Community Psychoanalysis

     I woke up this morning and said to Sapphire, who was lounging near my shoulder waiting for me to wake up and fill the bowls, “What the hell kind of dream was that?” The entire dream was a close up of pressing an elevator button. It was  just a round silver button, no indication of up or down, which might have given it a bit more significance.

     Picking up some things the cats had been bowling off the shelves, I found myself holding a framed picture of myself as a toddler that Kate had found, rescued from the basement, and kept on her bureau, and the grief hit me hard and fast like a summer storm.  There was no point in looking for an awning to hide under, I have learned that you just have to let it pour until the sun breaks through.

    The list of mindless chores was especially long today because I went into the office despite being off on Wednesday.  I had been invited to the first meeting of a “Community of Practice” and I prefer to zoom from the office where there is faster internet and a lack of interfering felines.

     The Community of Practice meeting was the latest in a chain of events that started with an email from someone wanting to talk to me about “community psychoanalysis” and New Alt.  I was totally puzzled by this because when I was in graduate school, the school was split between the psychoanalytic professors, mostly elderly jewish men, and the cognitive behavioral therapy people, who tended to be younger and included more women and queer people.  As students, we had to pick one or the other to focus on, but even those of us who chose CBT still had to take a number of psychodynamic classes, which felt about as useless as the year we spent learning to administer and score the Rorschach.

    Given this experience, I thought of psychoanalysis as an old-fashioned, resource-heavy approach that was only applicable in dyadic private practice settings, possibly with a couch, multiple times a week.  I could not imagine what on earth that would have to do with our work at New Alt.

    However, I have a general policy of meeting with anyone who seems well-intentioned to see if there is actually anything they can offer our clients, so I passed it on to Misty to schedule and found myself in a meeting with a woman from Pulsion Institute, a psychoanalytic training institute not far from us in midtown.  She explained that they were trying a radical new approach of using psychoanalytic thought in an anti-oppression framework to  address larger sociopolitical issues.  The idea was not to just use this modified analysis to help individual people, but also as an intervention in the greater psychoanalytic  world, particularly the training institutes.

    They had created a new curriculum for “community psychoanalysis” to train therapists in an approach which makes the service more accessible by providing it in groups – either of clients or of agency staff.  They had been testing it out in various settings with low income participants facing a variety of socioeconomic challenges, and they reached out to me to find out if we would be interested in having two of their “candidates” lead a group for our clients in the fall.  After gently testing them by bringing up various challenges that arise with our clients and getting well-considered responses, I decided to give it a try.  Mental health resources are in such limited supply for our clients, that the potential of adding to their options is appealing.

    Which brings us to the Wednesday evening meeting.  I had no idea what to expect so I watched with interest as the screen began to fill up with mostly analysts, but also several psychiatrists, and people from the non-profit world like me, about 25 people in total.

    One by one they began to introduce themselves and talk about their connection to community psychoanalysis.  Several people were from places whose work I knew well- like Fountain House, where both multiple of our staff and clients are members.  Others, though, were describing projects they had created, like a program where volunteer analysts met and worked with low income mothers and babies in their homes, with no fee.  I still have no idea how one would involve an infant in analysis, but I was struck by the grassroots nature of the model, and the philosophy, so much like my own, of finding out what people need and then working on that.

    As other analysts in the group described their work with groups of women in shelters, and former prisoners, and young people aging out of foster care, I was struck by another similarity in our approaches.  One after another, they described working with clients “for as long as it takes,” which is really where my heart is, even though technicalities of funding and capacity mean that we cannot do that as an organization. 

      In reality though, the most valuable thing we offer, a consistent relationship with a trustworthy adult, is not something that ends when the program ends.  We might not be able to keep having aged out clients come for dinner, or give them OMNY cards, or help them through the day to day complexities of dealing with government services, but they know without it being said, that if they find themselves in real trouble at some point, they can call  me - not the organization - and I will answer.

    To me, this is a matter of ethics, of not doing harm. The need for a consistent adult presence becomes less frequent as we grow and become more independent, but people are not equipped to be alone in the world. Even if it’s only the knowledge that there is one person that they can call if everything falls apart, being able to touch that knowledge, can provide a base for building and moving forward.