How politics and social issues enter the therapeutic space

The therapeutic space – that sacrosanct time/place/confidential-conversation/unique relationship – is honored as a truly safe space in which a person can be open about his or her innermost feeling states, thoughts, urges, and history to both herself or himself as well as to another, the therapist. While a person may discuss their relationships and situations in their current lives, in other ways this space may seem cloistered away from the outside world. However, in times of severe external environmental disruption – whether on the personal level, or national or global level – it is only natural that events far removed from the patient’s personal past may inevitably become part of the therapeutic conversation.

Such are the times we live in. There are several crises facing the world at the moment – climate change, famine and starvation, movements of and refugee status of massive groups of people fleeing violence, war, poverty and starvation, the rise of nationalism and extremism to mention a few – and these are inevitably affecting the lives of people seeking therapy for other personal reasons. In my own practice, I am finding that such current crises as the separation of children from their parents at the American southern border,  can cause vicarious traumatization of many who are not directly affected. Approaching the anxiety, anger and sense of helplessness therapeutically may involve much more discussion and disclosure by the therapist of the shared external reality than ordinarily, as well as involve shared discussion as to possible actions that can be taken to help the situation, while bearing in mind the resonances the external situation may have with a patient’s own past.

Similarly, it is essential that those in the helping professionals use their expertise and voice to facilitate humanitarian and political responses to the crises. Such actions are occurring through many professional organizations. Psychiatrists, psychologists, social workers, lawyers are offering their services to assist children and families who have been detained, separated and threatened with deportation.