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.
The Sanctity of Therapist Neutrality
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 largely been replaced with modern evidence-based approaches, certain core tenets, such as the importance of therapist neutrality, remain widely accepted.
How Politics infiltrate therapy
In recent years, political discourse has infiltrated the therapeutic space. In a May 2026 article in Politico, Christine Kim discusses the massive mental health toll related to the state of the world: “With anxiety over politics reaching new heights and crises flashing relentlessly across our screens, mental health professionals say they’re seeing an influx of patients distraught about the news coming out of Washington and beyond.” (Kim, 2026).
The highly polarized US presidential election of 2016, in which Donald Trump defeated Hillary Clinton, led to a surge in political discourse during therapy sessions. Some patients struggled with feelings of helplessness and anxiety. A 2019 study by Solomonov and Barber surveyed therapists from all US states, and found that 87% reported that they had discussed politics in session in the previous three weeks. In addition, 63% reported political self-disclosure. Results suggest that patients who perceived their therapists to have similar political views reported stronger therapeutic alliances (Solomonov & Barber, 2018).
The patient-therapist relationship is not friendship
A therapist and patient are not friends. Patients should be able to express their feelings about geopolitical events without fear of criticism or retribution. Therapists should focus on the genuine grief or anger or fear that patients feel rather than defending a political stance.
In fact, therapists have a professional obligation to provide non-judgmental and respectful treatment regardless of political viewpoints. National governing bodies such as the American Medical Association (AMA) and the American Psychological Association (APA) have issued guidelines for ethical conduct and emphasize the necessity of non-discrimination against patients based on race, gender, sexual orientation, gender identity, or other personal factors. Dr. Jordan Conrad points out in a May 2025 article that “a worrying trend has emerged among mental health professionals who object to working with patients who do not share their political views.” This amounts to discrimination based on political beliefs.
Political differences have long existed but historically have not caused the level of disruption and chaos in the therapeutic relationship that has emerged recently. Polarizing topics have included views on abortion, gay marriage, DEI, apartheid, Black Lives Matter, and the Me Too movement. Yet these issues did not systematically seep into the therapeutic space causing insidious destruction of the relationship between the patient and therapist.
Therapist self-disclosure
Therapist self-disclosure has been a highly debated topic. There are instances in which therapist self-disclosure is acceptable and considered helpful to the patient. This should be decided in a thoughtful and purposeful manner and for specific reasons. For example, a therapist who is treating a new mom may share that she too is a mother. Or a therapist may share that they identify with the same religion or cultural background. This can serve to enhance the alliance with the patient and foster a sense of belonging. However, when a patient expresses views that are different from the therapist’s, the therapist should use this information to understand the experience of the patient. They should not gratuitously argue or try to persuade the patient to accept their position.
Impact on therapy
In a thought-provoking piece published in October 2025 in the Wall Street Journal, Jonathan Alpert makes salient points about politics in therapy, He writes, “Therapists often pathologize politics, treating patients with particular viewpoints as abnormal.” He clarifies, “Neutrality isn’t etiquette—it’s the foundation of therapy. Without it, patients censor themselves or leave.” He cautions, “Patients aren’t giving up on therapy. They’re giving up on therapists. Increasingly, they turn to TikTok influencers, partisan echo chambers or chatbots. Artificial intelligence lacks depth and accountability but can offer neutrality-something many human therapists no longer provide. If that trend continues, therapy will cede its purpose to algorithms and leave patients unmoored from reality.”
