Abstract
Given some of the challenges beginning therapists experience in the development of their new roles, they may be more susceptible to becoming overwhelmed by their countertransference, lack the awareness to track all of the processes taking place in the therapy room (e.g., projective identification, transference/countertransference dynamics, etc.), and have a propensity to be pulled into enactments. This paper explores how therapy processes, client trauma, and clinician levels of experience intersect therapeutically with the dyad’s identity features and may impact the therapist’s ego functions. A case is discussed that explicates how racial identities in a dyad can create enactments resembling those of marked historic and cultural imbalances in Western society, taking away the minority therapist’s ability to think and speak in English due to the intense projective identification and countertransference experience of inferiority and incompetence in the presence of a patient with various identities of privilege. The role of internalized racism within the minority therapist is also explored in rendering them unable to process the deeper dynamics evoked in the therapeutic and supervisory dyad with the patient when the patient used racially charged language.
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Notes
Aron (2003) refers to “a third space” or “position of thirdness” as a capacity “to think while remaining affectively engaged, and to maintain the tension between a tendency to dominate and to submit to the patient” (p. 629).
A pseudonym has been used, and protected health information de-identified, to protect the privacy and rights of the patient.
The use of the word “minority” is this section is to distinguish a lack of representation of an identity group rather than the problematic overuse of the word to depict inferiority.
References
Aron, L. (2003). The paradoxical place of enactment in psychoanalysis. Psychoanalytic Dialogues, 13(5), 623–631.
Bion, W. R. (1959). Attacks on linking. International Journal of Psychoanalysis, 40, 308–315.
Chapman, R. T. (2006). Internalized racism of the clinician and the treatment dynamic. Journal of Emotional Abuse, 6(2), 219–228.
Chused, J. F. (2003). The role of enactments. Psychoanalytic Dialogues, 13(5), 677–687.
Csillag, V. (2014). Ordinary sadism in the consulting room. Psychoanalytic Dialogues, 24(4), 467–482.
Ferenczi, S. (1988). Confusion of tongues between adults and the child: The language of tenderness and of passion. Contemporary Psychoanalysis, 24, 196–206.
Goodman, G. (2005). “I feel stupid and contagious”: Countertransference reactions of fledgling clinicians to patients who have negative therapeutic reactions. American Journal of Psychotherapy, 59(2), 149–168.
Gutiérrez-Peláez, M. (2018). Confusion of tongues: A return to Sándor Ferenczi (M. Squirru, Trans.). Routledge. (Original work published 2012)
Hamer, F. M. (2002). Guards at the gate: Race, resistance, and psychic reality. Journal of the American Psychoanalytic Association, 50(4), 1219–1236.
Hamer, F. M. (2006). Racism as a transference state: Episodes of racial hostility in the psychoanalytic context. The Psychoanalytic Quarterly, 75(1), 197–214.
Hill, C. E., Sullivan, C., Knox, S., & Schlosser, L. Z. (2007). Becoming psychotherapists: Experiences of novice trainees in a beginning graduate class. Psychotherapy: Theory, Research, Practice, Training, 44(4), 434–449.
Holmes, D. (1992). Race and transference in psychoanalysis and psychotherapy. The International Journal of Psychoanalysis, 73(1), 1–11.
Holmes, D. (2006). Racial transference reactions in psychoanalytic treatment: an update. In R. Moodley & S. Palmer (Eds.), Race, culture and psychotherapy: Critical perspectives in multicultural practice (pp. 61–73). Routledge.
Holmes, D. (2016). Come hither, American psychoanalysis: Our complex multicultural America needs what we have to offer. Journal of the American Psychoanalytic Association, 64(3), 568–586.
La Roche, M. J. (1999). Culture, transference, and countertransference among Latinos. Psychotherapy: Therapy, Research, Practice, Training, 36(4), 389–397.
Leary, K. (2000). Racial enactments in dynamic treatment. Psychoanalytic Dialogues, 10(4), 639–653.
Leary, K. (2012). Race as an adaptive challenge: Working with diversity in the clinical consulting room. Psychoanalytic Psychology, 29(3), 279–291.
McLaughlin, J. T. (1987). The play of transference: Some reflections on enactment in the psychoanalytic situation. Journal of the American Psychoanalytic Association, 35(3), 557–582.
McWilliams, N. (2004). Psychoanalytic psychotherapy: A practitioner’s guide. The Guilford Press.
Sheehi, L. (2015). The unmatched twin: enactments of otherness and the autobiography of an immigrant clinician. In M. Nayar-Akhtar (Ed.), Identities in transition: The growth and development of a multicultural therapist (pp. 137–154). Karnac Books.
Sheehi, L., & Sheehi, S. (2016). Enactments of otherness and searching for a third space in the Palestine-Israel matrix. Psychoanalysis, Culture & Society, 21, 81–99.
Tan, R. (2006). Racism and similarity: paranoid-schizoid structures revisited. In R. Moodley & S. Palmer (Eds.), Race, culture and psychotherapy: Critical perspectives in multicultural practice (pp. 119–129). Routledge.
Tang, N., & Gardner, J. (2006). Interpretation of race in the transference: perspectives of similarity and difference in the patient/therapist dyad. In R. Moodley & S. Palmer (Eds.), Race, culture and psychotherapy: Critical perspectives in multicultural practice (pp. 89–99). Routledge.
Vaslamatzis, G. (2005). Projective identification, containment and sojourn in the psyche: Clinical notes on a specific type of transference-countertransference interaction. International Forum of Psychoanalysis, 14(2), 116–119.
Waska, R. (2013). Working to understand our role in the patient’s mind: Countertransference and the problems of immersion. British Journal of Psychotherapy, 29(4), 466–480.
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Báez-Powell, N.N. Ramifications of client’s use of projective identification, racism, and enactments of otherness: A nascent clinician’s struggle inhabiting her identities in the therapy room. Psychoanal Cult Soc 28, 232–249 (2023). https://doi.org/10.1057/s41282-023-00378-5
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DOI: https://doi.org/10.1057/s41282-023-00378-5