Supreme Injustice

It is early on a  Monday morning in the summer of 2022 after a weekend in which television news programs  and social media were relentlessly ruminating on the Unites States Supreme Court ruling of the Friday before. I open my Zoom window to start the session with my psychologically insightful and high achieving female patient. She is in her sixties and starts by sharing her reaction and associations to the Supreme Court taking away the constitutional right to abortion. This judicial decision abandons almost 50 years of precedent. It paves the way for at least 24 American states, possibly more, to ban reproductive rights.

My patient is outraged and in agony. Gone is her usual melodic voice. Once upon a time, she was a Catholic nun and a social progressive. She understood from working with young people, minorities, and people with limited incomes how disproportionality and violently oppressive laws against abortion can affect women. She is not familiar with Sándor Ferenczi’s 1929 essay on “the unwelcomed child,” or the relational ideas of Jessica Benjamin on maternal subjectivity and recognition, or sociological research. Yet, she has great compassion for others. It’s not a reaction-formation. It comes from a deep place in her heart. On a personal level, she is worried how her daughter-in-law’s body and family might be affected by the long reach of the government. She is incredulous at the glibness of the supporters of the new ruling and their perverted religious arguments in support of the Supreme Court. “How could they be so idiotic and callous!“, she says. From my perspective as her analyst, her reactions are additional evidence of how culture and society saturates individual subjectivity.

On a daily basis, women face many complex decisions. In our modern world, they can face the decision of whether or not to terminate crisis pregnancies they did not plan, did not want or cannot continue for reasons ranging from desire to health concerns. The decisions often take on violent dimensions when anti-abortionists or governments trample human rights. Accessing safe, legal abortion is a fundamental right. International human rights laws and treaties hold that denying women, girls, and pregnant trans people access to abortion is a form of discrimination and jeopardizes a range of health concerns. United Nations human rights committees regularly call for governments around the world to decriminalize abortion in all cases and to ensure access to safe, legal abortion in certain circumstances at least.

The 1948 Universal Declaration of Human Rights does not mention reproductive rights per se, but many of its sections are foundational to them. For example, Article 1 – the right to life, liberty, and security of person – supports proper pre- and postnatal care to reduce maternal and infant mortality, the freedom to choose whether and when to have children (and with whom), the right to live without fear of sexual (or other) violence, and the right to refuse medical or traditional treatments (e.g., hysterectomy, female genital cutting). Yet, many of the world’s women, including women in some developed Western nations, lack reproductive rights or have limited access to educational information and medical services they need to make decisions and thus exercise the rights their governments have guaranteed.  

The prestigious NGO Human Rights Watch holds that reproductive rights are human rights, including the right to access to abortion. States’ obligation to provide women, girls, and other pregnant people access to safe and legal abortion is part of their core human rights responsibilities. As Human Rights Watch has stated in amicus curiae briefs to high courts in countries around the world, international human rights law and relevant jurisprudence support the conclusion that decisions about abortion belong to a pregnant person alone, without interference or unreasonable restriction by the state or third parties. Their arguments have been received by the courts in many countries such as Brazil, Columbia, South Korea and most recently by partner organizations in the Unites States.

As I write, Indonesia's parliament has approved a new criminal code. This new code  bans anyone in the country from having extramarital sex. Sex outside marriage will carry a jail term of up to one year under the new laws, which will take effect in three years. Human rights groups say the new provisions will disproportionately impact women, LGBTQ people and ethnic minorities. The moral injury inflicted on women is immense. It’s highly likely that in the largest Muslim country in the world, abortion decisions will be affected by this criminal code. Naturally, it follows that all people of whatever gender and/or sexuality will lose their freedoms to one degree or another.

Psychoanalysts and psychoanalytic psychotherapists are familiar with the dilemmas inherent in the decision of whether or not to terminate crisis pregnancies. The decision is of the most intimate kind. It involves women’s bodies and is not an easy one. It involves the emotional and private lives of people. Depending on the culture and society of the women, it can be a highly conflictual, guilt-inducing, and shameful decision. Of course, clinicians must always be conscious of their own values and it goes without saying that they must be open to possible blind spots. But is there really an argument about the best way to protect autonomy, human rights and reduce maternal mortality and morbidity? In my opinion, morality and misogyny must be challenged.  

Psychoanalysis supports awareness of one’s inner world and its psychodynamics. It is about subjectivity in the context of self and other. In other words, it is about psychological liberation. Human rights support liberation from the other direction – the external, real world. They complement inner liberation. By extension, reproductive justice, including the right to abortion, is also about freedom. Any wrecking ball targeting this freedom is a supreme injustice.

Spyros D. Orfanos, PhD, ABPP, Director and Clinical Professor, New York University (NYU) Postdoctoral Program in Psychotherapy and Psychoanalysis; Senior Research Fellow Center for Byzantine and Modern Greek Studies, Queens College, City University of New York; Fellow of the American Psychological Association and past president of the Society of Psychoanalysis and Psychoanalytic Psychology (39) of the American Psychological Association (APA), the Academy of Psychoanalysis of the American Board of Professional Psychology (ABPP), and the International Association of Relational Psychoanalysis and Psychotherapy (IARPP). Dr. Orfanos practices psychoanalysis and psychotherapy, teaches, supervisors, and publishes internationally. In 2016, he co-editor the special supplement of Psychoanalytic Psychology (APA) on “Psychoanalysis and the Humanities.” In 2017, he founded the NYU Human Rights Work Group (HRWG) which he partnered with Physicians for Human Rights and the NYU School of Law. HRWG provides mental health services to asylum seekers, Guantánamo detainees, and Afghanistan university refugees and students trapped in Kabul. In addition, he is completing a series of psychoanalytic studies on the Greek composer and activist Mikis Theodorakis (1925-2021).