Clinicians see politics entering the therapy room
If you are feeling more anxious about politics and the state of the world today, you are not alone.
According to the American Psychological Society’s 2024 Stress in America study, 77% of US adults reported that “the future of our nation” was causing them significant stress. The economy was a problem for 73% and the 2024 elections for 69%. In comparison, the 2014 study listed money (64%), work (60%), family responsibilities (47%) and health concerns (46%) as the top four sources of stress.
“People are feeling the impact of government policies, worrying about losing their jobs, if they will be able to buy a home,” said Elisa Bronfman, Ph.D., a clinician and assistant professor at Harvard Medical School. “There is a sense of hopelessness.”
In a published essay, Bronfman and Johanna D. Sagarin, Ph.D., clinician and assistant professor of practice at Assumption University, wrote about ways the current political polarization has affected their relationships with patients.
In their weekly consultation talks, Bronfman and Sagarin realized they were experiencing similar trends—a shift in the way politics has entered the therapy room
Issues include people relishing the downfall of the “other side,” patients demanding to know the therapist’s political leanings, and parents asking if their troubled child would grow up to be like one politician or another.
“It got us thinking, said Bronfman. “We were noticing these trends, but no one seemed to be talking about them.”
Between extreme political polarization, fears of economic collapse, social media’s daily presentation of real-life horror stories, and more, people are struggling to stay engaged but not to be dragged under.
Bronfman said a lot of patients are worried about the world. “It is hard to keep living and pretending things are okay. We have talked about how remaining functional is a political action, too. Going to work, taking care of yourself, that is also political action.”
Being bombarded by negative news, patients have trouble moving forward in their own lives. There can be a sense of guilt when they are not in a dangerous situation but know that others are, Sagarin said.
“We have had conversations about living life on two levels,” said Sagarin. “It’s about allowing oneself to feel okay, while recognizing that there are things that you need to respond to.”
In therapy, they have found that CBT techniques can help. But, there is only so much reframing that can be done when the fears are based on real life events.
“People are coming in just distraught over what is happening,” said Sagarin. “We can’t really talk about how this may be distorted. These are real things.”
It is important to help people sort out their values and define what it means to live a good life in the world today, she said.
“We are teasing it apart to help the patient identify what is important to them and what they can do about it,” said Sagarin. “This is not about getting comfortable with what is happening if it is antithetical to your values.”
Therapists, of course, also need to sort out how to live in today’s political climate.
Practicing self-care, taking time off, monitoring news intake, seeking consultation, or doing concrete actions in an unsettled world are all prescriptive to being able to continue caring for others.
“A lot of people, including therapists, are a little exhausted by this combination of the pandemic and political anxiety,” Bronfman said. “So, as therapists, it is also important to ‘walk the walk, talk the talk.’”
And, while a patient may demand that a clinician has the same political leanings, the same does not typically work the other way around. It is important to accept not always aligning politically with clients, but realize your job remains the same.
“I have worked with many people who have different beliefs about the world and unless they are harmful in some way, I try to support them to be their best self,” said Bronfman. “Unless there is something dangerous going on, our mission is to help them with their mental health.”