In this state all is noise and chaos and devoid of meaning. It is difficult to imagine: our lives are so much more made up of light and sound and thoughts and feelings that form meaningful patterns and which help us to make sense of our lives and may grant us pleasure. The patient experiencing a psychotic episode is robbed of these harmonies. We cannot know the mind of another, and certainly not the mind of a psychotic other, but we can imagine that such noise, such a dissolution of meaning, would be intolerable. In this context it becomes understandable that a person in such a state should urgently seek to find or construct meanings and, in this process, to employ themes that are culturally or spiritually familiar - albeit often in deeply strange ways, given the disorder of mind.

When I read that study, I thought immediately of my father telling me about trauma being in my mother’s blood. Add to that despair and detachment. Add to that an inability to follow rules, form lasting relationships, or feel guilt. Those are all things that are also true of me, in some measure. They are the qualities I most detest in myself. They are qualities that would make it difficult for me to be a mother.

This individualisation of trauma is typical of medical model thinking, but its unfortunate consequence is that our society is disinclined to regard the victims of structural violence as being the victims of trauma. Accordingly, the empathy we ordinarily show survivors of (individual) traumas is withheld from those who are victims of social trauma. It is no wonder, then, that we think nothing of confining offenders with the most traumatic social histories to the most traumatising places on earth.

Who we are is a product of where we have been. Psychotherapists usually understand this in respect of a given patient’s personal history - the absent father, the critical mother, the jealous sibling, the abusive cousin - but equally, there can be no denying the importance of one’s social history either. The areas we live in, the schools we attend, the quantity and quality of our caregiving, the various affirmations and discriminations that come our way - each of these experiences is layered in complex ways by social, economic and political forces far beyond the control of any single person.

This wound we call ‘apartheid’ will continue to be picked at compulsively. In both mind and practice, empathy has its limits; the relational pathologies of shame, envy and impasse are here to stay. The shame-filled violence, the envious value delusions and the ambivalent-avoidant attachments will persist long after we are gone. No matter the reparative attempts: there is a brokenness at the heart of our nation that cannot be wished away. If one considers the matter at the level of the individual, when the parent, teacher, or psychotherapist succeeds in providing optimal conditions for empathetic connection with a child, student or patient, it is hardly unusual for the latter to collapse the frame with enactments derived from still-active complexes.