ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Mental Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1601917
This article is part of the Research TopicConflicts, Hate and Violence in PsychotherapyView all 3 articles
Complete title: The long arm of repression: Determinants of psychotherapy use among East Germans and its relevance for today`s institutional trust -Psychotherapeutic implications of political repression in the former German Democratic Republic
Provisionally accepted
Marie-Theresa Kaufmann1*
Hannah D. Nussmann2Ayline Heller3,4
Christoph Kasinger4
Elmar Braehler4,5Adrian Gallistl1
Bernhard Strauss1- 1University Hospital Jena, Jena, Germany
- 2Dortmund University of Applied Sciences and Arts, Dortmund, North Rhine-Westphalia, Germany
- 3GESIS Leibniz Institute for the Social Sciences, Cologne, North Rhine-Westphalia, Germany
- 4Johannes Gutenberg University Mainz, Mainz, Rhineland-Palatinate, Germany
- 5Leipzig University, Leipzig, Lower Saxony, Germany
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Introduction: Maintaining trust in social institutions is a critical challenge for Western democracies. We examine the role of psychotherapy on institutional trust in the former German Democratic Republic (GDR; now: New Federal States of Germany) which used open and covert methods to keep opposition members under control.Methods: The study with n = 1805 individuals who were born and socialized in the former GDR (i.e. born before 1980) was conducted in 2022. Logistic regression models to predict a person’s probability of psychotherapy use after the system change from the GDR to the New Federal States of Germany were built using a basic model derived from the literature with predictor variables such as gender and education. This model was extended by experiences of repression. In a second analysis, linear regression models to predict institutional trust were analyzed following a similar strategy with the addition of psychotherapy experience as a predictor. Results: Reporting repression in the GDR (44% of the total sample) was related to a higher probability of psychotherapy use. In the group who reported personally experienced repression (15% of the total sample), psychotherapy appeared to be relevant for higher levels of institutional trust.Discussion: Psychotherapy might have the potential to help regaining institutional trust after a system change. Psychotherapists should consider that patients who experienced (post-)socialism were commonly affected by repression and might show less institutional trust including the healthcare system. Furthermore, this study revealed an estimation the occurrence of repression in a representative sample in the former GDR.
Keywords: Psychotherapy, Repression, systemat change, GDR, Institutional trust
Received: 28 Mar 2025; Accepted: 27 Jun 2025.
Copyright: © 2025 Kaufmann, Nussmann, Heller, Kasinger, Braehler, Gallistl and Strauss. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Marie-Theresa Kaufmann, University Hospital Jena, Jena, Germany
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