In Pursuit of Racial Equality in American Psychoanalysis: Findings and Recommendations from the Holmes Commission

Chapter 1

Overview

For there is always light, if only we’re brave enough to see it, if only we’re brave enough to be it.

—Amanda Gorman, The Hill We Climb

The impetus for the formation of The Holmes Commission on Racial Equality in American Psychoanalysis (the Commission) in August 2020 came from mounting demand that American psychoanalysis express itself on the importance of psychoanalytic understanding of race. The continuing racial atrocities occurring in the United States in 2020 became the catalyst for the leadership of the American Psychoanalytic Association (APsA) to consult with the co-chairs of Black Psychoanalysts Speak (BPS), Craig Polite and Kathleen Pogue White, on how to address race within APsA. Following these discussions, APsA’s leadership accepted the BPS recommendation that a commission be formed for the psychoanalytic study of systemic racism, naming Dorothy E. Holmes as chair. Three co-chairs of the Commission were chosen by the chair in collaboration with APsA leadership: Anton Hart, Dionne R. Powell, and Beverly J. Stoute. The chair and co-chairs collaborated to select the full membership of the Commission and the Commission Methodologist, Michael Russell. Commissioners were selected based on their extensive clinical and scholarly experience with and commitment to the understanding of race in psychoanalysis as well as to gain representation of multiple diversities (levels of experience, mental health disciplines, races/ethnicities other than African American/Black, gender, and sexual orientation) in order that our study of race be informed by broad aspects of intersectionality. ¹ Systemic racism is a key element in intersectionality in that systemic racism represents the fact of discriminatory practices embedded in the structural practices of organizations, occurring across institutions and across marginalized individuals and groups. Intersectionality most broadly includes numerous other identities beyond race subject to oppression.

The Commission held its first monthly video conference meeting on October 6, 2020, to establish operational guidelines. We decided that the entire Commission would meet monthly, and the leadership team and Methodologist would meet weekly. We developed the practice of beginning each Commission meeting with a roll call and inspirational music or a text message. We discussed how we would engage each other and the range and scope of our work. We recognized the fruitfulness of conducting our meetings as a collective in which we as Commissioners and consultants would find our way to purpose and methods by sharing our own personal and professional stories about systemic racism. The regular meeting schedule and practices continued through June 2023 when the Commission adopted the final report, then the Commission met intermittently to process reactions to the report. The leadership team continued meeting regularly through March 2024.

Purpose

The purpose of the Commission was to appraise systemic racism in American psychoanalysis and to offer recommendations and a path forward to reduce its pernicious effects. We studied how well systemic racism is understood; whether, how, and to what degree systemic racism impacts the experience of considering and deciding whether to enter the field of psychoanalysis; how systemic racism affects experience across career development once one enters training; how systemic racism influences teaching and learning in the classroom and supervision; to what extent systemic racism is enacted across all domains of psychoanalytic experience; when enacted, how it is processed and to what extent is it resolved; and how race is experienced on the couch.

At first, we limited our focus to identifying influences of race within APsA. However, the Commission quickly recognized that our volunteer participants came from a wide array of institutions governed by various bodies, including but not limited to APsA. Thus, we shifted our focus and our title to The Holmes Commission on Racial Equality in American Psychoanalysis.

Conceptualizations of Race

The Commission’s work recognized several aspects of race. We considered “race” not as a biological category based on innate differences, but as a pseudoscientific social construct perpetuated to support systemic racism (Wilkerson 2020). We defined “racialism” as the exposure of all members of a society to ideas and narratives that influence individual thoughts and perceptions about members (meaning everyone) of racialized groups. We defined “racist acts” as behaviors performed by individuals or small groups that reflect prejudice, discrimination, stereotyping, or antagonism directed against a person or people on the basis of their perceived membership in a particular racial or ethnic group, particularly a minoritized or otherwise marginalized group.

Positioning the discourse of race and racial experience in the intersubjective realm, Kimberlyn Leary (2000) “uses the term racial enactments to designate those interactive sequences that embody the actualization . . . of cultural attitudes towards race and racial difference” (p. 640). Racial enactments demonstrate how unconscious ideas about race and racism may play out in group processes as social and intrapsychic forces interpenetrate (Harris 2000). By its co-constructed nature, enactment differs from acting out or acting in, although the three share that the action is otherwise inaccessible to introspective consciousness. Building on Benjamin’s (2004) concept of how to get out of the doer and done to interaction, Layton (2006) elaborates:

Normative unconscious processes refer to that aspect of the unconscious that pulls to repeat affect/behavior/cognition patterns that uphold the very social norms that cause psychic distress in the first place. (p. 242)

Enactments may occur when the members of a group are unconsciously pulled by the same norms, or when members of a group are pulled by destructive norms. Such enactments are more easily unraveled if we are aware of these norms and how they operate.

This study focused on “systemic racism,” which we understood to be systems and structures within society—and for the purposes of this study, within and across psychoanalytic institutions and their policies and practices—that produce advantages for people in a dominant racial/ethnic group through the oppression of people in nondominant racial/ethnic groups. These structural elements of racism are embedded in individual psyches and institutional practices and can be ubiquitous, operating outside the conscious awareness of the individual, institution, or society carrying or practicing systemic racism. For ease of flow in the text, the phrase “race and racism” was used and should be considered shorthand for the systemic racism we found in the results of our questionnaires and interviews. That is, the findings about racism held up across different institutions with different administrative and governing auspices, thus were systemic.

The Commission also recognized that how race/ethnic groups are named is controversial and unresolved. Many fields struggle with this issue with the intent to adopt approaches that are not a capitulation to Euro-white normativity. The Commission adopted the convention of using uppercase for African American and Black and lowercase for white, while recognizing that “white” and “Black” are pseudoscientific socially defined labels. We understood that the matter of naming is evolving. In naming Black, Indigenous, and People of Color (BIPOC), we realized that BIPOC represents a very diverse group of people. However, given the small representation of people of color in the field of psychoanalysis, we reluctantly opted to group all people who were not white into a single group labeled BIPOC for data analysis purposes. We made this decision while recognizing that as the field diversifies, future studies may grow out of this work that elaborate the nuanced perspectives of diverse and intersectional identities.

History and Context

The Commission Report is issued at a time of great upheaval within American psychoanalysis regarding acknowledgment and acceptance that the “social” is deeply embedded in and inseparable from the psyche and is an essential focus for psychoanalytic thought and practice. This broadened, more inclusive, and informed view on what is essentially psychoanalytic is enthusiastically embraced by many, but is also met with curiosity, confusion, uncertainty, fear, and in some instances, fierce resistance.

The current tension about race in American psychoanalysis has important historical precedents. Freud “othered” and then extruded early psychoanalytic pioneers who differed from him. They were considered deviant. American psychoanalysis was built on exclusion by limiting training to physicians until the force of a lawsuit required unencumbered disciplinary inclusion. There was decades-long silence among psychoanalysts about the Holocaust. The persistent silence delayed for much too long exploration and understanding of the fact that the Nazis used systemic racism toward Jewish people to support and defend the Holocaust. LGBTQIA+ people were unwelcome and considered unfit for psychoanalytic treatment or training as analysts. These sad facts of psychoanalytic history harmed many people and diminished the discipline of psychoanalysis. In each instance, positive changes were made and are still being made.

In 1964 in the United States, a visionary leader rose to the country’s need, a leader whose history was drenched in his own personal and systemic racism (also known as, and used hereafter interchangeably with structural racism). Nevertheless, his actions turned the nation forcefully and fruitfully toward wholeness by promoting, encouraging, protecting, and then signing into legislation the Civil Rights Acts of 1964 and 1968, and the Voting Rights Act of 1965. He withstood withering opposition and was undeterred. That leader was President Lyndon Baines Johnson. President Johnson accepted the wise counsel of Martin Luther King, Jr., who shared with Johnson his view that there were “new white elements” (King 1998, pp. 242–243), including Johnson himself, whose love of country was stronger than the grip of systemic racism.

The Holmes Commission study was conducted at a transformational moment in our country and in the field of psychoanalysis. The hard reality of structural racism moved from the margins to the center of public discussions. With that shift, more work is being done to understand structural racism. This social and intellectual ferment affected both our personal awareness and theoretical formulations of otherness, which evolved even as the study progressed. The demographics of our country have changed, providing further context. According to the 2020 U.S. census, complex changes in birth rates, death rates, and immigration have led to greater racial and ethnic diversity in our country. In 2020, as a consequence, the under-18 non-Hispanic white population of the United States became a minority (Frey 2021). As a result of these patterns, our educational and social institutions face new challenges. The APsA and its institutes have not been spared from these pressures, nor have our members’ practices. The authors of this report have borne witness, as mental health professionals, as psychoanalysts, as citizens in a divided nation, and as individuals with personal histories of their own, to the collective challenges we all face as the gates of our country and of our field of psychoanalysis open to diverse voices.

Historically, our field has not been diverse racially or in other ways. The Holmes Commission was created to clarify and understand the impediments to equity and inclusivity. In this study we examined what occurs with respect to systemic racism on a granular level in the lived experience of psychoanalytic training and education across American psychoanalysis.

The conception in August 2020 and birth in October 2020 of The Holmes Commission occurred during the years of a global pandemic when the threat of annihilation was real, not just intrapsychic, affecting us powerfully. How the pandemic factored into our work will only be understood as the work of equity and inclusivity is consolidated. How did the social upheaval in the wake of George Floyd’s globally broadcast murder drive us “to do” something? When only 0.0007% of psychoanalysts are African American (Fuller et al. 1999; Powell 2018; Stoute 2023b), psychoanalysis in theory, clinical practice, and across institutions and governing bodies, has failed to meet the challenges posed by systemic racism, nor achieved racial equity. Statistics on clinician numbers representative of other ethnic diversities are not even known. As you read the Commission’s report, we suggest you consider the social context that has contributed to who we are, and the psychoanalysts we were seeking to become, as we navigated the challenges of this work. The Commissioners and the Commission Methodologist studied systemic racism while racial division and violence and a global pandemic threatened us all. The urgency was and is pressing. Structural racism is one of the most important issues of the day.

It will never be possible to fully convey the two-and-a-half-year experience of our work together. We became painfully aware of racial enactments as expressions of unarticulated, sometimes inchoate systemic racism occurring in the Commission as we worked. No one escaped with a dry eye, without a psychic laceration, without a challenge to foundational beliefs, or without deep personal and historical hurts being activated. We characterized some of the experiences that erupted as enactments because they were co-constructed among us, were at the moment of their expression not understood by some members of the Commission as embodiments of systemic racism, and were either unbearable to be known as such or were from inaccessible realms of our individual and collective selves. It was only when someone was able to share their experience of what was enacted that we could begin to identify the racial dimensions and work through them.

As we prepared the final report of our work, having processed multiple occurrences of racial enactment in the Commission, we observed what we thought was the same phenomenon in APsA, when disarray and organizational breakdown occurred, including resignations of members of color and the eventual resignation of the APsA President. We offered our views and suggested meeting after executive leadership decided that an APsA member who identifies as a Palestinian woman of color, and who was considered by some to be antisemitic, could not speak at APsA. Many welcomed the Commission’s offers, however some, including some leaders, found our offers intrusive, polarizing, and destructive, and rejected them. Perhaps we could have been clearer that we were recommending processes that would listen to all voices, with the goal of addressing the pain felt by all.

As one Commissioner offered about the process work we did in the Commission when racial enactments took place:

I respect the fierce urgency of now that guides the Commission’s resolve not to let this moment pass without transformation. I’ve been challenged to my core on The Holmes Commission and at times resisted, out of a mixture of denial and self-preservation, but confrontation has been leavened by recognition and compassion that have helped me learn and continue in the work. I trust that the Commission can model the openness, self-reflection, and compassion that make bearable the pain and conflict required in the continuing examination of systemic racism.

All of the Commissioners remained steadfast to the enduring belief that, as Dr. Martin Luther King, Jr. (1967), wrote in Where Do We Go From Here: Chaos or Community? “racial understanding is not something we find but something we must create” (p. 28). As we studied the problem of racial inequity in our field, we struggled to bear the pain of what we discovered. We survived the pain by bearing it together as a collective. As an African American–centered leadership team creating a Black-centered space, we brought an African American cultural sensibility and historical perspective to the work integrating inspirational messages and group rituals as discussed in the winter/spring 2023 edition of The American Psychoanalyst (available in Appendix J) and evolving our group’s leadership style to meet the demands of this challenge. We as a diverse group came together in the Commission as an integrated collective of numerous viewpoints with the mission of exploring and mitigating systemic racism in American psychoanalysis.

Overview of Data Collection and Analytic Methods

In 2020, APsA charged The Holmes Commission with the “mission of investigating systemic racism and its underlying determinants embedded within APsA and psychoanalysis, and to offer remedies for all aspects of identified racism” (American Psychoanalytic Association n.d.). Given this charge, the study did not set out to “prove” that systemic racism existed, nor did it attempt to test formal hypotheses about the causes or effects of systemic racism. Rather, the Commission designed and conducted an evaluative study that aimed to document various ways in which systemic racism influences policies, practices, and experiences within institutes, APsA, and the field of psychoanalysis. Data collected were intended to be descriptive in nature and to be used to stimulate and inform discussions and potential actions within institutes, APsA, and the field more broadly.

This evaluative study employed a mixed methods design that used questionnaires and small group interviews to collect data from three groups of participants: faculty, staff, and administrators; candidates associated with training institutes; and people who were psychodynamically oriented but had not entered a psychoanalytic training program. Data were collected via questionnaires and interview protocols tailored to each group of participants and were approved by an Institutional Review Board prior to use. Data from the field was also collected throughout the course of the study.

The mixed method study was designed to include a wide range of psychoanalytic institutes from across North America. Psychoanalytically oriented mental health professionals in both APsA and in allied psychoanalytic membership organizations were invited to participate regardless of membership organization affiliation. This allowed representation from psychoanalysts and psychoanalytic trainees from a variety of theoretical perspectives and geographic locales. It also allowed exploration of whether some clinicians chose not to enter APsA-affiliated psychoanalytic institutes for training because of their perceptions and expectations of the way diversity and equity were addressed or not addressed. While study participation included the United States and Canada, “psychoanalysis” was used to refer to a study of the United States, as the predominant respondent participation (>99%) was from psychoanalytic institutes in the United States.

The questionnaires covered five themes: institutes’ efforts to understand and address race and racism; issues with race from recruitment through mentoring after graduation; curriculum, racism as an analytic lens, and supervision; and the experience of race on the couch in one’s personal/training analysis; and the occurrence and lived experience of, and response to racial enactments. It is important to note that while questions included references to individual and institutional manifestations of race and racism, our focus was on manifestations of race and racism across institutions and different governing structures; that is, our focus was on systemic racism. Analyses of responses to the questionnaires provided by 1,990 participants were conducted separately for each group of participants and were examined both collectively for all respondents and separately for people who identify as BIPOC or as white.

A second source of data was small group interviews conducted to probe more deeply into specific topics, including manifestations of race and racism across institutions and different governing structures. To obtain a diverse range of views, when selecting participants first priority was given to people who identified as BIPOC, second priority was given to people who indicated on the questionnaire that they did not believe racism was an issue in their institute, and third priority was given to people who identified as white and indicated some level of concern about racism. Data from the field was the third source of data, and included a variety of information provided through personal experiences of the Commissioners, communications on list servers, professional publications, and conference presentations. A fourth source of data was the process in which the Commission itself engaged for more than 2 years, over which time the study was designed, conducted, analyzed, and reflected upon, including the Commission’s own enactments, to inform the main findings and recommendations. Data from all four sources—the questionnaires, the small group interviews, reports from the field, and the Commission’s own process—constituted the key findings of the study.

Questionnaires

The questionnaires were developed over an 8-month period using an iterative design process during which the Commission identified major themes (domains) of interest, items were co-developed and revised, draft instruments were piloted with small sets of potential participants, and revisions were made to improve clarity. Both selected-response and open-ended response items were used throughout the questionnaire, with several open-ended response items inviting respondents to provide additional information or details regarding their response to a given selected-response item. The final versions of the questionnaires collected information about a variety of demographic characteristics of participants and covered multiple topics including institutes’ efforts to address race and racism, the occurrence of and response to racial enactments, curriculum coverage of a variety of topics, analytic training, admissions practices, and support during and following training.

The questionnaires were administered online using Qualtrics survey software. Questionnaire data were collected in four waves between September 17 and December 12, 2021. For each wave, institutions and professional organizations provided email addresses for their members. During each wave, members of the various institutions and professional organizations were contacted up to three times to invite their participation in the study. Approximately 8,200 potential participant email addresses were provided across the four waves, of which just under 10% of addresses were duplicates or no longer valid. Because we did not have information about the roles in an institution or organization of potential participants, the first set of questions presented to the respondents collected information about their roles, titles, and background. This information was then used to determine whether the respondent was a member of one of the three groups of interest and, in turn, determined which version of the questionnaire was presented to that respondent. In total, 2,259 responses were received of which 1,990 were from members of the groups of interest.

Analyses of questionnaire responses were conducted separately for each group of participants and were examined both collectively for all respondents and separately for people who identified as BIPOC or as white. Analyses of selected-response items consisted of the calculation of descriptive statistics for each item on the questionnaire and statistical comparisons between select groups of interest, such as respondents identifying as white compared to those who identified as a member of a BIPOC racialized group.

In quantitative research, statistical analyses are conducted to test whether observed differences between two or more subgroups in a sample are statistically significant. As part of some statistical analyses, a p value is calculated. When comparing responses between subgroups, we used a p value of .05 to guide our focus on survey questions that merited closer attention. However, when reporting findings for subgroup comparisons, we follow the practices of a growing body of social scientists and do not report p values (Benjamin et al. 2018; Lambdin 2012; Trafimow 2014; Woolston 2015). When we omit p values, we do so to minimize misinterpretation. As is well documented, p values are often misinterpreted as indicating the significance of a difference, the magnitude of that significance, and/or the probability that a difference was due to random chance alone (Wasserstein and Lazar 2016). In fact, a p value simply indicates the probability of obtaining a statistical value equal to or greater than that which an analysis obtained. More technically, a p value represents “the probability under a specified statistical model that a statistical summary of the data (e.g., the sample mean difference between two compared groups) would be equal to or more extreme than its observed value” (Wasserstein and Lazar 2016, p. 131). Regardless of the statistical significance of the p value for an observed difference, human interpretation is required to determine the practical significance and associated meaning of that difference (Kirk 1996).

In addition, we recognize the limitations and challenges of grouping respondents with various racialized identities and resulting experiences into a single group, BIPOC. However, the notable underrepresentation of members of these racialized groups resulted in small samples for these racialized groups. Small sample sizes decrease the stability of findings resulting from comparisons among groups with small sample sizes. To minimize unstable comparisons, we opted to place these respondents into a single group. Open-ended response items were analyzed holistically to identify patterns in responses and to select quotations that provided insight on a given topic.

Interviews

The second set of data was obtained by conducting small group interviews to probe more deeply into specific themes identified during analysis of the questionnaire responses. All interviews were guided by a semistructured protocol that was developed following a preliminary review of the questionnaire data. The semistructured interview protocols covered several main areas of inquiry: the response to racist incidents or racial enactments; attention to diversity issues (race, racism, and white supremacy); transition of the field of psychoanalysis toward racial equity; the impact of race and racism on the decision to pursue or not pursue psychoanalytic training; race as a psychoanalytic topic; and increasing inclusivity. In addition, a template summarizing interviewee responses for each theme addressed in the protocol was completed by all interviewers shortly after completing each interview. In each themed chapter that follows, qualitative data in the form of anonymously reported quotations from respondents in the interviews are integrated throughout to illustrate the lived experience on the individual level that the survey reports in group aggregate.

The interviewers consisted of members of The Holmes Commission and Advanced Candidates in psychoanalytic training programs. The interviews were conducted with the primary aim of deepening understanding of various influences and experiences, encouraging reflection on current practices, and supporting the identification of opportunities to strengthen training programs and the field of psychoanalysis. All interviewers were psychoanalytically trained, so had prior training in conducting psychodynamic interviews before the Commission training session. All interviewers participated in a 1-hour training session in which the semistructured protocol, the procedures for conducting and recording the interview, and the approach to summarizing the interview were reviewed.

The sample of interview participants was selected based first on a survey item that asked whether they would be willing to participate in an interview. Of the approximately 600 people who expressed willingness, 80 faculty members, 70 candidates, and 20 people who were positioned but had not yet entered the field were invited to participate, of which 53 faculty members, 55 candidates, and 18 people who were qualified to but had not entered the field were interviewed. To obtain a diverse range of views, first priority was given to people who identified as BIPOC, second priority was given to people who indicated on the survey that they did not believe racism in any of its forms (individual, institutional, or systemic) was an issue in their institute, and third priority was given to people who identified as white and indicated some level of concern about racism. All interviews were conducted via Zoom and were video recorded. Together, the summary reports and review of the recordings were used to compile a 29-page technical report (see Appendix G). Both interviewers and interviewees gave permission to use their anonymous quotations.

Other Sources of Data

Data from the field was the third source of data. Data from the field included a variety of information provided through personal experiences of the Commissioners, communications on list servers, communications sent to Commissioners during the study, professional publications, and conference presentations. A fourth source of data was the process in which the Commission itself engaged for more than 2 years, over which time the study was designed, conducted, analyzed, and reflected upon, including the Commission’s own enactments, to inform the main findings and recommendations. Data from all four sources—the survey, the small group interviews, reports from the field, and the Commission’s own process—constituted the key findings of the study. All statistics in the report are from The Holmes Commission Appendices A, B, C, D, E, and F. All quotations in the report are from The Holmes Commission Interview Summary Report (Appendix G). Permission was obtained from all study participants and interviewers to use their quotations anonymously. The appendices are provided online by The Holmes Commission to give readers additional information about the work.

Demographics

Demographic data collected for the study population included racial identity, ethnic identity, gender identity, organizational affiliation, and institutional role. As reported in Appendices E and F, 24.5% of the survey study participants identified themselves as candidates, 44.7% as institute faculty, and 26.8% as psychodynamically trained psychotherapist clinicians. As shown in Table 1, of the 61% of candidates who opted to provide demographic information, 73.3% identified as white and 22.1% identified as a member of one or more groups categorized as BIPOC. Of the 73.7% of faculty who provided demographic information, 85.7% identified as white and 14.6% identified as a member of one or more groups categorized as BIPOC.

Table 1.

Racial and Ethnic Identity

With which of the following racial and ethnic identities do you identify? Check all that apply.	Faculty (Percent)	Faculty (Number of People)	Candidates (Percent)	Candidates (Number of People)
Asian, South Asian, Southeast Asian, East Asian, Pacific Islander, Asian American	3.9	23	11.7	33
Black, African, African American, Caribbean	4.2	25	7.5	21
Latinx, Hispanic, Central American, Latin American, South American	3.9	23	8.9	25
Middle Eastern/North African	1.9	11	0	0
Native American, Alaska Native, Native Hawaiian	0.7	4	0	0
White	85.7	508	73.3	206
Not listed, please describe your identity	8.3	49	4.6	13
Total		593		281
Did not respond		212		180

An effort was made to include gender diversity (Table 2) and study participants from psychoanalytic organizations throughout the United States and Canada. In addition to inclusion of psychoanalytic psychotherapy clinicians who did not train at psychoanalytic institutes, psychoanalytic institute affiliation data (Table 3) clearly demonstrated inclusion of organizations outside APsA.

Table 2.

Gender Identity

With which gender do you most identify?	Faculty (Percent)	Candidates (Percent)
Male	33.6	27.4
Female	64.2	67.6
Gender variant/nonconforming 2	0.7	1.4
Not listed, please describe	0.3	2.1
Prefer not to answer	1.2	1.4
Total number of respondents	592	281
Number of respondents who did not answer the question	213	180

Table 3.

Affiliation

Is your institute affiliated with . . . 3	Faculty (Percent)	Faculty (Number of Respondents)	Candidates (Percent)	Candidates (Number of Respondents)
American Psychoanalytic Association	76.7	428	62.3	175
International Psychoanalytical Association	54.3	303	36.7	103
Other, please describe	14.2	79	10.0	28
Total		558		281
Did not respond to question		247		180

Developing the Report

After the data were collected and compiled, we divided into work teams to analyze the data and produce this final report. These smaller writing groups grappled with a stark realization. Struggle as we might, as well intentioned as we consciously try to be as psychoanalysts, our educational institutions and membership organizations were not succeeding in their efforts to be inclusive. In addition, racial enactments impaired effective functioning on many levels throughout our educational organizations.

In conclusion, although The Holmes Commission study focused mainly on race as the current marker of diversity in psychoanalytic training and education, we recognize that race is but one marker for stratifying difference. Ethnicity, gender, sexuality, culture, religion, physical ability, and socioeconomic position, to name a few, are interrelated at the level of our lived experience and worthy of reflection in our psychoanalytic understanding of the many intersecting social locations of otherness (Stoute 2023a).

As a field, we must come to understand that diversity is manifested as inclusiveness of all social identities, sociocultural positions, points of view, academic beliefs, and personal attitudes. Understanding the structural impediments to diversity, equity, and inclusion (DEI) in our minds and in our organizations is a necessary first step if we are to advance as clinicians, as a field, and as a society in a diverse world. The question of whiteness and leadership is a proposition horribly loaded, that one’s response to that question depends on where you find yourself in the world, what your sense of reality is. That is, it depends on assumptions we hold so deeply as to be scarcely aware of them. (Baldwin 1965)

The systemic racism and lack of diversity in our field and leadership has deleterious consequences and it is doubtful that we fully comprehend how much it has diminished us all as practitioners and as a discipline. As The Holmes Commission has done its work, widespread cross-racial, cross-gender, cross-discipline, and cross-cultural support has emerged throughout the field and uplifted us. We hope the results from this study and the work of this Commission are important next steps toward developing educational and training models that advance psychoanalysis toward equity and unlock the true radical potential for change that psychoanalysis offers the world.