Psychoanalysis in El Barrio

By Dr. Sara Hueso

This summer, BGSP hosted the viewing of the documentary, “Psychoanalysis in El Barrio,” followed by a discussion led by guest psychoanalyst Dr. Maria de Lourdes Mattei, featured in the film.

This 50 minute documentary emerged from two important conferences held in New York City. The first conference was Latin American Contributions to Psychoanalysis in 2013, and the second conference was Psychoanalysis in El Barrio held a year later.

The film features ten psychoanalysts from a variety of Latin heritages reflecting on the complexities of working with issues of culture, class, immigration, language, ethnicity and race within the Hispanic population.  El Barrio is the name given to Hispanic neighborhoods riddled by socioeconomic challenges. Very soon, the viewer can recognize the applicability of these reflections to other marginalized groups of people.

These psychoanalysts speak from a place of identification. Having been marked by their own struggles to integrate into a new culture and their personal conflicts regarding the place of their culture of origin, their reflections have the quality of being both intellectually and emotionally stimulating.

The film challenges the notion that Hispanic patients affected by poverty can only benefit from psychotherapies that offer very concrete interventions.  “Even the poor can afford to have an unconscious,” says Dr. Patricia Gherovici.

As the film takes us into the Barrio and introduces us to some of its inhabitants, their fertile psyches are revealed to us. One woman candidly shares her ideas about the meaning of her dreams; another speaks of the frustration of having meaningful treatment withheld from her husband. These people are emotionally present to their struggles.

The whole notion of non-analyzability is challenged.  Instead, these analysts acknowledge the tight relationship between social issues and individual psychology and invite us to look into our biases and inability to adapt to the patient’s context as interfering factors in working with this population. They alert us to the infantilizing, degrading and “othering” functions of many of the labels we utilize when thinking about Hispanics, revealing our prejudice and misunderstanding of the cultural and social idiosyncrasies that these patients bring to the therapeutic interchange.

The documentary denounces the wounding power of treatment approaches that fail to deeply recognize these patients,  as has been the case with short term and goal oriented treatment modalities that are not interested in the life story of the person.  In contrast, the film advocates for a psychoanalytic approach.  Each psychoanalyst highlighted different aspects of the pursuit:  Dr. Mattei conceptualizes psychoanalysis as a “sensibility,” an opportunity to discover who the person really is. David Ramirez refers to the willingness to enter the “wilderness in our heads.” Daniel Gaztambide alludes to the psychoanalytic encounter as a space to hold all the bits and pieces of the “Frankensteinish Pastiche” of the self.  Clinical material presented in the film increases our appreciation for the complexities of holding two or more cultural heritages and two or more languages in tension with each other, and how this may play out in the therapeutic process.  Examples were given that illustrate how some experiences remain language specific, where primary emotions are often associated to the first language, while the second language tends to be more intellectualized and utilized to dominate the original emotional experience until it is able to become more integrated.

On a different level, the film extends a critique to rigidly institutionalized psychoanalysis. This group of psychoanalysts makes a strong case to extend psychoanalytic practice to non-traditional spaces, de-medicalizing it, writing about it in more readable terms, bringing it to communities and to mainstream culture. They call us to reflect on the political and social power the psychoanalyst and psychoanalysis has to subvert the socio-economic order, as it empowers the marginalized to find their voice, to “free-up things that have been occluded by the oppression of socio-economic circumstances.”

Being an immigrant myself and a clinician with extensive experience working with this population, I was greatly moved by the film, but even more so, by the presence of Dr. Mattei in the discussion. She exuded warmth, depth and balance. We, the audience, seemed overwhelmed. I venture to say, the audience was struggling with some feelings of hopelessness, and helplessness. The film captured the challenges and complexities of the analytic endeavor, and laid it on our laps. Dr. Mattei proceeded to metabolize some of these defeating feelings by sharing how her own experience of the challenges has changed over time and will continue to do so, how she has learned to accept the limitations yet appreciate the immense power of the moment, where the “encounter” happens.   She enacted this tension with the audience, as she worked on connecting with each person by name, spoke of her own experiences in candidly deprecating ways, drawing us nearer to her in identification.  She related a story of a couple that after years of mutual reproaches had “seen” each other for who they were, at least momentarily (chuckle).  She embodied her ideas in the way she conducted herself with us.

The event aroused a couple of memories that brought to life some of the elements of the discussion.  When I was no older than eight years old, I traveled to NY, from my home country Venezuela. As I observed the luggage carriers that were helping us, I remember thinking: “Everybody is so smart here (in the US), everybody speaks English.”  This memory helped me take account of my own internalized ethno-racial prejudices, developed even at this early age. It made me wonder how much of these still live in me, even now being an “insider.”

During my years as a student in BGSP, I often felt that my experience could not be fully expressed in English. Once, an instructor asked that I say my idea in Spanish. I proceeded to speak in Spanish with the awareness that I was indeed expressing myself more accurately. For many years, I held on to the feeling that I had been taken care of lovingly, as the instructor had opened up a space for me to exist more fully.  I had not become consciously aware, till listening to Dr. Mattei, of the maturational value of the instructor tolerating the imperfection of the connection, the limitations of our communication. He did not allow himself to feel hopeless; we both knew he would not “understand” me, yet we tried. We were both willing to honor the attempt.  No doubt, that was a gift. I dare say this is the essence of this documentary: it is a tribute to our attempts to work past our limitations to see the other, to the extent possible.