The Freud Museum

Events Archive

29 June 2002 - 30 June 2002

Women Today

Diversity and Identity in a Complex World

Conference Report

Women’s Therapy Centre
25th Anniversary Conference

'Women Today' was a conference organised to celebrate the 25th anniversary of the Women's Therapy Centre in London, and to reflect on the revolutionary changes that have taken place for women in British society in that time. The conference was organised into four themes, reflecting the multi-layered and complex nature of women's lives in the modern world: Culture, Race and Difference; Body Matters; Dreams, Words and Memory; and Gender Politics and Women's Mental Health.

Tirril Harris, Chair of the WTC and Senior Research Fellow St. Thomas and Guy’s, introduced the conference with a reflection on the revolutionary changes that have taken place for women in British society over the twenty five years of WTC’s existence, highlighting women in the workforce, fertility, the abortion law and the pioneering role of the WTC. She observed that these changes to the structure of society have involved a dynamic interplay between inner and outer world events and that this theme would be explored in greater depth over the two days of the conference.

Culture, Race and Difference
Saturday morning was devoted to ‘Culture, Race and Difference’, a topic which has long been central to the thinking and work of WTC.

Barbara Fletchman Smith, psychotherapist and author of Mental Slavery gave a powerful and moving paper discussing the history of slavery and how the devastation it caused may be linked to many different kinds of trauma in both black and white patients today. Fletchman then illustrated and fleshed out these links with clinical examples from her practice. She observed that, though slavery was abolished four generations ago, ‘freeing yourself was one thing but claiming ownership of that freedom was another’. This paper raised awareness of slavery, not just as a tragic social phenomenon of the distant past, but as something still very present and in need of healing in the collective psyche of contemporary British culture.

Yasmin Alibhai-Brown is a writer, broadcaster and columnist for the Independent, as well as President of the Family Therapy Institute and author of several books. Her talk, ‘Multiple Identities and Women in a Globalized World’, focused on changes in society and in her own thoughts and feelings since September 11th. She conveyed a deep dismay with the conservatism that seems to be on the ascent in the West and the collapse of dialogue into an ‘us and them’ mentality. A central theme of the talk was the need to find a way of existing with the high degree of complexity which is a fact of life in today’s world and how the old maps of ‘feminist’ or ‘anti-racist’ ideas are no longer sufficient because they leave out other inequalities that do not fit within this schema. Alibhai-Brown asserts that ‘it is no longer possible to apply an overall methodology’. She suggests rather that one must now operate with a ‘human rights template’ which must be applied anew in each individual situation.

Gita Patel, staff therapist at the WTC, read a thought-provoking paper entitled, ‘The Concept of Self: the Impact of Culture and Racism’. Patel’s starting point was to define ‘culture’ as a dynamic process and ‘racism’ as the deeper, darker side of multi-culturalism and diversity. She maintains that ‘all models of health and healing must remain embedded in the culture in which they’re practiced’ and uses Kleinman’s concept of ‘category fallacy’ to think about how the Western model of the self is based on culture-specific values, such as individualism, and is not a ‘pure’, universal model as is so often assumed. In contrast to the familiar Freudian self, or ego, which is conceived as a development from a merged state to individuation and separation, she considers the Indian self which is grounded in a very different set of values, culture and philosophy. The Indian self involves a movement towards a merged state; in its most highly evolved form it is conceived as a merging with the entire cosmos. It is eternal with no distinction between self and object, no self-awareness and no sense of individuality. The Indian self has permeable boundaries and is maleable and adaptable. Patel goes on to talk about how an Indian patient in therapy with a British white therapist whose model of mind is embedded in western, individualistic culture, may split the self, developing a ‘Western’ self within the therapeutic relationship but reverting to an Indian self within the family. The paper ended with a discussion of ‘internalised racism’ which occurs in societies in which structures and assumptions are based on white-superior/black-inferior hierarchies. This often results in an unconscious denigration of the self and in the case of a black patient seeing a white therapist, the power dynamics of the relationship may reinforce the idea of ‘whiteness’ as the desired state.

The final presentation of Saturday morning’s session was given by Angela Powell and Gwen Williams, both staff therapists at WTC. In a talk entitled, ‘Working with Race and Colour’, they shared some of their thinking and considerable experience as black women psychotherapists working with both black and white patients at WTC and in other settings. They addressed the difficulty and current lack of discussion of race and colour within the psychoanalytic psychotherapy profession and highlighted the fact that most of our training organisations do not currently include these issues in their curriculum. They suggested a possible reason for this in the traditional and historical focus on inner world experience. As race and colour have been thought of as external world elements, they have not been considered relevant to discussions of psychic experience. Powell and Williams used Sonia Jenkins’ definition of ‘diversity’: ‘Openness to new experience and ideas and informed connectedness to one’s reference group’. They then made the thought-provoking observation that, in their experience, white therapists often do not see themselves as part of the discussion on race because they do not define themselves in terms of race but rather in terms such as, English, Irish, Catholic, etc. This was a wake up call and invitation to many white therapists present to think more deeply about their own relationship to race and colour.

Body Matters
Joan Raphael-Leff, psychoanalyst and professor of psychoanalytic studies at Essex University, as well as author of several books including, Psychological Processes in Childrearing and numerous papers, chaired the afternoon session. She opened with a reminder that we are ‘embodied’ and have all come out of female bodies - obvious facts which are nevertheless often obscured by the psychoanalytic focus on the mind.

Marilyn Lawrence, psychoanalytic psychotherapist at the Tavistock Clinic, presented a stimulating, if somewhat controversial, paper called, ‘Female Fears: An Exploration of Anxiety’. In this paper she links anxiety in women with their mental representations of female sexuality and the body and discusses how the differences between the sexes are at the centre of psychoanalytic thinking. Whereas the boy fears loss of potency as described in Freud’s famous ‘castration complex’, Lawrence maintains that the girl fears something getting inside and damaging her. Part of her argument is that females are, by nature, more introjective than males and she connects this with the openings into the female body. When this becomes pathologised, the result may be a rigid defensiveness against penetration; a cut-off, narcissistic, emotionally ‘no-entry’ world. This state is accompanied by an internal object felt to have intrusive intentions which immediately gets projected onto the analyst. According to Lawrence, the origins of this intrusive internal object are in the possessive attachment to the pre-oedipal mother. Lawrence described these patients as typically quite intrusive as they try to control the object from the inside. Characteristic features are blurring of boundaries and denial of separateness or difference between self and object with the hateful longing for fusion projected into the analyst. Lawrence then demonstrated how these theoretical ideas work in practice with a brief case study. During the discussion session after the paper some dissenting views were expressed from the floor. A well-known attachment-based psychotherapist observed that ‘intrusion’ could be re-framed as ‘a longing to make an impact in a relationship where you matter’. Others commented that they found the emphasis on biology retrogressive. Though none could criticise the integrity of the paper or the impeccable preparation and presentation of its author.

Anne Aiyegbusi, nurse consultant in the Women’s Services at Broadmoor, a high security psychiatric hospital, gave a moving talk called, ‘Body Language: Working with Women in Secure Care’. In a warm and accessible presentation style, she shared her experience of working with this difficult group of severely damaged women who often use their bodies violently to express trauma that cannot be thought about or spoken. Aiyegbusi talked about how women’s responses to what is, in fact, emotional and sexual abuse are often misunderstood, causing them to be labelled ‘delinquent’ at an early age. Most of this population have suffered massive and repeated violation of their psychic and bodily integrity which is then often tragically re-enacted within the health and social care system. Historically there has been little psychological understanding and support available to the carers of these women, resulting in a failure to make links between their behaviour and the abuse that was done to them. Lack of support combined with the disturbing emotional impact of this group on carers has made this one of the most unpopular areas in which to work. It was Aiyegbusi’s own struggle for understanding that eventually brought her into contact with psychoanalytic thinking and practice. Here she found the conceptual tools she needed to be able to make sense of the bodily acting out and other primitive forms of communication used by the women in her care.

Colleen Heenan, Senior Lecturer in Psychology and a psychoanalytic psychotherapist in private practice, gave a dense paper entitled, ‘Which Bodies, Which Selves’, in which she makes use of both psychoanalytic and postmodernist thinking to deconstruct traditional views of femininity and gender. Heenan observed that, although these theoretical models can be disparate in perspective, they have a mutual interest in the body as a site for expressing conflict. She spoke about the phenomenon of internalised misogyny in terms of a ‘penoptical male connoisseur’ which exists in the internal world for the majority of Western women; an internal masculine arbiter of beauty who informs women’s view of themselves. In developmental terms she traces this back to the mandate commonly given to little girls ‘to appear rather than to be’. Women who have internalised these assumptions tend to blame themselves for their ‘shortcomings’ and, in order to maintain their attachment to the culture, keep working on themselves and their bodies rather than working to change these inhibiting cultural assumptions. This raises a challenge for therapists and feminists working with women, and particularly women who have eating disorders. Heenan related this thinking to her work on a reflexive research project in which she acted as both therapist and researcher in a group for women with eating disorders.

Dreams, Words and Memory
The Sunday morning session began with Margot Waddell’s presentation of a paper entitled, ‘The Vale of Soul Making: Psychoanalysis and Poetic Imagination’. Waddell is a psychoanalyst and Consultant Child Psychotherapist at the Tavistock Clinic as well as author of several books. Her paper was a rich and poetic exploration of some of the affinities between psychoanalytic and poetic processes in human development. Using a Bionic lense, she spoke of development as rooted in a capacity to engage with and suffer experience; a capacity to work on experience internally in order to generate meaning. This capacity to form symbols (symbol formation) is necessary for any type of creative process, including living. She noted that the abstract expression of private experience is at its greatest intensity when it becomes universal, as in great poetry and works of art. The struggle for both poet and psychoanalyst is to find forms for as yet unknown psychic experiences. She spoke of the use of metaphor to attempt to arouse cognition of the unknown by referring to the known and how the unapprehended nature of things may be revealed within the ‘form’ of the psychoanalytic session. The apprehension of psychic reality requires an evocative language that is able to express experience which goes beyond the sensual realm, and there is always a danger that meaning will become pinioned by the discursive process of psychoanalysis. Waddell read several beautiful poems by Anne Stevenson, Carole Satyamurti and Emily Dickinson to illustrate and amplify the ideas in her paper. One of these, ‘Passed On’ by Satyamurti, depicts a young woman’s painful mourning process after the death of her mother, during which the external figure of mother is let go and installed as an internal object - a container to express the meaning, or poetry, of her own life.

The next speaker was Eva Hoffman, well known writer, editor and lecturer. She is the author of Lost in Culture and Exit into History, as well as numerous papers and articles on culture and politics. The starting point for her talk on ‘Transculturation’ was her own personal experience as a young woman of moving from Poland to North America. She described a process of change at a deep psychic level where language and identity intersect. This involved for the first few years an almost total suppression of the Polish language, her ‘mother tongue’, as an expression of her anger at the loss. She also described a painful blow to her self-esteem as she went from being eloquent in Polish to clumsy and lacking in the language of her new home. Speaking from the immediacy of her own experience she described how, without words, the world recedes into an inner darkness and how the power to image, or imagine, is connected to the ability to name. Transculturation needs to happen gradually; it took time for the new language and culture to ‘drop into the psyche’ and the development of a new grammar of selfhood also requires time and space. Hoffman conceives of this process as a dialectic between past and present, an inner dialogue in which the two languages gradually become friendly with each other. To therapists working with patients in their second language Hoffman warns that it is important to be aware that subsequent languages exist at a different level in the cerebral cortex than the first language. The distance between self and language is closest in the mother tongue and a second language may emanate from a shallower place in the psyche. Hoffman also discussed language as a metaphor for the incorporation of culture into the psyche and how much coherence we risk when we fall out of its matrix since culture constructs us in the deepest possible ways - all aspects of feeling and perception, forms of intimacy, gender and selfhood.

The final speaker of the morning was Eileen Aird, Clinical Director of the Women’s Therapy Centre and psychoanalytic psychotherapist, as well as author of Sylvia Plath and several papers on literature and women’s education. In an engaging presentation entitled, “The Light of the Mind’: Poetry and Depression, Aird explored the poetry of Sylvia Plath in terms of depression and spoke of Plath’s oeuvre as an embodiment both of the state of depression and of the release from it. In ‘The Moon and the Yew Tree’, the poem from which the title of Aird’s talk is quoted, ‘the light of the mind’ is ‘cold and planetary’ and ‘blue’. In the end it is a poem about the light closing down. ‘The message of the yew tree is blackness’ - depression, loss of connectedness and no hope of change. The Bell Jar is another symbol for this cut off state of being -the self is trapped in the bell jar, temporarily without resources. Aird makes a link with the psychoanalytic view in which depression is connected with grief over the loss of the good object - ‘The grasses unload their griefs on my feet as if I were God’. Desire is felt to be unattainable, which leads to loss of hope and detachment from current objects. What is good can be admired and desired but not held within in any secure way. Aird reminds us that ‘The Moon and the Yew Tree’ was written only weeks before Plath’s death by suicide and speculates that the large number of mythologising projections onto Plath after her death represent the search for the relief of an apparent causality. Aird’s paper suggests that the magnitude of her poetry perhaps resides in Plath’s ability to let us into her mind with such extraordinary generosity.

Gender Politics and Women’s Mental Health
Joanna Ryan presented us with a deeply thoughtful paper entitled, ‘Where now? Recent thinking on psychoanalysis and homosexuality’, which raised some fundamental questions which psychoanalysis has yet to address. She directly challenged the historic pathologisation of homosexuality referring to The Women’s Therapy Centre as a place that provided workshops where being a lesbian could be safely addressed.

She referred to a recent research study by three psychiatrists in London on attitudes within the psychoanalytic profession. It was clear that while the majority of analysts accepted the training of gay or lesbian students there was an underlying assumption that a gay or lesbian life was not a viable one. It seemed self evident that therapists had not been taught in their training how to think about homosexuality in a non pathologising way. In which case how do therapists manage this theoretical vacuum? While in the UK attitudes are deeply ambivalent the American Psychoanalytic Association has an explicit policy on nondiscrimination in relation to the selection of candidates to the training. In 1996 the then president made a public statement to the effect that psychoanalytic claims that there is an intrinsic link between homosexuality and psychopathology were incorrect.

She argued that a more detailed exploration of transference and counter transference reactions was needed. She suggests a way forward would be to dispense with the terms masculinity and femininity and their attendant theorisations.
While there was a marked liberalisation of attitude she did not think that a new theory of homosexuality solved the dilemma of pathologisation. She suggested there were a variety of post-modern positions that led away from notions of fixed gender identity. Perhaps we are learning to play with identity and should hold out for the possible primary status of homosexuality - meaning that it just ‘is’ in the way that heterosexuality always has been.

In the light of the absence of the government’s paper ‘Women’s Strategy for Mental Health” which was supposed to be published this May, Joy Dalton presented her own innovating strategy. She emphasised that there are still many challenges for women and that any strategy must have a political statement that underpins the designs of services and treatment. Focusing on the plight of inpatient services and the risk to women, with violence on wards, issues around ethnicity and lesbians not wanting to be in mixed environments, she lays stress on the fact that people should be kept safe in their own environments

Historicaly she pointed out that the focus moved away from the environment and society producing mental health to a biological and genetic cause. Thus, the search for a cure stemming from better medication led away from any political dimension.
In her strategy she brought our attention to a need, not only for structure, but also for understanding. She suggests that we should look at the meaning of the behaviour of the women on the wards and the notion that many of the violations these women have suffered were before and beyond words and ask ourselves what is the meaning of the metaphor? In general services she recommends entering into a differnet kind of relationship by hearing women’s stories to bring meaning into the mental health services. For training, a cultural change is needed where NHS staff share their life experiences and are valued for it.

She finishes by stressng that it is the psychological aspect that is missing and that there should be a fruitful dialogue with the therapeutic community. The strategy for women has been put in the box marked “difficult” so a political view has to be taken.

Women Today: Conference Assessment
At the end of the conference Susie Orbach commiserated that Luise Eichenbaum could not be there and that these two full days had left her full of deep pleasure and exhaustion. The process of creativity at the WTC reminded her of sisters pushing each other and daring to think. A conferences of this calibre, she said, is a surrender to new possibilities. For her, what came out of the conference was The Body and Sexuality, saying, “I don’t think we have a theory of sexuality at all.’ going on to to say that we don’t dare to contest what is really important.
Since 9/11, she added, all thinking is being challenged creating a new space and we need to argue for a political platform - to be co-hosts, not guests.

Eileen Aird thanked Ivan Ward and Erica Davies of the Freud Museum and Susan Austin and Anne Burne of the WTC.

report by Lisa Chisholm and Trudy Harvey, Womens Therapy Centre


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