Cultural, Racial and Structural Adversities in Childhood and Adolescence: Psychoanalytic Perspectives on Development and Treatment

In this current highly polarized environment, in a world filled with violence and war, escalating racial and religious intolerance, we devote this special anniversary issue to furthering our understanding of the impact of societally generated adversities on the lives of our children and youth. In keeping with the mission of the journal, we explore the impact on development and seek to enhance our clinical understanding of those whose lives are negatively affected by growing up as “other.”¹ Our hope is that this rich trove of articles will enhance appreciation of cultural differences, social trauma and also increase awareness of sources of resilience, found in family, community and the therapeutic process. We hope our readers will learn, as we did, by reading these wonderful contributions, thereby increasing our efficacy as clinicians bringing a psychoanalytic perspective to working with our children and youth.

We listen to many voices in this issue, authors from diverse cultural and racial backgrounds who have much to say about the impact of growing up in racially stigmatizing cultures, the legacy of slavery and colonialism and their continuing negative impact on self-development of children of color. Our first two authors specifically consider the profound impact of these legacies, bringing with them marginalization, racial hatred and all of those aspects of inequity that were laid bare during the pandemic of the past two years (Adams, 2022; Padron, 2022). Each uses a psychoanalytic lens to consider the impact on development and treatment, defying the cultural tendency to focus solely on symptom management.

Next we are treated to a scholarly exploration of how a series of mothering practices, which originated in West Africa centuries ago, created a style of parenting that the author indicates supported survival and resilience of enslaved people through extending caregiving responsibilities to the community at large (Bryant, 2022). The consistent nurturing, responsiveness, and attunement to the needs of their infants and children which such extended caregiving provides, is seen to this day in the intergenerationally transmitted family patterns of African Americans, and needs to be recognized, along with a linkage between culture and spirituality, as a source of resilience and resistance.

Continuing to discuss aspects of cultural difference, and their differential impact on personality development, our next author (Kanwal, 2022) considers the devastating assault on a continuity of self, experienced by teens who are torn between family cultures which are collectivist and the values of the individualistic American culture in which they wish to be included. He presents significant theoretical and clinical considerations as he describes the identity struggles of adolescents who are navigating such cultural dissonance (Kanwal, 2022). Our next author, a Chinese immigrant psychoanalyst in training in the United States, also confronts cultural issues, intertwined with trauma. Rethinking her understanding of the psychoanalytic process, she explores her recognition of the developmentally facilitating relational aspects of psychoanalytic work, as she struggles to support the growth of her foreign student patient with whom she shares a cultural history (Duan, 2022).

Other articles introduce us to narratives that describe the experiences of living through trauma too often exacerbated by complex social systems (Kaufmann, 2022; Price, 2022; Spielberg, 2022; Stephens, 2022). We learn of problems endured by both mothers and children as they navigated “welfare” systems (one the US and the other in the UK), formalized social structures that while intended to support, were at times terribly destructive to the development of those they were supposed to assist. Each article speaks of a person who defied the stigmatization and traumatic aspects of their experience, again raising questions of factors which contribute to resilience. While both articles explore experiences that occurred some years back, we seek to consider how much has changed over the course of years. We need to learn from these narratives and value their lessons which seem to relate to personal strengths as well as the power of deep interpersonal connections.

Our next article explores difficulties children of color have in schools, where learning difficulties and histories of trauma are too often misunderstood and problematic behaviors are too frequently mischaracterized by school personnel. We learn of the work of one young therapist trainee, struggling to cross a racial divide, and his creative efforts to engage a silent, mistrustful child, whose withdrawn and noncompliant behavior led to trouble with school authorities (Spielberg, 2022).

As we delve further into community interventions we explore a school/university partnership, the development of a psychoanalytically informed clinic designed to bridge the divide between school and treatment center in one underserved community (Daisy-Etienne et al., 2022). The emphasis on collaboration among all parties, and utilization of a uniquely designed “nested mentalization” (Slade et al., 2016) approach integrated with a model of supervision called “weaving thoughts” (Salomonsson, 2012) illuminates the clinical power of reflecting upon the needs of the individual clients, children, families, as well as all members of the staff in a clinic largely staffed by graduate student therapists. Another university-based treatment program working with parents and their children carrying a diagnosis of ADHD also utilizes a mentalization-based treatment approach (Conway et al., 2022). Presenting clinical material reflected upon by a consultant, we gain an appreciation for the critical importance of therapeutic attunement, enhancement of reflective functioning in all participants and the role of a supportive consultant, facilitating graduate students in their efforts to master the mentalization-based therapeutic process. Here too, the importance of approaching each child and family as individuals, often with intersecting identities, illustrates the importance of focusing on development of reflective capacity, a process variable that is the subject of much current interest within the psychoanlytic community.

What this group of articles underscores, is the critical importance in our work as clinicians of looking beneath the external manifestations of difficulty, gaining knowledge of cultural values and family structures which are less familiar to us, as we recognize and work clinically with the individual in context. Equally important, each of the authors in this issue argues for and believes in the value of incorporating a contemporary psychoanalytic sensibility in their work with those who have been societally marginalized, traumatized, and “othered.”

Journal of Infant, Child and Adolescent Psychotherapy special issues of direct relevance to the theme of this special issue

Mothers, Infants, and Young Children of September 11, 2001: A Primary Prevention Project

Volume 10, Issue 2-3, 2011, pages iv–388

Violence in Schools, Homes, and on the Streets: Psychoanalytic Collaboration with Educators, Law Enforcers, and Community Leaders

Volume 13, Issue 4, 2014, pages 281–ebi

Health Disparities, Trauma, Disruptive and Criminal Behaviors and the Adolescent Brain

Volume 15, Issue 3, 2016, pages i–253

Forced Migration: Mental Health Considerations in Working with Children, Adolescents and Families of Refugees and Asylum Seekers; Susan C. Warshaw, Ed.D., ABPP, Editor in Chief and Co-editor, Daniel Kaplin, Ph.D., Guest Co-editor

Volume 18, Issue 4, 2019, pages 307–431

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Susan C. Warshaw

Susan C. Warshaw, Ed.D., ABPP, Editor in Chief, Journal of Infant, Child and Adolescent Psychotherapy; Clinical Associate Professor, Clinical Consultant (Supervisor) New York University Postdoctoral Program in Psychotherapy and Psychoanalysis; Faculty, Supervisor, William Alanson White Institute Child and Adolescent Psychotherapy Training Program.

Kirkland Vaughans, Ph.D., Adjunct Clinical Professor, NYU Postdoctoral Program in Psychotherapy and Psychoanalysis, Senior Adjunct Professor, Derner School of Psychology. Clinical Director, Derner/Hempstead Child Clinic.; Founding Editor in Chief of the Journal of Infant, Child and Adolescent Psychotherapy.

Martha Bragin

Martha Bragin, LCSW, Ph.D. Professor and Chair, Global Social Work and Practice with Immigrants and Refugees, Silberman School of Social Work, Hunter College, City University of New York, Faculty, Mitchell Center for Relational Studies Institute for Psychoanalytic Training and Research (IPTAR).

Kirkland Vaughans

Kirkland Vaughans, Ph.D., Adjunct Clinical Professor, NYU Postdoctoral Program in Psychotherapy and Psychoanalysis, Senior Adjunct Professor, Derner School of Psychology. Clinical Director, Derner/Hempstead Child Clinic.; Founding Editor in Chief of the Journal of Infant, Child and Adolescent Psychotherapy.

Notes

1. Prior special issues of the journal have explored themes of relevance and are listed at the end of this introduction.