When you look at the news, there’s pain and violence on every broadcast. But is this something we should help our clients process?
Patrick Dougherty would say yes. And he has some clear, helpful guidelines for how to bring up difficult and divisive political and social issues in therapy.
It’s one way we can help clients become more regulated and healthy as they interact and engage in their sphere of influence.
Patrick Dougherty, MA, LP, is a licensed psychologist, teacher, and author. He’s worked with collective trauma since shortly after serving with the Marines in Vietnam and working in Northern Ireland during The Troubles.
With all the upheaval in the world – from refugee and immigration issues, to mass shootings and terrorism, to the growing nationalistic movements and beyond – we are all impacted.
Many of our clients feel overwhelmed by these issues and events, but they don’t process the emotional and social impact these events have on them.
And it leaves us with collective anxieties, despair, and traumas that are recognized but unprocessed.
While we are at an unprecedented moment in the history of the world, we also have unprecedented tools to respond to collective trauma. One such tool is our understanding of neurological regulation. Because many of these issues/events happen between people, one way clients regulate is when they connect with a deeply attuned other.
But to best serve our clients, we have to attend to our own anxieties, fears and griefs about these issues. We are, after all, both citizens and therapists, often impacted by events at the same moment our clients are.
So how do we do that? And how do we help our clients process their fears about global events?
Here are three ways for therapists to bring up social/political concerns and invite clients to talk about them in therapy:
- Write a short letter explaining your concerns about the impact of current world events on the mental health of individuals.Put the letter in the waiting room where your clients will have a chance to read it before their session. I have liked writing this letter as it helps me focus my thoughts.
- Ask your clients at the beginning of the session how they are doing with the recent events in the world. This felt awkward for me initially, but it became easier and felt more relational than the letter in my waiting room.
- Write an email to all of your clients. This can be especially helpful at times when there is an event that you are sure is having an immediate impact on most people. It also helps them begin to understand that these events can affect their mental health.
I have found that I need to be quite directive in these conversations, as for some clients it is easiest to talk about social/political issues through opinions or diatribes. For that reason, I developed some clear guidelines:
- I ask them what impact the social/political issues are having on them emotionally and socially. Most recently, I have found not a surprising but an alarming amount of fear, anxiety, and despair, with several clients curbing some of their normal social activities.
- If they start going into opinion or a rant, I stop them quickly, and ask them to come back to the more personal impact of current events. I remind them that we are concerned about the emotional and social impact of these issues in their lives.
- At times I will join them, as a fellow citizen, when the grief or trauma of an event is fresh for both of us. That it is not just “therapeutic” but human and relational to do so.
Through these discussions, I’ve found that the majority of people who are not rattled by current events are civically engaged in their communities. So now I ask a question I would have been very uncomfortable asking prior to this:
“Do you think there is any civic engagement you could or would like to do that would help you respond to your feelings of ____________?”
As therapists, we know that when we feel vulnerable it either draws us closer to others or pushes us away. Our clients need us to be aware of how these issues impact their lives and be a deeply attuned presence to their vulnerability.
In doing so, we can help them regulate their nervous systems and live an engaged and conscious life in this chaotic and changing world.
Do you talk with your clients about how global events impact them? If so please leave a comment below and tell us how you do that, and what response you’ve gotten.
I have found that many clients are fearful of sharing their feelings/thoughts about their concerns out of fear of offending even those closest to them. Even the home environment can be highly charged on many topics. Allowing clients to fully express their concerns without fear of judgement is very therapeutic. The ‘safe place” I create becomes essential.
When clients have personal hopelessness, despair, fear etc. global issues compound their emotions, usually clients most overwhelmed bring it up. I validate their feelings as a citizen, I like to explore their personal emotions that maybe current or past , then assist them in identifying how they’ve overcome those emotions and how they can do self protective strategies to prevent overwhelm and or proactive strategies that they are capable of impacting their immediate environment.
I couldn’t agree more, Shirley. Thank you for your response. Beautifully said.
Yes. Thank You. Very important information!
I work with clients from war torn countries and they have to deal with trauma at different levels: (1) their own personal trauma, (2) worrying about their families back home and (3) worrying about the country they left behind. I validate their fear and pain about what is going on in their homeland but we try to concentrate on the here and now for them, especially around the trauma they personally experienced.
I do, including the personal and the political projections of the events. Also about how can one be engaged in one’s role as citizen and not only familial and close circle of friends roles
World events have been top of mind for many of my clients, and they have found it quite helpful to talk about their personal fears and existential weariness with the increased violence around us.
I like your suggestion to curtail rants, and to focus on their personal psychological concerns.
Thank you so much for all this suggestions, very important and nurturing…
It is always important to have a social/family group that we are attached with and from this place we can connect to larger groups and individuals. I believe the best thing to do is to first acknowledge the common bond between humans that is very basic. We have a need to feel a degree of safety under any circumstance in life. To create a safe place with safe people is always number one. It can start with self care and actions we take to calm and nurture the self. The world is not about safety and life is not safe but we can help people to manage chaotic emotions in a calm and safe environment. We can use all available tools in work with people to increase tolerance and teach health and wellness. We can notice the skills a person already uses and apply the same skills to personal wellness. Sometimes people cannot see what they already know when they are conflicted and have lost focus. We feel because we can and this is useful in life and living. We do not handle huge pieces of information well and that is why we need to handle huge problems in small pieces. Focus on the small pieces and only the small pieces.
Safety is key! Exactly! As well as calm and nurturance. I also love your pieces analogy. It’s true.
Agree it can help to provide that solace clients need in a session, when they might be totally turned off from their bodies and reactions to the violence. That fear response can only be a way to help them cope with the situation without dissociating or feeling hopeless. The therapist also knows more regarding how certain violence might impact a client. Avoiding the subject is disrespectful not genuine. Knowing about the polyvagal nerve health through socializing can be an effective way to heal. Sharing their fears in a session has been helpful through these past few months of violent eruptions. Clients do look to you for reactions to help them acknowledge the fears now imposed on today’s society instead of minimizing reactions. If we pretend all is well, then we are not paying attention to our own body and disregarding the client’s reaction to world around them.
So true, Marcia! So well written! I love polyvagal theory. Thank you for your response!
This is extremely helpful. In the face of world events, I think it is important to help ourselves stand in the power we have personally, socially, etc. To feel helpless in the face of the chaos around us can be really dangerous. I find comfort and personal relief in talking to clients about violent and disturbing events. I also find that they are helped by journal writing from an emotional point of view….their fears, felling disempowered, disconnected. Also by reminding them that deep listening to others…honing our communication skills creates human connection so we don’t feel alone.
I have several police officers and vets that I am privileged to work with. I have extended by text my personal acknowledgment of the recent horrors and tragedies that have erupted in the world, close and far away from home. I have also extended free support to these individuals to process this in my office if they wanted. They have all responded with gratitude, but have indicated they are moving forward, so far.
Thank you for this information. I have made it a point to not see images of war, violence and terrorism as a way of keeping myself grounded, knowing that those who come into my office have often been compulsively watching. If I need to know someone will tell me and I will be present to that person’s experience. Since taking the course on fear with Tara Brach, I have been practicing RAIN when I hear about events on the news.
During my weekly DancingFor Healing class with my patients, I start the class with short dedication from each participant and finish it with meditation directed to the world or a group of people affected by a current event . It’s very rare a patient misses to address in his/her dedication the current tragic issues .
As an ally I think it’s imperative to broach racial, religious and LGBTQA related media topics with my clients who identify as such. They often express relief in being able to process these traumatic events in the safety of our session. It is also obvious when there is something else they’d rather discuss.
Thank you for bringing up this current reality. I am trying to deal with my own distress about it. I think we sometimes make a false dichotomy between external and internal, as if social was somehow not as important as personal. Our social context shapes us and we need to acknowledge that.
That’s true! Thank you for your insight and honesty!
This article is timely and helpful. It addresses what is currently so pervasive I. Regards to current events being the cause of death and destruction. A thought provoking and refreshing article. Thank you.
I believe most of my clients feel helpless about what to do to help so they prefer not to discuss it too much in a session. But friends and family express more fear and sadness. Some need to rant, some need to hide from feeling by going deeper into work, or school, and others are becoming active by lending energy into helping others, I.e. raising funds for vaccination education and implementation for children in Uganda. Others – still in shock. I have friends who are vacationing in the U.S. and are afraid to return to their homes in France.
I handle it very individually. With some clients it feels natural to address it, and sometimes go into more detail about it, and for some it seems necessary to talk a bit about it, before moving on to their main subject for the therapy. Just so it won’ t be a silent “elephant in the room” shadowing, what really is of concern for the client.
Sometimes it can also be valuable to do some psychoeducation on media-watching. Like not warching again and again the same repetitive seqences of events, which often happens when these events are covered by the media. Sometimes for example choosing to listen to News instead of watching the same anxiety-producing scenes. The visual channel can have much more impact psychologically. It is enough to know about it, maybe see it once.
I couldn’t agree more with the idea of watching the news once and then avoiding the repetition that makes the events appear as if they are still happening for days!!! I also agree that listening to radio programs that do an in depth analysis can be very helpful to understand the socio-political context and, to avoid the generalized dread and fear that may influence people’s perception of their own safety. Issues of social justice and triggers to the client’s personal circumstances may need to be addressed, as they do impact a person’s progress when healing from trauma. I often feel that people already in therapy have a better opportunity than most to process and to make sense of these events.
I think the closer the client is to the traumatic event the more the need to process it-when 9/11 occurred my group therapy clients spent lots of time processing it-and the fear that it could happen here (we are 50 miles from San Francisco and the GG Bridge) but the sense of hopelessness, despair and anger feel like other issues that have happened in my client’s lives and must be faced in their time–it all brings up so much sorrow-
I agree with Ulrike. I am also a psychotherapist in private practice in Paris and so far we have had two terrorist attacks in Paris as well as the recent one in Nice.
During the first two attacks, I asked my clients how they were doing and coping with what had happened.
Very few wanted to go into their feelings as they wanted to discuss the problems that had brought them into therapy. These responses came primarily from English speaking clients, some of them from other European countries.
However, the french clients spoke more of their anger, often directed against the government but again, unless they directly knew someone involved in the attack, were very impersonal.
I think that when terror occurs in your neighborhood and it ultimately brings up feelings of helplessness that it is a coping mechanism to not speak of it and deal with other things.
When I have been asked to do trauma interventions in a community setting, people are more open to speaking of their feelings and concerns and linking with others. I will really be interested in hearing from other therapists in Europe and around the world.
I curiously have noticed that very few of my clients want to talk about “the world” and their reactions to that . . They think we loose time on “THEM”( Except those who have been clearly involved in terrorism attaques etc . and who are mostly terribly angry . … in order not to feel their fear .