Politics and psychotherapy

“Hi all, been thinking about political content on this list-serve recently, especially after a member was recently rebuked for posting a link in support of Bernie Sanders. I asked administrators for the policy pertaining to such posts and saw in the supplied policy an item that asks members to refrain from making political endorsements.

Endorsements of what? I wondered, as the policy didn’t specify endorsement of individual candidates or campaigns, which appears to have been inferred. What about endorsement of political opinions, or of political realities (via presumed consensus), as they are implicitly described sometimes in this forum. For example, when members post articles about single payer/payor systems, or police brutality, or white privilege, the articles don’t so much endorse candidates or specific referendums, but they tend to presume consensus as to what our world is like. So, when clinicians speak of “bringing awareness” about a social condition, they are not inviting debate so much as asserting authority, more or less dispensing what they think are facts about a world situation.

This sets up a tricky situation for mental health professionals and for this list-serve. If we have clients who proclaim a mental health condition that is dominantly attributable to an external reality, such as a social condition or political situation, versus a greater weight of attention to an internal disorder, then the onus is upon us to become educated as to that external reality, (perhaps eschew focus upon internal pathology) to educate colleagues about that external reality, which in effect means we will be endorsing a social/political view, and instructing those who don’t appear to perceive the political reality, such as others on a list-serve.

In light of this, it seems arbitrary to censor endorsements of individuals or their campaigns–merely a rebuke of the unsubtle–when the infiltration of politics into our profession is another kind of reality.”

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That’s from a message I posted last week on an EBCAMFT list-serve. About the same time I fielded a compelling suggestion from a client who hadn’t read my post, to the effect that politics were a part of people’s lives and are therefore a valid topic for psychotherapy. Didn’t I agree? she more or less challenged. Sort of, I more or less replied, intrigued by her argument, but not wanting to study up on each political topic she seemed to want my interest in.

What’s most compelling is the idea that a person’s external reality, the community (or polis) in which people live, is inextricable from a person’s psychology, no less so than a person’s intimate relationships, or their unconscious functioning. I am reminded of a discussion some years back with a Mastersonian consultant, to whom I asked about the cultural lens within the Masterson model. It’s not there, she said, though I’m paraphrasing her. Indeed, it’s not explicit or otherwise clear, unless you comb through libraries worth of material, that the discipline of psychoanalysis has ever been influenced by cultural relativism, though it surely has by politics (think influence of two world wars on notions of death instinct and repetition compulsion).

However, I think the reverse is true. Take the concept of internalized oppression, for example. This idea, derived firstly from Sigmund Freud’s writings, latterly from object relations theory, holds that individuals formulate representations of self based upon what is introjected from caregivers. Thus, if a child is demeaned, he or she will formulate a negative experience of self and act accordingly. Cultural relativists simply take this principle and apply it to peoples, especially those marginalized. And so this is part of the individual’s experience, this attachment to a community, a system. Well, that’s a lot to fit in the room, at least.