Politics and Religion: Revisiting Psychotherapy’s Third Rail

People feel satisfaction when they are competently engaged in activities in ways that reflect their intrinsic values. Seeking help in understanding the dilemma Dr. James faced, I consulted the late Anthony Putman, a former colleague in the descriptive psychology community (4, 5). Putman thought that satisfaction becomes especially profound—what he called “ultimate satisfaction” (6)—when it involves the immediate experience of participating in activities in ways that reflect a person’s worldview. Naturally, this perspective includes one’s place in that world. At these moments of belonging, people feel cohesive, authentic, and sound. The corresponding elation and vitality become desire or, if appraised pejoratively, addiction. Once found, ultimate satisfaction is hard to relinquish.

This satisfaction requires a community that facilitates the expression of a person’s intrinsic values. Religions and political movements provide this space. Putman wrote (personal communication, March 14, 2016):

Bob’s a good example of how pathology is understood through the lens of status and world. Bob seems to be suffering from status degradation [5, 7] in his own mind and, he believes, in others’. He wants to be eligible with the attractive classmate but knows he is not; he doesn’t have the resources and opportunities others do. He can either see that as his own failure (depression) or as an unfair provocation (anger).

Bob clearly does not experience ultimate satisfaction in his world. Then he goes to the Trump rally and finds a community whose world makes sense to him. He participates in it and experiences elation. “Finally, I can be me and say what I think, and it fits here!” Good luck prying Bob away from his new world.

Dr. James must choose between being a therapist for Bob as he is or sticking to his own political/religious guns. I suggest that the latter is unprofessional and unethical. Dr. James has no play here unless he genuinely gets Bob’s world and recognizes the core therapeutic issue: Bob ordinarily lives in a world with no authentic place for him. He needs a world that does—and that’s the core issue of his therapy. Dr. James has a core dilemma in doing therapy with Bob: “What am I doing by doing that?” The canonical answer is helping [the] client live an authentic, satisfying life. But of course, he may also say, “Helping a budding fascist realize his full potential.” Therapeutic ethics say the first trumps everything else—but therapists are people, living their own lives. What is right for James may appropriately override what’s right for Dr. James. Hard choice, made, as all choices, in the light of incomplete information—but that’s life as an adult.

I think Putman captured the central dilemmas. Bob ordinarily lived in a world with no authentic, satisfying place for him and needed a world with such a space.

Can therapy provide space where participation is authentically satisfying? This space requires establishing a significantly valued relationship, which must happen before political or religious acts or beliefs can be examined.

How can therapy be authentically satisfying? When I asked this question in my supervision seminar, maintaining empathy was the first answer. Some trainees wondered whether it would be proper to ask, How do you imagine I am feeling about what you are saying? However, because this question might provoke troublesome defensiveness, a safer route might involve asking Bob how other significant figures in his life might feel about his words.

Psychotherapy requires tolerant and uncertain negotiation, with the therapist empathically attending the unfolding improvisation. One way or another, therapy will involve the therapist’s professional and personal values. This happens silently and out loud. With their careful attention, kindness, and appreciation, therapists demonstrate and model their deeply held values. But something also needs to change in ways that help the client progress. That is why clients attend treatment. They need acceptance, but something about them or something they are doing also needs to be addressed. Redescription, interpretation, and tactful confrontation serve this purpose, which is where the question, How do you imagine I [or significant others] feel …? might be useful. Appropriate functioning requires understanding that everyone stands at the center of their own world. Too often, clients do not adequately keep this in mind.

Therapists who acquire trust, show fair-mindedness, and demonstrate an accurate appreciation of their client’s experience are in a position to employ redescription, interpretation, and empathic confrontation. Still, how does a therapist handle Bob’s racist epithet and his joy of participating in fascism? This question boils down to whether Bob can find an authentic place for himself as a participant in the tiny community he has with Dr. James. Here, the size of the community does not matter, but significance does. For this approach to work, Dr. James must be able to accredit and maintain Bob’s good standing within the dyad. They both must value belonging before their participation in negotiation and improvisation can allow the possibility of an alternative ultimate satisfaction.

Therapeutic improvisation requires openness and acceptance between the therapist and the client in order to tolerate the assimilation and accommodation that take people somewhere new and, likely, unanticipated. But consider the dilemma that occurs when one party brings to the improvisation an idea or behavior that is unacceptable to accommodate. Rather than immediately challenge, the therapist should pause, hold the idea a bit longer, look closely at it, and somehow indicate to the client, What do I do with this? I am reminded of the annoying but sometimes wise parental approach of indicating that a child’s behavior is bad without attributing essential badness to the child. This works when the child’s trust in being loved is securely intact. I sometimes remind students of the similarities between parenting and psychotherapy.

Dr. James was smart to recognize he needed a firm alliance with Bob before exploring Bob’s politics (assuming Dr. James had sufficient reason to do so). The outcome of such an exploration will always be uncertain, but if the relationship is significant and trusting, Bob can at least hear and consider Dr. James’s questions. Change can occur only when a client can safely consider another’s view and when the relationship with that person provides reason enough to do so.

Why touch the third rail in the first place? Why not stop with the principle that, to the extent that people can effectively engage in their communities, it is not the therapist’s job to judge? This principle, of course, is complicated by the overlaps and conflicts that naturally attend communities. All people are members of multiple communities: professional, ethnic, religious, recreational, and so on. Some people get along, and some are in intractable conflict.

A culture is an umbrella term that encompasses a multitude of communities. As a collective of communities, cultures have a stand-alone viability that covers the life spans of all members. Cultures differ regarding worldview, core values, and social practices (5). National societies often house a variety of cultures. Certain institutions, religion being a prime example, function as cultures when they provide a complete guide to proper and improper behavior—prescribing and prohibiting. Fundamentalist strains of Judaism, Christianity, and Islam offer and demand such total worldviews (8). Religion and authoritarian/totalitarian politics become sources of intractable conflict when their core values and practices are hostile toward other communities within shared cultures—people who otherwise appear to be neighbors. As Putman put it, “Participants in such disputes literally live in significantly different worlds. What ultimately keeps these worlds apart is what ultimately holds each one together” (6).

I suspect that many therapists are becoming uncomfortably acquainted with clients wedded to cultural communities whose values threaten cosmopolitan society. It is reasonable to think that we are living in a period of culture wars. Therapist-citizens who value diversity and are devoted to their client and to their community struggle here, but those struggles must be discussed to be overcome.

In the 1950s, the psychiatric anthropologist George Devereaux (9) wondered how to distinguish the normal from the abnormal in cultures and religions different from his own (6). He explored this question by observing the lives and spiritual practices of Mojave shamans. He noted that no ordinary Mojave would choose a shaman’s liminal and difficult path. Nonetheless, shamans occupy an important role in Mojave culture.

Devereux observed a pattern common in the developmental history of shamans: they offered shamanism as a cure. The Mojave recognized that it is unfortunate to “be disturbed,” but some people with certain disorders could enter the ranks of healers. Some forms of disorder can be shaped by ritual.

Devereux contrasted the shaman’s culturally syncretic disturbance, common in Mojave culture and guidable by the culture’s ritual options, with idiosyncratic disturbances that rendered an individual pathological, without a valued place in society. Likewise, politics and religion might provide a place to find satisfaction even for those who are disturbed, but only if the disturbance is sufficiently shared, valued, and addressed by the community. In such a situation, otherwise troubled people can engage in some of the valued practices of the community. However, what is valued in one community can be anathema to another.

In a cosmopolitan multicultural society, communities exist side by side, overlap, share, compete, and clash. Sometimes the values of one community require action against another. Ideally, these disagreements should be a matter for politics, not therapy. Not living in that ideal, people need to sort out disagreements the best way they can. I doubt that there is a fully satisfying solution. Because conflict comes with the therapeutic territory, it needs to be thought through and carefully addressed without knowing whether, when outside of the consulting room, Dr. James and Bob will act with indifference toward each other, forge an alliance, or go at each other’s throats.