Welcome to my blog, which speaks to parents, professionals who work with children, and policy makers. I aim to show how contemporary developmental science points us on a path to effective prevention, intervention, and treatment, with the aim of promoting healthy development and wellbeing of all children and families.

Tuesday, October 8, 2013

Reflections on the government shutdown: why is health care so threatening?

 I may be putting myself out on a bit of a limb here, but the draw of the blog makes it hard to sit silent while our country heads towards disaster.

As I listen helplessly to a report on NPR  about our country being in the grips of an irrational game of chicken, I found myself being curious about the motivations of the tea party conservatives. Drawing a lesson from psychoanalyst Peter Fonagy, who identifies the ability to attribute motivations to behavior as a uniquely human characteristic, I wonder if taking a stance of curiosity rather than anger might be useful.

This led me to consider another psychoanalytic construct, namely that of transference.  The tea party hardliners refer to Obamacare as an invasion of privacy. This idea is grotesquely depicted in the commercial showing a creepy Uncle Sam invading a gynecologic exam. Before he enters, the patient,  a young woman, is being cared for by what appears to be a kind, motherly doctor.

The notion of transference describes how strong feelings from a past relationship, often with a parent, find there way in to a current relationship. This phenomenon can occur in relationships with spouses, children, co-workers, in addition to the setting where Freud originally identified it, namely in the patient-therapist relationship.

In the intimacy and privacy of the patient-doctor relationship, such as that between a young woman and her female gynecologist, these type of transference feelings naturally occur. That made me wonder if to those who made the commercial, Obamacare, as represented by Uncle Sam, in some way represents a third invading the primary caregiver-child relationship. If so, that might help explain the intransigent behavior of those who are unable to accept that Obamacare, or the Affordable Care Act, is the law, and are willing to hold the country hostage rather than face that fact.

But Obamacare is not a threat to that intimate private relationship. In fact, if it works, and health care costs do go down, and insurance companies lose some of their power, it may in fact strengthen the relationship.  With increased emphasis on prevention, the healing power of the patient-doctor relationship might be brought in to better focus than under the current system, when doctors are forced to see more and more patients in less and less time.

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