When should a therapist share personal views and reactions with clients? What should you do if you become triggered by a client’s polar opposite—or even offensive—views? And how can we avoid sending messages to clients that our regard for them depends on whether they agree with our viewpoints?

These are all questions clinicians need to be considering, says therapist Bill Doherty, the founder of Citizen Therapists for Democracy. They’re questions that can arise when conversation with clients enters the realm of politics—long considered a taboo topic in therapy. But in order to fully understand what motivates and moves those we treat, we need to feel comfortable, Doherty says, broaching the subject of politics and our clients’ civic commitments.

In this video clip from his 2017 Networker Symposium keynote address, Doherty tells the story of his work with one couple who, only after years in therapy, shared that they’d been active in founding a local community organization—a fact that greatly contributed to Doherty’s view of who they were as people, and thus made therapy much more productive.

Therapists have very little history in talking about civic commitments, Doherty says. “The idea of clients as citizens of larger communities, as contributors to their larger world and not just as receivers of social support,” he explains, “hasn’t entered the mainstream of therapy.”

But person by person, Doherty adds, we can change this. Draw up an intake form, he recommends, that includes questions like, Sometimes people have commitments to groups or causes outside of the family and their close social world. If that’s true for you, could you write down what those commitments are? By doing this, Doherty says we make space for the idea that our clients are more than just the problems they bring to us in therapy.

“In our offices, we promote the kind of personal agency that’s necessary for a self-governing, democratic people—a people whose worlds are public as well as private,” Doherty says. “We therapists are connectors, trust-builders. If we expand our vision of therapy and the role of the citizen therapist in society, we can contribute to a flourishing democracy where people can be agents of their own lives and builders of the commonwealth.”

William Doherty

William Doherty, PhD, is professor of family social science and director of the Minnesota Couples on the Brink Project at the University of Minnesota. He’s the author of the forthcoming book, The Ethical Lives of Clients: Transcending Self-Interest in Psychotherapy