Class is Dismissed

Within the therapeutic relationship, social class is a piece of multiculturalism that is often overlooked.

By Michelle Jurkiewicz, Fall 2009

When I set out to write an article examining social class in the therapeutic relationship and began pouring over texts in attempt to capture its complexity, I found a considerable amount of research dedicated to multiculturalism in psychotherapy, including some classism and internalized classism. I discovered that most of this literature reduced social class to the disadvantaged client (other) deserving to be understood by the middle-class therapist (us).

The more I looked, the more my initial subject became elusive, so I sought the expertise of several therapists committed to social justice and cultural competence. The consensus remained the same. Little is written on the impact of social class in the therapeutic relationship outside of a few books on money in psychotherapy.

I began to think critically about why the impact of social class on the therapeutic relationship is rarely explored outside of an “us versus them” dichotomy. I believe my rising anxiety offers insight to understanding such scarcity. Unlike other social contexts, which are treated as categorical variables (such as race), class is conceptualized on a dynamic continuum.

Many individuals in the United States struggle to locate themselves on this continuum due to the elusive nature of social class. Therefore, both therapist and client are likely to overlook the effects of classism and internalized classism on themselves and fail to bring it into the therapeutic relationship.

It is certainly important that therapists receive training in understanding the concrete experiences of classism in their clients’ lives. Yet, it becomes even more important to understand the meaning that individuals attribute to these experiences and how it influences their self-concept and worldview.

In a 1996 article, Glenda Russell suggests that clinical work addressing internalized classism frequently includes exploring and working with loss, grief, envy, anger, and shame. These issues become further complicated as they are experienced between therapist and client.

Susan Bodnar offers a case example to illustrate the complex impact of social class on the therapeutic relationship. She describes her work with Jennifer and how her own working class background stifled the treatment. Bodnar wanted to be sensitive to Jennifer’s fears of being exploited, so she allowed her to pay slightly lower than the ordinary fee despite Jennifer’s financial wealth. Hypersensitivity to others’ fears of exploitation is a common behavior among working class individuals.

“After 14 years of education I was still the hired help neglecting my own needs, not to mention the vitality of my analytic observations, in order to not rock the boat and jeopardize my paycheck,” she wrote.

Once she recognized the clinical impact of her internalized classism, she stopped colluding with Jennifer’s endless rants about her “rich bitch mother.” After a difficult confrontation, Jennifer’s dissociation subsided so that she could finally speak of core trauma that had been transmitted from her “rich” mother to herself.

The complex interplay of social class on the therapeutic relationship cannot be reduced to the middle-class therapist learning about the disadvantaged other. The complexity can only be captured within the interactions and relationship of therapist and client. Social class, classism, and internalized classism have major effects on people’s lives and help shape how people view themselves, others and the world around them.