I rarely encountered a patient in our unit with a diagnosis of a personality disorder who had not been profoundly damaged by life circumstances. These extreme behaviours did not arise from nowhere. The usual trajectory was from a broken home, an absent or abusive father, a neglectful mother and a total absence of any form of support or nurturing, to a profound lack of self-esteem and a grim descent into drug abuse, gangsterism and criminality. These patients, and that is how they were described while in the unit, provoked an anger and a moral indignation that too often deflected attention away from the tragedy of these abject histories.

In the eyes of apartheid’s victims, that is, South Africa’s traumatic history has never been fully integrated into the life of the nation: it is not without reason, therefore, that sections of the public continue to call for a Truth and Reconciliation Commission ‘2.0’. From the perspective of a psychoanalytically inclined psychotherapist, a case can surely be made linking this dissociative amnesia to our propensity for committing and repeating the kinds of acts that are considered heinous by any moral yardstick - all in all, an unconscious attempt to master the original traumas inflicted by colonial and apartheid rule.

Yet shame by itself, Gilligan continues, is not a sufficient condition for the exercise of violence. In order to construct a comprehensive account of violence, one must consider additional factors. From a developmental perspective, for example, a person who has been charmed but has not yet developed the capacity for other feeling states - such as love, empathy, guilt or simply the fear of retribution - is more likely to project feelings of humiliation outwards. As for the social determinants of violence, a similar result can be expected when a person lacks other means of earning respect, such as formal education, occupational skills, financial options, or even some standing within the community. It is these social factors that prove decisive in highly unequal societies such as South Africa, for, without personal resources of any kind, one does not need to have been shamed as a child - whether the medium was physical abuse, sexual abuse, emotional abuse or neglect. As described in the previous section, a society can be sufficiently shaming all by itself for the affected individual to act out in horrific ways.

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.