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

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  = 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. 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 of the occurrence of repression in a representative sample in the former GDR.