This Couch Has Bed Bugs: On the Psychoanalysis of Homelessness and the Homelessness of Psychoanalysis

Abstract

In an era of managed care, how can psychoanalytic principles be woven into a community mental health system? By exploring hateful countertransference reactions—both his own and those of members of the community in which he practices—the author examines professional tensions that arise in working with a homeless client. What do such reactions tell us about the complexities of working psychoanalytically in public practice settings? Through this lens we can begin to understand what a homeless client may represent to her city, as well as to her therapist. The author also considers how psychodynamic thinking can challenge current "best practices" in community mental health by focusing on long-term stability.