When Therapy Turns Political Disagreement Into Psychological Harm

Political disagreement has always strained families. Thanksgiving dinners have ended in arguments. Siblings have gone weeks without speaking after a heated election. None of that is new.

What has changed is the ease with which cutting off parents, siblings, and lifelong friends can be described as an act of psychological self-care. The language of trauma, boundaries, and emotional safety, once used to help people understand serious psychological harm, is now sometimes applied to ordinary political conflict.

One of the clearest examples came after the 2024 election. Dr. Amanda Calhoun, then a chief psychiatry resident at Yale, appeared on MSNBC and discussed people whose relatives had voted for Donald Trump. She said it was “completely fine” not to be around family members who had voted in ways they believed threatened their livelihood, adding that establishing such boundaries “may be essential” for their mental health.

I publicly disagreed. Good therapy should help people distinguish between discomfort and danger, not confuse the two.

Political estrangement is not a fringe phenomenon. A study published this year in PNAS Nexus examined what the researchers called “political breakups,” relationships lost because of political differences. In an April 2025 survey, 37% of Americans reported having experienced one. Among those who had, 62% reported losing a friendship and 40% a family relationship.

The study doesn’t tell us that therapists caused these ruptures. It does tell us that political disagreement is reaching deeply into Americans’ personal relationships. The researchers also found that people who had experienced political breakups tended to view their political opponents more negatively, perceive them as more extreme, and attribute more selfish motives to them.

I see versions of this in my practice. Patients tell me they’ve stopped speaking to a parent over a vote, ended a friendship after an argument about politics, or decided a sibling no longer belongs in their life. When we slow the story down, the circumstances can look different from the language used to describe them. There may have been no abuse, intimidation, or ongoing harassment. There may have been arguments, hurt feelings, and sharp political disagreements, but not necessarily danger.

Some family relationships are genuinely abusive, manipulative, or dangerous, and distance may be the healthiest choice. I’m not talking about those situations. I’m talking about ordinary political disagreements being interpreted as psychological harm.

I’ve spent nearly two decades helping patients deal with strained relationships. The goal isn’t to make people tolerate abuse or surrender their values. It’s to help them figure out what they can tolerate, what they can change, and when a relationship is genuinely harmful. Disagreement alone shouldn’t answer that question.

That’s where therapeutic language can get us into trouble. Concepts like boundaries, trauma, triggers, and emotional safety can be useful. But when they’re stretched to cover ordinary conflict, they blur an important distinction. A boundary can become a way to avoid a difficult conversation. Feeling distressed can become evidence that another person is unsafe. A painful disagreement can be recast as psychological harm. Once that happens, walking away starts to look therapeutic.

Cognitive Behavioral Therapy (CBT) has long recognized a paradox of avoidance. Escaping something that makes us anxious can bring immediate relief, but that relief can reinforce the belief that we couldn’t handle the situation in the first place. Avoidance can become self-reinforcing: I escaped, I feel better, therefore escape must have been necessary.

That doesn’t mean every estranged family should reunite, nor does it mean people have an obligation to endure endless political arguments. It means relief alone isn’t proof that avoidance was healthy.

Politics makes this problem harder because political beliefs can involve deeply held questions about morality, identity, and rights. People can reasonably find another person’s political views offensive or even repugnant. But being offended, angry, or distressed isn’t automatically the same as being psychologically endangered.

Good therapy should preserve that distinction.

The stakes extend beyond individual families. Living in a pluralistic society requires us to encounter people whose beliefs we dislike. Families are often where we first learn how to do that. A parent can be wrong about politics and still be a loving parent. A sibling can cast a vote you find appalling and still be the person who shows up when you’re sick. Human beings are more complicated than their ballots.

Therapists should be careful not to flatten those complicated relationships into the language of safety and harm. Our job isn’t to tell patients whom to vote for, whom to agree with, or which relatives deserve a place at Thanksgiving. It’s to help them think clearly about their relationships and make decisions based on the full reality of those relationships rather than the emotional intensity of a political moment.

Therapy can help people leave abusive relationships, recover from trauma, and build healthier lives. I’ve seen it do exactly that. But it should also help people develop the resilience to tolerate ordinary conflict, remain curious when possible, and disagree without assuming that discomfort itself is evidence of harm.

Therapy is supposed to help people engage with reality, not withdraw from it. If we start treating political disagreement itself as psychological harm, we risk not only more estranged families but also a society less capable of living with disagreement at all.

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Jonathan Alpert is a psychotherapist in New York City and Washington, D.C., and author of the book “Therapy Nation.” Find him on X @JonathanAlpert.

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