The Person Underneath the Names

Therapy has become more identity-aware in the last twenty years, and that's mostly been a good thing. The field had a long history of treating its own assumptions as universal — white, male, secular, middle-class, heterosexual — and pretending the consulting room was a culturally neutral space. It wasn't. The work of clinicians like Kimberlyn Leary, Dorothy Holmes, Anton Hart, and many others named what had been pretended away, and the field is better for it. The room isn't neutral. The therapist's identity is in it. The patient's experience of being differently positioned in the world matters. None of that is in dispute for me.

What's harder to talk about is the step after that — the move from identity-aware to identity-organized. Increasingly, both patients and therapists arrive at the work with elaborated identity frameworks already in place. Identity becomes the explanatory architecture: what something means, what's missing, what's broken, what's affirmed. That has real uses. It also has costs that don't always get named.

The cost I watch for is over-narration. When a patient has a story about themselves that's well-worked, well-defended, and well-supplied with categories, the story can do something that looks like understanding but functions like distance. The patient knows about themselves but doesn't know themselves. The categories become a way of organizing experience that keeps the experience from being had freshly. I've sat with patients who could name every facet of their identity with precision and could not say what had happened to them last Tuesday.

This isn't an indictment of identity work. It's an observation about how any framework — psychoanalytic ones included — can be used defensively when it becomes the organizing layer rather than one layer among several. The patient who's over-narrated through psychoanalysis has the same problem, just in a different vocabulary.

My stance is something like this: I don't pathologize anyone's identity. I take seriously what it means to be positioned the way you're positioned in the world you live in. We're all better off when we're able to help others know who we are instead of the other way around. And I'm also alert to what gets lost when identity becomes the only frame — when the work shrinks to identity confirmation rather than including identity as one part of a larger picture of who you are.

In practice this means I work with everyone. I don't position myself as a specialist in any one identity category. Not because the clinicians who do are wrong — they're often doing essential work for patients who need exactly that — but because that's not where my expertise is. My expertise is in being curious about the person underneath the names. Identity is part of that picture. So is what was unsaid in your house growing up. So is what your body knows. So is what shows up between us in the room.

I'm more of a verb person than a noun person. There is action under a defined category; let's not let the category end the conversation. That's not a political position. It's a clinical one, rooted in the psychoanalytic traditions I've trained in. The work is to get underneath the organized self-narrative to what hasn't been articulated yet. Identity claims, like other claims, can be doorways or doors closed against the room behind them. The work is figuring out which is which.

If you want a therapist whose practice is organized around your particular identity, there are people who do that beautifully, and I'd encourage you to find them. If you want someone who'll meet you as a person whose identity is welcome material but not the frame, I might be your person.

Identity is welcome here. So is what's underneath it.