The Myth of Politically Neutral Therapy
“The personal is political.” - Carol Hanisch, 1970
In this series, we will discuss the myth of politically neutral psychotherapy. In reality, every action has political weight, and therapists need to understand how their practices can reinforce or challenge the systemic injustices that lead to everyday suffering.
The privilege of dissociation
In graduate school, most counselors are taught that psychotherapy is not political and that a practitioner’s political beliefs should have no bearing on how they work with clients. At first glance, this seems true. It would not be helpful of me to lecture to my clients on who they should vote for or what tax policies are best for the community. I would not be an effective counselor if my goal was to infuse my clients with my opinions.
However, the familiar notion that mental health is separate from politics just isn’t true. Really, only highly privileged folks are able to think and feel that politics exist in a far-off land with little to no affect on their well-being. For the rest of us, political decisions affect us greatly. Changes in medical coverage affect whether some of us go bankrupt in order to pay for treatments. Changes in judiciary policy determine whether a family member who was incarcerated for a nonviolent crime will be able to be at home for Christmas. Changes in healthcare policy determine whether abortions or gender-affirming care are accessible. Changes in tax policy affect whether we lose out of a few thousand dollars that could have gone towards our families’ needs. Changes in administrations can affect whether we feel safe at all in this country. These things greatly impact our lives, our well-being, and our suffering. And, unfortunately, many of these changes happen because the rights, humanity, and dignity of whole populations are ignored.
The personal is political. Therapists know this well, especially if they work with low-income and marginalized populations. Every client we work with is affected by local, state, and national politics. Every conversation about stress, work, bills, or loans (just to name a few) is impacted by the political situation that the client exists in.
What would these conversations about the endless stress of debt, bills, inaccessible healthcare, inaccessible education, discrimination, low wages, and inequality look like in a world where racial, social, economic, and environmental justice were guiding political principles? How much would the mental health of low-income, marginalized populations improve if they were afforded upward mobility, equitable treatment, and freedom from wage-slavery? How many clients aren’t really “mentally ill,” they’re just being forced to endure political and economic abuse?
With respect to my professors and guides who were able to keep politics out of the counseling room, I don’t know what else to say to a client who suffers from outright injustice than:
You should not have to go through this. Let’s get connected with folks who are working to change it.
Political by default
There is no such thing as a politically neutral stance. To be apolitical is to tacitly endorse the current systems of power that you exist in. Therefore, even therapists in their supposedly apolitical roles must make intentional choices about how to address systemic injustices.
For those unconvinced, consider how therapists may reinforce the status quo when we treat mental health as an isolated variable that has nothing to do with the systems of power and oppression in our world. When we approach a client’s suffering over bills, wage slavery, and inequality with the mindset that they need to change their cognitions or behaviors, then we are doing little more than helping our clients to get better at enduring abuse. We may implicitly be helping them believe the lie that their suffering has nothing to do with their exploitation.
How would you help a client in an abusive relationship? Would you help resource them, give them relaxation techniques, check their cognitive distortions, and send them back to their abuser with more tolerance for abuse? Or, would you help them get out of the abusive situation?
How we work with a client (what we see as “dysfunctional,” what targets for change we identify, what we validate, etc.) will depend on our values and our read of whether our systems are just or unjust. So, we have to make a choice rather than try to remain apolitical: how do we deliver therapy in a way that works towards justice?
The CBT snake in the grass
While many conventional therapy modalities are helpful, and some may bolster a treatment plan, they may also neglect how our intense reactions to an unjust world are appropriate. Anger and sorrow are not merely symptoms of our cognitive distortions or our maladaptive behaviors; anger and sorrow can be profound and sacred indicators that something is wrong and needs to be changed. When we treat these as a mere symptoms of mental illness, we side with the powerful, whose power is contingent upon whole populations being dissociated from their intuitions and sense of justice.
To update psychotherapy in light of this, therapists must understand how our efforts reinforce or challenge the injustices that lead to suffering. In our next entry, we will talk about how therapy needs to be informed by critical theory, lest it becomes yet another tool of sustaining the status quo. From there, we will discuss how conventional tools of therapy can be paired with a larger vision of justice for the communities we work with.
