Black Rage as a psychosocial experience

The construct of Black Rage is rooted in the notion of moral injury, defined as: “a betrayal of what is right either by a person in legitimate authority or by one’s self in a high stakes situation...[that] impairs the capacity for trust and elevates despair, suicidality, and interpersonal violence”. Further, it represents the “trauma that occurs when one’s actions have profoundly violated one’s code of ethics, when one has been a victim of such violation, or when one has been a passive witness of such violation” (p. 269).

Moral injury induces an internal struggle between expressing “indignant rage” and controlling retaliatory rage. Black Rage is a specific response to the moral injuries, the “collective unconscious store of transgenerational traumas”, experienced by African Americans. It also contains superego imperatives about “what is right”. Stoute postulates that Black Rage is an adaptive mental construct that preserves dignity, mitigates trauma, and promotes defensive sublimation. It shields the vulnerable self from devaluation and helps racialized others in their struggle “to withstand attacks on linking, in order to preserve the capacity to think” (p. 278), to love while being hated, and to remain calm while feeling indignant rage.

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Accreditation as a social defense

Healthcare management struggles to be both a scholarly discipline and a legitimate practice. Legitimacy is often equated with being “business like”. As such, healthcare management scholars and practitioners have made “professionalization” a priority in an effort to legitimize the field (Gerard, 2019; 2021). Accreditation is at the center of this effort.

Accreditation of healthcare management programs (along with clinics, behavioral health programs, and hospitals) makes sense on the surface, but it is also a way that faculty and students (and clinicians, managers, and executives), unconsciously, protect themselves from having to confront the field’s complicity with questionable managerial techniques that at best reinforce existing health (and healthcare) inequities and, at worst, exacerbate social injustices.

Working in healthcare settings, as managers and as clinicians, requires awareness of self and other experiences in the face of acute fear, anxiety, loss of hope, and even death – while holding hope for recovery, health, and life. Yet, in today’s healthcare environments, managers and clinical staff avoid these emotional complexities with technical models, data-driven interventions, and pretentions to rigorous science. The psychoanalytic question here: what do these efforts represent unconsciously, and what do they attempt to cover over or deny?

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Subjectivity and desire in research

"Is an interpretation always, to some extent, an imposition of our own discursive or psychical attachments?"

The answer to this question, in part, lies in exploring the subjectivity of researchers/analysts and participants/analysands in the research encounter. In part, it lies in tracing what happens to psychoanalytic concepts in the research process. This is the project taken up by Claudia Lapping in her 2013 paper entitled "Which subject, whose desire? The constitution of subjectivity and the articulation of desire in the practice of research".

The article reminds us that our inner emotional experiences are always both a potential source of insight and a path towards imposing our own needs and desires on organizational members. Interpretation is sometimes the expression of our own, not others', desires. And, sometimes it is an attempt to hide the lack that we cannot bear to acknowledge. The research encounter inevitably evokes something about us. We may attribute these aspects of our experience to the other (through interpretation) when, in fact, they reveal something about our selves.