Del Sentimiento de No Estar del Todo: Reply to Csillag and Orfanos

This response presents associations elicited by commentaries from Csillag and Orfanos (this issue), on the author’s paper discussing issues of language, race, and social class in an immigrant clinical dyad. The author describes ways in which these issues were experienced during the process of writing and sharing the original essay, provides some reflections on the state-dependent nature of epistemological truth in clinical enactments, and offers, through biographical fragments, an example of how the principles organizing our psychic experience inform and are informed by our cultural context.     

A Country of Two: Race and Social Class in an Immigrant Therapeutic Dyad

This paper explores some of the ways in which social structures and fantasies organized around race and social class emerge in the intersubjective space created by a patient and a therapist who emigrated from the same country. Incorporating some of his own experiences of identity and otherness, the author discusses, through the lens of his countertransference, how communicating with the patient in their native language allowed for access to early internal object-relations, unconscious threats to his sense of belonging, racialized self-states, and feelings of shame associated to some of these dissociated self-states rooted in historical oppression and trauma. The author suggests that the “country of two” populated by patient and therapist is a dynamic co-created space, that emerges from the dialectic interplay of sameness and difference along the lines of race, social class, and culture.