This paper draws on a wide range of experience of being part of the South African psychoanalytic ... more This paper draws on a wide range of experience of being part of the South African psychoanalytic community. It uses this to discuss access to voice, defined as the ability to sustain a speaking/writing self that relates in an authentic way both to theory and experience. Struggles with voice seem to have affected groups across South Africa in different ways. The paper will suggest that being on the psychoanalytic periphery has encouraged an idealization of – and sometimes rebellion against-the centre, with complicating effects on our independence of thought. This dynamic, amplified by the effects of working intensively with theories that deal with unconscious phenomena seems to have encouraged local groups to repeat, rather than move beyond, some traumatic aspects of the history of the psychoanalytic movement. Practical problems in relation to confidentiality, boundaries and intimacy are raised. The paper will end with some suggestions about ways forward.
This paper is concerned with the extent to which the clinical subject, in postcolonial clinical e... more This paper is concerned with the extent to which the clinical subject, in postcolonial clinical encounters, is able to speak, and be heard, through and beyond the structures of clinical theory and practice. The paper aligns itself theoretically with the project of Subaltern Studies, and particularly the work of Spivak, in her quest 'to learn to speak to (rather than listen to or speak for) the historically muted subject of the subaltern woman'. It is concerned specifically with the complexity of learning to speak to the muted clinical subject of postcolonial Africa. It argues that this task is bedevilled by representations of Otherness (black, woman, illiterate, poor, rural) in clinical theory that speak for, but seldom engage in dialogue with, the clinical subject. Multivocal texts available in narrative therapy projects present an interesting challenge to conventional authorial ownership. More broadly, subaltern psychology, as a theoretical direction, offers an opportunity to understand ways in which muting occurs, and to work actively against professional deafness.
Sources of communication failure in interviews with psychiatric patients are identified and analy... more Sources of communication failure in interviews with psychiatric patients are identified and analyzed. In both research and clinical practice, it is common to attribute these failures to the illness of the patient. The incoherence of some schizophrenic patients is an example. At times, however, communicative nonsuccess may be the result of interviewers' inattentiveness or preconceptions about the patient. Issues of power and control also affect the outcome of interviews. Interactions between clinicians and patients and the contribution of the clinical interview format to communicative nonsuccess in interviews are important points of focus for future research, and their study could be beneficial in clinical training programs.
This article traces the changing form and content of histories taken from patients in South Afric... more This article traces the changing form and content of histories taken from patients in South African psychiatric settings over a period of a century, and analyses ways in which current history-taking practice continues to be moulded by dis-cursive practices which have their origin in mid-19th century British psychiatry. It examines the implications of clinicians being record-keepers of their own clinical activities, and comments on ways in which patient identities are constructed by records produced through history-taking activities. The postmodern perspective usefully interrogates the assumption of a linear and unambiguous relationship between past events and present distress, and offers an opportunity for clinicians to understand patients' life stories as rich and ambiguous discourses through which relationships to both past and future are constantly in the process of negotiation. Hierdie artikel ondersoek die form en inhoud van hoe die persoonlike geskiedenis afgeneem is van psigiatriese pa-slente in Suid-Afrika oor die afgelope eeu. Dit ontleed die maniere waarop huidige geskiedenisafneem praktyke steeds be"invloed word deur praktyke wat hul oorsprong het in Britse psigiatrie teen die middel van die neentiende eeu. Oit het implikasies vir klinici wat hul eie kliniese aktiwiteite dokumenteer. Die artikel lewer kommentaar oor manier waarop pasisnte deur hierdie dokumentasie gekonstrueer word. 'n Post-modeme benadering bevraagteken die llniere en on-dubbelsinnige verhouding tussen gebeurtenisse in die verlede en huidige probleme, en bied 'n geleentheid vir klinici om hul paslents se lewensverhale as ryk en dubbelsinnige diskoerse te sien waardeurverhoudinge tans en in die toe-koms voortdurend onderhandel word.
This paper examines the role played by psychodynamic formulations in the training of South Africa... more This paper examines the role played by psychodynamic formulations in the training of South African clinical psychologists. It describes formulation practices commonly encountered in training arenas. Misconceptions about the nature and function of psychodynamic formulations are outlined, and the implications of exposing trainees to more than one psychodynamic theory are explored. The informal use of psychodynamic terms in psychiatric talk, and some effects of this on the way in which patients are perceived are described. The paper argues that trainees' difficulties in learning how to formulate psychodynamically are compounded by issues of authority and access to discursive space in wardround and case conference settings. The implications of living in a post-colonial context are described, and the importance of constructing culture-sensitive formulations is stressed. The paper concludes with some suggestions for a coherent and learner-friendly approach to teaching trainees how to formulate psychodynamically.
... 19 For example, Sadowsky's treatment of the colonial psychiatry/oppression link is very ... more ... 19 For example, Sadowsky's treatment of the colonial psychiatry/oppression link is very sophisticated and careful, and yet the title of his book, Imperial Bedlam ... 44 Emily Dickinson, 'Much madness is divinest sense', Selected Poems, James Reeves, ed., (London, Heinemann). ...
This paper draws on a wide range of experience of being part of the South African psychoanalytic ... more This paper draws on a wide range of experience of being part of the South African psychoanalytic community. It uses this to discuss access to voice, defined as the ability to sustain a speaking/writing self that relates in an authentic way both to theory and experience. Struggles with voice seem to have affected groups across South Africa in different ways. The paper will suggest that being on the psychoanalytic periphery has encouraged an idealization of – and sometimes rebellion against-the centre, with complicating effects on our independence of thought. This dynamic, amplified by the effects of working intensively with theories that deal with unconscious phenomena seems to have encouraged local groups to repeat, rather than move beyond, some traumatic aspects of the history of the psychoanalytic movement. Practical problems in relation to confidentiality, boundaries and intimacy are raised. The paper will end with some suggestions about ways forward.
This paper is concerned with the extent to which the clinical subject, in postcolonial clinical e... more This paper is concerned with the extent to which the clinical subject, in postcolonial clinical encounters, is able to speak, and be heard, through and beyond the structures of clinical theory and practice. The paper aligns itself theoretically with the project of Subaltern Studies, and particularly the work of Spivak, in her quest 'to learn to speak to (rather than listen to or speak for) the historically muted subject of the subaltern woman'. It is concerned specifically with the complexity of learning to speak to the muted clinical subject of postcolonial Africa. It argues that this task is bedevilled by representations of Otherness (black, woman, illiterate, poor, rural) in clinical theory that speak for, but seldom engage in dialogue with, the clinical subject. Multivocal texts available in narrative therapy projects present an interesting challenge to conventional authorial ownership. More broadly, subaltern psychology, as a theoretical direction, offers an opportunity to understand ways in which muting occurs, and to work actively against professional deafness.
Sources of communication failure in interviews with psychiatric patients are identified and analy... more Sources of communication failure in interviews with psychiatric patients are identified and analyzed. In both research and clinical practice, it is common to attribute these failures to the illness of the patient. The incoherence of some schizophrenic patients is an example. At times, however, communicative nonsuccess may be the result of interviewers' inattentiveness or preconceptions about the patient. Issues of power and control also affect the outcome of interviews. Interactions between clinicians and patients and the contribution of the clinical interview format to communicative nonsuccess in interviews are important points of focus for future research, and their study could be beneficial in clinical training programs.
This article traces the changing form and content of histories taken from patients in South Afric... more This article traces the changing form and content of histories taken from patients in South African psychiatric settings over a period of a century, and analyses ways in which current history-taking practice continues to be moulded by dis-cursive practices which have their origin in mid-19th century British psychiatry. It examines the implications of clinicians being record-keepers of their own clinical activities, and comments on ways in which patient identities are constructed by records produced through history-taking activities. The postmodern perspective usefully interrogates the assumption of a linear and unambiguous relationship between past events and present distress, and offers an opportunity for clinicians to understand patients' life stories as rich and ambiguous discourses through which relationships to both past and future are constantly in the process of negotiation. Hierdie artikel ondersoek die form en inhoud van hoe die persoonlike geskiedenis afgeneem is van psigiatriese pa-slente in Suid-Afrika oor die afgelope eeu. Dit ontleed die maniere waarop huidige geskiedenisafneem praktyke steeds be"invloed word deur praktyke wat hul oorsprong het in Britse psigiatrie teen die middel van die neentiende eeu. Oit het implikasies vir klinici wat hul eie kliniese aktiwiteite dokumenteer. Die artikel lewer kommentaar oor manier waarop pasisnte deur hierdie dokumentasie gekonstrueer word. 'n Post-modeme benadering bevraagteken die llniere en on-dubbelsinnige verhouding tussen gebeurtenisse in die verlede en huidige probleme, en bied 'n geleentheid vir klinici om hul paslents se lewensverhale as ryk en dubbelsinnige diskoerse te sien waardeurverhoudinge tans en in die toe-koms voortdurend onderhandel word.
This paper examines the role played by psychodynamic formulations in the training of South Africa... more This paper examines the role played by psychodynamic formulations in the training of South African clinical psychologists. It describes formulation practices commonly encountered in training arenas. Misconceptions about the nature and function of psychodynamic formulations are outlined, and the implications of exposing trainees to more than one psychodynamic theory are explored. The informal use of psychodynamic terms in psychiatric talk, and some effects of this on the way in which patients are perceived are described. The paper argues that trainees' difficulties in learning how to formulate psychodynamically are compounded by issues of authority and access to discursive space in wardround and case conference settings. The implications of living in a post-colonial context are described, and the importance of constructing culture-sensitive formulations is stressed. The paper concludes with some suggestions for a coherent and learner-friendly approach to teaching trainees how to formulate psychodynamically.
... 19 For example, Sadowsky's treatment of the colonial psychiatry/oppression link is very ... more ... 19 For example, Sadowsky's treatment of the colonial psychiatry/oppression link is very sophisticated and careful, and yet the title of his book, Imperial Bedlam ... 44 Emily Dickinson, 'Much madness is divinest sense', Selected Poems, James Reeves, ed., (London, Heinemann). ...
The argument in this chapter is arranged around movement in and out of two kinds of homes, famili... more The argument in this chapter is arranged around movement in and out of two kinds of homes, familial homes and nursing ‘homes’ – colonial lunatic asylums. Asylums, and the various institutions that regulated movement of the insane in and out of them, were home to a particular kind of suffering and violence; and the chapter is concerned with the meanings of this for a settler colony. In this contested landscape of Britain recollected, for the British ruling class, as a nostalgic model for ‘home’, and with the challenge of domesticating a space imagined as both empty – a wilderness – and populated by ‘foreign’ native bodies, the many acts involved in classifying the insane had a significant role to play. The first part of the argument takes corporality seriously as an essential factor in the care for those with wandering wits. It concerns itself therefore with the care for bodies, interrupted by insane states of mind. It focuses on the role of classification in particular as a structuring activity in the arrangement of movement in the care for the insane.
The second part of the argument suggests that the ways in which insane bodies were treated offers an opportunity to think about another form of interior: the ways in which insanity in a settler colony metabolized the relationship between a wish to maintain rule-bound order and the unconsciously disruptive effects of disavowal of trauma, violence and dislocation. Just as there is violence in losing one’s wits - a loss of cohesion and a tear in the social fabric, a break in the politeness of going on being - so too was there violence in the appropriation of land, and intrusion into the lives and subjectivities of displaced peoples. This chapter will explore levels of this interior: the madness of colonialism, madness representing the trauma of settlers of colonized peoples, displacement of anxiety from one place to another, symptom formation as repetition of trauma refigured, dislocated from its original site, a temporary release from fear and aggression
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Papers by Sally Swartz
The second part of the argument suggests that the ways in which insane bodies were treated offers an opportunity to think about another form of interior: the ways in which insanity in a settler colony metabolized the relationship between a wish to maintain rule-bound order and the unconsciously disruptive effects of disavowal of trauma, violence and dislocation. Just as there is violence in losing one’s wits - a loss of cohesion and a tear in the social fabric, a break in the politeness of going on being - so too was there violence in the appropriation of land, and intrusion into the lives and subjectivities of displaced peoples. This chapter will explore levels of this interior: the madness of colonialism, madness representing the trauma of settlers of colonized peoples, displacement of anxiety from one place to another, symptom formation as repetition of trauma refigured, dislocated from its original site, a temporary release from fear and aggression