‘Class Is in You’: An Exploration of Some Social Class Issues in Psychotherapeutic Work

Abstract

The absence of frameworks for discussion of social class issues within psychotherapy is one concern of this exploratory paper. Another is to raise questions about how we might think psychoanalytically about the far‐reaching impact of class. A small exploratory qualitative research study is described in which experienced psychoanalytic psychotherapists were interviewed about class issues. The interviews mainly concerned their perceptions and understandings of class issues within psychotherapeutic relationships, but were framed by biographical and professional experiences relating to class. The reports from pairings of differently classed therapists and patients raised many questions about the ways in which class and class differences can be experienced and understood within the transference/countertransference matrix, as well as the surrounding anxieties and projections.

Social class and the therapeutic relationship: The perspective of therapists as clients. A qualitative study using a questionnaire survey

“…Despite many respondents reporting how class did not affect their therapeutic alliance, several of these had strong reactions to initial impressions and of feeling unequal; attributions that are ‘often emphasised within the intensity of the therapeutic encounter’ (Ryan, , p. 60). This lack of awareness reflects, perhaps, how social class impacts on the relationship in other, more elusive ways (Kraus et al., ).…”

“…Interestingly, findings from this study show that inequality also exists where there is social class similarity, something Liu (2011) terms as 'lateral classism', though feelings of inferiority were generally exacerbated in lower-class clients with a higher-class therapist, supported in research by Balmforth (2009) and Proctor (2002). These power imbalances, possibly originating from innate socialisation messages (Kim & Cardemil, 2012) and from classism experienced earlier in life (Liu et al, 2007;Ryan, 2006), were being felt within the hierarchical structure of the therapeutic relationship (Chalifoux, 1996). Moreover, respondents who felt inferior appeared unable to raise this issue with their therapists, perpetuating feelings of powerlessness and inequality.…”

Social class as a relevant variable for middle-class women: Implications for psychology training and practice based on a qualitative investigation.

“…What is more, these women described lacking the language or opportunities to recognize that their social class and class-based expectations were social constructions. In this way, the women experienced what Ryan (2006) described as the missing framework for thinking about and discussing social class. Hartman (2005) attributed silence about social class to the fact that class experiences reside in the unconscious.…”

“…In part, limited considerations of the middle class in psychological research, training, and practice (Barolet, 2002) seems grounded in the class-blind ideology that has pervaded psychological practice for decades (Ryan, 2006). Notwithstanding the dominant belief that the United States is a classless society (cf.…”

Trainee estimates of working alliance with upper‐ and working‐class clients

“…Other empirical findings indicate that therapists report being less interested in treating lower‐social class clients and may avoid working with them due to a fear of poor outcomes in therapy (Aronson, ; Sutton & Kessler, ). Therapists also report greater negative countertransference reactions to lower‐social class clients and are more likely to believe that medical treatments are most effective for these clients (Ryan, ). Therapists are also less likely to attend to situational and environmental factors expressed by lower social class, including employment concerns and housing conditions (Balch & Miller, ).…”