Treating Democracy Grief in Psychotherapy

A trauma therapist's insight on contemporary politics in the therapy session

Posted Dec 15, 2019

In an article in the New York Times on December 13, 2019,  Michelle Goldberg writes that “democracy grief is real.”  She says that while “the entire Trump presidency has been marked, for many of us…by anxiety and anger,” more recently there has been an increase in “a demoralizing degree of fear, even depression.”  

123rf 105996010 Katarzyna Bialasiewicz
Source: 123rf 105996010 Katarzyna Bialasiewicz

Like Britt Peterson noted this summer in an article in the Washingtonian, Goldberg tells us that therapists are seeing an increasing amount of psychological distress in certain groups of clients who are disturbed by the political climate created by the current president and his followers.  

Traditionally, therapists are supposed to take a neutral position about politics and strongly held beliefs so that we can help our clients find their way through their own values. Yet like the therapists that both Goldberg and Peterson interviewed, I find myself feeling more and more that my own values and related distress – as a liberal, white, older, Jewish woman – affect how I work as a psychotherapist. 

As a psychotherapist, I firmly believe in respecting my clients’ beliefs, even when they do not mesh with my own. I believe that my job is to help people who come to see me work through whatever is impeding their ability to live their lives as fully as possible, not to convince them to agree with me and my values. This isn’t, I will freely admit, always easy. Especially now, when even on New York’s mostly liberal Upper West Side I sometimes work with individuals who support at least some aspects of what the Trump administration stands for. 

Yet as a psychotherapist, my work often involves helping individuals whose lifestyle and value-system, as well as their life circumstances and experiences, are different from mine. 

Ms. Goldberg quotes Kimberly Grocher, a psychotherapist who is also a respected colleague of mine. She writes that Grocher, whose clients are primarily women of color, said that during her sessions the political situation “is always in the room.” Trump, she said, has made bigotry more open and acceptable, something her patients feel in their daily lives. “When you’re dealing with people of color’s mental health, systemic racism is a big part of that,” she said.

I am not a person of color nor, at least in New York city, a minority. Still, I understand that prejudice, whether racial, ethnic, religious, gender-related, education, or belief-system oriented, causes pain and suffering. I, like many, want to live in harmony with others, no matter what their religion, sexual or gender identity, ethnicity, race, or even financial situation says about the current administration’s attitude of hate and prejudice and bullying behavior. 

The question becomes: “How do I help someone manage their fear, anxiety, and despair during this time?” And, at the same time, there are other cases where I ask myself: how I can help those clients that accept at least some part of the belief system of the current administration when I am so opposed to it all?

This is, and at the same time it isn’t, a psychological issue.  But the answer to both parts of the question may be very similar. The psychoanalyst Larry Epstein once wrote about his work with a person who hated him – and who he hated in turn. The therapy was highly successful, which Epstein attributed in great part to the fact that he encouraged (well, actually pushed) the woman to talk about her hatred of him. 

My daughter-in-law, a former middle school teacher in a Title One school in the south, told her students: “Sometimes talking or saying things out loud helps you understand them better.” She has, over the years, received feedback that this statement changed their lives. This, I would suggest, is one of the most important things therapists can offer their clients these days. 

But there is more. I take great comfort from the words of Jonathan Foiles, a trauma therapist and colleague, in an article he wrote for Slate in June, 2018. He writes: 

"America has always been a contradiction in terms. The same man who wrote some of the most stirring words of the Declaration of Independence believed they only applied to white male property owners and was a slaveholder. The highest aspirations of our democracy have not been realized for most of our history; it is no aberration that the first black president was followed by the first white supremacist president. We must learn to see representative democracy not as something that was enacted with the Declaration of Independence or the Constitution, but a hope to which we have often aspired and seldom reached. This is meant not to spur us even further into despair but rather to reduce our own myopia and realize that our struggle is nothing new."

I believe that we have lost the capacity in this country to disagree with one another. In truth, we may have lost it long ago, if we ever actually had it. Some years ago a young French friend told me he was stunned that we Americans were so polite to one another. “You never seem to have passionate conversations. It’s so boring!”

I work hard to open up conversations with people whose beliefs are alien to my own and listen to what they believe and understand about why they believe these things. But I also ask that they listen to me in return. Even with clients, I have voiced my own thoughts and opinions, not with the intention of convincing them of anything new, but with the intention of keeping a conversation going.  Because I believe that within the conversation will be seeds of a connection – an "attachment," as the current psychological language likes to call it. And those seeds are what we need to grow a new kind of compromise in the world. 

Gone, then, is the Freudian non-speaking analyst, replaced by an individual who is interested in what her clients believe, but who is also willing, on occasion, to put out her own values and judgments. Again, this is not with the intention of changing a client’s mind, but with the intention of opening up a dialogue – a discussion – within the context of a relationship. 

Foile encourages his clients not to give up hope, but not to try to influence something they cannot actually control. He suggests we take action close to home. Again, he writes:

"Because of the sheer number of groups Trump threatens, chances are there is someone in your backyard who is more terrified than you are. Many of us are beginning to feel like we don’t recognize this country, but people of color and other minority groups have felt like that for most, if not all, of our country’s history. Now is the time to work together in solidarity with them and to open our eyes beyond our own experience. Find the refugees, the undocumented immigrants, the trans teen who needs someone to listen. Support them individually and partner with organizations that fight for their rights, whether it’s an immigrant rights group or your local LGBTQ center."

Although I imagine that Foile would agree that we must continue to fight for the values that we believe in, he also states definitively that he disagrees with the idea that democracy is dying and that we need to grieve its demise. He says that democracy, like life, is a work in progress.  And he encourages us to counter despair with hope – not with a false belief that “all will be well,” but with a belief that we can work at building a better future.

I would simply add that there is an important truth that many of us don’t want to look at here. Many of those who support our current administration have long felt that their voices were not being heard. For them, at the moment, democracy is working. To maintain hope, I do believe that all of us have to acknowledge that there is room for difference in democracy, even while we stand true to our own values. For me, at least, that also means finding a way to listen to and understand beliefs that don’t align with my own.

I believe that change occurs, always, within the context of relationships. Almost every form of psychotherapy involves some sort of an emotional connection between therapist and client. Within the context of the connection and the conversations that take place within it lies the key to change. I would go so far as to suggest that the same is true outside of therapy. Only by talking and listening to one another, not in changing minds, can we really hope to create change. Maybe we can even come up with a better version of democracy. 


Please note: I very much want to know your thoughts, reactions, and opinions, so please comment on this blog. You are also welcome to send me a message via my website, but please know that I am not always able to respond to those messages. You may actually get more useful feedback from other commenters. 


Epstein, L. (1977). The Therapeutic Function of Hate in the Countertransference. Contemp. Psychoanal., 13:442-460.

Foiles, J. This City Is Killing Me: Community Trauma and Toxic Stress in Urban America. Belt Publishing, Aug, 2019.

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