Psychoanalysis and the urban poor∗

Abstract

This paper considers, from a psychoanalytic point of view, work with urban poor patients. A previous attempt, from an ego psychological perspective, to adapt psychoanalytic theory and technique for work with such patients is reviewed. An attempt is then made to elaborate an object relations perspective, based largely on the work of Fairbairn. The two approaches are compared and contrasted, especially with respect to common problems that arise in work with this group of people, such as missed appointments, crises, and requests for “concrete”; help. Finally, there is a review of how the structure and policies of the public clinics in which most poor patients are seen impact on analytically oriented work.