The Freud Museum

Events Archive

1 January 1992 - 31 May 1992

Psychotherapy Black and White

Conference Report

This year the Freud Museum organized what many people considered to be the most important public event of the year in the field of psychotherapy. It was a series of five professional seminars for social workers, counsellors, psychiatrists, probation officers and community health workers, about psychotherapy and ethnic communities. About three quarters of those who attended were black professionals.
The series was organised in cooperation with the inter-cultural therapy centre, Nafsiyat, and their director Jafar Kareem. It is with great sadness that I have to report that Jafar Kareem died suddenly on 12th September 1992 at the age of 62.

Nafsiyat was founded by Jafar in 1983 with the intention of providing psychoanalytic psychotherapy for cultural and ethnic minorities who for one reason or another were not getting psychotherapeutic help when they needed it. Either the clients themselves resisted the idea, regarding psychotherapy as so much mumbo-jumbo and not 'scientific', or they were deemed to be 'unsuitable' for psychotherapy by the refering agencies (ie. they were the victims of prejudice). From the standpoint of psychotherapy we could almost argue a human rights issue here - the right to be listened to.

Jafar himself located his theoretical position firmly within the legacy of Freud, and also acknowledged the contribution of Freud's pupil Sandor Ferençzi. Like many others who have followed Freud, he adapted his techniques to the specific demands imposed by his particular client groups. In 1978 he described inter-cultural therapy in the following way:

"It is a form of dynamic psychotherapy that takes into account the whole being of the patient - not only the individual concepts and constructs as presented to the therapist, but also the patient's communal life experience in the world - both past and present....[T]his means that when we are treating patients from black and ethnic minority groups we have to take up the issues of their real life experience of racism."

It is only by acknowledging the real life experiences of racism that it is possible to open up a recognition of the unconscious meaning and the symbolic structures involved. Nafsiyat treated many people who would otherwise not have received help from any source: some of them were regarded as 'hopeless' cases, taken to Nafsiyat by social workers or probation officers as a last resort. The outcome studies and careful research work undertaken by Nafsiyat (now included in the book 'Inter-Cultural Therapy' co-edited with Roland Littlewood) show the effectiveness of their approach with short term treatment. Jafar hoped that the understandings he worked for would eventually become commonplace in psychotherapy, and that Nafsiyat would make itself redundant.

However, as well as the psychoanalytic psychotherapy approach, other views were also represented in the series. It is important to understand that when trying to introduce the principles of psychoanalysis or psychotherapy to the general public - even professionals from related disciplines - there is no point in taking a heavy handed approach by prohibiting certain modes of thought before you start. We have to try to overcome resistances in a more subtle way, by building bridges, not by destroying them. The series also included talks by members of black mental health organizations, and by consultant psychiatrists working in general hospitals.

The full programme was as follows:

(1) PSYCHIATRY, PSYCHOTHERAPY AND ETHNIC COMMUNITIES

The relevance of psychotherapy to black and ethnic communities. Reasons why people become ill. The reluctance of black communities to take up psycho-therapy services. Ways of extending appropriate services for particular client groups. Follow-up and outcome studies for ethnic groups using psychotherapy.

Speakers: Jafar Kareem, Roland Littlewood (Nafsiyat)
Chair: Maurice Lipsedge

It is perhaps a testament to Jafar Kareem's sense of commitment - and the overwhelming feeling of responsibility that so many black professionals feel - that he gave his talk less than a week after having undergone major heart surgery.

(2) THERAPEUTIC PRACTICE 1

(a) The Fanon Project Experience

(b) The Group Analytic Experience

Speakers: Peter Hall and Victor Simpson; Tony Clayton and Eric Ferron
Chair: Radha Bhat

In this seminar Peter Hall and Victor Simpson discussed some of the organisational, funding, and administrative problems encountered at the Fanon Project, a day centre and residential unit in Brixton, and how these factors influence clinical practice. In the second half of the seminar, Eric Ferron and Tony Clayton convened an experiential 'median group' in order to bring to life some of the unconscious assumptions about race and cultural differences we make about each other.

(3) THERAPEUTIC PRACTICE II

(a) The Nafsiyat Experience

(b) The White City Project Experience

Speakers: Lennox Thomas, Sue Holland
Chair: Jean White

In this seminar both speakers gave talks describing some of the fine texture of psychoanalytic psychotherapy practice within the context of an intercultural setting. The way transference is manifested in the inter-cultural situation, the receptivity of clients to interpretation, the structure of resistance, and the trajectory in which therapeutic change takes place, were all discussed at length, and made for a stimulating afternoon's work.

(4) FAMILY DYNAMICS AND RACISM

The varieties of family structure in black communities.
Differences in competence and life-cycle developmental tasks across different cultural groups. The impact of racism on family relationships. Young black people and psychotherapy.

Speakers: Aggrey Burke, Radha Bhat, Annie Lau
Chair: Tele Amuludun

Each of the speakers (who were all psychiatrists working in the NHS) presented fascinating clinical and research material to talk about their topic. In particular a statement by Aggrey Burke sticks in the memory since it so succinctly and movingly joins together the social and psychological dimensions of the problem: "How does a young black single mother, living in poverty in a dilapidated high rise block, feel about herself and her environment? She feels unloved, and dumped". He went on to show the importance of the relation to the mother as a determinant of mental ill-health in these conditions.

(5) PROBLEMS OF TRAINING FOR BLACK PSYCHOTHERAPISTS

How do issues about race and culture manifest themselves in psychotherapy trainings? What are the training organizations doing to encourage black therapists? What are the psychotherapy institutes doing to make services accessible to black communities?

Speakers: Sonia Francis, Isha McKenzie, Mary Coghlan

This was perhaps one of the most important seminars for the participants of the series. Both Sonia Francis and Isha McKenzie gave illuminating and forceful accounts of their own experiences of training, and the woeful lack of provision for black trainees. Mary Coghlan is chair of the intercultural committee of the UK Standing Conference. She discussed the situation at national level and gave her own views on the need for an extension of services.

Over 70 people enroled for the seminars, with a similar number put on a waiting list. The most lasting impression was of a group of people coming to the meetings with a genuine desire to learn something, and to participate in an ongoing debate. This attitude and openness in such a delicate area was a tribute not only to the speakers but also to the organisers of the series. In this respect I would like to thank Dr. Audrey Cantlie and Dr. Radha Bhat for their invaluable help and advice over a period of some months.

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