AUTHOR=Kaufmann Marie-Theresa , Nussmann Hannah D. , Heller Ayline , Kasinger Christoph , Brähler Elmar , Gallistl Adrian , Strauß Bernhard 

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

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1601917

DOI=10.3389/fpubh.2025.1601917

ISSN=2296-2565

ABSTRACT=IntroductionMaintaining 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.MethodsThe study with n = 1,805 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.ResultsReporting 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.DiscussionPsychotherapy 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 of the occurrence of repression in a representative sample in the former GDR.