Is My Therapist Good or Not?

Daniel Mackler
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I frequently get asked by people on the internet whether or not I think their therapist is good.  For a variety of reasons, I usually do not feel comfortable answering them directly.  However, I do feel comfortable writing about the subject here, as a sort of amalgamated response.  As such, here are some questions I might ask such people, and here is how I might respond to their answers.

What does your gut tell you about your therapist?

I have learned that those who want my opinion generally have mixed feelings about their therapist, which is why they’re asking me.  The problem I’ve noticed is that many people who are in therapy lack confidence in trusting their gut, and may have actually gone to therapy to become better connected with their gut in the first place.  So that can make my question confusing to answer.

As a personal example, I recall my gut telling me that one therapist I worked with, back around 1999, was bad news.  This was early in our relationship, but I so wanted to believe in her quality, and so wanted to have her like me and validate me, that I found it very hard to trust my gut.  I ended up sticking with her for a year-and-a-half and replicating with her my childhood relationship with my rejecting parents — which is a perfectly common thing to do in therapy.  The problem was, she, like so many therapists, was so much like my parents that she did nothing to help me resolve this core issue.  In fact, I came to sense that she preferred my inability to trust my gut, because it worked to her advantage.  She was a person of limited self-questioning abilities, she was unaware of these dynamics herself, I came every week like a hopeful and idealizing child, and I paid up on-time.  What a farce!

What is your therapist’s opinion on psych drugs?

I don’t trust any therapist who is quick to suggest psych drugs, both because the drugs have lots of side effects and because they block people’s growth processes.  The message in suggesting psychiatric drugs is this:  “You can’t do the inner work yourself, thus you need a medication.”  Not only is that false, but it undermines a person’s potential.

But what about therapists who are slow to suggest psych drugs but still suggest them occasionally, let’s say for more extreme problems like that thing known as psychosis?

Well, I don’t trust them either.  My reason is that therapists who suggest psych drugs are really saying that what they have tried has failed and that they don’t know what else to do to be helpful.  But really, what have they tried?  How far have they gone to really be creative in the relationship?  What alternatives have they explored?  And how much emotional risk have they taken to self-reflect on — and be open with their clients about — their own shortcomings?

I recognize, however, that some people, especially if they are in great emotional pain, might wish to try psychiatric drugs.  Although I don’t think it’s a good idea, and I’m all for exploring non-drug alternatives, ultimately I respect their choices.  But that doesn’t mean that I support therapists who suggest the drugs themselves.  I don’t.

How would your therapist work with someone who feels suicidal?

A therapist’s job is to try, by all means that respect a client’s autonomy and confidentiality, to prevent suicide.  The best way to do this within therapy is to build a stronger, deeper relationship with the client.  I’m against hospitalizing people or using any forms of force against them.  Instead, the therapist’s job is to create an environment where clients can feel free to speak their minds and not have anything they say held against them.  When a client — or anyone — feels heard, understood, respected, and welcomed in a relationship, things begin to change in them, such that they begin to experience the template for a more meaningful life.  I’m not saying this is easy, because that has not been my experience, but that is what I’ve seen.  In short, when there’s a strong relationship between a therapist and client — or between any two people — that relationship becomes a leverage against suicide.

Also, from what I’ve seen, if therapists are really afraid someone might kill himself or herself, they can always offer to see the person more often.  See him or her twice or three times a week, maybe every day if possible.  Lower the fee.  Be more flexible.  Be more honest.  Talk on the phone between sessions.  And explore ways with the client for him or her to engage more deeply with others beyond the therapy relationship.  All of this is part of the real job description of therapist.  And if the therapist is not up for the task then he’s in the wrong field.

That said, if the person who feels suicidal is not interested in engaging with the therapist in a more deep, meaningful, and flexible way, or simply is not able to, then I think it’s fair for the therapist, who naturally would be extremely uncomfortable by this, to talk about his or her feelings openly with the client and potentially extricate himself or herself from the therapeutic relationship.  After all, doing the healing work is not just the therapist’s job.  It’s primarily the client’s.

Does your therapist have children?

Although this question might seem odd, I find it important.  Speaking generally, I am skeptical of therapists who have children.  Too often they have, by becoming parents, stymied the potential of their own internal growth process.  Also, with our world as screwed up as it is, and with this knowledge having been no mystery for the last fifty years, I am skeptical of anyone who has kids.  After all, those who have children most directly contribute, and have contributed, to the problems of the world.

I am most troubled, however, by therapists who have young children.  After all, their job is to give the best of their emotional energy to their children, not to anyone else.  When therapists have young children, someone gets abandoned in the equation — either the kids, the therapist, the therapist’s partner, or the clients.  And more often than not, to some degree, it’s all four.

Meanwhile, the answer to this question alone is not enough for me to assess a therapist’s quality.  I have seen some simply rotten therapists who never had kids.  And there are some therapists who have kids whom I think are far better than average, even brilliant in some ways.  But for engaging with a therapist in the deepest work, I’d still prefer one who had no kids.

How much does your therapist charge?

From what I’ve seen, better therapists generally charge less money.  They’re not in the business to get rich and comfy and they recognize that higher fees often just add to a client’s anxiety.  Instead, they’re in it for altruism first.  They want to help others, and wealth be damned.  If this isn’t the case, they’re in the wrong profession.  However, I understand that everyone needs to make a living.  I was a therapist, after all, and had rent and student loans to pay.  But I worked on a sliding scale, and a very sliding one, and I often asked my clients if whatever they were paying felt fair to them.  If it didn’t, or if I sensed it didn’t, then it didn’t feel fair to me either.

Meanwhile, so often people have told me they pay therapists, often quite substandard therapists with a glossy exterior or some degree of fame, ludicrous amounts of money — on an ongoing, long-term basis.  It’s enough to make me want to throw up.

Do you feel your therapist understands you?

I feel a therapist should have a quick, intuitive understanding of people — and a wide range of people.  If you don’t feel your therapist understands you then I think this is a problem — and one that might well be worth bringing up in session.  Who knows, it might lead to some unexpectedly fruitful discussion.

For me, I wouldn’t want to work with any therapist who I felt didn’t understand me pretty quickly.  And personally I never did work with one who got me — which is part of why I haven’t been in therapy in years.  Yet one might argue that my therapists did understand me and I just didn’t realize it.  To that I would disagree.  I know how it feels to be understood.  It’s a totally different feeling for me than being misunderstood.

Also, therapy is probably the easiest place to understand someone, especially in light of their childhood history, because therapists have a great power, and even responsibility, to ask clients personal questions and create a safe environment to witness their replies.  The problem is, to really understand a client, the therapist has to understand comparable sides of his or her own self first.  And from what I’ve seen, a lot of therapists don’t.

Does your therapist love you?

I learned as a therapist that love comes in different forms.  Not infrequently I felt love for clients in the first session.  I could feel very drawn to them, have a sense of deep compassion for them, even cry with them.  It didn’t always happen, but often it did.  But there was another type of love, a deeper kind, which for me, I learned, took about six months at the minimum to develop.  This second kind was based more on understanding, connection, and relationship — a real and personal relationship that needed time to develop.  It was never an instantaneous thing.  Maybe it’s a bit parallel to love in romance — the difference between falling in love and really loving someone.

I think everybody deserves a therapist who really loves him or her on that deeper level.  But did I love everyone I worked with?  Honestly, no, I did not.  But I did love some people who most people probably thought were pretty unloveable, and also some people who probably were convinced that they themselves were unlovable.  And I also came to learn that I don’t think I particularly helped the people I didn’t love.  But why didn’t I love them?  I think the reasons are varied.  Maybe they weren’t that open.  Maybe they weren’t that honest with me or with themselves.  Maybe they triggered something in me, something unresolved within myself that blocked me from being more open or honest.  Maybe we didn’t have enough time.  Or maybe they hated me for wanting them to grow, because growth was so painful for them.  I don’t know.  It’s been five years since I was a therapist, which was, incidentally, the most difficult and confusing job I’ve ever done.  I loved it, but I’ve found being a filmmaker much easier, and not even comparably so.

Meanwhile, I don’t think any of my therapists ever loved me.  I only ever saw one for more than six months, and I’m confident she didn’t love me.  I think my realness threatened her facade too much.  I think she actually hated me for it.

How does your therapist act when you challenge him or her?

Challenging a therapist can foment a crisis — and crisis, as they say, is made up of two parts:  danger and opportunity.  To stick with the opportunity part, there’s a lot to learn in these moments of crisis.  If your therapist is a jerk when challenged — gets defensive, becomes insulting, puts you down, tries to make you feel stupid, is rude, cuts you off, uses psychobabble, rejects you, never acknowledges what he or she is doing — then that’s a pretty good sign that your therapist isn’t much good.  There are a lot of arrogant therapists floating around camouflaged, and sometimes their arrogance isn’t too noticeable until they get challenged.  So I think it’s not a bad idea to challenge them, if, that is, you feel the urge.

However, sometimes therapists get challenged unfairly — get accused of unfair things, have words put in their mouths, have clients act out traumatic, historical, emotional dynamics on them, etc.  These moments also tell a lot about therapists’ characters — in essence, their quality.  For instance, do they still behave respectfully when under pressure?  Or do they regress into childlike behavior?  Do they blow up?  Do they make threats?  Do they start diagnosing you?  Do they practice the silent treatment?  In light of this, even a potentially unfair challenge is, in my opinion, actually fair — because it’s all an opportunity to learn.

I will admit, though, being challenged when I was a therapist could be exhausting.  Yet I always felt it was part of the job.  And I believe that if a therapist doesn’t see it that way, and doesn’t defend a client’s right to challenge, then he or she is in the wrong profession.

Is your therapist a radical person?

Perhaps this seems like a silly question, but I think it’s vital.  Being a therapist is a radical job, because real healing — real growth — is radical.  Also, the underlying thing that causes people to come to therapy in the first place — trauma — was radical as well, just in a bad way.  Thus, a therapist had better be radical if he or she hopes to be up to the task of walking with people through their traumatic history on the painful journey to healing.

Me, I don’t trust therapists who are not radical people.  If I were seeking a therapist I would want someone who has walked and probably still is walking their own lonesome valley, through hell and high water.  I am and all the best therapists I know are still going through real and radical struggle.  It’s hell to grow.  It’s hell to be honest in this screwed-up, abandoning, and rejecting world.  I wouldn’t want to bring my painful and radical issues to someone who is living in comfort and for comfort.  I think they couldn’t help me.  In fact I know they couldn’t, because no one who was particularly comfortable ever has.

What is your therapist’s opinion on psychiatric diagnosis?

For me it’s simple:  any therapist who puts belief in the healing value of psychiatric diagnosis is not someone I’d want to seek for help.  I have often thought that it would be easy (though pointless) to teach Kindergarteners to diagnose people according to the DSM.  It would probably be easier than teaching them how to read and write.

Psychiatric diagnoses are not only simplistic, but actually tell nothing about how to be useful with people, that is, how to have a relationship with them.  Being a good therapist is a gift — the gift of an artist.  Diagnosing people is painting by numbers.  But worse than that, it’s harmful.  It blocks growth, spawns stigma, and muddies waters.  And though it might comfort some people coming for help, for there are always people who will be comforted by the air of science, diagnosis doesn’t help people find their way out of the maze of trauma.

What is your therapist’s opinion on forgiving parents?

When therapists are quick to forgive parents their errors, and are quick to preach forgiveness, I am quick to say that I don’t trust them and I don’t want to refer clients to them.  To me, forgiving parents is not part of the healing process, no matter what the Dalai Lama or Eckhart Tolle or Mother Teresa might have said.  Yet so many therapists preach forgiveness.  Why?  Because they haven’t done much to heal their traumas and instead took on the mindset of their traumatizers.

Those who preach forgiving parents are really just preaching dissociation.  No one who has really gone into the depths of his or her childhood despair and rejection — that ubiquitous childhood experience — would expect or encourage forgiveness.  Instead they would respect the anger and sorrow and even rage that comes with breaking dissociation, moving through depression, and following the trail of grief.  Healing is hell, and there’s no way around it.  Often it entails breaking, and breaking deeply, from those who set up or even directly caused the trauma.  To touch upon an earlier subject, this is another reason why I tend to mistrust therapists who have children of their own.  So often when people have a child they are quick to realize how imperfect they themselves are as parents, and in so doing are quick to forgive the imperfections of their own parents.  This might sound healthy on the surface, but I have observed that it’s a lot easier for parents to forgive those who traumatized them than to look at the ways they are culpable of replicating those traumas on an innocent other whom they created.  To me, preaching forgiveness is a sign of a stymied healing process, and why would I want to go to, much less pay, such a person for my own healing?

Does your therapist work to recognize the traumatic roots of your present-day problems?

A good therapist works with you to seek out the childhood root of your problems in order to help you solve them.  Our screwed-up behaviors and thoughts didn’t just come from nowhere.  They are not chemical imbalances and you are not a freak of nature.  Our problems are coded — and sometimes not-so-coded — expressions of what happened to us.  They tell the stories of what others in power did to us and didn’t do for us.  They tell of our history of pain and abandonment and loss and letdown and violation.  They tell of our parents’ failures, both overt and covert, intentional and unintentional.  If a therapist doesn’t seek to look at your life in the framework of your childhood history then how in the world are they looking at you?

Although I acknowledge that there is definitely a time to study and face the here-and-now and not put it on the back burner, any good therapist knows that those who do not understand and heal the wounds of their childhood history are doomed to repeat them.  I have, however, observed that many people who come to therapy are not interested in studying their childhood.  They may not even remember it — and may want to keep it forgotten.  This can help keep pain at bay, but it makes it impossible to evolve.  In fact, I would go so far as to say that if people in therapy don’t study their childhood history and make really good sense of it then they’ve never really engaged in therapy.  And chances are such people will think this essay is a little, or maybe more than a little, crazy.

What if you decide you’re stuck with a lousy therapist and simply can’t find a good one?

Personally, I’d try self-therapy — or whatever word you want to use for it.  That’s what I ended up doing — and that made all the difference.  In fact, I think even if people do find a really good therapist it’s still in their best interest to simultaneously do self-therapy.  After all, it’s not the therapist’s responsibility to heal you — it’s yours!

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90 COMMENTS

  1. Daniel,
    This was an entertaining and interesting article. I like your point about self-therapy. Meta-analyses, like those presented by Sami Timimi in one of his talks on Youtube, show that what the client brings to the relationship and what they are doing outside of therapy is much more important than what is going on in therapy. There is a lot that people can do for themselves with awareness and effort.

    I have to question you on one point; you said,
    “Too often they have, by becoming parents, stymied the potential of their own internal growth process… I am skeptical of anyone who has kids. After all, those who have children most directly contribute, and have contributed, to the problems of the world.”

    I thought this was a joke at first. But maybe you are being serious… if so, what sort of realistic evidence leads you to this notion about having children correlating with being a poorer therapist, or is it simply based on your feeling about how overcrowded /problem-filled the world is? Given that over 80% of human beings have children, that doesn’t leave a huge pool of therapists who aren’t “tainted” by their offspring in your view. Realistically I’d guess there are loads of therapists with children who are great therapists, and many without children who are poor therapists.

  2. Thanks Daniel. I found this article entertaining and enlightening as well. To me it points to the fact that if anyone were good enough to be a good therapist they would probably be too good to the point of me idealizing them and thereby eliminating the benefits. Honestly, I don’t really trust therapy and haven’t been able to go in many years, despite occasionally trying to convince myself I “should.” It seems finding friends with therapeutic qualities is easier, freer (not just financially, but in the sense that there is no false paradigm or fake roles being played out, or if there are, they are acknowledged as such) and more honest.
    I’m a bit too scared to trust a therapist as re-parenting influence, despite having heard of friends who have supposedly had that experience and benefited from it. Of course, it would be great to be re-parented sometimes, yet I guess I would never be able to let go enough into the “game” to allow it. Hmmm….brings up vulnerable feelings to even think about that…yet something in me just doesn’t believe in therapy for myself I guess, when I’m honest with myself. Bummer. I wish I could.

    • Chaya
      I think you are very wise indeed, not trusting therapy. Essentially it places one at an enormous power disadvantage that, as an adult, is quite unnatural to volunarily commit to. Therapy is a relationship that is open to the most horrendous abuses imaginable, and really should only be entered into if there is a very real and pressing need.

      In many ways it is no less dangerous than medication – a fact I think too few people acknowledge.

      Don’t regret not being able to make yourself go there – just keep on being respectful and aware of where you are at….and thankful that you are in a position to make such a wise choice!

    • “It seems finding friends with therapeutic qualities is easier, freer (not just financially, but in the sense that there is no false paradigm or fake roles being played out, or if there are, they are acknowledged as such) and more honest.”

      Exactly. Most people simply need a good friend and psychotherapy is a fake relationship.

    • The problem about idealizing is very real. A lot of this article and the comments is about reconciling ourselves to the fact that this world does not seem at all ideal. People seem to have an innate need to look for justice and truth in the world and the desire to see it embodied in a person is understandable – but it’s never going to happen, since we are all “beings in the process of becoming.”
      I think a good therapist would be one with the least ego possible, who would turn his clients back to themselves at every opportunity and let them go through self therapy with a little gentle prodding when necessary. Needless to say, most of us have experienced the opposite where the “professional” was too eager to flout his professional skills.
      As i read the comments here and the replies of the author, one thing that encourages me a lot – something very beautiful, actually – is that people want to forgive each other, to find the good in one another, not just because it’s a more comfortable existence that way, but because instinctively, intuitively, we all want to create a better world for ourselves and each other. Forgiveness is an incredibly complex subject and for a person without a belief in some kind of Divine Providence i think that real forgiveness will forever remain elusive (and hard to attain even with belief), but the aim to get there is something very special and precious.
      There’s so much trauma in the world, so much suffering – but there are also so many people who want to make the world better. it’s a privilege to be a part of that

    • Chaya,
      (I like your picture). “I wish I could”, you eloquently express your desire and ambivalence. Many accounts suggest that a “guide” can be useful if not necessary. The “solo path” is not for everyone. Friends are not therapists (although they might be much more). Keep looking as there are fine persons out there who can help.

    • Right. I would add that in my experience, having kids opens a person up to levels of compassion for others that people without children don’t easily access.
      I would also question many people’s motivation for those who don’t have children. Maybe they have “stymied their own growth” by giving of their precious time to others who are dependent on them – but isn’t that part of what being a compassionate human being is all about – giving of oneself to others? One could argue the opposite: A therapist who is so focused on his personal growth that the idea of having children and dividing his attention and strengths with others is anathema, will view his clients simply as another way to achieve that personal growth, by providing him with a feather in his cap, or, if the therapy isn’t “successful,” as a drain on his resources and a pain in the neck.
      If the therapist really is good at what he’s doing – helping others to reach their potential – I would have thought that he was doing mankind the greatest service by having children who will hopefully follow in their parents’ footsteps.
      As an aside, I’ve found as a mother that when I’m using a fuller range of my strengths and capabilities i.e. not just those that are demanded by being a mother (although most are!) then my children gain from my increased satisfaction with life and joie de vivre. So I don’t agree that children/spouse suffer from a parent being devoted to his job, as long as it doesn’t go overboard. I would say the opposite – that it’s complementary.

  3. This first part of y0ur article is almost exactly what happened to me. I had a gut feeling this therapist who I was seeing for over a year who is a woman was a total snob and always treated me at a distance and a few times even laughed at me behind my back. Even though I was suicidal and chronically depressed she never once ever called or showed any effort that she really cared. I wanted so much for her to like me and care about me but now I realize it was completely pointless because I don’t think this women had any heart at all or she just didn’t like me. I also had a suspicion she was gossiping about me to other staff. Like you I tend to be a very real and honest person and that probably pissed her off. I even bought her a thank you card. It’s been two weeks since she left the mental health clinic I’ve been going to, and after opening my heart up to this person which is very sacred to me, all I got from her was “by” with this fake empathetic look.

    I never want to do therapy again, the whole thing at least in my experience is completely devoid of any real warmth or compassion. I feel like my trust and heart was taken advantage. Even though I’m a man, I tend to be very sensitive, its not a quality I’m proud of. After all this I feel even more hopeless about the future.

  4. “To me, forgiving parents is not part of the healing process, no matter what the Dalai Lama or Eckhart Tolle or Mother Teresa might have said.” Yet so many therapists preach forgiveness. Why? Because they haven’t done much to heal their traumas and instead took on the mindset of their traumatizers.”

    Daniel, I’m going to offer a different perspective, here. My healing was centered around forgiveness, which I learned about later than sooner in life. I learned, from my parents, by example, to hold grudges, because they did. Then, I unlearned this, because I learned that carrying a grudge was like carrying around baggage, and I saw how this weighted my parents down daily.

    I did not want to keeping carrying crap around like this. I had done years of therapy which amounted to nothing because no therapist was recognizing the effects of an insidiously abusive family dynamic.

    When I finally felt burned out on struggling emotionally with my family, I took a workshop where I learned all about the healing energy of ‘forgiveness,’ which meant letting them off the hook, once and for all, and looking at my own path and story, seeing how all of this fit into MY life path, detaching altogether from the family current. I did not abandon my family, but after forgiving a couple of them for their less than uplifting messages to and behavior toward me, I changed my boundaries with them and took back my power, shifting the relationship with my family into one that was not harmful to me, because by forgiving them, I got a clearer sense of who I was, and was able to detach from their life perspective, which I do not share. This turned out to be an ok thing, detaching from the family philosophy of life and way of being.

    As a result of this particular healing work, I healed with my dad before he died, which was a miracle God-send for me. Now, I can see the gifts my dad bequeathed to me and the value he had for me. He was abusive without a doubt, but he was also gifted in many ways. He was also a very loving and compassionate man, a physician who worked with people who could not afford medical care. We’re all such paradoxes, can’t pigeon hole anyone, really.

    So forgiveness helped me to 1) heal my heart and learn forgiveness in general, 2) take responsibility for my life and path, 3) redefine who I am in a relationship, and 4) appreciate the value which my dad brought into my life, which I would have otherwise missed had I stayed angry at him for not being a perfect father. That’s off the cuff, I’m sure there is more if I thought about it for a few minutes.

    I’m not implying that forgiveness is THE answer all by itself, but I think it’s a critical component. We still have to work out whatever distortions occurred as a result of toxic relationships, but at some point, forgiveness really moves us forward because it leads us to self-responsibility while expanding our capacity for love. The place you give it hear and what I pick up from how you phrased this, especially the word ‘preaching,’ I feel belittles what is actually a vital healing step.

    Btw, I don’t follow the Dalai Lama nor have I ever read Eckhart Tolle–in fact, I get a bit tired of hearing him quoted. While his words ring true, I don’t find him terribly convincing. I do, however, have a great deal of respect for the works of Mother Teresa, probably because I have a personal story about her which really opened my heart.

    My 2 cents on forgiveness. To me, embodying forgiveness is vital in healing, in that it shifts our perspective, and therefore, our personal reality, for the way better. Doesn’t mean we’re doormats. Thanks as always, Daniel, for speaking your courageous truth as always.

    • Almost left out the all-important punch line: as a result of my heart healing and forgiveness work, and also by making a film where I express all of this and sending it to my family (this was after my dad had passed away), the family system dynamic has shifted dramatically, as they grew as a result of my doing all this work on behalf of healing from family issues. It was textbook family healing–I spoke my truth and forgave, and as a result, they all had opportunities to grow, shift, and heal their own hearts, which most of my family has done.

      So to add to the list of benefits of forgiveness, it is contagious, which is a good thing.

    • Alex,

      what you say resonates greatly — as the oft-cited cliche has it, forgiveness is to help the forgiver, not the party being forgiven. But I wonder if Daniel’s point is coercion—i.e., the therapist insisting that the person forgive (not helpful), rather than showing that forgiveness can be healing in and of itself, and letting the person decide.

      • The phrase which most caught my attention and where I beg to differ is, “Forgiving parents is not part of the healing process.” Forgiveness is most definitely part of a healing process which occurs as the result of being harmed by others, whomever they are. And when it’s parents, then I feel this is especially the case, for the sake of our own inner balance.

        True, it cannot be forced, as nothing should ever be forced, to my mind. But at some point, it will be extremely relevant. I don’t see how it could be otherwise.

        • p.s. being around people who are unforgiving is tough, I think, as I feel it is risky and unsafe; these are the folks who carry the past around with them in a very heavy and oppressive way, and whom I feel continue to pay forward the abuse, one way or another.

          • I don’t think forgiveness is necessary. I think it depends whom and for what you forgive. Sometimes letting yourself hate and despise someone can be liberating as long as you don’t turn it into an active obsession and a quest for revenge (hate is not the opposite “equivalent” of love – it’s a different beast altogether).

            I think people tend to overemphasize the positive feelings because the society conditions us to do that (forgiveness is very good for the abusers too) but the negative ones are also very important. I don’t think one is a full person without both.

  5. The fact that so many therapists, including Freudian analysts (!), rely on drugs attests to the limited efficacy of therapy, either because good therapists are hard to find, or therapy (I assume you mean talk therapy) is not appropriate in all situations, or some combination of both. Early childhood experience is of paramount importance (Bessel van der Kalk makes the case brilliantly in his book “The body keeps the score”), but assuming that it ALL boils down to bad parenting is reductionist, non-scientific and ultimately not helpful to the cause of effecting positive change in the mental health system (channeling Bettelheim is not good strategy). Early childhood experience is critical, but there is more to it than that. A recent study from the UK found that bullying has a greater (negative) impact than parental shortcomings. An article previously posted on MIA (Inheriting Stress) speaks of the intergenerational transmission of trauma (the impact of epigenetics) even with OK parenting. A wise therapist needs first to come to grips with what he/she does not know, and help the client identify the best intervention, which may be outside the therapist’s experience or area of expertise.

  6. Dan, Interesting and honest post .You taught me a lot about therapy. Living on disability income I’ve talked to social workers . I thought therapist’s were for rich people. Are they the same thing? When I did talk to the SW’s I most alway’s automatically put on my method acting academy award winning John Lovett hat , at least totally on guard. I mean these people can rearrange your life by what they write on paper or recommend to somebody. And I have seen that paper and it’s a bunch of horseshit . And that horseshit follows you around . Then more horseshit gets added and pretty soon your surrounded . Of course if your acting is good enough you can get these yahoos on your side.
    I thank G-D I’ve most always had at least one good friend to talk to. In fact about 15 years ago I had a epiphany . Here it goes . In any relationship parent and child , husband and wife , strangers meeting, or any people together . If there is not friendship going on between them there’s nothing much going on at all .You can quote me on that one . It just came in one day .
    Now as far as people that have hurt you .( whoever) My policy is always call out to their face the people that have hurt you. There is nothing wrong with payback . That way you don’t carry stuff around like Dr. Strangelove and harm other innocents. I even had people eventually apologize and explain themselves which made forgiveness and reconciliation possible on occasion. Some still have payback coming . They just haven’t got it yet .Some are are bound to get it cause of the way they behave.
    Dan one of these days when you least expect it you my find your self responsible for a child you love and I’m sure if that happen’s you will rise to the occasion as best you can. Ahhhhh Friendship.
    Fred

    • Great comment, Fred.

      I confronted directly each and every abuser, one way or another–from family members to therapists to social workers to psychiatrists–and each time, the abuse got worse and worse, and then ‘the system’ (referring to group system) would take over, and that would really get especially toxic. I did all of my forgiveness work after it was apparent that abusers can be relentless and that there are enablers around that gives the illusion of power to the abuser. Either way, it can be dangerous, although I agree that one way or another, that energy needs to be given back.

      I think this is where it gets interesting, and totally unique, in terms of healing. We, as humans, can be very conscious and creative in how we give back what is not ours, while at the same time, encouraging some kind of healing to occur, so that the entire dynamic of the group system changes for the better, and not just stays stuck with same group roles as before. For me, that was a lot of trial and error in communication, but I learned a great deal in the process of finding that delicate balance.

      Most often, that means radical change in dynamic and perception. It also tends to bring with it some surprises as truth comes to light about what really is going on in that group system, which is where change is most radical. Fascinating process to watch this, and quite eye-opening.

  7. Daniel, I agree with most of what you said. I don’t agree that a therapist with children is going to be a bad therapist. This, to me, is too much of a sweeping generalization. i think any therapist who is distracted by something in their lives, be it children or spouse or “that other career” or their own issues, including financial struggles, won’t be a good therapist. That’s pretty much the rule of thumb for any career, right? A person not fully engaged in their job won’t be a good worker. There are indeed people who successfully juggle career and work, who are either mothers or fathers.

    I often looked at how long they’d been working for the agency and the overall stability of that agency. What about supervision? Who was ruling over them and just how money-driven was this ruling organization? I’d rather see a therapist who did indeed have a go-to person, but not one that was overbearing or restrictive or regularly threatening employees with firing if they didn’t comply.

    I believe that my biggest mistake in life was to go to therapy. It enslaved me for over three decades. Eventually, I realized these people were power-mongers who had the gall to turn me into a dependent child and act as surrogate parents. When I broke free, I gained a new sense of self I never could have had otherwise.

    To me, therapy is a form of prostitution. These people collect money from needy people who otherwise have either no friends or no one to talk to. I find that therapy, because it condones these dependencies, is causing us to talk to each other less, to care less, and to shove the unwanteds of society into “treatment” instead of offering friendship, caring, and empathy. Societies that have less therapy most likely have more cohesive families. I can tell you that here in Uruguay, where there are hardly any shrinks, we also have very few nursing homes nor the equivalent of the ADA. Why? Because families care for those who are elderly or sick. The coolest thing is when I see a person my age wheeling an elderly parent through the market, doing shopping together. You don’t see that nearly as much in USA. Disability is seen differently and I truly believe that since people help each other so much more, disability laws are not actually an issue. But you have to come here and see for yourself.

    After I saw that therapy didn’t help my eating disorder one bit, I begged for pills. I knew the new research on this and I wanted in on it. I believe eating disorders can’t be treated by therapy since I see them as not being mental health issues at all. However, it took me over three decades to realize this.

    Self-therapy? Yes, everyone does self-therapy and it’s more effective than anything you’ll get in an office. i had to be my own nutritionist, too, and really, that’s why i do no suffer from an eating disorder anymore. I feel like it is part of my experience, so it is within the story of me, yet I no longer suffer as I did for so long. They say eating disorders are the most fatal mental illness. While that might be true, I don’t see these problems as “mental” at all. That’s why “recovery” rate is so low.

    Julie Greene (my real name)

    PS if anyone needs to talk about ED with someone who has been through it, or if you know anyone who might want this, you can contact me at 617-923-8524 (leave message) or write to me at [email protected]. I write back to everyone and I don’t charge a cent.

    • “To me, therapy is a form of prostitution. These people collect money from needy people who otherwise have either no friends or no one to talk to.”

      This is how I feel as well. It’s a fake relationship for money. This is why I refused to talk to them (which later proved to be a good idea since they were all an abomination). Nonetheless there may be value in this for some people just as much as some people find help in prostitution.

  8. Re: Forgiveness

    IMO, forgiveness is a spiritual law. Much like gravity is a physical law. If you hold something in your hand and release it, the object hits the ground, ever time.

    Forgiveness (or lack thereof) is a decision. So is love for that matter. Both may involve feelings, but neither is contingent on feelings alone. In other words, if we wait until we feel like forgiving, it may never happen.

    Nobody should feel forced to forgive, but it cannot take place by force anyway. Just as love cannot be forced. I think there is often a confusion about forgiveness versus reconciliation. One can forgive someone and take them to court. Or forgive a friend or relative, and never see them again. The two are very separate issues.

    I’m not a perfect parent, but throughout the years, when I’ve made mistakes with my sons, I’ve gone up to them later to explain that their dad didn’t do things perfectly, and said I’m sorry, and asked for their forgiveness. I think this taught them that it was okay to feel hurt, recognize that it was my issue, not theirs, and realize that forgiveness was their choice. I think this may be why they are better men than me; which is what every I think every dad hopes for in his sons.

    Duane

    • “Forgiveness (or lack thereof) is a decision. So is love for that matter.”

      No and no. I disagree vehemently… but – maybe that is different for different people. I’ve sen people who claim these things are decisions and they indeed do act like this in their lives. For me it’s not this way and every time I try to act as if they were it’s a failure all around.

      I think people are different and that’s why everyone has to find his/her own way. Telling your story may help some people but it’s never a recipe for everyone.

  9. I want to add one more thing. A therapist must recognize psych abuse and must at all times be an advocate for their patients. So if a patient reports abuse in a facility, as mandated reporter that therapist is obligated to raise hell. Mental health is more about human rights, that is, right to privacy, right to respect from others, and right to be treated in a dignified manner.

    I want also to respond to Duane’s wonderful comment on forgiveness. I was once told to beg Jesus to forgive someone who had harmed me. Wow, did that feel forced (I’m Jewish, too). You can’t force it, you either feel it or you don’t. If there was one thing I hated, it was saying “I forgive” when I never felt that inside. It felt cheap, fake, and in the long run, was totally unhelpful.

    I certainly forgive my parents. I hate that therapy was very quick to blame them and turn me against them for a while. I feel that therapists duped my parents into paying the bills for their incompetency and for their continued damages to me. I forgive those therapist who clearly tried but were incompetent or ignorant. I don’t forgive the ones who hadn’t resolved their power issues and acted like the gestapo.

  10. Thank you for this. I agree that preaching forgiveness is a definite red flag in a therapist. For people who have been traumatized in abusive relationships, forgiveness can mean siding with the abuser and abandoning the part of oneself that has been hurt. That is the opposite of healing. Sometimes, a person needs to be angry and put the blame where it belongs – on abusers – as this is the only way to cut through the shame that has been installed inside of them. Forgiveness may or may not later arise on its own, but forgiveness should not be the goal of therapy. And nobody loves the doctrine of forgiveness more than abusers, because it lets them off the hook for what they have done.

    I also agree that the parent status of a therapist should be taken into consideration by the client. The last thing a traumatized person needs is to be invalidated or gas-lighted by a therapist. This is exactly what will happen if the client was traumatized by spanking, let’s say, and the therapist has spanked their own child and cannot deal with the feelings that come up when spanking is remembered as abuse by the client. Now, it could be argued that any therapist who was spanked in childhood might have an emotional incentive to minimize spanking’s effect on the client, in order for their own childhood memories to remain idyllic. That is true, but parenthood can only magnify the effect. And it does.

    This is not abstract for me. I have been bullied in therapy to forgive and I have also had adverse childhood experiences minimized because therapists couldn’t handle their own emotional baggage. So I think even the more controversial points in the article are well founded. I feel tremendous sympathy for the people who report being railroaded by therapists into inappropriately (for the client) blaming someone for their problems, but my therapy experiences have been just the opposite. Most of the therapists I’ve seen have done everything they could not to go there.

    • “For people who have been traumatized in abusive relationships, forgiveness can mean siding with the abuser and abandoning the part of oneself that has been hurt.”

      It can also cause a person to rise above their environment, own their experience, and shift perspective–which is not only healing for the individual, it creates shifts outside of one’s self, because when we truly forgive and work out the trauma as our own, then we are no longer susceptible to bullying because it has transmuted, the perspective has changed. You want change? This is how it happens.

      “And nobody loves the doctrine of forgiveness more than abusers, because it lets them off the hook for what they have done.”

      I think a lot of abusers don’t feel they have anything to be forgiven for, so to many this makes them defensive. When we walk away, they are left with their own bullying mentality. Most people who practice abuse or oppression on others love it when they piss people off, because it shows them they have power over others. I think forgiving disempowers abusers. That’s been my experience.

      Learning what it means to truly forgive is empowering, because this is how we take back our power, by releasing the burden of resentment, which harms our bodies in the long run, and keeps us vulnerable to life stress, as resentment is chronic stress.

          • Alex,

            I agree with what you wrote.

            IMO, it’s about overcoming past traumas, and when these traumas involve abusers, they can only be overcome by releasing the person who did the harm.

            This involves moving away from the abuse if they deny the abuse, and are unwilling to own it and stop it.

            But this is their issue. IMO, the only way through this is by forgiveness.

            IMO, anything short of this leaves the person who was harmed *connected* emotionally to one who harms, without their own recognition. This hardly lends to healing.

            It traps a person, when the human spirit needs to be free.

            Duane

  11. Daniel

    thanks for this piece. I have been considering my position in therapy for a while now, and this blog and the responses are helping clarify where I want to be.

    I am fully with you regarding forgiveness, but perhaps not for the reasons others may have expressed for disagreeing with you. To me forgiveness is merely a sanctioned reversal of the power imbalance that formed the basis for the original abuse…as the “forgiver” you become the holder of the power over the person who wronged you. I tend to think that placing ones self in a position of power or superiority over another, even if only in one’s own mind, and even if for perceived “good” is somewhat dehumanizing to both one’s self and others.

    An apology when heartfully given and received has enormous healing potential, but forgiveness per se as it is often practiced is a sham, and anyone who advocates for it as necessary and/or sufficient for “healing” is operating out of power-based thinking and that is not helpful.

    I have some issues with your views on parenting and therapy – I suspect the ONLY way to esolve some issues is through parenting and re-parenting.

    But then again, I think I have some even greater issues with the therapy relationship as it is currently defined and practiced…it is simply too power-based and too open to abuse, with little or no recourse for the “inferior” partner….it is simply not a healthy place to go!

  12. The bit about parents being therapists I find a tad controversial.

    The rest I love. It seems an important discussion to have.

    I remeber Peter Breggin on one of his internet radio shows saying that after every therapy session, or every time you see a human service professional of any kind, you should feel better (a little better, or a lot better, he didn’t specify). I took that to heart and decided if I was going to offer to help anyone in distres that is what I should aim for.

    Conversly if I am seeing someone to try to get help with my distress and I do not feel better after each conversation I need to talk to them about this. If things do not improve after two or three session I need to say goodbye. That’s my rule these days.

    life is still a pain though, a lot of the time.

  13. Wow, well, I’ve commented a lot on this blog, so I’ll make this my final post here (which means I can’t even come back to read because I KNOW I’ll be tempted, but I’ve made my position clear and don’t want to overstate it).

    So for the sake of my own closure with this issue of ‘forgiveness’ as it’s been discussed in this blog, I’m both surprised and not surprised to see the utter *resistance* to even exploring the issue of forgiveness. Our society is one of deep resentment for the betrayal most of us have experienced.

    Forgiveness a practice, which takes a lot of strength, courage, and heartfelt humility, and which brings clarity when we are sincere in our hearts about it. I’m seeing forgiveness here associated with a lot of things which I feel are more illusory than not, projections.

    It’s simply about healing the heart. Nothing else to think about, when we practice forgiveness. Indeed, that is a choice. Mine was to make heart healing a priority, and it has served me well.

    Main thing is that it healed my partnership, going on 30 years now. We blamed each other for a lot of things, and we each deserved it, as well as the forgiveness we practiced. That was the experience of a lifetime that led to supreme transformation for us both.

    We are not in a power relationship whatsoever, it is a total partnership. We’re building a performing arts healing center together, and it’s happening. I’ve no doubt that this would not be the case were we not to have practiced forgiveness. It brought us into a well-integrated partnership, because we were both humble enough to own our shit with each other.

    Thanks to all for your authentic truth. It’s what I enjoy most about open dialogue, learning the truth of others and appreciating this global diversity. Also, getting clear on my own perspective and refining it for my own clarity and grounding.

  14. I have found great healing and support from several therapists over the years…those who were humble and willing to share a bit of their lived experience with me at the right moments helped me most…and that includes therapists who shared their joys and struggles raising their children…as a parent, I have found it my greatest honor and challenge to support my children in growing up and having the best foundation possible…the therapists I have had who were also parents helped me the most with my commitment to be my best as a parent and as a person…I think that there are many different perspectives that all have merit…best wishes Daniel…I admire your contributions which have exposed trauma and hypocrisy in psychiatry , your work sharing what actually helps people, your honesty and your integrity…

  15. Daniel

    A very challenging and provocative blog that makes many good points.

    Your point about the downside of being a parent as it relates to the quality of a therapist is very insightful and clearly outside the “box” of conventional thinking.

    I have been a therapist for 22 years and a parent of three girls (2 adopted). The youngest was 15 when I became a therapist. I believe I was slightly above mediocre as a parent. Perhaps my greatest attribute was that I did not over indulge my children. My focused involvement in left wing political activism (trying to change the world) prevented me from falling into the trap of teaching or providing entitlement. Fortunately, my children do not resent me for this, but see this activism as a vital form of education and exposure to different ways of thinking.

    Raising a nuclear family in this society is a powerful cultural expectation, especially for women, and has restraints, limitations and conservative pressures that very often limit our freedom to radically change ourselves and challenge the status quo. While many people would say that parenting is an unselfish way to conduct one’s life while dedicating such an enormous amount of time and energy to raising children, it can also be a very narrow and selfish approach to life that follows powerful cultural expectations and unconsciously driven personal needs.

    I have great respect for those revolutionary activists, especially women, who have resisted these powerful cultural expectations in order to more fully dedicate themselves to their political activism and not be weighted down by intense family type obligations.

    This could also apply to aspects of being a better therapist, which also requires great personal and political responsibility and dedication of time and self sacrifice in order to do decent work with people who are very often at a quite vulnerable stage in their life. While the work of great artists is most often an act of political critique and protest of the world; the same could be said of good therapists. How can a therapist help someone if they are not politically and culturally aware of what is wrong with the world and the environment around them, and also prepared to fight to transform that world? Daniel makes this same point when he asks “Is your therapist a radical person?”

    Yes, some parents can work to rise above these family limitations, but I believe Daniel’s cogent point speaks to some of the inherent conservative and selfish cultural weight that derives from family obligations in today’s world and how it influences our world outlook and behavior.

    I share Daniel’s and Uprising’s views on forgiveness. One’s righteous anger about abuse and trauma must first be as fully understood as possible and then channeled in a way that moves both us and the world forward. We must find a way to avoid allowing anger to control us in narrow and self defeating ways, but try to redirect it in a positive way. To just let it go or “forgive” it away will not really work in the end or lead us toward full transformative change. To change the world is to change ourselves.

    Richard

    • Richard, I recognize that you have worked long and hard in the field to help make change happen, and I have great respect for that. I’m sorry that you are not moved by a father and son reconciling after a difficult relationship which caused me to feel a bit crazy at times. To me, family is not about obligation, it is about love and support. Maybe it’s my culture, being Latino and Jewish. I do find the North American mainstream white culture to be awfully cold when it comes to family. That’s not me. Nothing to do with obligation, but more from my heart’s desire.

      Families have become the hotbed of unseen trauma, and this challenges everyone, whether clinician or client. I took control, here, and as a result, the family system changed in every respect, and we have all evolved from what had been a very challenging situation for me and my family for years.

      For a therapist to not see value in this is a red flag to me, as is diagnosing from afar, with no foundation. How could these NOT be red flags, if we are serious about walking our talk, here.

      For me, true forgiveness and letting go of resentment and blame, and instead taking full responsibility for my life experience DID change me internally and caused many transformations for me, as well as for all those involved, including my partner, who also healed with his family and shifted his perception, thanks to my example. I was the one who had embodied disability, so my healing was inspiring to my partner and he followed suit.

      What we both discovered together was that holding on to anger, resentment, and bitterness is what causes all sorts of illness, both physical and mental, as well as emotional instability. Perhaps in another time this fueled the illusion of change, but those days are over.

      Peace is not gained with war and fighting of any kind. I think that’s common sense that many seem to not grasp.

      I give up around here. What I see mostly is the same old judgments and misconceptions that came to light as I traversed in the mental health world. Cold.

      • Alex

        My response above about “forgiveness” represents more general comments about how this process in various therapy approaches is often over rated and too often pushed on people. This was not directed towards your particular posts. I am NOT denying the authenticity of the work you have done with your father; it does sound reconciling and healing for you.

        I wish I had worked harder to do more work with my own father before he died in 1991. I was just becoming a therapist at that time in my life. As I have pondered more the fact that his own father died when he was 13 years old and then he was sent to a military prep school, this certainly handicapped some of his ability to parent in a good way. If I had the opportunity to do it over again there are many issues I would love to engage with him about and perhaps achieve a greater state of healing and even more forgiveness.

        You say: “Peace is not gained with war and fighting of any kind. I think that’s common sense that many seem to not grasp.”

        I could not disagree with this statement more. This is simply not born out by any analysis of history and does not represent common sense. Our own civil war was an inevitable consequence of certain historical class contradictions that allowed for the existence of slavery and violent means were necessary to end that form of oppression. The violence began with the slavery in the first place. Of course its legacy still exists today in many forms and has not ultimately led to “peace” for people of color.

        As long as classes exist in society there will be an enormous amount of violence perpetrated against those on the bottom. Are you suggesting that the oppressed are not ever supposed to ever defend themselves, even using forms of violence to do so? If a woman being raped uses some form of violence to defend herself to achieve her own survival or some level of “peace” in her life is she somehow wrong or corrupting her human essence?

        There can be no peace without justice, and there can be no justice without struggle. And it is inevitable that the oppressed will be forced to use violence to defend themselves and achieve peace in their lives at this stage in human history. I do believe we can and must achieve a point in human progress where the forms of social organization create the material conditions where violence of all forms will disappear and no longer be necessary.

        Richard

  16. Daniel, thank you for this excellent and essential essay. I found it,, like so many articles here on MIA, to be a breath of fresh air, thought provoking, and not a little self-identifying. To wit:

    I can so relate to the farce that therapy often descends into. One funny experience I had came fifteen years ago, for example, when, after an horrific experience triggered some untended and unresolved trauma (unbeknownst to me then). I was referred to a male therapist by a lawyer friend who had attended the same grad school some twenty year earlier. Upon entering his office I noticed a fire hydrant at the far end of a rather large office. I couldn’t look away, glancing at I every few minutes or so. I found it both ‘cool’ in one sense, as I find dissonance in general to be appealing. But after a few more glances the therapist asked me, ‘do you know why that fire hydrant is in here? I said no; where he then replied that ‘We’ put out fires in here’! And there it was, what it was that gnawed at me. Fire! I asked him if all fires were attempted to be put out. He said, unequivocally, ‘yes’. I then mentioned that fire was symbolic of transformation-trying to get some, perhaps, greater clarity than I had coming in; than my Jungian tendencies might otherwise lend. He shut me down pretty quick, and then we went to another topic when, then, I found his very next comment (I can’t recall now what it was) to be rather sophist or, in the least, shaky, and called him on it. He then erupted in- to this statement-and I mean was loud and angry: ‘do you have to intellectualize everything!” At the end of the session, he wanted me to take so psychological test ( don’t recall which one) that cost $300. He said it would help him to better understand me and assist his treatment. I told him, ‘if you take it too, and we’ll compare the two and see how they line up for an optimal treatment praxis. He then told me he couldn’t work with me. Duh!!! I bit my lip and left before it could get any worse.

    I haven’t met a therapist yet-and I stopped looking over a decade ago-that’s worth my time. I know there are good and some very good enlightened Soul’s out there, and I would be blessed to have some time with them. I mean…sometimes it just a privilege to speak with someone who’s been down a similar road, and has gained some hard earned wisdom and intelligence because of it. I thought that’s what was at the core of therapy.

  17. i enjoyed this post, thanks daniel.

    re: forgiveness – in my experience, if we can’t forgive our parents, then we also can’t forgive that part of ourselves that inevitably reminds us of – and acts similar to – our parents. thus, we end up not being able to truly forgive and love ourselves, if we can’t forgive our parents, at least on some level, and that’s a huge obstacle to growth and happiness.

    there’s a time for everything, and i agree that pushing clients to ‘forgive’ before they actually really understand what they are forgiving is enormously counter-productive, and usually just pushes emotional responses down a level further, where they become even harder to access and heal in the future.

    these ‘lost emotions’ often pop again later in life as the basis for so-called psychosomatic physical issues.

    If the problems are not solved at an emotional level they don’t disappear: they just cause other emotional and / or physical issues down the road.

    That said, in my experience many clients are very resistant to plumbing the depths of what their parents ‘did’ to them, even if they have a superb therapist who’s encouraging them to do that work, because it’s far too painful, especially if they themselves are parents, and are aware that at least on some level, they are doing similar things to their own children, usually unwillingly, and can’t seem to stop themselves from repeating their parents’ mistakes.

    it takes a very big therapist, with some very big spiritual back-up, to have the courage to encourage their clients to plumb those depths. if a therapist hasn’t gone to those dark places themselves – and come out of it again – they simply can’t guide their client through the process. i believe it has to have been experienced personally by a therapist, for them to successfully guide others through the process.

  18. rivkalevy,

    I agree. In fact, I don’t think anyone’s “knowlege” can ever surpass their own personal experience when it comes to building good relationships or overcoming past hurts or traumas; or how someone who does not practice forgiveness in their own personal life can counsel others on the subject.

    Unfortunately, there are addiction therapist on their 5th cup of coffee, and 2nd pack of cigarettes: family therapists on their 2nd marriage and 1st custody battle.

    I’ll take a good close friend over a licensed therapist almost every time.

    Duane

  19. I agree Duane , Daniels videos are are amazing , one talented film maker. If I had the do re mi I’d try and get him to direct a film idea that came to me recently. Imagine a modern day take off of the Hunchback of Notre Dame . Filmed at Harvard Psychiatric where Justina was captured . Also at Harvard U with a Bell installed that Qasamoto rings at key intervals. His father who adopted him instead of being a priest is the psychiatrist responsible for the drugging of children and toddlers . His adopted son is maybe hunchbacked but definitely also diagnosed as the S word . But mainly he has taken it upon himself to save the children from his father the well known psychiatrist , other psychiatrists , and from psychiatry itself . His love interest maybe a beautiful nurses aid that also wants to save the children . There is a nurse that posts here that was on the floor with Justina. A little more research , a little more polishing a script,If there were backers maybe Daniel would like the idea. A motion picture like this could bring the children’s plight to the forefront. Can it be done Daniel?
    In Solidarity , Fred

  20. A thought-provoking essay, to say the least!

    I think the area of kids is a tough one. If we all waited until we were fully healed to have kids, there wouldn’t be many kids in the world. Which might be a good thing, except the people who haven’t done any healing at all are having kids by the bushel without any such compunctions.

    My feeling is that the therapist’s choice to have or not have children is not particularly important – the question to me is whether the therapist has done his/her own work of healing and is continuing to do that work as part of making sure s/he is doing a good job as a therapist. I would tend to agree that quality therapists are rare as hens’ teeth, because becoming a therapist in no way requires that the person have accomplished any degree of emotional health or sanity before offering his/her services. I am very much in the camp of Alice Miller (whom I know you value highly as well) in believing that unexamined issues from our own upbringing prevent our being really available to our clients (or our kids) and that we tend to act out those issues that we haven’t consciously faced on both our clients and our children.

    I would never claim to have completed my healing process. My childhood was no worse than most and better than many, but there were traumatic experiences in abundance, and I am quite certain there will always be more to learn about that. What I think makes me viable as a therapist is that I am aware of what happens when my own issues get triggered, and I have processes in place to recognize and get assistance when that occurs. I like to believe that I am very good at keeping my own issues out of the discussion with clients, and I think the results I’ve had speak for themselves. I don’t think clients need a perfect person as a therapist. I think they need a HUMBLE person who recognizes the potential harmful impact of everything s/he says or does, and is very gentle and respectful in all interactions with the client. A good therapist is also constantly working to put the client in the seat of power and helping him/her see ways to regain control of his/her life, rather than advising or critiquing or in any way pushing the client toward the therapist’s goals. This is not easy to do unless you’ve done your own work first.

    I was very fortunate to have found a good therapist on the first try back in my 20s. She helped me get started on the path of understanding my childhood and my own reactions to it, as well as helping me see that I always had choices and options. She had a young daughter she was raising and it did not prevent her from being a very helpful agent in my life. I find it very sad that others aren’t able to find a person like that, and I hope that I’ve been able to be that person for a lot of other folks who have encountered me. I’m sure I wasn’t for every one of them, but I know I have been for some, and it is something I feel very good about.

    I agree that therapy is an art form, and that it takes a different form in each person I am trying to help. As to forgiveness, I think that is completely at the option of the person who has been harmed. Pushing forgiveness would be a giant red flag, because people who do that are usually not comfortable dealing with their own anger and grief towards those who have hurt them. But I also agree with Alex that a time comes when forgiveness makes sense and is healing, at least for some pe0ple and situations. I have certainly forgiven my mother for the most part for her failings early in my life, partly because of my own parenting experiences and partly because of good therapy helping me recognize the impact her limitations had on me. But I still recognize those limitations and have been able to reconsider my expectations of her as an adult so that I don’t keep hurting myself by expecting things that I know she will never be able to deliver.

    Therapy is very complicated and emotionally challenging. A good therapist is very rare, and bad therapy can do a hell of a lot of damage. Perhaps the most important point in the essay is to screen one’s therapist hard and thoroughly, and to trust your gut if it feels like this one isn’t right for you. I’d say the odds are at least 9 out of 10 that the therapist you are in front of will be at best of marginal help. Do your homework and find a good one if you can. They are out there, but you can’t tell by the degree. You can tell best by how you feel when you are talking to them.

    —- Steve

    • A good therapist (or teacher or guide or coach) is also one who challenges their clients, which is how we grow, when we are challenged. Too many therapists enable their clients’ false self-beliefs by wanting to be liked and thought of as ‘competent,’ so they will not challenge the client to grow beyond the relationship, for fear of angering the client. Many therapists I’ve known enable victimhood and are not really authentic with their clients.

      Conversely, many people choose a therapist that will repeat their family drama–from that feeling of familiarity, one way or another–and this is the cycle that often must be broken, for healing to occur beyond a certain point of perpetual stuckness and eternal repetition of toxic relationship dynamics.

      People are not made of sugar, they will not melt in the rain. Most therapists don’t give enough credit to their clients for having their own mind, despite looking for clarity around certain issues. And often, nor do they give credit to the indelible power of the human spirit.

      • I also think the word HUMILITY is, more often than not around here, used in context as some kind of personal attack and a way to demean others, rather than to really understand what it means to be humble. Ask any survivor of the mental health system–how much more humble can one get, than to go through what they put us through? That stays forever.

        Showing confidence and certainty after that kind of experience is a sign of well-being, confidence, and clarity. The more we deny healing in others, the more we sabotage our own efforts of trying to bring about necessary change. Denial of others’ healing is sabotage.

        • One last thing, then I’m off of this particular jag (this topic of what makes or doesn’t make a good therapist is near and dear to my heart, for a lot of reasons): one clear observation I made as I went through my assembly line of therapists, is that most psychotherapists I’ve known get really triggered by powerful clients and don’t own their insecurities around this, which is where the topic of humility would come in, to my mind. This is why people get diagnosed, stigmatized, and gaslighted.

          Ok, I think I’m complete in this area. Therapists–in and out of school– gave me grief more than anything else. This was my experience, not to generalize to the experience of others. But it was a HUGE problem for me, in this field, which is why I no longer identify with the mental health field or its teachings in any way.

          I totally respect and appreciate the challenges of the myriad truths we express here, but if we don’t express what we truly feel from the depth of our personal experience, then we’re not getting anywhere fast, as far as healing, growth, and radical change are concerned. Thank you for the opportunity.

  21. As a newly qualified psychotherapist, so much of what you write resonates with me and yet goes against what i was taught. Maybe in 50-100 years your views will be more widely accepted. I salute your courage in raising awareness on the inadequacies of the way psychotherapists are trained and how some use their title and credentials to hide behind or hold power over their clients.

    • I agree that caution is warranted but at the same time, several years ago, I had a great therapist who because she acted more like a life coach was very helpful. By the way, I feel she tried to tell me that perhaps antidepressants weren’t doing me any good but unfortunately, I wasn’t ready to hear the message. Anyway, my point is that your mileage will vary in situations like this.

  22. Psychotherapy can be harmful to patients. That’s the focus of another blog I stumbled upon and, as a psychotherapist myself, I couldn’t agree more. Like any professional service one might seek out, there are highly competent practitioners, there are those who are mediocre and those who are simply bad apples. So, how does someone in need of mental health treatment know if they are in the right hands? The blogger does such a thorough job of describing “bad therapy”, that I thought it would be useful to share this with your readers for help with evaluating therapists and their treatments. My colleagues in the field might want to check this out as well…

    Paradoxical Asymmetrical Structure of Therapy Relationships (from [trytherapyfree.wordpress.com]

    The structure of therapy is antithetical to and models the opposite of goals one would hope to achieve in real life/relationships:
    1) Goal: mutuality and natural give-and-take reciprocity e.g., mutual trust, mutual respect, mutual sharing, mutual dependence, mutual vulnerability, mutual love, etc.
    Therapy: asymmetrical dynamics of exposed and hidden, wounded and healer, needy and needed, subordinate and authority, payer and payee, etc.
    2) Goal: authenticity, e.g., connection based on both people revealing their true selves and developing mutual love and respect
    Therapy: artificial relationships based on payment, theories, labels/assessment/judgment, contrived boundaries, and one-way intimacy
    3) Goal: independence or healthy mutual dependence
    Therapy: one-sided dependence or co-dependence
    4) Goal: happiness and a generous spirit
    Therapy: self-focus/self-absorption, which is correlated with depression
    5) Goal: trust that is earned based on mutual sharing and commitment
    Therapy: “trust” that is demanded based on status and paternalism
    6) Goal: peaceful terms with one’s past and personal relationships
    Therapy: fishing for problems with one’s past or personal relationships; possibly misleading interpretations/false memories prompted by “innocent” inquiries that damage outside relationships and create incentives to continue the therapy relationship
    7) Goal: honesty, openness, transparency
    Therapy: closed-door shrouding in secrecy, hiding information about perceived mechanism of action and outcome data, subtle manipulation, transference, uneven exposure/voyeurism dynamics
    8) Goal: “Always act in such a way that you treat humanity, whether in your own person or in the person of another, at the same time as an end-in-itself and never merely as a means.” — Immanuel Kant
    Therapy: Dehumanizing instrumental relationship in which the therapist uses the client as a means to profit and gratification by withholding information needed for a client’s true informed consent. Therapist belief that she knows best and that the end justifies the manipulative means.
    9) Goal: ability to acknowledge, take responsibility for, and learn from one’s mistakes
    Therapy: therapist is always right and blames the victim/client when anything goes wrong (and often uses unfalsifiable jargon to cover it up, e.g., “resistance,” “denial,” “defensiveness,” “projection,” “not ready for change,” etc.)
    10) And the list of antitheses between our goals and what therapy models goes on . . .

    If you are considering or currently in therapy, I encourage you to be on the look out for any of these “warning signs” and either inquire initially or address them with the therapist. Being open and direct with your therapist can act as a proving ground for interpersonal interactions outside the therapist’s office. Even initiating termination with your therapist can be therapeutic.

    Therapy can result in profound personal transformation when it is practiced with intelligence and compassion. I agree with the blogger, that the patient and the therapist must see eye to eye on the therapeutic goal, be open and honest with one another, respectful and willing to fess up to failings and to celebrate victories.

    I check in regularly with my patients on how we are progressing (or not) towards their goals. The patient is in the driver’s seat and I am always on the lookout for signs of when they might be overly compliant, dependent or too willing to give up their own stake in our relationship.

    So, let’s not abandon hope for getting help. With the right therapist, one can receive relief from emotional suffering. Admittedly, my profession does a poor job of oversight. In part, confidentiality and privacy prevent scrutiny of therapists. The onus then is on the therapist to keep up with current best practices. My own, self-imposed oversight include regularly attending trainings, consulting with mentors and peers and ongoing supervision. Video taping my sessions (with patient consent) allows me to review sessions and get feedback about my work from colleagues.

    Perhaps the initial question a prospective patient might ask: “What measures do you take to insure accountability of your methods?” With the right therapist, psychotherapy can be helpful not harmful.

  23. This should be called “What I want in a therapist.” – not so general. This article is full of many generalizations and misunderstandings, though there is a lot of truth in it. Others have hopefully created some discussion around the blanket statement about therapists who are also parents (Parenting a special needs child was essential for me opening up as a person and made me a MUCH better therapist).

    Regarding fees: The only therapists I know who routinely slide are ones that already have money. Either they married into money, or came from money, so they do not have massive student loans and bills to pay. The other therapists who slide even if they cannot afford it are often very needy – they are needy for clients, and they are needy for the interpersonal interactions with clients. As a result, they are subtly using their clients and are more prone to act unethically or in a way that creates dependence. Almost all therapists I know who don’t slide, do have “slots” for pro-bono or low paying clients. But they do not automatically slide. It is not to “get rich” – although there are some who really are into it for that and charge accordingly. Often it is about making sure one is secure enough in a practice to do good work. If one is not secure, anxiety takes over and bad practice is inevitable. Private practice is VERY inconsistent work.

    I agree with many of your statements, especially if working with people who have sustained quite a lot of psychological damage and their suffering is immense. But we know the number 1 predictor of success in therapy is the ability to form a collaborative relationship. One does not have to be deep or radical to do this – and many great therapists get great outcomes for less serious problems.

    So again, I think you are talking about what YOU need – but your generalizations are so broad and dismissive, my hope is it does not deter others from seeking treatment.