FAQ for Therapists – Citizen Therapists for Democracy

Common Questions and Concerns

I’m intrigued but I’m very nervous to mix politics with my therapist hat.

It all depends on what is meant by politics. If it’s partisan politics (vote for my candidate or party), then it doesn’t have a place in therapy. But if politics broadly means how people with different views figure out how to live together and govern themselves—and then the policies that emerge from this process—then it’s game for conversation in therapy. (Example: clients are affected bv the politics of health care and might benefit from discussing it and figuring out how to respond to it.) Having said that, we generally prefer to use the term “public issues” rather than “politics” because the latter is so often construed as partisan. (It’s hard to fight common word meanings.) So let’s frame your concern as mixing clients’ public stresses and concerns with their personal stresses and concerns. If that makes still you nervous, then Citizen Therapists for Democracy may not be right for you.

Doesn’t this cross a line between professional work and private, political work?

See the previous answer about the meaning of politics.

As professionals, we are entrusted with promoting the public good, and in the case of therapists, public mental health in particular. That’s why society allows professions to self-regulate, for example, by setting entry criteria and ethics codes, and kicking people out who stop meeting our standards. If fact, health professionals are supposed to promote public health even if that means less business for them: think fluoride in the water and less sodium in fast food. So, a professional therapist is supposed to be concerned with more than his/her individual clients, and this can mean engaging in the public (political) work of policy and disagreement.

To be quite concrete, if you treat anxious or depressed Latino or Muslim clients who are frightened about Trumpism (and anti-Semitism is on the rise), is your job only to treat their symptoms or to also oppose the public xenophobia? We believe the nature of our work inherently combines public and private.

At the level of conversations with clients, we think that the line between the public and personal has been too broad, as if our clients live in a social bubble and should only talk about their micro world in our offices. The personal/public split is overdue for reconsideration in mainstream psychotherapy. (It’s been long abandoned by feminist and ethnic minority therapists who see the inherent connection between the public and the persona.) The challenge is how to do this integrative work in an ethical way that respects client autonomy and employs all the skills we’ve learned as therapists, plus some new ones.

Okay, but why a visible, collective effort by therapists? It could create a backlash against therapists. Why not each of us doing what we can locally?

Keep in mind that Citizen Therapists for Democracy is not an “anti” movement. We are promoting democracy and public mental health, and in those contexts will oppose threats from any quarter. Further, there is collective power when members of a healing profession engage the public domain in their role as professionals. The media also take note when professionals work together. For example, therapists all over the country doing “political stress teach-in” is a lot for impactful (and media friendly) than an individual doing this work locally. Having said that, we think that local is where the action will be for Citizen Therapists for Democracy. We want to activate that action and spread what’s learned there.

What about the power imbalance in therapy? Therapists should be a blank slate in terms of public and political values less their clients be pulled in a political direction.

This is a key issues we have to be very attentive to. Respect for the client’s autonomy and boundaries are central values in psychotherapy. Having said that, therapists don’t “de-skill” themselves when they become citizen therapists, and the dangers of too much influence are probably not any worse in public issues than in personal ones.

On the matter of the blank slate, it’s really a myth in therapy. If a client learns that his/her therapist is in an organization that opposes aspects of Trumpism, well, that’s probably not going to be such a big surprise based on lots of assumptions the client has already made (you drive a Prius and have the New Yorker magazine in the waiting room). In the same way, if a client worries out loud about family members being rounded up and deported, and the therapist agrees that this is a scary public policy, is this not a validation rather than a misuse of therapist power?

How is Citizen Therapists for Democracy different from Citizen Therapists Against Trumpism?

For starters, Citizen Therapists Against Trumpism was not an ”organization” with members and a budget. It was a manifesto and a Facebook group community.

After the election, the question was “What next,” now that Trump was going to be the President. After consulting with colleagues, Bill Doherty decided that a membership organization, with annual dues, was needed to expand the work and make it sustainable. He also decided to go beyond the “anti-Trumpism” goal to get at the seeds of social dislocation that had fed Trumpism, and to encourage therapists to be agents of civic renewal. In fact, this was consistent with the manifesto which focused on what Trump stands for and represents—a social force that is happening around the world—than on the man himself and his candidacy.

Do I have to be a liberal Democrat to be part of Citizen Therapists for Democracy?

No. Some Republican, conservative, and libertarian therapists signed the manifesto because they opposed Trumpism, even though they were not supporters of Hillary Clinton and progressive Democrats. They are fully welcome in Citizen Therapists for Democracy. Having said this, no doubt most members will be on the progressive side of the political spectrum and very few Trump supporting therapists are likely to see the organization as a good fit, unless they have changed their minds since the election.

What about international members? They were not allowed to sign the anti-Trumpism manifesto.

Only U.S. therapist could sign the manifesto in order to avoid pushback that a lot of “foreigners” had signed (presumably because they didn’t want to make America great again). The new organization welcomes therapists from outside the U.S. because the threats to democracy are international, along with the need for therapists to respond. Having said this, we hope that international therapists will be patient with the inevitable American-centric tone because the vast majority of members will likely be Americans and because the Trump Effect is so strong in the U.S. We will do our best to learn from our international members and to contribute to their development as citizen therapists.

Why does Citizen Therapists for Democracy de-emphasize the personality of Donald Trump? Couldn’t a good case be made for him having a personality disorder, which would seem to be in the purview of mental health professionals?

This is a strategy issue, not a “truth” issue (does he have a disorder) or an ethical issue (the “Goldwater Rule” from the American Psychiatric Association). The social forces that allowed Donald Trump the man to become President, and that are rising around the world, are so much bigger than his personality that focusing on a diagnosis risks marginalizing the contributions of therapists. Once mental health professionals took a diagnostic position during the campaign, that’s all the media wanted to know from them—before the media moved on to more interesting topics. Furthermore, arguing about a mental health diagnosis for a public figure risks “weaponizing” diagnosis and inviting others to use it less responsibly in the future, with every candidate for President being subjected to “partisan diagnosis.”