Political Therapy: When Your Client Talks Politics

Can’t you just feel the tension of this year’s political climate?

Look at you, reading a blog post about politics on a psychology website.

And who can blame you? Only about 24 million people may have tuned in to the live presidential debate between Clinton and Trump [1], but everyone is talking about it. With the presidential election coming up, you can bet your clipboard that your clients are going to bring this into session.

Most clinicians can agree that political conversations have little place in the therapy room. Angsting about presidential prospects and governmental goings-on appears to have limited healing power for our clients. Regardless, our clients continue to ask us where we stand on gun control, whether we are pro-life or pro-choice, and for whom we plan to vote.

So, what do we do when our clients want to talk politics?

Let’s break it down…

Rule #1: Set the Tone

Creating a space to talk about politics is the first, perhaps most important, condition for making political discussions therapeutic. Those of you familiar with the psychodynamic concept of “maintaining the frame” [2] might also recognize how critical this is as part of the therapy process.

Start by setting the frame for what political discussion in therapy might look like through the process of informed consent. In addition to the ethical guidelines for consent, you also need to clearly communicate what therapy is about, how people can benefit from therapy, and why therapy might be different than a relationship in “the real world.”

Q. What might that look like?

A. Here’s an example of something you could say:

“Sometimes you might come to therapy and talk about the news or politics, which is fine. However, I am more curious about how you think/feel about those topics than the topics themselves.”

Why it works: This communicates to the client that it is okay to talk freely about politics while also keeping in mind that the therapist might turn the discussion more inward.

Simple enough, right? Clear communication of the expectations for your sessions can help set the tone for building the therapeutic relationship. This brings us to the next rule…

Rule #2: Focus on the Relationship

Allow me to briefly preach to the choir.

The beginning stages of any relationship are formative. In therapy, building rapport is essential for fostering a strong therapeutic alliance [3]. Your ability to create a safe space and be a trustworthy person may also influence whether or not your client comes back for future sessions.

Let’s say your client comes in and immediately starts ranting about [insert controversial political issue here]. This might feel like a diversion or avoidance in therapy. Maybe your client is trying to break the tension by talking about safe topics. Or, maybe your client is telling you about their internal world using the only language available to them – political drama.

Depending on taste and theoretical orientation, some therapists choose to interrupt political conversations to conserve precious intervention time while others let the client lead the session.

I tend to lean towards giving the client the floor to talk about whatever they feel is important, particularly in those first few sessions. This can be a great way to build rapport with clients who feel ignored and unheard.

In general, clinicians should attune to the needs of their clients and weigh the costs and benefits of discussing political content.

Q. What are the potential costs of talking politics in therapy?

A. Here are a few examples:

• Clients may use politics as a way to avoid talking about “the real issues” they experience
• Clinicians may get pulled into a conversation that does not relate to the therapy goals
• Clients may leave feeling a lack of emotional connection with the therapist

Q. What are the potential benefits of talking politics in therapy?

A. Here are a few examples:

• Clients can express their feelings about politics in a safe, judgement-free space
• Clinicians can listen for themes in the content, such as loss, grief, or fear, that may represent a longstanding pattern in the client’s life
• Clinicians can use this as an opportunity to validate the client’s concerns and help them feel understood

Set the tone, attune to the needs of the client, and provide space for sharing or intervene when appropriate. So how do we intervene?

Rule # 3: Bring it Back to the Client

Let’s say the client has come to therapy and monologued about presidential nominees for the past two sessions. Your sense is that they are avoiding talking about deeper issues, and you feel the need to intervene.

I firmly believe that therapy should be the client’s time in the spotlight. Therapists might jump in with some self-disclosure or here-and-now processing, but the focus should always be on the client. In a way, talking about politics can make therapy less about the client. We can avoid making therapy about [insert politician]’s latest absurdity by bringing it back to the client.

I use “bring it back” very intentionally. Every opinion presented by the client is littered with emotional undertones that can bring you closer to entering their world.

The best way to use these opinions is to simply reflect the emotion and apply it to the client.

Here are a few examples:

Example #1:

“I can’t believe those people that support gun control. They just don’t want Americans to be able to defend themselves.”

Emotional undertones:

• Fear
• Vulnerability
• Frustration
• Feeling unsafe

Example reflection:

“I can hear how concerning that might be for you. I wonder if thinking about losing your firearms makes you feel [insert emotion].”

Example #2:

“Can you believe what [insert politician] said about [insert latest topic]? The nerve of that person!”

Emotional undertones:

• Anger
• Hurt
• Disgust
• Example reflection:

“It sounds like that made you feel [insert emotion]. I wonder if you’ve been feeling that a lot lately.”

Example #3:

“Global warming is going to kill us all. I can’t sleep at night because I’m constantly worried about pollution and melting icecaps. What should I do?”

Emotional undertones:

• Worry
• Possible guilt/shame
• Despair
• Example reflection:

“You seem to be really burdened by thinking about global warming. I wonder how this, plus your lack of sleep, is affecting your [presenting problem].”

Notice how each example reflection (although not perfect) is used to bring the conversation back to the client’s experience. This technique also models an introspective mindset for the client and can help spark insight and self-curiosity. I also use this type of reflection in fast-paced BHC work, where honing in on specific presenting issues is critical.

Bonus Tip: Stay Informed

Psychologists are really good about continued education when it comes to updated research, therapy, assessment, and consultation practices. However, sometimes we aren’t as good about keeping up with the political climate.

Although familiarity with Trump or Clinton’s international trade policy is arguably less important in our everyday work than knowing the latest research about trauma and immigration, staying informed can help you engage with the clients who bring this up in therapy.

A simple way to do that is to check out a “What you need to know for Monday” news article before you start your work week. In addition to the biggest political stories, you can also stay up to date on major events across the globe.

Do you have other tips on staying up-to-date or advice on how you handle political discussions in therapy? Share them with the Time2Track community in the comments below!

References

[1] 24 Million Watched the Presidential Debate: Neilson. (2016). Yahoo News. Retrieved from https://www.yahoo.com/news/massive-viewer-numbers-us-presidential-debate-fox-190446396.html?ref=gs [2] Langs, R. J. (1978) Technique in Transition. New York: Jason Aronson, 24, 26.[3] Leach, M. J. (2005). Rapport: a key to treatment success. Complementary Therapies in Clinical Practice, 11(4), 262-265.

Images via Joseph Sohm / Shutterstock.com & Trevor Collens / Shutterstock.com