The Labor of Analysis: A Conversation with Gabriel Tupinambá

Loren Dent: A notable propensity among younger trainees in American psychoanalysis is their repeated return to institutions that often prove disappointing. This ongoing attachment, despite persistent frustration, suggests a broader collective challenge: difficulty or reluctance in moving beyond unsatisfactory institutional frameworks.

There seem to be at least two distinct dynamics at work. One is something like a libidinal attachment to disappointment itself, where the frustration becomes part of the structure of desire rather than an obstacle to it. The other is the limits of training and authorization—a difficulty in feeling entitled to form alternative collectives or pursue different modes of work and learning.

Presumably, Brazil differs significantly in terms of licensing and professionalization, yet you also address this issue. Even among Lacanian institutes globally, similar patterns emerge.

Gabriel Tupinambá: Some of these dynamics are quite general. You could find similar patterns in other institutional or organizational contexts that don’t necessarily involve political complaints in the strict sense. That is, not every frustration takes the form of a political demand that claims legitimacy because it’s political and unmet. Some frustrations are more basic.

Politics changes things because political demands point to something shared. They’re not just consumer complaints. They require a sense of entitlement and exposure—stepping out of one’s place and addressing others. That’s why people organizing political activities are often frustrated by critiques from participants. Those critiques have a legitimacy that wouldn’t exist in a non-political context. Politics invites disagreement in a way that everyday institutional life doesn’t.

There’s also another distinction that feels important, especially before we even get to questions of authorization. Some demands require follow-through. If you were to respond to them—by inviting them into further work and asking them to participate—they would engage. But other demands aren’t really demands at all. They’re expressions of discontent, and the discontent itself is already the fulfillment. Making the complaint positions the person morally or politically and aligns them with certain values; that’s enough.

You can usually tell when this is happening because there’s no interest in follow-through. Any response is seen as inadequate or illegitimate. The complaint appears only in that singular moment, and the person has no ongoing relationship to the issue or the context. If you look closely, you’ll often see that people who primarily fulfill their political identity through complaints don’t have very active political lives otherwise. That’s different from situations where frustration and demanding are genuinely productive. In many cases, they’re necessary for building an organization.

We dealt with this directly in a year-long assessment of a collective, the CPT—Collective of Psychoanalytic Work. The group grew very quickly, from about 20 people to 3 or 4 hundred in just a few months. Tasks that had been manageable suddenly became overwhelming. The people who initially volunteered couldn’t keep up, and they were frustrated that others weren’t stepping in.

When we wrote our assessment, we used a framework that proved very helpful: complaints as frustration, privation, and castration.

Frustration arises when people feel something could be done but isn’t. There’s usually a clear sense of who is at fault—someone isn’t doing their job. It’s the most accusatory form. Privation is different; It appears when people feel something can’t be done by us, others can do it. There’s a sense of being excluded or left behind. This often comes with a superegoic pressure—we should already be there, even though there’s no clear agent responsible. Castration appears when limits are recognized as structural and shared. When we realized that many things we couldn’t accomplish were also challenges other organizations faced, it completely changed the tone. Those limits actually opened connections with other groups, even outside psychoanalysis, facing similar problems.

What we realized is that organizations need mechanisms to move across these different ways of relating to limits, rather than treating frustration itself as the problem. If people don’t have political experience, how else are they supposed to learn which limits are contingent, which are structural, and which are historical? They can only learn by positioning themselves differently in relation to those limits—first experiencing frustration, then privation, and eventually something like castration. The key is whether there’s a way to turn those experiences into something. Otherwise, frustration just circulates. But if there are structures that allow it to transform, it can become productive.

Participating in collective processes becomes an education in what collective life actually entails. You begin to learn that organizations have limits, that they can accomplish more than any individual, but never everything. And that those limits don’t automatically mean someone else is benefiting at your expense—though of course, sometimes that does happen.

That’s why it matters to get a feel for what’s actually happening. Sometimes, simply explaining constraints, processes, and limits changes everything. Other times, what’s needed is a new space where frustration can be worked through and transformed. And sometimes, yes, the complaint is just the satisfaction of a prior demand, a way of signaling one’s position rather than communicating anything.

Loren Dent: Share a bit about what you learned from the research from the CPT relative to class tensions within professionalized psychoanalysis.

Gabriel Tupinambá: When we were still a small group—around ten or fifteen people—we initially wanted to create a concrete economic instrument to lower the cost of clinical work. For example, a common fund for vacations or emergencies, since we don’t have social security through our work. We thought about renting shared spaces and similar ideas. But even within that initial group, there were already strong class distinctions.

Some people have wealth from outside psychoanalysis and barely need to sell their labor at all. Others survive entirely by selling their labor as analysts. In a strict Marxist sense, if you survive by selling your labor and don’t own the means of production, you’re working class. But sociologically, that category is very stratified. There are many layers within it, and psychoanalytic workers are distributed across them in a very uneven way. We had a sense of that from the beginning, which is why we decided to do the inquiry. There was no way to generalize otherwise.

The responses confirmed this. We received responses from almost all Brazilian states. We had many more responses from analysts who were doing okay or relatively well financially than from those with very low incomes. Roughly half reported earning more than 6,000 reais per month—about $1,000. That doesn’t go very far once you account for rent, food, and basic expenses, but it’s roughly comparable to a PhD stipend.  Within that group, a significant subset earned much more—10,000 reais or more per month. The bottom half earned less than that stipend level, and many earned far less.

But this doesn’t represent analysts as a whole. It represents analysts who were willing to participate in a political inquiry. That’s an important distinction. For many respondents, it was shocking to realize how much some analysts actually make. This led us to another realization: these dynamics are very similar to what happens in the art world. There’s a shared difficulty in defining what the work actually is, and that ambiguity tends to erase class distinctions. Artistic work is supposed to be irreducibly singular. So it’s very difficult to establish any common standard based on the work itself. That ambiguity makes it hard to understand in what sense artists are workers—what it means to sell their labor, or even whether they’re selling labor at all.

We see something very similar in psychoanalysis. In Brazil, psychoanalysis has become a viable option for two very different fractions of the working class. One group comes from a middle class with cultural privilege—access to universities, academic careers, symbolic capital—but whose prospects are shrinking. Becoming an analyst replaces paths that are disappearing: teaching, research, and grants.

For the first group, Lacanian psychoanalysis, with its heterogeneous and informal training pathways, offers a way to preserve something they were about to lose. Instead of taking a job they experience as degrading, they can become analysts. The other group comes from socially ascending backgrounds—often the first in their families to attend university. They don’t want to settle. They want to do something meaningful, something they believe carries truth. Psychoanalysis appears as an alternative to standard professional tracks.

These two trajectories converge in the same analytic spaces. People speak the same language, attend the same seminars, and share the same project. But for one group, psychoanalysis is a better job; for the other, it’s the last stop before having to get a “real” job. That difference creates tension, because they can’t agree on what psychoanalysis is. Is it a profession? A vocation? A form of resistance to proletarianization? Or a temporary shelter from it? We encounter this constantly—both in trying to promote collective projects and in analyzing the internal composition of those collectives. Different class positions produce different strategies, expectations, and frustrations.

Loren Dent: Before we go further, I think it’s worth noting the structural difference between how psychoanalysis functions as a profession in Brazil versus in the U.S., because I think a lot of what you’re describing would look very different from the vantage point of a city like New York. In the U.S., you can’t legally offer anything resembling psychotherapy without a clinical license—typically in psychology, social work, counseling, or psychiatry.

New York State offers a terminal license in psychoanalysis. Someone with, for example, a PhD in comparative literature can retrain as a psychoanalyst and obtain a license in psychoanalysis (LP) through certain institutes, without becoming a psychologist or social worker. But that still involves a state-regulated curriculum and licensing process. There are also clear hierarchies among licenses and training programs, including huge differences in debt burden. And outside of that, people can’t simply become analysts without passing through formal clinical training. At the same time, psychologists here can uniquely supplement analytic work with testing or assessment, which can be very lucrative. Psychiatrists, of course, can prescribe medication and practice analysis or therapy.

Gabriel Tupinambá: Brazil is complicated, and things have been changing recently. Until about five years ago, psychoanalysis wasn’t regulated at all. There was no direct way to be licensed as a psychoanalyst. The only recognized certifications were through psychology or medicine. Universities were the bottleneck. Most people studied psychology, encountered psychoanalysis there, and then specialized further. Their legal status came from being psychologists or psychiatrists, not from being analysts. Alongside that, psychoanalytic societies and schools were offering their own certifications. These had no legal standing. The state didn’t recognize them as guarantees of quality. They were private credentials.

Typically, analytic societies required prior training in psychology or medicine to provide legal cover, and then offered their own certification on top of that. Lacanian schools disrupted this model by accepting candidates from other academic backgrounds. That made psychoanalysis more accessible, but also more precarious. If you trained as an analyst without a psychology degree, your analytic diploma had no legal value. That created anxiety. Should you risk practicing with only that certificate, or should you return to university and obtain a psychology degree for legal protection?

Brazil’s relationship to bureaucracy plays a big role here. Laws exist, but enforcement is uneven. People constantly calculate whether a rule will actually be applied. That ambiguity shapes professional decisions. For many, it seemed safer to pursue psychology training either before or after analytic formation. That created two parallel routes: one legally covered, one informal and autonomous. The informal route has clear economic consequences. Without a psychology license, you can’t bill health insurance. Patients must pay directly, and your work is considered informal, autonomous labor. That also limits access for poorer patients, who expect mental health care to be integrated into insurance systems.

But something else started to happen because this arrangement was very unstable. For a long time, there was an uneasy symbiosis between Lacanian schools and universities. Universities provided legal certification through psychology degrees. Lacanian schools insisted that what they were offering had nothing to do with state regulation. They argued that psychoanalysis regulates itself through its own internal mechanisms, and that this autonomy was essential.

This position was strongly defended during a recent public hearing on the possible regulation of psychoanalysis. Very prominent analysts argued that the state should not regulate psychoanalysis because it already regulates itself. That autonomy was seen as something precious. The problem is that once you defend self-regulation, you can’t easily control who else claims the same right. Evangelical churches began offering psychoanalysis courses, training pastors and priests in what they called “Christian psychoanalysis.” These programs were much cheaper and far more accessible. They didn’t require prior academic training. From a legal standpoint, they weren’t offering health services at all—just a private service that anyone could choose to use. This deeply unsettled Lacanian analysts. They didn’t want state regulation, but they also didn’t want these forms of self-regulation to proliferate. Lacanian schools at least required an undergraduate degree before analytic training. The church programs did not. At the same time, private universities began offering undergraduate degrees in psychoanalysis. This responded to a real demand: people who wanted to become analysts without first pursuing a psychology degree. But for Lacanians, this felt like a betrayal. This wasn’t what they meant by autonomy or self-regulation.

So now you have multiple pathways: the most secure route—psychology degree plus analytic training; an intermediate route—other academic training plus Lacanian formation; and newer routes—church-based programs, undergraduate psychoanalysis degrees, or online courses offered by analysts who need money. People choose among these options based largely on class position. If you can afford legal risk, you might practice without a psychology degree. If you need income quickly, cheaper online courses or church programs may seem like the only viable option. This produces intense tension. A position that once defended autonomy against state control now appears reactive, even conservative. Lacanians find themselves wishing the state would intervene to block other forms of training.

Loren Dent: I want to raise another dimension of this: the role of insurance—not just health insurance, but also liability insurance. The U.S. has an unusually strong culture of risk aversion among clinicians. Many carry expensive malpractice insurance against fears that, in practice, are largely exaggerated. But that culture shapes formation in very concrete ways. In Brazil, if someone trains through an online course, offers psychoanalysis as a private service, and a patient commits suicide, what actually happens? Is there any mechanism of accountability, or does the informality of the arrangement effectively mean liability is limited?

Gabriel Tupinambá: I’ve never seen anyone face consequences like the ones U.S. clinicians fear. When cases do arise, they tend to involve extreme situations—multiple patients denouncing someone for abuse, for example. Those cases might go to an ethics committee or become civil cases. But routine malpractice litigation simply isn’t part of the landscape. That makes risk aversion a very interesting cultural contrast.  Brazil is different even from other Latin American countries. In places with strong histories of labor struggle and political repression, those histories remain very present. Brazil is more ambivalent.

Brazil was the largest slave society in history. The scale and duration of slavery here are not comparable to those in the United States. Structurally, this matters. There’s a famous Brazilian anthropologist who contrasts “colonies of extraction” with “colonies of settlement” (Ribeiro, 2000).  Brazil was an extractive colony. The Portuguese didn’t intend to live here. Enslaved Africans didn’t choose to be here. Indigenous people didn’t want colonization. The country wasn’t built around shared habitation. It was built around extraction, with state structures layered on top, and communities forming only secondarily. That produces a very different relationship to labor, rights, and institutions.

In the U.S., extraction coexisted with settlement. Communities were built and defended, even if violently and unequally. Rights, however unevenly distributed, became thinkable. In Brazil, the idea that rights are stable and enforceable is far weaker. People who insist on their rights are often treated as exceptions. Trade unions here aren’t just mediators of rights; they’re political instruments for making rights exist at all. This shapes how informal labor is perceived. Working without legal clarity isn’t scandalous. It’s normal. The idea that your job comes with clear protections and enforceable limits simply isn’t widespread.

Loren Dent: Here, one effect of this culture of risk aversion is that clinicians are trained in environments—community clinics and hospitals—where anxiety about liability is constant. Trainees internalize bureaucratic fears around suicidality and violence. Over time, many become afraid of working with certain patients altogether. Sometimes that fear gets displaced onto poverty or class. People decide they don’t want to work with patients who feel too risky, too unpredictable, or too hard to hold in mind outside the session.

This connects to your recent article (Tupinambá, 2025), in which you argue that the central issue is not access so much as formation—especially in working with the poor and marginalized. Access matters, of course, but I was struck by your emphasis on formation, given how different the institutional climates are between Brazil and the U.S.

Gabriel Tupinambá: It might help to distinguish three things that often get collapsed together: the client, the patient, and the analysand. Clients are consumers. In principle, they’re always right. They define standards based on what they want. Complaints operate at that level. Patients are different. They relinquish some authority over standards to someone else. In a medical context, that’s what makes malpractice meaningful. You allow another person to act against your immediate wishes because they’re responsible for your care. Analysis is something else. I strongly disagree with the idea that analysts have no responsibility, but the responsibility is different. The analytic relationship isn’t reducible to client satisfaction or medical duty.

This is why suicides are such a complicated issue. You can frame them as failures of responsibility, but you can also experience them as something that happens outside your responsibility. That’s often harder to bear. How do you mourn or process the loss of someone who wasn’t your friend or family member, but for whom you were the closest witness to a final act? Jean-Claude Milner once wrote that analysis either does something or does nothing at all. I still don’t fully know what to do with that statement—it can be misused—but I think it captures something important.

You can’t really “kill” an analysand in the way you can kill a patient through a surgical error. You can exploit someone by doing nothing for years and being paid. But analytic malpractice, if the term even fits, has more to do with preventing an analytic experience from ever really taking place. There are certainly situations where harm occurs during an analysis. Anxiety can be increased. Signals can be missed. Things can deteriorate. But that’s not the same as choosing the wrong analytic intervention in a causal sense.

Cultures that tightly bind client rights, patient protection, and professional standards have such difficulty separating analysis from healthcare. Psychoanalysis worked hard to gain legitimacy by aligning itself with mental health, and now it struggles with the consequences of that alignment.

This is where access comes back in, because access means something different at each level. From a consumer standpoint, access means affordability and availability. From a patient-care standpoint, access means flexibility—adapting care so it isn’t imposed inappropriately. But analytic access is something else. It’s access to the conditions that make analysis possible, including access to what makes someone become an analyst. Analysis isn’t just something you consume. It’s something that opens onto production.

Many analysts who want to expand access offer something very different from what they themselves had access to. They had analysis, but they also had time, intellectual space, and institutional access to decide whether analysis would become central to their lives. That option is part of what access really means. So democratizing analysis isn’t just about distributing sessions. It’s about democratizing the conditions of analytic formation. Otherwise, you expand consumption without expanding production, and the structure collapses.

This is also why the analyst–analysand relationship is so strange. There’s asymmetry, but not the kind that fits medical responsibility. Analysts mediate someone’s experience with themselves. They don’t control the outcome. That mediating position matters. If we don’t recognize it, we end up either medicalizing analysis or romanticizing irresponsibility.

Loren Dent: I want to raise something that troubles me about the access discourse, particularly in the projects I’ve been directly involved in. There seems to be a structural tendency for access initiatives to resolve themselves by exploiting the most precarious workers in the system—trainees in community settings, early-career analysts, people whose political commitments make them susceptible to appeals to altruism.

They’re given the most precarious patients, often for minimal pay, and the patients themselves get shuffled from therapist to therapist as trainees rotate out. At the same time, there’s a moral appeal to altruism that exploits people’s goodwill and superegoic dispositions. Your article made me think about desire here—not just material constraint, but what it would mean for formation to include questioning one’s desire to do this work. Otherwise, people become a workforce servicing the moral needs of middle-class virtue signaling.

Gabriel Tupinambá: That resonates very strongly. In Brazil, many Lacanian schools responded to demands for access by creating referral systems. But what often happened was racialized and classed matching: poor Black patients were sent to poor Black analysts, under the assumption that they’d understand better and be willing to charge less. The approach exploited the assumption of an innate desire to serve. Analysts would take on many low-paying patients, then eventually need a second job or burn out. Analysis became temporary by necessity.

At one point, I consciously took on as many patients as possible for as little money as possible—sixty patients a week, paying between one and ten dollars. I could only do that because I had a postdoctoral grant. It was intense and unsustainable. And that’s where I think analytic malpractice really appears: when conditions make it impossible for analysis to last as long as it needs to. Responsibility isn’t about saving the patient. It’s about making the analytic experience possible at all.

I think what you’re describing captures how fragile the current reconfiguration of psychoanalysis really is. On the one hand, it creates opportunities for socially minded analysts to work in ways they wouldn’t otherwise be able to. On the other hand, it relies on a very unstable equilibrium. It exploits differences in class position, political identification, and desire to cover a structural gap without actually transforming it.

It’s not sustainable in the long run. Either people burn out, or they’re forced to leave these projects because they can’t survive materially. And when that happens, the analytic processes are often cut short. That, to me, is much closer to what we should understand as analytic malpractice—not harming someone directly, but failing to sustain the conditions under which analysis could continue.

For a long time, there was this idea that analysis should never be free, because payment structures desire. Then came the opposite position: that analysis should be free to be truly political. Both positions have serious problems. When analysis is free, it’s usually students who provide it. At some point, they need to get paid work, and they leave. Analyses end not because something has been worked through, but because material conditions force an interruption.

At this point, some of us no longer justify payment based on analytic dogma. Still, we also don’t believe that democratizing analysis simply means making it free or extremely cheap. Offering your labor for free is itself a marker of social position. Patients often recognize immediately that you’re not from the same world they are, because they would never do that themselves. It raises a question: why are you doing this, if not for money?

This question actually led me to the research that eventually became my book (Tupinambá, 2021). I had the intuition that patients didn’t really know what they were paying for. At first, they think it’s medical care—they’re here to be cured. Once they realize that’s not what analysis is, the question of payment becomes unclear. I started wondering whether other forms of exchange could play a similar role, not as a replacement for money, but as something that answers the question of why the analyst is there. For example, I asked some patients to write their own case studies at some point in the analysis. Not for publication, but as a way of saying: this matters to me, this is what happened here. In some cases, it worked remarkably well. It deepened engagement without producing the confusion that free treatment can create.

That made me think differently about access. Making analysis accessible to working-class or marginalized communities doesn’t require making it free. It requires making it sustainable. Of course, fees need to be lower than those charged by analysts in wealthy neighborhoods. But that variation already exists. The real barriers are often logistical: long commutes, lack of local analysts, or the assumption that psychoanalysis simply isn’t for people like them.

The problem is that if we don’t know what we’re actually training people to do—if we can’t articulate what analytic work is—we can’t support these new experiments responsibly. Instead, we end up filtering them based on class prejudice, even when we pretend we’re making technical or ethical judgments.

Loren Dent: What you’re describing raises a question I find difficult to think through: how do we move from the level of analysis—understanding what’s happening—to the level of collective strategy, given that the organizations that ostensibly exist to coordinate that strategy are themselves limited to address this?

Here in New York, any serious attempt to approach these issues would likely involve accreditation, liability, and licensing. Who gets to train analysts? Do they need clinical licenses? What does lay analysis mean today? Do we engage in electoral politics? Do we try to unionize psychologists and social workers around these issues? That’s a huge amount of work. And many people who care about these questions don’t trust professional organizations like the American Psychological Association to represent them.

Gabriel Tupinambá: It’s similar here. Nobody really trusts existing organizations. And part of the difficulty is that it’s hard even to think these things through individually, let alone collectively. There’s very little clarity about what’s actually at stake. Without collective clarity, it’s impossible to decide which paths are worth pursuing or to make sacrifices in that direction.

I think we’re still at a very early stage. Before choosing strategies—more analysts, more access, more funding—we need to step back and ask: what is analysis as an experience? What is invariant? What has to be present for that experience to occur? Only then can we evaluate which institutional paths actually support that experience, rather than undermining it. Otherwise, we oscillate between two inadequate solutions: overproducing analysts without changing conditions, or overextending existing analysts by exploiting their desire.

Loren Dent: There’s a tension I keep running up against, both in this conversation and in my own thinking: how do we articulate what’s essential to analytic work without that articulation immediately becoming a policing mechanism—a way of drawing boundaries that ends up serving institutional or class interests rather than the practice itself?

Here, many people feel ambivalent. On the one hand, expanding access clearly requires changing the conditions of analysis—where it happens, how it’s paid for, and possibly even its form. On the other hand, there’s a real worry that some efforts to collectivize analysis turn into a kind of warehousing. You reach more people, but something essential gets lost in the process.

Is analysis necessarily dyadic? What happens to analytic speech in group settings or institutional contexts? What becomes sayable or unsayable under those conditions?

Gabriel Tupinambá: Before these collective processes really took off in Brazil, I was concerned that politicizing psychoanalysis would lead to a kind of blanket authorization. There are problems; whatever solves them must be good. That would bypass the question of rigor. What reassured me was seeing that, in practice, people were genuinely preoccupied with preserving what makes analysis analytic. Among those involved—especially people with a longer analytic trajectory—there was a constant concern with whether the core conditions of the experience were being maintained.

The question wasn’t simply how to expand access, but how to do so without destroying the thing itself. And that concern appeared spontaneously, not as an external imposition. That’s important because democratization involves both access and analysis. You can’t sacrifice one for the other. Creating massive online sessions or group formats without attention to analytic conditions doesn’t solve the problem.

What encouraged me was realizing that when demands come from workers themselves, people tend to care deeply about doing their work well. Unionized bakers usually want to make better bread. They don’t hate baking; they hate the conditions that make good baking impossible. Something similar applies here. When analysts push for better conditions, it’s often because financial pressure makes analytic work worse, not because they reject the work itself.

The difficulty is that psychoanalysis has a complicated relationship with its own definition. On the one hand, there’s been a long struggle for social recognition—aligning with mental health, medicine, and science. On the other hand, there’s also been a romanticization of not knowing what we do, of resisting definition altogether.

That makes it very hard, now, to pause and say: what is this practice, actually? It goes back to the distinction between client, patient, and analysand. What I’m most certain about in daily practice is that the analyst mediates someone’s experience with themselves. The analysand isn’t at your mercy. You don’t control where they go.

That matters because if you think you do control outcomes, you’ll either medicalize analysis or become paralyzed by fear of harm. But if you recognize the mediating position, you can think more clearly about responsibility without inflating it. Responsibility here isn’t about guaranteeing outcomes. It’s about sustaining the conditions under which something can happen. That also changes how we think about training. If we’re clear that analysts aren’t producing effects in the same way doctors do, then defining analytic work doesn’t necessarily mean creating rigid norms or protocols.

It means identifying what must not be eliminated: time, continuity, the possibility of speech, the analyst’s relative independence from institutional imperatives. If those conditions disappear, then whatever remains might still look like care, or therapy, or support—but it’s no longer analysis. And if we don’t clarify this, we won’t be able to support new analytic practices emerging under different social conditions. We’ll just reject them instinctively, often on class grounds, even if we pretend the objection is technical.

That’s why I don’t think the appearance of churches, online courses, or unconventional training routes is the real problem. They’re symptoms of a transformation that was already overdue. The real problem is our inability to articulate what we’re defending and why. Without that clarity, we can’t distinguish between degradation and transformation.