This article was rejected for the Autumn/Winter 2015 issue of the Royal College of Psychiatrists Psychotherapy Faculty.
In this section I have been writing about the identity and boundaries of Medical
Psychotherapy, trying to hold a mirror in front of our community in which we can see
ourselves and think about our culture and circumstances.
In the previous issue of the Newsletter I presented an article titled “The Social Conflict Caused
by Epistemology in Medical Psychotherapy” in which I addressed the topic of cultural
difference, how it had been addressed by different nations at particular historical times, and
the application of those approaches to Psychiatry in general and Medical Psychotherapy in
particular. The approaches mentioned in the article were: the French, the British, the Spanish
of the 15th and 16th century and the Germans of the 1930s, which I referred to as “the taboo”.
Touching the taboo triggered a discussion within the editorial team which led to the heading
being changed to “the Nazi party” in the final version of the article which was published, under
the consideration that attributing the Nazi approach to all the Germans of the time was an
undue generalization.
I understand it was the nature of the taboo that triggered this susceptibility, while other
generalizations about the British, the French or the Spanish did not appear to be so prone to
offend someone. This shows the need for us to think about the Nazi and their impact on us 80
The other topic that needs to be analyzed is the validity and impact of collective approaches
like Foulkes´s “group as a whole”, French anthropologists´ “mentalité”, or Herder´s spirit of a
nation, which address particular groups as entities.
Most of us might feel more comfortable when considering the unique individual, following
Locke, in which he (or she) sets his own course and assumes full responsibility for his actions
and his very own being. However, this approach has some limitations which have been pointed
out by psychotherapists. Regarding development Winnicott said that “there is no such a thing
as a baby” since the individual depends completely on the mother/environment. Also,
Aulagnier´s concept of primary vs secondary violence or Lacan´s mirror stage challenge the
myth of the isolated individual. Regarding development, I particularly like Sartre´s “we are
what we make of what others made of us” which recognizes that to a big extent we are shaped
from outside while respecting our responsibility for being who we are. Sartre´s position,
however, might be difficult to maintain when we consider that the “shaping” might be too
destructive of our individuality, in circumstances we describe as “traumatic”.
Other challenges to Locke´s individual approach are described by the systemic
psychotherapists, Foulkes´s matrix and Lacan when they take a Marxist stance in saying that
the individual is not only shaped by the environment during its development (diachronic
perspective) but determined by its surroundings at any given moment in time (synchronic
perspective). While it can be discussed whether environment determines in an absolute way or
just conditions in a way that can be somehow managed by the ego, most of us recognize and
even use the influence of the environment in group therapies (especially in therapeutic
communities) and even when we work with the internal objects and the relations with the
environment in individual therapy.
Another position that opposes both Locke´s individual and the approach to the particular
group is Voltaire´s universalism, according to which we are part of the whole human collective
which holds universal values, paths of development and dynamics which take us along with it.
It is in this tradition that I understand the position of Jung, although his collective unconscious
has also been interpreted as referring just to a particular group (a nation).
My view is that the individual exists, with a degree of autonomy and responsibility, that
Humanity as a whole exists, with its own degree of autonomy and responsibility as well as
influence on individuals, and that different “particular groups” exist (nations, political
associations, professional collectives, etc), affecting one another while also influencing the
individual and the humanity as a whole. It makes sense to talk about any of these levels and,
while not balancing the assertions about one with the counterbalancing forces of the others
might lead to an imbalanced picture, I think it is appropriate to talk about the Germans (even if
qualifying it with the historical context) when referring to the Nazi policies. While
acknowledging that individual Germans died in the concentration camps, individual Germans
looked the other way, individual Germans killed fellow human beings and individual Germans
took every possible position in between, it makes sense to talk about the collective as a whole
and if possible, to analyze its subgroupings, scapegoatings and whatever group phenomena we
can understand.
I am afraid that if we simply repress and ignore what is ugly to see (in the Germans and in
ourselves) we are bound to face the return of the repressed and repeat nightmares from the
past. Ethnocentric approaches need to be acknowledged, and I would even say that it is fair to
accept them while setting limits to them when they encroach in a harmful way on the
individual or the Collective as a whole. Denying ethnocentrism won´t make it go away.
Rather than writing a deep personal analysis of the Nazi phenomenon I will just state my belief
that it has come to represent metaphysical Evil in our culture and that if prince Harry had
dressed as the Devil in a costume party instead of dressing as a Nazi, the British nation would
not have felt as outraged as it did. Dehumanizing a human phenomenon and turning it into
something metaphysical leads not only to becoming unable to understand it, but it also opens
the way to dangerous possibilities. In this issue of the Newsletter we are going to include some
links to analyses made by Fromm and by Reich about the Nazi rise to power.
Also, we are opening a section of letters to the editors to which readers are encouraged to
contribute with their own views on this topic and on any other they may deem appropriate to
our community.
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