Why Therapy Can't Be Apolitical

Many of us were taught in our graduate therapy programs to be a tabula rasa – a blank canvas for our clients to project upon (Bergkamp et al., 2023). Historically, our profession has emphasized the importance of separating ourselves from our work as a means of preserving professional boundaries. But the therapeutic relationship is widely thought to be the most important factor in effective treatment. If that is true, how can therapists who hold politicized identities remain “blank slates” and still connect with their clients? Or vice versa – how can clients from marginalized groups feel safe when their therapist is walled off by the tabula rasa?



The seeds of psychotherapy were planted decades ago by highly educated white men. From Sigmund Freud’s psychoanalytic approach at the turn of the 20th century to Carl Rogers’ person-centered therapy in the 1940s, treatment was only accessible to people of considerable financial means. Early case studies centered on the experiences of wealthy white people, and over time, this narrow subset of data became the foundations of therapeutic modalities.



In fact, much of what we accept as fact in psychology has been decontextualized before being disseminated. A 2018 paper in the Journal of Clinical Psychology describes this phenomenon by saying that research on psychotherapeutic effectiveness is often published “without addressing the historical context and particular timing in which data were collected” (Solomonov & Barber). Going on to discuss trends in psychotherapy in a post-Trump United States, the authors suggest that without an understanding of the time, place, and political climate, our research is inconclusive (2018).



We can observe this trend in publications on the psychological implications of the COVID-19 pandemic, for example. While all living people were impacted in some way by the effects of the pandemic, some were affected more acutely than others. Take occupation, for example – the effects of the pandemic on healthcare workers are well-documented, but what about service industry workers? Restaurants were closed for months at a time, forcing workers into the impossible choice of whether to find work elsewhere, wait it out, or return to work in a potentially risky environment. The financial pressure alone might be enough to force someone’s hand. Without the lens of the social determinants of health – things like access to food, water, housing, and transportation – our answers to these questions are not as descriptive. Some may call this perspective too political or divisive, but it is undeniable that to create evidence-based practices and policies, we need to have a solid understanding of the problem at hand.



Applying this same logic to our clinical work, what happens in the therapy room may not be as effective if we remain politically neutral. From the client perspective, the therapeutic alliance is stronger when there is a perception of shared values, including politically (Solomonov & Barber, 2018). This builds trust and rapport, and suggests that if therapists are willing to self-disclose regarding political beliefs, their clients will benefit. Inversely, if we are rigid and impersonal, our clients will not likely respond with openness.



It is often said in the field of psychology that therapists serve as “mirrors” for our clients (Canant, 2017). We do so through techniques like reflecting, summarizing, paraphrasing, interpreting. Our aim may be to identify patterns, to offer an alternate perspective, or to create new insight. But another way we mirror clients is through our use of self – to “receive and reflect reality” (Canant, 2017). In this case, how can we act as a mirror if we are expected to remain opaque?



Though the origins of psychotherapy involve primarily white and wealthy practitioners and patients, our field is more diverse today than ever before. The American Psychological Association reports that in the 2021-22 academic year, 48 percent of master’s level psychology students and 46 percent of doctoral level students identified as non-white (Assefa et al., 2023). For some, knowing that a clinician has shared lived experience may create a feeling of safety. But research has shown that we do not need to perfectly reflect back our clients’ identities and experiences to be effective. While clients often have a preference for clinicians with shared identities to their own, this does not always equate to improved therapeutic outcomes (Cheng et al., 2021).



What is effective is a strong working alliance between therapist and client. This means fostering empathy, collaboration, and mutual trust – all of which may be compromised by remaining neutral regarding sociopolitical issues. Clients are naturally curious about us, as we are about them. Who are we voting for in the city council election? Do we have partners or families of our own? What music do we listen to on the drive home from work – and do our playlists reveal any clues to other parts of our personalities? As psychologist Suzanne Friedman (2015) wrote of her work in couples’ therapy in a piece for the Society for Advancement of Psychotherapy, “my willingness to relax boundaries…has helped [the client] to trust me.”



Asking therapists to obscure or deny their beliefs can also be damaging at times. A clinician who is asked to “stay out of politics” at work might then feel pushed to self-edit in small ways that lead to a lack of authenticity. This might look like removing a pride flag pin from their jacket or removing certain books from their shelves to avoid having to self-disclose about political beliefs or identity. By presenting as truly neutral or unreadable, we are not creating a blank slate for the client to project upon – we are creating a barrier around opportunities for understanding and connection.



Having authenticity as a therapist does not mean answering every question a client asks, or sharing copious information about our lives. But it does mean prioritizing what Carl Rogers referred to as congruence, defined as showing authenticity and being clear, direct and consistent in the therapy room (Kolden et al., 2010). Congruence means walking your talk, so to speak, as a method of showing that you are grounded in the same reality as the client, or that you are sharing an experience together. “I seek to create a connection in which both participants can be real with one another,” writes Friedman on the topic of authenticity (2015). This might look like sitting together in acknowledgement of the heaviness and grief you both feel after a mass shooting, or the anxiety and hopefulness of an approaching election day.



When it comes to political matters, congruence as a therapist does not mean mirroring everything your client feels, or sharing with them your every thought, but rather, letting them know that you are here with them. This connection is inarguably more valuable than any perfectly implemented intervention. The personal is political, after all.