Community Paper

Thirty years of a proud link with Prof. Leslie Swartz

Valerie Sinason

Received: 20 Feb. 2025; Accepted: 23 May 2025; Published: 30 Nov. 2025

Copyright: © 2025. The Author(s). Licensee: AOSIS.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

On 09 August 1993, over 30 years ago, I and my colleagues were excited when I received a fax from Professor Leslie Swartz, Director of the University of Cape Town (UCT) Child Guidance Clinic. I was 47 years old at that moment and a Consultant Child Psychotherapist at the Tavistock Clinic in London where I ran what was then known as the Mental Handicap Workshop. Terms used for intellectual disability change every few years in countries all around the world. It is when a subject is unbearable that there is pressure for a change of terms in the hope that the new words will bring progress with them. I was part of a very small, passionate and active international group of professionals who were pioneering psychoanalytic psychotherapy for children and adults with an intellectual disability.

Although our small group had psychoanalytic training and understanding, we were open to and inspired by all work which focussed on the rights of children and adults with an intellectual disability to be heard and enabled. It was also 2 years after my book Mental handicap and the human condition; New approaches from the Tavistock (Sinason, 1992) was published by Free Association Books in the UK and usefully became an extra international contact point for those involved in this work, with Sweden being the first country to approach us. Slowly we had contact with other countries in Scandinavia and the next change happened, thanks to the Belgian psychoanalyst Johan de Groeuf. Through him, we were able to add a further handful of passionate practitioners from France, Germany, the Netherlands, Greece and Italy. All together we only amounted to 30 or so people who met yearly and we worked hard at producing books and papers and conferences.

We had not had any contact with Africa. At that stage, 35 years ago and just before Nelson Mandela’s release from prison, there was little concept of people with an intellectual disability being able to make use of any treatment, let alone a talking treatment.

So, the fax from Professor Swartz stating that he, Professor Chris Molteno, and Trevor Lubbe (a South African child psychotherapist now sadly dead) were seeking British Council funding for me to come and give lectures on abuse and disability was profoundly meaningful. He added ‘many of us (including me) are very excited by your work and are most keen to have the benefit of your input here’.

The funding was agreed and my first visit was a life-changer. Whatever it was I had the honour of imparting, I received back tenfold. Such powerful and moving lessons were learned by me under the rigorous, compassionate, loving, decolonial and non-hierarchic umbrella of Leslie Swartz. He was and is a powerhouse of energy, kindness, strategy, person-centred relationships and brilliance. A very rare combination.

Indeed, I felt such energy and joy in my visits that the numbers of events I could take part in increased each year. For my second year, historically just after the release of Nelson Mandela, Leslie pointed out that the 48 engagements I had carried out amounted to two years of lectures. The second-year visit melted into the third-year one and each year my holiday break was spent in South Africa until the coronavirus disease 2019 (COVID-19) pandemic and my husband’s illness, stopped my travelling. My South African ‘professional’ family and I have now known each other for 30 years and I remain deeply impacted by the remarkable work going on there.

For the first report I was asked to write to the British Council. I could say that under the leadership of Professor Swartz the Cape Town Child Guidance Clinic was outstanding for its leadership, its highly skilled and dedicated senior staff and deep personal and professional community commitment. It offers an unrivalled training for the small number of high calibre postgraduate students it can take on. It provides work placements and supervision that will ensure South Africa gains the clinicians it has desperate need of as well as strengthening community resources. Clinic staff had an anti-apartheid ethos and vision long before it was politically safe to do so and this showed in the attention given to multi-cultural work. Respect for the intolerable living conditions people faced in the townships did not turn into a ‘soft’ acceptance of abusive structures.

My father, the late and deeply missed Professor Stanley Solomon Segal (OBE), who was the reason children with disabilities went to school instead of hospital in England, was so moved by the work the University of Cape Town Child Guidance Clinic did that he discussed their work with his organisation, The Council for Special Education, which awarded Leslie and the Clinic an international award for the fine work done. My colleagues and I all realised from the very start that we were being privileged in the contact being made.

Leslie made sure that I provided supervision and teaching each year for the postgraduate students so that they had an update on psychoanalytically informed work for individuals and groups of patients who were abusive victims and lived with intellectual divisibility, whatever their previous theoretical background. In fact, when I look at the huge range of talks, consultations, supervisions and conferences I took part in over 30 years, you can see the brain and heart of Leslie Swartz behind it all. We shared a view that whatever our own theoretical and professional allegiances were, they were secondary to the wider needs of children and adults who had been stigmatised and unheard.

As a yearly resource, Leslie generously arranged for other groups to meet me, all united by our determination to provide better resources for this group of citizens. However, although I had the honour of working in so many hospitals, universities, clinics, townships and with organisations and individuals who cared about abuse and disability, it was the UCT Child Guidance Clinic that remained my first port of call and I was thrilled to be made an Hon Consultant Psychotherapist.

What I learned from Leslie at the same time was a decolonial way of teaching. Students who visited townships had the instructions to find out what help might be useful for the individuals and groups bravely trying to create grassroots help with poverty, domestic abuse, alcoholism, and rape. There was never any imposition of a ‘You need this and you don’t need that’. I was profoundly moved and impressed and took this back to the UK. It was of no surprise that Leslie had also taught his reception staff to say hello in Xhosa and made the clinic as welcoming as possible for all. Later, he completed university courses in Zulu.

In the first meetings between clinic staff and township groups, Leslie and his staff had a range of ice-breaking exercises to both enable the students to understand environmental differences, levels of inequality as well as to introduce themselves in a meaningful way. I recall one particular introductory exercise that had a powerful impact on me and the students. It was an apparently simple introductory exercise. Each individual in turn had to begin with the following words and complete the sentence ‘To get here this morning I had to …’ I will never forget how it could unpack in shocking moments the difference between lives (using pseudonyms for each participant):

One student said sweetly:

‘My name is Mary [a pseudonym] and to get here today I tidied my bedroom first, had a mug of coffee and put my childhood teddy on an armchair.’ (Mary, 22, female)

Another young woman of about the same age from the township said:

‘My name is Ola and to get here I had to get through the taxi wars and leave my baby with my mother in Transkei. I hope she is safe. I hope I can travel back safely.’ (Ola, 24, female)

Leslie not only absorbed the key psychoanalytic concepts around intellectual disability with great ease, he put different issues of inclusion into effect by employing a lecturer and group therapist with a visual disability, Professor Brian Watermeyer, now a leading international figure in this field. This brought issues of disability right to the front. Another key colleague of Leslie, Dr Bev Dickman, taught prosecutors how to work with people with an intellectual disability so that Cape Town had a much higher level of success in prosecuting perpetrators of abuse of people with an intellectual disability than the UK.

It is hard to convey how Professor Swartz stood for rigour and the highest level of research presentation, writing and thinking and yet at the same time had humour, compassion and an attachment-based way of learning, teaching and being. His moral compass was impeccable and he managed to deal with the harsh external inequalities while never underestimating what could be done internally either.

If I was shocked by the brilliance of the work going on, he was shocked by the praise I expressed. He made it clear in those first post-Mandela years that some white visitors to South Africa came in a patronising way, under the idea that they were educating the poor clinicians who did not have access to the latest thinking and then behaved in quite an authoritarian way. He and his colleagues had not only had to initially contend with unequal and poor resources, then at the University of Cape Town, but also ‘help’ that was unhelpful. However, the opening of borders with Mandela’s presidency meant the gifts in South African teaching could be shared with and acknowledged by ‘the wider world’. I was proud to be a part of that. When IASSID, the International Association for the Scientific Study of Mental Deficiency held its 13th world conference in South Africa, I was thrilled to curate a ‘Learning from Cape Town’ evening.

The five presentations at the evening included Professor Leslie Swartz, who was then Head of the Psychology Dept at Stellenbosch University and working through partnership with the Southern African Federation on Disability (SAFOD). The others, all met through my work with Leslie, were Nokuthula Shabalala, Bev Dickman, Susan Manson, Janine Hundermark and Gill Douglas, and, of course, Brian Watermeyer who considered the many themes and dynamics around physical and learning disability from the position of dealing with his own visual disability.

A gift from Leslie is the equal two-way process with which he approaches all relationships. From his own life and his disability work he had a deep awareness of the negative power of shame in people’s lives. This shame came from feelings of being negatively stigmatised through difference, whether over cognitive, physical, emotional, religious, racial or sexual difference. Leslie had a strong desire to lessen this toxicity in everyone he met.

Having recognised Brian Watermeyer’s gift at honing his own lived experience at a time when the term ‘lived experience’ was in its infancy, he then himself wrote about the impact of his father’s disability and then his mother’s illness and dying. In typical fashion, his perfectionism meant that his memoir of his mother’s life was done through a PhD. It was in 2020 he gained a PhD in English studies at Stellanbosch University. His dissertation memoir ‘How I lost my mother, a story of Life, Care and Dying’, 30 years after his first PhD. It was published in 2021 by Wits University Press. It included the socio-political aspects of care with a privileged white woman being cared for by a poor black woman as part of the personal memoir.

At a time when internationally we have been disappointed in the private behaviour of leading figures it is also a tribute to Leslie that he is the same consistent person personally and professionally, in his academic writing and his personal writing.

Those of us who were first reached out to by Leslie in his wish to aid his country to the best he could, now watch in amazement at how his work has extended across Africa, United Nations, America and Europe with research, papers, thriving students and colleagues way beyond our initial European horizons.

‘So there are ants on my computer! This is Africa’ he would smile and every situation, literal and symbolic, would receive that benign acceptance. ‘Shame!’, he would add, with a warm smile that de-shames everyone.

Acknowledgements

The author declares that no financial or personal relationships inappropriately influenced the writing of this article.

V.S. is the sole author of this research article.

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Data sharing is not applicable to this article as no new data were created or analysed in this study.

The views and opinions expressed in this article are those of the author and are the product of professional research. They do not necessarily reflect the official policy or position of any affiliated institution, funder, agency, or that of the publisher. The author is responsible for this article’s results, findings, and content.

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