Political Division Is Damaging Therapeutic Alliances

Political discourse has entered therapy sessions in ways that can become toxic for patients. When therapists do not maintain strong boundaries around political discussion, patients can feel judged and criticized. Intense disagreements about geopolitical events, including the Israeli-Palestinian conflict, can lead to sudden ruptures of long-term, carefully nurtured treatments. Patients may feel devastated about harm to people they feel connected to, and they can experience therapist expressions of disgust or apathy as boundary violations. Such violations can cause real trauma, prompting some patients to abruptly terminate treatment. A strong therapeutic alliance and firm boundaries are presented as critical for treatment success, including the idea of therapist neutrality and concealment of personal beliefs to help patients access their own thoughts and feelings.

"In recent months, I have heard of many instances in which therapeutic boundaries were crossed during discussions of geopolitical events. A particularly charged current schism involves opposing stances between patients and therapists on the Israeli-Palestinian conflict. Both patients and therapists feel passionately about issues pertaining to Gaza, Israel, Zionism, racism and genocide. To the detriment of patients, this has led to the sudden rupture of long-term, thoughtfully nurtured treatments."

"Instead of therapy being a supportive refuge where individuals can process intense and painful feelings, it has become for some a place where patients feel judged and criticized. Many patients are devastated about what has happened to people with whom they feel a sense of belonging and connection. When therapists abandon their neutrality with expressions of disgust or apathy toward a patient, this is a boundary violation. Such violations cause real harm to patients."

"Some patients who have experienced this antipathy from therapists have abruptly terminated treatment, feeling traumatized and betrayed. A strong therapeutic alliance and firm boundaries are critical for the success of treatment. In 1912, Freud adopted John Locke's concept of tabula rasa or "blank slate" as a central therapeutic technique. Freud recommended that therapists purposefully conceal details about their own lives and beliefs in order to facilitate patients' access to their own thoughts, feelings, and memories."

"This also allowed therapists to listen more objectively and absorb important details and nuances. Although traditional Freudian analysis has large"

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