ABSTRACT Psychoanalysis in the United States has traditionally been a practice of long-term, individual therapy conducted within the safe and comfortable surroundings of a consulting room. Through my work as a white man with a largely African American, low-income patient population in a hospital emergency room, I learned it can also be used in that fast-paced, crisis environment. Doing so, I learned, required a full engagement with my biases, cultural history, memories and personal traumas. It required understanding how structural racism is embedded in the work, the role it plays in defining my patients’ reality coming into the ER, and their options once there. Although the first priority is to determine safety: Is the person in danger of harming themselves or another, if one broadens the scope of one’s attention, as an analyst does, to the full person, do one’s perspective, role and opportunities shift? I learned that I could do more than provide a descriptive diagnosis and disposition; I could actually begin the healing process. I learned I could better understand myself and my patients. The process was healing to both of us.

中文翻译：

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存在与形成：城市急诊室中的精神分析、种族和阶级

摘要 美国的精神分析传统上是在咨询室的安全和舒适环境中进行的长期个体治疗实践。通过我作为一名白人男性在医院急诊室的工作，主要是非洲裔美国人，低收入患者群体，我了解到它也可以用于那种快节奏的危机环境。我了解到，这样做需要与我的偏见、文化历史、记忆和个人创伤充分接触。它需要了解结构性种族主义是如何嵌入到工作中的，它在定义我的病人进入急诊室的现实中所起的作用，以及他们在那里的选择。尽管首要任务是确定安全性：这个人是否有伤害自己或他人的危险，如果一个人像分析师一样扩大了自己的注意力范围，对一个完整的人来说，一个人的观点、角色和机会会发生变化吗？我了解到我可以做的不仅仅是提供描述性的诊断和处置；我实际上可以开始治疗过程。我了解到我可以更好地了解自己和我的病人。这个过程对我们俩来说都是治愈的。