What’s Politics Got to Do with Therapy?

Client: Sorry I was late. I just had to take a quick detour to the polling station.

Therapist: Oh, OK. How did that go? What did you vote?

Client: Ummm…

Therapist: It’s fine, you can talk about that kind of thing here. That’s what therapy is for.

Client: Well, um, I thought about it but decided like… with my husband. He votes Tory so I did too.

Therapist: Seriously! You voted Conservative!

Client: Yes.

Therapist: God, that’s awful. How could you? Don’t you realise that voting Conservative is going to make things worse for you and for everyone else. I thought you were trying to get better!

Client: Well I….

Therapist: Just… Let’s just forget it and get on with the session.

What does it mean to bring out the political dimensions of therapy? If your view is something like the above then it’s very, very wide of the mark. No therapist (I hope) would ever respond in the way above. It’s demeaning, patronising, leading… and about as far away as the kind of democratic stance that most politically-interested therapists would want to take as is imaginable.

Engaging with the political in therapy, then, isn’t about some kind of crass bludgeoning of clients with our own political views. It’s far more subtle, complex, and nuanced than that. So what is it, and why should therapists consider the political dimensions of their work?

First, our clients live in a political world. Whether we like it or not, politics is all around them. There’s the economy for starters, that we all live within; then there’s social and political problems that clients can face, like racism and disablism. And, of course, there’s our much wider ecological environment. All those things impact upon us: Clients get upset about the war in Ukraine, for instance, or their afraid of climate catastrophe, or they struggle against homophobia in their workplace. And to address such issues only as ‘intrapsychic’, internal problems (‘for instance, ‘You’re angry with Putin because you’re really angry with your father’) is to ignore and minimise the real ‘in-the-worldness’ of our clients’ problems. True, we may be more able to address intrapsychic problems in therapy than in-the-world ones, but that doesn’t mean it’s any less important to acknowledge the true situation that the client is living in and the roots of the problems that they’re facing. After all, so much of therapy is about helping clients to live authentically and honestly in their worlds.

Second, political issues seep into the therapeutic relationship. Supposing we are a white therapist working with a black client. We may not mean to be racist, but racist assumptions and biases can still creep into our work. Stereotypes are so prevalent in our society it would be amazing if we managed to avoid them altogether. So, for instance, if a black client is struggling to get work we might assume that is it because they are not well educated, or perhaps—even worse—we have internalised the stereotype about black people being lazy. Beating ourselves up about holding these stereotypes isn’t particularly helpful; but it is essential that we engage in a thorough examination about our beliefs and biases towards all marginalised groups—disabled people, Jews, lesbians, etcetera—just as we would about other aspects of our conscious and unconscious experiencing. Why? Because otherwise there is a terrible danger that we will inadvertently impose those stereotypes on our clients: hurting then, insulting them, and compounding the negative stereotypes that they will have already internalised as they grew up. That’s the opposite of a healing relationship and what we want to do as therapists.

Third, the whole counselling and psychotherapy profession is embedded in a political system: such as who pays us to work, how we get to train, what work we do. A few of us might live in a protective domain of private practice, but even that is affected by political factors: for instance, who gets to come and pay for our fees. If someone is unemployed, for instance, it might be much more difficult for them to have therapy with us than if they are a city banker. So recognising political factors is essential for how we think about the counselling and psychotherapy profession, and how we act as members of national organisations like the BACP and NCS to make the profession as good as it can be.

All this really leads up to a final point, which is that thinking about political issues is just a natural extension of what we do as therapist. As therapists, we want people to thrive more, to live better, to live happier and more fulfilled lives. It’s the very raison d’etre of our work. And if we care about that, surely we also care about making a better world for everyone, and not just the specific individuals who we work with in the therapy room. Would we really want to see a world, for instance, where our individual clients were happier but everyone else was more miserable? I’m sure not. I think most of us come into the therapy professions because we care deeply for people’s wellbeing, and while we can only work with a certain amount of people, our care and concern goes beyond just those who come in to see us. So engaging with the political is a way of making those ripples spread outwards. Of seeing how our values, aims, and practices in the therapy room can then also be extended to the others that really matter to us.

What can we do? Well, exploring the interface between therapy and social change is one starting point, and this is what the new TaSC (Therapy and Social Change) Network is about. We are very far from having all the answers, but we want to try and forge a deeper understanding of the links between therapy and social change, including how therapists can make a positive difference to the wider world. And not being afraid of politics is also a really important starting point. ‘Politics’ is often a dirty word in therapy circles, perhaps because there are the fears of the kind of therapist-driven dogma illustrated above. But no one is talking about that: politics doesn’t mean giving our clients political leaflets or expecting them to come on marches with us! It’s about seeing us, and our relationship with our clients, as part of a wider world; and of seeing ourselves as part of a movement towards greater mental wellbeing for all.

Acknowledgements

Image by Tim Marshall at Unsplash.