The Importance of Hope: Leadership in History and Psychotherapy

Many pivotal moments in history turn on one extreme or the other of hope. Clinicians in behavioral healthcare know the importance of these extremes as well. History contains many stories of the instillation of hope at moments of profound hopelessness in society. Similar reports abound in the annals of psychotherapy, often around managing hopelessness and thoughts of suicide.

My thoughts are prompted by a podcast by the historian Jon Meacham entitled “Hope, Through History.” He was motivated to take on this audio project by the social crisis connected with the COVID-19 pandemic. His podcast brings to life five moments in history: the Great Depression, World War II, the polio epidemic, the Cuban Missile Crisis, and the 1918 influenza pandemic.

Meacham highlights how leaders managed grave social crises. He takes us inside the mind of leaders when hope was fading in society. These leadership experiences are similar to some of the realities that therapists must confront each day working with people with serious mental illness. There are real parallels to be found between finding hope in history and within psychotherapeutic practice.

Lessons of history

Each historical crisis explored by Meacham focuses on the role of a leader. Each era is replete with historical details, some familiar and others less so, and the period least well known for U.S. listeners is World War II under Winston Churchill. The Battle of Britain is the struggle of a new national leader trying to bring hope and resolve to a divided country facing its potential demise in war.

Churchill assumed leadership in Britain with the war underway and no allies fighting beside him. The country was split on the question of negotiating or fighting with Germany. He certainly would have rejected any suggestion that his challenges were like those of a psychotherapist, but in fact he needed to motivate millions of people who were immobilized and feeling hopeless about the future.

Churchill is renowned as an extraordinary communicator, and in this moment his message was complex. He started by speaking to the nation about the dire situation they faced with the belief that there could be no sugar-coating of realities. Only then did he speak of the grounds for optimism, of their goals and strengths. He followed this with realistic plans and steps they would take in battle.

The most poignant parallel for me as a clinician is his first step confronting the depths of a seemingly hopeless reality. I remember learning as a psychology intern how to speak with a suicidal client. I had doubts about the wisdom of directly discussing the depths of someone’s hopelessness and thoughts of suicide. Would it not intensify the problem? Yet “happy talk” is ill-advised in times of crisis.

The duration of the Great Depression seems an even more apt comparison. FDR had to rally people to take incremental steps, and so he took one concrete action after another. His “alphabet soup” of New Deal programs each failed on its own in lifting the country out of the depression. Yet together they sustained hope, activated people, and succeeded in moving the country forward in small ways.

The parallel with psychotherapy is clear. There is rarely one great step out of despair and hopelessness. Therapy must move at a pace each patient can handle. Each step forward must be meaningful and manageable. The therapist’s empathic understanding often starts from some personal experience of change. Good therapists, like good leaders, listen and act partly based on who they are as people.

Lessons of psychotherapy

Working with suicidal patients is one of the more intense experiences in a behavioral healthcare career. As someone who lived through the personal and professional challenge of having a patient complete suicide during treatment, I have long been a conscientious student of what drives suicidal thinking and behavior. Hopelessness is a clear element of such thinking. It is the fulcrum around which action turns.

A therapist must grasp the full complexity of what brings a person to a point of hopelessness. Aaron Beck, the father of cognitive behavior therapy, was the first to point to this as a key to understanding suicidality. Plumb the depths of that experience before discussing any solutions. When things seem hopeless, talk of any other issue seems pointless. Understand the contours of that hopelessness first.

One of the things to be understood about hopelessness is that it immobilizes. In fact, many people are so profoundly immobilized by these feelings that suicidal behavior is temporarily blocked. The therapist who first meets patients where they are in the moment must then help them experience how hope energizes. This action-oriented focus is a pathway out of the despair and lethargy of hopelessness.

The belief associated with hopelessness is that there is no way out. All solutions are blocked and the cornerstones of one’s life no longer matter. The hopeless person experiences this as a reality rather than a belief, and the therapist is needed to guide the person in seeing the difference between external events and personal interpretations of those events. So too must national leaders guide in a crisis.

Inspiring people to move in the right direction

Hope is not optimism. It is not a positive outlook or attitude. It is not a passing thought or feeling. Yet the word is sometimes used in these ways. The more clinical sense of hope being described here relates to the issue of agency. Hope is being used here to capture the will and determination to move ahead. Goals are distinct from the energy one has for pursuing them. Hope fuels the engine.

It is worth exploring moments of extraordinary world historical crisis and moments of deepest personal despair to gain perspective on the challenges of everyday living. Leaders in every area of life, from sports to business, must periodically tend to the level of hope within their teams. This can determine who wins the next game or the next piece of business.

We all face challenges, whether our role is leading a family, business, or country out of crisis. FDR brought hope and resolve to his task of repairing our country in the Great Depression. It was not his first encounter with adversity. He was partially paralyzed by polio at the age of 39. His recovery and accommodation to disability is inspiring. It may have felt like job training as he took office in 1933.

This is the beauty of great leaders and great therapists. At the time of crisis you don’t ask where they went to school. You want them to fully recognize the depths of the problem and not be deterred. You want them to take meaningful steps forward without thoughts of any simple solution. You want them to help you believe in a better future and in your ability to make it happen. You want hope.

Ed Jones, PhD, is senior vice president for the Institute for Health and Productivity Management.