A pal of mine, a Zen Buddhist monk, was asked by a mid-level corporation to present a mindfulness workshop for staff because people were overworked and getting burned out. The monk said, “No, I can’t do a mindfulness workshop, but I’d be glad to talk about collective bargaining if you’d like.” The invitation was rescinded.

Psychoanalysis can embody more of that refusal, a refusal not dependent upon the offer, but one which recognizes a different measure of value. In her book, Persian Blues, psychoanalyst Gohar Homayounpour equates the origins of blues music and psychoanalysis as protests against the dominant culture, both holding their deepest purpose when at the margins of society. And she notes both, when mainstreamed, lose their reason to exist.

Right now, go ahead and try to find contemporary blues music that wouldn’t be out of place on a cruise ship. Some professions and practices may remain undiluted at the margins, but psychoanalysis may be at the wrong margins. Our lack of outreach to communities and institutions where psychoanalysis is not available has, so far, upheld the cultural biases psychoanalysis has earned as an elitist, solipsistic, jargon-loaded crowd talking only to itself.

In Chicago, we have a plan for a psychoanalytic training program for clinicians in community mental health clinics. Too often, talented and dedicated clinicians, often minorities, who are systemically underpaid, overworked, and lacking real resources , take work in communities where psychoanalysis is not an option for patients and psychoanalytic training and supervision are not available. These clinicians, often minorities, working with clients, also often minorities, must leave community settings for better pay, benefits, and education if they even consider that an option due to the structural racism in psychoanalysis. This interruption of care and protection ripples through the families and communities of these patients, further redefining mental health care negatively.

The lack of trained psychotherapists and psychoanalysts in community mental health supports the old “evidence-based” model of medication-and-case-management-only, as Bertram Karon argued decades ago in his paper, “The Fear of Understanding Schizophrenia”:

“If the therapist does not know how to do therapy, it is true that medication works better than psychotherapy. If bicycle riding were studied the same way, using only people who had never ridden a bicycle before, it would be concluded that human beings clearly cannot ride bicycles.”

Without this effort of creating a community psychoanalytic track, we foreclose on a potential generational change. Consider how many people in the field are in the field because they had an analyst with whom they changed the trajectory of their life. Consider how many people became psychoanalysts because their parents are psychoanalysts. This doesn’t happen where psychoanalysis is not an option.

We cannot stay comfortable on the cruise ship as we watch our government gleefully dehumanize those who are not white, cis-gendered, heteronormative males. If our field doesn’t reach out to populations that have no access to psychoanalysis, then we continue supporting the transgressions of a cruel authority that decides what people are worth the investment. Obama will not be coming to the rescue.

April 18th, 2025