Our Duty as Mental Health Therapists in a Constitutional Crisis
By Delta Larkey M.A. LMFT
Therapy is about holding space for the complexities of the human experience—both the joy and the heartbreak. As a therapist for nearly eighteen years, I’ve had the privilege of accompanying individuals through life’s most profound challenges. Our training teaches us some basic guiding principles about the boundaries of our work, particularly the importance of not imposing our own beliefs, values, or judgments on clients. This makes sense regarding personal decisions, such as whether a client should stay in a relationship or how they should navigate grief. The role of a therapist is to support, not direct. But can we still hold fast to these principles when the political climate and federal occupation of the Twin Cities directly impact our clients’ lives?
In times of political upheaval and state-sanctioned violence, mental health professionals find themselves in a position that requires not only clinical care but also moral clarity. We cannot ignore the collective trauma, fear, and psychological wounds that rip through the fabric of our communities, particularly when those wounds are caused by systemic injustice, social upheaval, or governmental overreach.
When societies experience terror, injustice, or moral collapse, individuals often suffer from what is known as moral injury. This is the psychological trauma that occurs when people witness or participate in events that violate their core values. In times of political violence, when democracy is threatened or when human rights are stripped away, individuals experience deep emotional conflict, guilt, and a pervasive sense of shame. This leads to depression, anger, addiction, and distrust of societal systems.
A cogent example occurred in the Summer of 2020. As a therapist in the Twin Cities, I was experiencing the uprisings that emerged following the murder of George Floyd alongside my clients. In those moments, it would have been unethical for me to avoid confronting the realities of racism, white supremacy, and anti-Black violence. As a white therapist working primarily with white clients, not addressing these issues head-on would have been to prioritize the racial status quo and ignore the psychological impacts of a community at a turning point. My clients wanted to talk about what was happening as they tried to make meaning about their own roles in racial injustice. Therapy must confront the societal forces that shape our lives, our minds, and our bodies.
We cannot pretend that the ongoing structural impact of white supremacy, the attacks on LGBTQ+ rights, the racial profiling and abduction of BIPOC off the streets, and the erosion of voting rights are outside of us. The decision to remain neutral is not ethically possible; neutrality is complicity. As therapists, we are duty-bound to hold space for what directly affects our clients' well-being, especially when it manifests in our therapy rooms. We must be able to name these realities and acknowledge how they shape our clients' psychological health. To remain silent and ignore these issues is to deny reality and our clients’ need to make sense of their lived experiences.
We have been told to avoid “politics” in treatment, but we cannot separate these discussions from the psychological health of our clients. The conversations we avoid in the therapy room are the very conversations that influence our clients’ safety and dignity. We must help them process their lived realities with clarity, offer them the tools to resist psychological manipulation, and support them as they navigate a rapidly changing world.
In times of crisis, Timothy Snyder's directive from On Tyranny, “Remember Professional Ethics,” is a vital reminder for mental health professionals. We are tasked with preserving the integrity of our practice, even when the societal systems around us are in freefall. History has shown us that professionals can be co-opted by oppressive regimes, whether through justifying torture, pathologizing dissent, or imposing silence. Now is the time to stand firm in our commitment to justice, to truth, and to the integrity of our profession. So how might we do that?
Amidst the political chaos, it is easy to feel isolated, alone, and ineffectual. Fortunately, we have a rich history of people joining together to fight for a common cause. The greatest defense against authoritarianism is everyday resistance by everyday people. Resistance movements are built from small acts, repeated, until those small acts become a movement. We can create an alliance that includes mental health workers from all areas of the field: large clinics, small private practices, independent contractors, non-profits, wellness centers, treatment centers, outreach workers, school staff, and hospital staff.
A constitutional crisis is not just a political event; it is a psychological reckoning. If we fail to uphold our professional ethics, we risk becoming enablers of repression. This is a call to action for my fellow mental health professionals and practitioners: let’s build a coalition committed to collective resistance and model what “Integrity” in our code of ethics truly means.
