and anti-colonial work.
  3. Many of these clinicians and authors essentially taught themselves how to conduct psychoanalytic psychotherapy, by reading psychoanalytic literature without concern for psychoanalytic Institutes or an analytic establishment as such. The case of Brazil and Argentina are illustrative in that “with the arrival of ‘trained analysts’ and the institutionalization of psychoanalytic training there was an erasure of the analytically informed clinical work and activism among psychoanalysts” (p. 201).
  4. Gaztambide recommends a greater openness in the frame of psychoanalytic training and advocates that we deepen the diversity of our tradition and expand our repertoire of ideas spanning clinical, communal, and societal applications of psychoanalysis. Furthermore, he recommends the inclusion of the thinkers discussed in his book in the canon of psychoanalysis and psychotherapy teaching and training. Specifically, he recommends Fanon’s clinical post-colonial psychoanalytic writings (Khalfa, Young and Corcoran, 2018), Freire’s work on humility and relational responsiveness, group work, and community activism.

I highly recommend Gaztambide’s book to every psychoanalyst, psychoanalytic therapist and scholar of psychoanalysis. Gaztambide demonstrates convincingly that cultural competency, fighting for social justice and psychoanalytic thinking need not be seen as antagonistic, which makes it an eminently important and timely contribution to the psychoanalytic literature. Gaztambide’s book is also important because it shows that psychoanalysts too often remain unaware that they have identified with the aggressor when staying silent in the face of a patient’s actual victimization. Gaztambide wants psychoanalysis to learn from liberation psychology (which has been derived from psychoanalytic principles) and adjust psychoanalytic technique when it comes to the treatment of trauma: to help the patient put their trauma into words and acknowledge it,  gain perspective on it and mourn it eventually, which leads to empowerment. As psychoanalysts, therapists and psychoanalytically informed scholars, in conjunction with the larger society, gain increased consciousness of longstanding systemic racism in our society and within our organizations,  perhaps the field has become ready again to embrace the social-justice orientation that was so present among influential first and second generations of psychoanalytic thinkers and clinicians , and which disappeared in Europe and other parts of the world when totalitarian and right-wing governments took over.  Perhaps we are now in the process of emerging from social unconsciousness and dissociation of racist attitudes and become able to feel empathy for the excluded other, and work toward equal access for all to our psychoanalytic organizations.


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About the Author

Rita Teusch, PhD, is a Training and Supervising Analyst and faculty member of the Boston Psychoanalytic Society and Institute. She is a part-time Lecturer in Psychiatry (Psychology) at Harvard Medical School, Cambridge Health Alliance, and provides supervision to psychology interns and postdoctoral fellows at Cambridge Hospital. Dr. Teusch has a private practice in Harvard Square, Cambridge, MA

Rita Teusch can be contacted by email here.


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