Many of us, deeply troubled by the uncertain political future of this country (or by other social stressors, like the environmental crisis), don’t know where to get relief from our suffering. Some work on acceptance, or emotional regulation, or rely on medication. Others may find talk therapy helpful in altering negative thought patterns. But what if these approaches are only partially successful, or merely address the surface symptoms?
Psychotherapy presents itself as a treatment that reaches deeper into the core causes of our psychological struggles, but is it really suited to dealing with political and social stressors?
The history of psychoanalysis as apolitical
People tend to think of psychotherapy as a treatment geared towards personal problems and internal conflicts—and for good reason. When Freud first created the field, he focused on the nuclear family rather than on society more broadly, and his concern was with anxiety aroused by conflicts between our unconscious drives and the forces of repression that forbid their expression. For Freud, psychic distress arose out of an internal crisis around who we are and who we want to be.
Today, following Freud, we still tend to define anxiety as an internal condition, often persistent and free-floating, in contrast to stress, which is understood as a reaction to external events. Anxiety we can work on by looking inward, but what, other than finding coping mechanisms to deal with them, are we do about events beyond our control?
If the trouble lies outside of us, how can psychotherapy help?
First, it’s important to note that psychotherapy has changed a lot since Freud’s day, and one of the significant shifts has been toward acknowledging that social factors are hugely important in psychic development and mental health.
That said, even Freud, who lived through both World Wars, had to make room in his theories for the effects of traumatic political events. After meeting with soldiers suffering from recurrent nightmares of the battlefield, he altered his theories on dreams, and in his groundbreaking paper, Mourning and Melancholia, which set out his ideas on depression, his catalog of losses that could prompt the condition included socio-political crises, such as the loss of freedom or other ideals.
Certainly, Freud would have considered threats to democratic freedoms or the health of the planet plausible causes of psychic pain.
Contemporary psychoanalytic approaches to social stress
Today’s contemporary psychotherapists have gone even further. They tend to view Freud’s ideas through the lens of social relativism, as a product of his culture and era, and now consider the private and the social inseparably linked. In other words, not only are we all shaped by social norms and conditions, but our experience of social and political events is shaped by who we are.
How thinking of the political as personal impacts treatment
In working with people dealing with external stressors, during Covid, for instance, and now into election season, I always consider the unique ways in which circumstances we all share will land for us individually. Even if the painful or terrifying events lie outside of us, the pains and terrors they arouse in us will be defined by our personal histories, fears, and fantasies. Ultimately, they’ll track back to the unconscious, which lies at the center of so much psychoanalytic theory and practice.
To offer a few examples from the Covid crisis: a patient who was raised by a sick parent felt especially powerless and trapped during the pandemic. Another, who dealt with social anxiety, felt a degree of relief in isolation, and a third, who was generally anxious, actually grew calmer in the face of an external crisis that aligned with his catastrophic vision of reality.
Now, in the days leading up to the election, I observe how a patient raised by a domineering father is utterly panicked at the prospect of a Trump victory—as if this outcome will confirm her unconscious conviction that she’ll never be truly free. Another patient, who endured a difficult ideological and personal separation from her very religious family, is haunted by fears of a civil war—one which echoes her own internal division, and the pain of going against her own loved ones.
In working with such patients, I don’t expect to rid them completely of their concerns about the objective fate of the nation or the world, but I do aim to help them separate the facts from the sometimes distorted or exaggerated experience of them in fantasy. If, together, we can’t make reality more palatable, we can possibly transform it from a nightmare into mere bad news.