Social Class Divisions in the Consulting Room: A Theory of Psychosocial Class and Depression

Abstract

Social class, is one of the most confusing, complex and critical dynamics in modem life for individuals and groups. Overshadowed by ethnic and gender studies for the past twenty or thirty years, the subject deserves our renewed attention, especially as groups and societies struggle with rapidly changing economies and shifting resources. The topic, however, evokes various avoidant reactions such as `It has been thoroughly researched previously' or `Of course we understand how social class dynamics affect our patients', largely because we clinicians as a group (middle or upper-middle class, university-educated and equally dedicated to individual psychodynamics) are embedded within our own social class views, values, expectations and assumptions. This article redefines and renames social class for psychotherapy as psycho-social class; reviews the `social ranking' theory of depression for individuals; and proposes a new extension of social ranking theory to group behaviours in order to suggest new group therapy interventions that address social ranking dynamics of depression.