Thinking Space: The Model

CHAPTER ONE

Thinking space: the model

"The disturbance of the impulse of curiosity on which all learning depends, and the denial of the mechanism by which it seeks expression, makes normal development impossible."

Thinking Space was set up to develop the capacity of staff and trainees at the Tavistock Clinic to think about racism and other forms of hatred towards difference in ourselves and others. Drawing on Bion's distinction between "knowing" and "knowing about", the latter of which can be a defence against knowing a subject in a deeper and emotionally real way, Thinking Space sought to promote curiosity, exploration, and learning about difference, by paying as much attention to how we learn (process) as to what we learn (content). The establishment and design of the forum was determined not so much by theoretical considerations, but by my many years of experience as a participant in and facilitator of "diversity" learning events. This has taught me that the subjects of race and racism tend to arouse strong feelings such as anxiety, guilt, shame, and anger. This emotional maelstrom often created numerous barriers to thinking and learning at such events. These included:

» fear of saying what one thinks because one might be severely criticized or labelled as racist

» saying what is politically correct to gain approval or acceptance

» being silent because of anxiety about getting it wrong and offending someone

» witnessing or becoming part of extremely angry exchanges between participants regarding who is right or who is wrong, or who is racist or anti-racist

» feeling upset, guilty, and ashamed about the unedifying behaviour of oneself and or others and deciding to give such events a wide berth in future.

These experiences were a particular spur to the idea of creating the Thinking Space forum, as a space that could enable participants to engage constructively with the feelings and dynamics that tended to emerge around the subject of race and culture in a way that did not derail or stop thinking and learning. However, there were a number of other factors that led to this initiative, which I would like to mention before outlining the model of practice developed and its theoretical underpinnings.

The lack of thinking about race, culture, and diversity in psychotherapy

There is growing evidence that social and economic inequality in British society is increasing and that prejudice and discrimination against people on the basis of their race, culture, class, gender, sexuality, religion, and age is still widespread. Psychoanalytic practitioners have, however, been largely silent about these hatreds, and a largely colour-, culture-, and class-blind approach continues to pervade the psychotherapy profession. Furthermore, despite increasing racial and cultural diversity in Britain, psychotherapy-particularly psychoanalytic psychotherapy-continues to be a largely white middle-class profession. This reinforces the perception, still common today, that psychotherapy, especially psychoanalytic psychotherapy, is a white middle-class "privileged" activity. There have, of course, been initiatives taken by a number of pioneering individuals and organizations-such as Sue Holland, who worked with depressed women on the White City Estate; Jafaar Kareem, who created Nafsiyat to provide intercultural therapy; and Luise Eichenbaum and Susie Orbach and the Women's Therapy Centre-which counter this perception. These individuals and organizations sought to make psychotherapy more accessible and responsive to the needs of the working class, ethnic minorities, and others in disadvantaged or oppressive circumstances. But while there is much to celebrate from these efforts, psychotherapy, in the main, continues to be largely the preserve of the better-off. There are many barriers, other than finance, to accessing psychotherapy by disadvantaged communities. These include prejudicial assumptions and attitudes towards them by psychotherapists and a lack of interest in developing psychotherapy services that are more accessible and responsive to people from adverse social and cultural circumstances.

There is also little or no attention paid in the selection and training of psychotherapists to issues of prejudice and discrimination on the basis of race, culture, religion, class, or sexuality. There is a widespread assumption that these are political issues and, as such, ones that are not within the purview of the psychoanalytic practitioner because psychoanalysis is concerned primarily with the internal world. This perspective assumes, erroneously, that there is no relationship between the external world and the internal world of the individual and that issues of race, culture, class, or sexuality are not vibrant aspects of the internal world that affect our feelings, fantasies, perceptions, identities, and relationships. This institutional attitude is, among other things, a defence against facing the reality of class and race in the profession and its implications. The unwillingness to think about the white middle-class nature of psychotherapy in terms of its membership, values, and clientele, on either an individual or an organizational basis, is a defence against guilt about an investment, probably unconsciously, in maintaining the status quo. There are a number of defences that are commonly used to prevent engagement with racism and other forms of exclusion-in particular, avoidance, denial, and turning a blind eye. Steiner helpfully says about "turning a blind eye" that "we seem to have access to reality but choose to ignore it because it proves convenient to do so. I refer to this mechanism as turning a

Thinking Space was set up because the psychotherapy profession turns a blind eye to its whiteness and its lack of diversity, and, when it does not, too often its approach is tokenistic. Most courses have one or two seminars on race or culture as an add-on, not as a thought-through and integral part of the training. While tokenism, or turning a blind eye, may provide some short-term relief, I believe it undermines self-confidence and competence within the profession as regards working with diversity and strengthens common underlying fears that these issues are too overwhelming to deal with. This is tremendously sad because psychoanalysis has the tools, both theoretically and clinically, to make a vital contribution to understanding and addressing these problems and their vicissitudes. Peter Fonagy wrote in his introduction to a book on taboos in psychotherapy that "Our clinical experience and our training have taught us that change requires taking the human mind places where it least wishes to be. Taking the analyst's mind to these domains is in the best interest of unencumbered work, which is obviously in the best interests of our patients." Promoting thinking about racism and other forms of exclusion within psychotherapy is, I believe, also in the interests of good analytic work and in the best interests of patients.