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Role of social class in mental health examined
(November 2007 Issue)

“Psychology and Economic Injustice: Personal, Professional, and Political Intersections”
By Bernice Lott and Heather E. Bullock American Psychological Association Washington, D.C., 2007

By Paul Efthim, Ph.D.

It's a familiar list. In introductory psychology textbooks, graduate course syllabi, diversity training workshops, the language is strikingly similar: we are told we'll be learning about differences in culture, ethnicity, race, gender, sexual orientation, age and disability status.

Why does "social class" so rarely appear on the list?

The answer is both simple and complex. Class awareness, by and large, is split off in the collective psyche. Despite (or perhaps because of) overwhelming evidence of the widening gap between rich and poor, the myth that we are pretty much all middle-class folks persists in American culture. Contemporary political discourse minimizes class hierarchies. Social class inequality is overlooked, even by proponents of diversity, because of deep social processes, power structures and unconscious beliefs that view middle-class status as universal and normative.

The good news is that psychology is beginning to take up social class more forcefully. In the psychoanalytic community, Lynne Layton has articulated the concept of 'normative unconscious processes' to help explain how class-related phenomena can lead to social and psychic cutoffs and dislocations.

From the field of academic psychology, Bernice Lott and Heather Bullock have recently published an excellent monograph on the role of social class in mental health, "Psychology and Economic Injustice: Personal, Professional, and Political Intersections." A longtime fixture at the University of Rhode Island, Lott is a widely respected feminist psychologist and authority on poverty and mental health. The book succeeds in reaching its stated goal: to tell readers not only what we know about critical concerns facing low-income individuals and families, but also what we need to do about these issues. It is an excellent introduction to the intersection of class and the psyche.

Both authors begin by telling their own personal stories as psychologists who grew up in working-class and low-income families. These narratives ground the book and help readers gain perspective on how and why they developed their professional interests in studying social and economic injustice. Later chapters present mind-numbing statistics that document the depressing realities facing poor people, especially women, in this country.

Lott and Bullock's chapter on the politics and rhetoric of class warfare should be required reading for all mental health professionals. The authors artfully deconstruct the political rhetoric that has been used for decades to deflect critiques of economic privilege. They also unpack two seemingly contradictory beliefs embedded in the dominant discourse: (1) the United States is a classless society and (2) almost everyone in the U.S. is middle class. As the authors point out, "both beliefs obscure the power of those at the top of the financial hierarchy and the struggle of those who are economically insecure." These myths combine with the "myth of meritocracy," which holds that "socioeconomic status is determined primarily by individual talent and ability and not by unearned advantage (e.g., inheritance, access to privileged social networks)."

The outcome of these beliefs is a form of internalized classism that leads one to distance oneself from or deny associations with socially devalued groups, i.e., the lower classes. Like internalized racism or sexism, such phenomena have destructive impacts on identity and self-concept and interfere with political mobilization.

The book's final section presents an agenda for professional activism. The authors exhort psychologists to see political action as a major component of our role in promoting human welfare. One of their most modest, yet powerful prescriptions: share information with our colleagues, students and others about our own social class backgrounds. It is rather striking how much shame and discomfort accompanies talking about class. As the late psychologist Anne Alonso was fond of saying, to dispel shame about something, we need to keep talking about it.

Paul Efthim, Ph.D. is a licensed psychologist in full-time practice in Brookline, Mass. He holds faculty appointments at the Massachusetts School of Professional Psychology and the Boston Institute for Psychotherapy.