The more I listened at case conferences, the more I realised that we were dealing with nested systems of dysfunction beyond the identified (child) patient: there was also marital discord, familial conflict, inadequate schooling, community decay and - it goes without saying - acute financial need.
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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.
I have maintained over the course of this book that various forms of inequality reverberate in the subterraneous life of South Africans, and that the major fallout has been the corruption of our relational needs. But is there empirical evidence of such a link between our external and internal worlds?
And just as therapist and patient must negotiate their hopes in dialectical conversation with one another, we, too, have to nurture between us the most fragile of cargoes, with the retaliation that what each of us does in our lives on a moment-to-moment basis will ripple through the ages. There has to be a revolt and a sincere engagement with it - failing which there can be no shared hopes, only selfish ones.
And yet this enduring struggle to re-cognise one another should not be seen as doomed to hopeless failure: this is because our earnest striving for mutuality is not a promised land but a process evolving all the time. The task before us is a daunting one - first creating and then immersing ourselves in a stream of openings for psychotic recognition, all the while appreciating that each of us is a moving target, different each time at the moment of being found.