Exploring Some Places Where Clinical and Political Overlap Many of us have experienced, or witnessed, how political values influence our relationships. Research from Afifi et al. (2020) showed that voting differences in romantic relationships are associated with less feelings of closeness. Warner et al. (2021) found that people are less likely to have accommodating communication with family members when there are perceived political differences.
There is an emerging—and growing—cohort of mental health clinicians that advocate for the necessity of exploring overlaps between The Political and The Clinical. In Decolonizing Therapy (2023), Dr. Jennifer Mullan explores how colonization is a core wound that commonly impacts the mental wellness of people targeted by systemic oppression. Dr. Kenneth Hardy has dedicated a large part of his clinical career to researching, conceptualizing, and strategizing to heal widespread racial trauma.
Conceptualizing Your Political Values
It is important to spend time grappling with how we make sense of what “political” means.
A diagnostic label is shorthand for indexing a cluster of symptoms. In a similar manner, a political label is shorthand for indexing a cluster of beliefs. For my purposes in this blog, I conceptualize political values as the cluster of beliefs that we each hold about what conditions make up a just society. Put more concisely, a person’s political values describe how they believe society should be.
For further reflection, please consider how you and people you know might answer the questions below:
● Should vaccination requirements exist in schools and workplaces?
● Should there be a maximum wage like how there is a minimum wage?
● What parenting strategies should parents use if they want to raise emotionally secure adults?
● In order to cultivate a healthy romantic relationship, what should each partner practice?
The way we answer these kinds of should-questions gives us insight into what we, and the people we know, value and believe in. Whether we consciously express these beliefs or not, I believe most of us have them.
I also believe that political reckoning and political becoming are ongoing processes, and we endure them as we are making sense of what it means to live among other people.
For more questions to process your political values, the Pew Research Center has an interesting reflective quiz: https://www.pewresearch.org/politics/quiz/political-typology/
How Politics Impact Mental Well-Being
Brooks Stephens et al. (2024) demonstrated how political beliefs overlapped with mental well-being. One of the most interesting findings to me was the correlations between racial awareness, critical consciousness, and suicidal thoughts.
Racial awareness is used here to describe how someone makes sense of the ways that racial discrimination and racist policies affect their personal well-being and livelihood. Critical consciousness was originally popularized by literacy teacher and movement leader Paulo Freire, especially in his iconic 1968 text Pedagogy of the Oppressed. Critical consciousness refers to one’s learned capacity for developing precise analyses of power and oppression, and utilizing these analyses towards social justice in one’s life and community.
When participants had high racial awareness but low critical consciousness, they were more likely to have higher levels of suicidal thoughts.
In other words, these participants were aware of how anti-Black racism negatively impacted their lives. What they struggled with was how to feel practiced, resourced, and empowered when it came to challenging the racism that impacted them. At this overlap of inner experiences, participants were more likely to struggle with higher levels of suicidal thoughts.
If we take these findings from Dr. Brooks Stephens’ team and put them in conversation with Dr. Kennedy Hardy’s writing, it may further our understanding of this correlation between racial awareness and suicidal thoughts.
In his book Racial Trauma: Clinical Strategies and Techniques for Healing Invisible Wounds, Dr. Kenneth Hardy identifies 7 invisible wounds that impact the everyday lives of people of color:
1) internalized devaluation;
2) an assaulted sense of self;
3) the feeling of psychological homelessness;
4) voicelessness;
5) loss and collective grief;
6) an orientation towards survival;
and 7) rage.
One concept we may explore more here is internalized devaluation. Dr. Hardy describes the ways that the constant, ideological devaluation of non-white people can impact our psyches. Being regularly inundated with media, policies, and conversations that express white superiority and non-white inferiority can take its toll. It is mentally and emotionally tiring defending against ideologies of white supremacy, even when there are important protective factors present (like racial pride in the family). If white supremacist devaluation of non-white people is internalized, people may begin to experience negative self-talk or chronic shame.
There’s a parallel process in how this societal process can also happen in the context of the home: if somebody grows up with a parent that verbally devalues them for years, then eventually that person may internalize the parent’s harsh voice as their own.
Through therapy, someone may begin to recognize that this loud, harsh inner voice does not actually belong to them. They may realize that they’d like to develop their own authentic voice instead.
Nurturing Critical Consciousness as a Protective Factor for Mental Health
This is where critical consciousness might come in. From my understanding of this concept, it includes the development of one’s authentic voice and personal beliefs.
Brook Stephens et al. discovered that participants with high levels of critical consciousness actually demonstrated lower levels of suicidal thinking.
To break down critical consciousness, let’s look at this concept’s two parts:
First, there is “critical.” Critical refers to a power-sensitive mindset when analyzing a situation. Critical theory refers to schools of thought that explore the role of power in different environments. Critical race theory looks at how power and race intersect to create empowering realities for some and disempowering realities for others.
Then, there is “consciousness.” Consciousness refers to one’s ability to have a certain level of practiced sensitivity to the facets of a complex issue. For example, someone with a feminist consciousness is well-practiced in analyzing how gender, sexuality, and power might inform the development and outcomes of different situations.
So…having a critical consciousness is a practiced ability to analyze how power is used to influence the development and outcomes of different situations. When well-practiced, especially in relationship-oriented settings with others, people may nurture different ideas for how to create meaningful change in their lives.
Political Protest as a Healing Mechanism
I had an opportunity to hear Dr. Brooks Stephens do a poster presentation on her research, where she spoke about different ways for people to put critical consciousness into practice. Some examples for practicing critical consciousness might include:
● learning about effective social justice actions at political education events
● engaging in acts of civil disobedience
● and, participating in street protests and boycotts
When her research participants demonstrated high levels of critical consciousness, through these kinds of practices, there was a correlation with lower levels of suicidal thinking
Perhaps one place that we can assess this overlap between political and clinical as therapists is by asking our clients about how they exercise political power in their own lives. And, if we are creative in our questioning and nonjudgmental in our clinical posture, we might be able to unearth surprising answers.
I know people of color that refuse to give into suicidal ideation because that’s “letting white supremacy win.” This is their personal act of protest that supports their mental health. I know queer people that make a point to develop some queer-only social spaces in their lives. This is another unique personal act of protest and empowerment.
If we are willing to recognize it, people are often engaging in everyday acts of political protest that reaffirms their dignity and their hope for a better world.
By Andy Pham, MFT
