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Thomas Marchevsky & Community Psychoanalysis and the Neoliberal Horizon Fernando Castrillon The Clinic, the Discourse of the Capitalist, and Reductionistic Politics of Identity

Community Psychoanalysis and the Neoliberal Horizon: The Clinic, the Discourse of the Capitalist, and Reductionistic

Politics of Identity Thomas MARCHEVSKY and Fernando CASTRILLÓN Universality is inherently dialectical. It lets us see what particular identity hides—connection in the midst of division. Universality allows for a response to a catastrophe like climate change that is equal to the magnitude of the event. Our particular identity, in contrast, leaves us with only a series of responses that can never add up to being adequate to the problem. The stake of the struggle between particular identity and universality is now existence itself. (McGowan, 2020, p.205)

The impetus for this essay is a growing set of concerns regarding transformations in the social field and their effects on how we think about and conduct our clinical work, particularly in relation to “community psychoanalysis.” By way of introduction, we want to provide some context for the experiences that led us to formulate the questions we bring forth in this essay. In addition to our work as psychoanalysts, we draw extensively from attempts to carve out a space for psychoanalysis in the university via our teaching and the clinical training of graduate students at the California Institute of Integral Studies (CIIS). The central conduit of this transmission has been the Community Mental Health program, a Master’s level course of study designed for the express purpose of social justice-oriented clinical training1—this primary objective has been accomplished by placing emphasis on maintaining a polyphony of voices within a diverse student body in conjunction with upholding a curriculum grounded in liberation and community psychology. Closely connected to this academic program is the clinical training site called The Clinic Without Walls (TCWOW).

From its inception in 2009, TCWOW aimed to address major gaps in the treatment of marginalized populations within the San Francisco Bay Area and to provide clinical training specifically in relation to community-oriented praxis. To this end, TCWOW has followed in the genealogy of Freud’s free clinics (Danto, 2007) and has operated without institutional constraints regarding the frequency of sessions and duration of treatments. Over the course of the last 13 years, both of us have served as clinical directors of TCWOW and have also provided clinical supervision and didactic seminars to the psychotherapists in training. During this time, we have introduced many students to psychoanalysis and collaborated closely with them throughout their clinical formation. It is on this basis of an ongoing engagement involving the practice and transmission of psychoanalysis that we have come to formulate what follows.

As will become obvious, many of our reflections in this article revolve around questions, issues, and problematics regarding reductionistic politics centered around identity and a methodological individualism rooted in neoliberal capitalist discourse. We understand identity politics as describing “how marginalized people embrace previously stigmatized identities, create communities on the basis of shared attributes and interests (which are typically held to be essential and unchanging), and rally either for autonomy or for rights and recognitions.” (Lancaster, 2017). We are well aware that any foray on our part into this vexed and thorny terrain will inevitably summon forth critiques, energetic arguments for and against, and even heated exchanges. We welcome these and look forward to engaging with them. In the same breath, we respectfully ask that our arguments, as abbreviated as they must be in an essay of this length, be understood in their knotty complexity and subtlety. Just as we endeavor to do, we ask the reader to give us the benefit of the doubt when confronted with something not fully explained or seemingly confusing, and to reach out to us with any questions or concerns they may have. Our objective is to advance an argument that is of benefit to clinical work, broadly speaking.

What “Community” Are We Speaking of?

“Community” psychoanalysis is a kind of quick shorthand, signifying a kind of practice that is oriented to the public at large, even if the work occurs with individuals, as opposed to “private practice,” which is the main modality of treatment conjured up when psychoanalysis is mentioned in the United States. Both terms, “private” and “community,” speak immediately to issues of social stratification, how these are understood, and how treatment in either modality operates within, against, or in collusion with the various forces operating in any given social field.

So, we ask, to what community are we attending in this essay? Following from the above, and in a more granular fashion, what social field is being addressed here, and how have transformations in this social field impacted and perhaps limited the possibilities for analytic work, particularly when it comes to community psychoanalysis?

In the case of TCWOW, we immediately realize that there are two different aspects of the social field we are attending to, but interestingly enough, they have significant overlap. While all possible folks that may qualify for services at TCWOW (the homeless, unemployed, uninsured, underinsured, non-English speakers, poor, working poor, immigrants, and their families) would seem to make up the principal aspect of the social field we are concerned with, we should quickly note that the trainees of the clinic make up another facet of the field that is of vital importance for our considerations. And we say this not just out of a sense of fairness, but because these therapists-in-training, themselves part of the larger discursive and structural weave of the university itself, play an outsized role in how the work is understood, what is imaginable, and what the aims of the work are assumed to be.

TCWOW trainees often describe the patients2 or clients they work with using various terms in a limited set, including “disadvantaged,” “oppressed,” “traditionally marginalized,” “poor,” under-resourced,” and “traumatized.” In all cases, the words used denote patients that are certainly not part of the elite, the well-to-do, or the ruling classes, and most often not part of the middle class or even the working class. What’s interesting, however, is that no matter what term is used, and regardless of the fact that these terms often found their genesis in a discourse that explicitly had class as its starting point, the above terms are now often entangled with other lines of social stratification, namely race, ethnicity, gender, and sexuality. The use of these terms, in this fashion, immediately signals the hollowing out of a previously well-established social class discourse, and its replacement with one that often obfuscates the always thorny yet fundamental role of class struggle. And we mean something quite specific when referring to social class. To quote Paul Heideman:

[R]ather than just the education or money someone has, class refers to an entire structure that imposes very specific logics of action on people in society. And because of the power the

2. Students and trainees often struggle with the term “patient,” associating it with the dreaded “medical model” they are encouraged to avoid. In reality, this difficulty reveals a misconception. We need only recall the Latin origins of the term “patient” to understand its suitability. Patiens means one who suffers.

capitalist class holds in society, any significant redistribution of power requires confronting that class. These arguments have massive implications for thinking about politics in general and undoing the structures of racial and gender oppression in particular. …While the liberal view of class is like a ladder, with a potentially infinite number of rungs depending on how narrowly one wants to define the groups, the socialist view is famously polarized, with overwhelming emphasis on two classes: capitalists and workers. Those structural positions, in turn, impose two things on members of a given class: common logics of action and common interests. … For socialists, then, class is less about common status and more about interests and actions. (2019)

Not surprisingly, these same measures of social division (race, ethnicity, gender, and sexuality) are the ones often, but not always, employed by TCWOW trainees to describe themselves. While this fact may strike many a reader as nothing novel, let alone momentous, it is of crucial importance for how the work is understood or articulated in a community clinic such as TCWOW. This is all the more so when we consider that TCWOW operates under the aegis of the university and is therefore structurally entwined with the larger discursive weave of identity politics that has taken almost all North American academia by storm. With this in mind, we now turn our attention to specific aspects of psychoanalytic practice and the discourse of capitalism.

The Co-optation of Psychoanalytic Practice

In the years following May 1968, Jacques Lacan elaborated his theory of the discourses, in a sense responding to the momentous social upheaval of the time by formalizing the structures of the social bond. For our purposes, Lacan’s theorization of the Discourse of Capitalism serves to examine the consequences of the dissolution of the social link in contemporary political economies. Without rehashing an explanation of Lacanian algebra (readily available elsewhere), we will consider how the theory and practice of community psychoanalysis is pressured and compromised by the ideological confines of neoliberalism.

Lacan’s comments on the Discourse of Capitalism provide a way of thinking through how neoliberal discursivity functions as a backdrop for contemporary psychoanalytic practice. Here, it is worth quoting Daniel Koren on this basic logic: illusion that each one can be, have and become “whatever s/he wants”. The Capitalist’s Discourse, under the guise of the market’s discourse, invades all spaces (political, economic, social, artistic, etc.). It transforms subjects into permanent consumers of objects, which has direct effects on the production machine, but leans for this on what is the foundation of subjects themselves: the lack. (2017)

Bearing in mind this concise summary, we can begin to think of how the clinic is shaped by a machinic apparatus that produces a very particular type of illusion. Two things immediately come to mind. First, that capitalism serves as a petri dish for the fantasies of the consumer (it’s no coincidence that broadly speaking within the mental health field, “consumer” is now used widely and interchangeably with the term “client.”). Second, that subjects within the Discourse of Capitalism attempt to circumvent the lack through demands articulated to and from the market. Our aim is to interrogate how psychoanalysis is con-scripted by capitalism, and as such, how the clinic ends up reproducing the very trappings in which it is caught.

Not only does the Discourse of Capitalism effectively supplant the Discourse of the Analyst, it also operates decidedly against the division of the subject by promising wholesale jouissance (Braunstein, 2012). In contrast to the ways in which subjects are compelled by the @ Ilures of capitalism, the function of the analyst is that of cutting discourse in a manner counter to unabated jouissance, and in doing so, it destabilizes the phantasm of the analysand and the analyst. If the symbolic cut is obviated, either because the analysand refuses to work through incisions or because the analyst simply fails to punctuate subjective division in the first place, then what remains is unbridled jouissance.

In our era of responsibilization (Pyysiäinen et al., 2017), we must ask ourselves how self-referentiality and claims to autonomy play out in the clinic. Insofar as the analyst is tasked with supporting the imaginary indexes of the analysand, the puncturing of the narcissistic image becomes nearly impossible. This is a vexed issue given that many contemporary political movements aim precisely to establish recognition via identifications, advancing this as a necessary means by which to bring justice to the marginalized. This project is especially appealing within the context of community-based work because it purports to respond to the urgent struggles of those who historically have been discriminated against. But it may be that the attempt to introduce dignity in this manner is in actuality driven by the satisfaction of conforming to the demand of the social field; these exigencies are all the more difficult to scrutinize, let alone resist, precisely because they constitute that which is assumed to rectify the injustices faced by the oppressed. But this is in fact only a semblance of care. Like other aspects of our contemporary moment, the noblesse oblige becomes yet another emblem of individual virtue (Rose, 1999), and the ingratiation of hollow modes of recognition ends up placing psychoanalysis in the same shopping aisle as many forms of contemporary psychotherapy. The logics of the marketplace dictates what it means to provide or undergo psychoanalytic treatment when psychoanalysis is ciphered through neoliberal ideologies. For this reason, psychoanalysis is at risk of a total merger with what Parker and Pavón-Cuéllar (2021) call the psy-complex (psychotherapy, psychology, and psychiatry). This essay is therefore in part an effort to carve out a space for community-oriented practice and, to this end, to disambiguate psychoanalysis from the so-called mental health professions. Only in such a clearing can the rarefied work of, and with the unconscious continue.

From Identity to the Subject of the Unconscious

A brief conceptual interlude is warranted here, as it will allow consideration of the problems at hand in a more technical manner and refine how we might listen. Identity is, in a very basic structural sense, constructed in and through language. For Lacan, a signifier in isolation is empty, in itself devoid of meaning. The signifier appears meaning-full only in its articulation with other signifiers, thereby producing signification. Because no single term can be interpreted in isolation and therefore cannot be essentialized, then any point of identification is necessarily linked to other signifiers. For example, two people born in the United States share the signifier of that place, but the articulation of what “American” represents is unique in each case. By extension, we can conclude that the sharing of an identificatory category cannot establish the ground of sameness. The moment any term is brought into relation with other terms, it is no longer a signifier in isolation—it is instead one element within a network of other signifiers. Thus, one person’s relation to an identity category will be necessarily different from all other persons’ relation to the same category. This is because for each subject, all terms occupy a distinctive place within the particular structure of their discourse. As useful and compelling as they may be in some relative sense, identity categories are inherently empty placeholders.

The analyst’s intervention on the signifier is the cutting of discourse to establish the unconscious structure of the signifying chain. To carry out this procedure, it is necessary to determine the place of the imaginary and its structural tie to the symbolic and real. As clinicians, it is vital that we attend closely to points of identification, not because they are valuable in their own right, but because they are the basis for the subject’s alienation in language. In the clinic, the extent to which self-representations are privileged is the degree to which the subject remains ensnared by the veils of the ego. It is therefore crucial to attend closely to these points of identification not to reify the image, but to determine precisely where the subject of the unconscious is caught or hides. In doing so, the analyst performs the cuts necessary to bypass the ego, consequently making possible the nascence of the subject of the unconscious. To pierce the narrow veil of identity is to open up to desire, the universal truth of the lack-in-being.

Solidarity in the Lack

A cursory glance at economic statistics is enough to grasp the stark disparities that exist in the United States and throughout the globe. With respect to class struggle, psychoanalysis is impotent since it cannot effect change at the level of the polity. Consequently, psychoanalysis as a clinical practice cannot in any real way produce “social justice” (as is sometimes misleadingly presumed) precisely because it cannot resolve material problems. If it isn’t already clear, our position is not a call for a resurrection of the patriarchy or a return to traditional values. No, quite the contrary. If there is a way through all of this, it will be via a profoundly radical reorientation of how we define and therefore how we might work toward social justice. As just one example of how the issue of identity might be dealt with differently, we quote Lancaster again:

Under the rubric of liberation, activists embraced identity in order to abolish it. Marxist ideas about class struggle — which similarly culminate with the abolition of social classes — influenced their ideas. They rallied around demands for adequate income, housing, medical care, ecological well-being, and meaningful employment. Their liberation struggle was ultimately a revolutionary call to action with a universalist view of freedom. (2017)

As can be readily observed, this formulation is radically different from an embrace of identity for its own sake, or as an end in itself.

Beyond the fact that identity politics fail to adequately take account of the material roots of oppression, paradoxically, such thinking instantiates the promises of a capitalist political economy (Michaels, 2006; McGowan, 2020) and therefore lead to further exploitation. And though patients may ask for it, and though we may be encouraged by our institutions to conform to it, no amount of politically correct language will resolve the very real inequities suffered by the poor, the marginalized, and the exploited. The atomized notion of individual liberation represented by the metonymy of 1+1+1+… is homologous to the depoliticization of American society writ large. Our general failure to cohere sustained, large-scale social movements is consistent with the predominance of highly individualistic, almost solipsistic discourses. What else then, might make possible a different kind of social bond? As Beshara points out:

Comradeship is a form of horizontal affiliation, which is not based on Imaginary identification, but Symbolic alignment of desire and Real enjoyment. Put differently, we are not comrades because we are the same, but because, despite our differences, we may share common interests. (2021, p.159)

It cannot be overstated just how different such a view is in contrast to current movements predicated on the pretext of social justice we’ve outlined above. Having said that, we also recognize the existence of many possible conceptions of struggle and comradeship issuing from a panoply of forms of racialized, sexualized and gendered hierarchies. These too function as symbolic, as well as imaginary and real, orders allowing for varied forms of solidarity and their own “universality thrust” (McGowan, 2020, p.26). Which is a way of saying that it’s important to recognize all forms of oppression. To quote Heideman again:

Movements fighting race and gender hierarchies have reshaped American society at different points, winning massive redistributions of power. Even when such movements are dormant, these forms of oppression shape the distribution of power in society and the degree of material oppression in ways large and small. These forms of oppression have an existence every bit as brutal and concrete as class exploitation. (2019)

Neoliberalism, Identity-Centered Politics, and the Clinic

We draw a straight line from neoliberalism, understood in political-economic terms and as hegemonic discourse, to identity politics. These are mutually co-arising phenomena that not only reinforce each other but are also predicated on the same epistemic misconceptions. To put it bluntly, both the politics of recognition and neoliberalism rely “on a methodological individualism that assumes macro-level social phenomena have micro-level causes and solutions. This fixation on individual choice and personal attitudes reproduces the epistemological fallacies of neoclassical economics and most of right-leaning social sciences” (Parenti, 2021, p.1). Perhaps the best way of proceeding is to ask what kind of strictures on community psychoanalysis and its praxis arise from a neo-liberalized social field? As well, what new demands are articulated to the clinic, and how might these complicate and potentially detract from the work of and with the unconscious?

We note that the demand, by both patients and trainees alike, and formulated in a variety of ways, is that the clinic join in the larger project of achieving and cohering stable identities, understood to be both authentic and outside of the strictures of mainstream morality and white-heteronormative supremacy. Attempts to go beyond this immediate project can easily be misunderstood and are often deemed oppressive or anti-liberatory. Hence, any work with the unconscious that puts into question the whole category of fixed identities, as explained above, can easily fall prey to being labeled antiquated, in opposition to liberatory politics or even in line with the “medical model”. It is only through the steady, careful, and persistent efforts of the clinic’s supervisors, trainers, and directors that a clear path beyond the politics of reductionism can be achieved. It should also be noted that once exposed to a coherent line of argumentation that delineates why it is important to interrogate the premises of identity, TCWOW students are often eager to know more and to practice in different ways.

Any attempt at a community psychoanalysis must necessarily deal with the always-looming specter of cognitive-behavioral therapy or CBT. If neo-liberalism and identity politics constitute two pieces of a triptych, then CBT most certainly functions as the third. Sharing the same epistemic bases as identity-centered politics, which sees oppression as a kind of “misinformation” and social construct (Parenti, 2021, p.3), CBT understands clinical issues as arising from incorrect cognition, faulty and incomplete information processing, or deficient knowledge bases and prior conditioning. In other words, the CBT cure, like that advanced by identity-politics adherents, is fundamentally about achieving correct thinking, based on inclusive data, framed and languaged in the approved manner.

This way of approaching clinical work is incredibly alluring, as any survey of graduate clinical training programs will immediately show. CBT has become the almost unquestioned gold standard of clinical training and practice. And part of its charm is that it matches so well with neo-liberal discourse. They are all of a piece and form an antipode to community psychoanalysis.

As well, CBT, like some aspects of identity-politics discourse, would seem to feed an extreme narcissism and individualism that we have noticed among many folks in the larger field. They sense that grand-scale social change can be enacted on a distributed, individual level (the metonymy of 1+1+1+…). And this makes sense if you believe that the important stuff is happening mostly at the level of the psyche and social forces are ignored or not fully recognized for the enormous role they play in the total equation. In this model, personal and social liberation (often and implicitly understood as being the same thing) are the result of a successful struggle against internalized oppression, a kind of unlearning or de-conditioning. By adopting correct language and thinking, appropriate attitudinal dispositions, practices, and gestures, a psycho-social cure can ostensibly be achieved.

Not wanting to reproduce the same epistemic fallacies noted above, we are quick to note that we are not blaming individual clinicians in training, let alone patients, for arriving at the doors of community psychoanalysis with the aforementioned stance. If anything, this set of positions is the result of decades-long and abiding patterns of political economy and discourse. In other words, they are a flowering or outgrowth of something much deeper. And it is something that the psychoanalytic clinic, be it of the community variant or otherwise, must necessarily deal with. z


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