Why Therapy is Political

As you might imagine, I belong to quite a few therapist Facebook groups. Typically these groups are concerned with helping one another serve our clients and grow our businesses. Posts about trainings, referrals, words of encouragement and advice, and occasionally policy affecting our profession or our clients are common. Lately, the conversation has started to shift in almost all of those spaces, and an existing chasm has begun to dramatically widen, with therapists who believe “neutrality” is bound by our professional code of ethics on one side and those who feel that our code of ethics demands action in the face of injustice on the other. To be clear, these groups represent a variety of helping professions: licensed psychologists, licensed mental health counselors (the license I hold), licensed independent social workers, licensed professional counselors, etc. Licenses differ by type of training and state they are held in and have different codes of ethics but these are all “parallel professions” meaning, for the most part, we all do similar work in practice. 

A few months ago, I attended a conference where I happened to be seated next to a pre-licensed mental health counselor who shared that she was doing her post-masters training in a religious/Christian setting. I expressed interest and curiosity and asked how she would respond to a client that disclosed same-sex feelings or a desire to end a pregnancy. She stated that she would counsel them based on Christian teachings but ultimately respect their decision to live their life the way they saw fit. I couldn’t help but think how vulnerable we are in moments of great emotional distress, and how powerful an influence a counselor’s words might be in those moments, especially when claiming to be backed by the word of God. I shared that I believed there is an inherent power imbalance in the counseling relationship that I believe we have a duty to try and minimize. Uncovering and supporting our clients values, and allowing them to lead from a place of safety and empowerment, are critical elements of that work. (Quick note: this might sound heavy but it was a very light and collegiate conversation, we were dancing around things a bit, but she seemed like a very nice person and we were both working to find common ground.)

She took the position that the clients in religious counseling deliberately choose a Christian counselor and that was a shared value system from the start. Aside from that, she felt it was an ethical violation for a counselor to impose their values on their client in any way. (I thought this was a rather large loophole. I also highly doubted that all clients in religious counseling deliberately chose that setting given the lack of access to high quality therapy, geographically and financially, for a majority of Americans, and especially for children, whose parents often arrange counseling.) I wondered what we each meant by values. I argued that counselors are not blank slates, and I did not think sharing personal values necessarily equated to an ethical violation if it was done in the best interest of the client and reinforced the client’s ultimate authority over their life. 

Somehow this brought us to the topic of racism. I stated that I would not allow a client to use racist language in my sessions. She felt that was wrong, that I had an ethical duty not to “correct” or try to change my clients language which reflects their world view. I stated that first and foremost, my therapy room is a place that deeply respects the humanity of each and every person. I would not allow a client to use racist speech or derogatory slurs because that speech represents a form a violence and would diminish that safety. As we are all part of this human family, and our treatment of others often reflects beliefs about ourselves, I would consider racist language to be a form of self and collective harm. I explained that for some clients, such language has become so normalized, they have not been invited into spaces where the expectation to honor human dignity is higher. I found when I did encounter this issue, clients welcomed the opportunity to engage in more thoughtful, respectful dialogue around their experiences and beliefs.

Now I’m seeing the same sorts of conversations playing out all over social media. In response to trauma counselors naming and calling out the harm that is being caused, there are others who are saying they feel therapists should be apolitical in their role. They are arguing that social justice and activism have no place in the therapeutic space, and that counselors who are using their position to speak on the injustices happening around them are in violation of their ethics. I could not disagree more. Oppression, cruelty, injustice, violence, exploitation, and their supporting systems, all create massive psychological harm. We have a duty as therapists to acknowledge these forces and speak out against them. We can not help people heal when they are not safe. When we ignore abuse, especially when it comes from people in positions of power with such overwhelming influence over our lives, we run the risk of pathologizing normal and healthy and necessary for survival reactions to that abuse. This is the very harm we have a duty to protect against. Sadly, this harm has been perpetuated often by the “helping profession” and with tragic consequences. Consider lobotomies women were subjected to for depression (often resulting from oppression by the patriarchy or lack of access to support) or the eugenics origin of standardized testing. We have an obligation to learn from these atrocities and remain vigilant in ensuring our work does not continue to perpetuate harm. 

While cultural, political, religious and frankly all manner of issues frequently come up in therapy, my work with a particular client might almost never focus on the current political climate, or we might focus on it almost exclusively. My goal is to walk beside my client, with grounded and authentic presence wherever they choose to go, to inquire into their experience with openness, curiosity, and compassion, and offer honest feedback to help them develop greater insight, self-understanding, and self-love. I hope by offering such accompaniment, they internalize that relationship to more effectively befriend themselves, as healing is cyclical and they are bound to encounter new challenges in their life beyond our time together. 

The therapy room is a sacred place. I always marvel at how no matter who enters my therapy room, when I have the honor of hearing their story, their joys, their heartbreaks, their wishes, I can not help but feel in response deep admiration, empathy, and even love for them. We all want the same things, to be safe, to be loved, to feel connected to a sense of community and purpose, to protect and care for the people and make proud those that we love. What we are seeing play out in occupied cities like Minneapolis is causing individual and collective trauma that will reverberate throughout our country and world for generations. It hurts us all and we all have an obligation as therapists in particular to vigorously defend the freedom of every single person to exist in their wholeness without threat of violence or discrimination.