The Mental Health Professionals who Perpetrate Against us

Monica Cassani

I think a lot about why I can’t work therapeutically with people in the mental illness system. I have found that the same traumatic dynamic comes up with some frequency outside that system, too, with “healers” of all stripes really — alternative doctors, energy workers, therapists of various sorts, you name it… if they are in the healing profession they’ve hurt me and people like me. Some of us are like magnets to people’s ugliness. This is a sort of karmic phenomena for some of us, and to change it we must become aware of how it works under the surface because it’s not a conscious process for anyone involved. Clinicians are the worst because they’re in a position of power and they deny that this is happening. That of course adds to the injurious nature of the dynamic.

As power dynamics will have it, when those in power deny their abuses it’s straight up oppression happening and it harms. Badly.

The problematic dynamic can arise with anyone I dare to be vulnerable with. Given that healing requires allowing ourselves to get vulnerable, this is a recipe for pain and disaster. I think most of us that have been gravely harmed by psychiatry have this dynamic going on to some extent. It’s also clear that not everyone experiences the mental illness system in this way. That has often given me pause and reason to contemplate what, exactly, is going on.

I have, indeed, found deeply respectful people who can see me and hold space for that which I’ve experienced, but those folks are a rarity and I have discovered I cannot find them by searching for them. They seem to, instead, reveal themselves as this journey of healing moves forward and healing comes. In my surrender process I find that good things come if I allow rather than search. It’s a nuanced thing and it’s often a source of annoyance and pain as I learn patience.

I worked in this sick system too for many years. So I’ve seen it from both sides of the proverbial couch.

These are some tweets that arose while I was musing on the victim/perpetrator axis:

Victim and perpetrator are involved in a sick dance. As a victim I meditate on my half of this dance… what am I bringing to the equation?

How do I release the burden of victimhood once and for all so that perpetrators no longer have any hold on me?

Vulnerability that the victim displays catches and brings out shadow shit in karmically matched perpetrators. How do we recognize and let go?

This is not about letting the perpetrator off the hook, but instead it’s about ending our own victimhood… no longer allowing it to happen at all. We can’t change them — we can become aware and thus learn to not engage at all. Ideally we come to do this with neither fear nor rage in our hearts because we start to understand and see the whole dance.

Those of us with psych survivor histories (complex post traumatic stress, etc) seem to bring out shadow shit in just about all so-called mental health professionals (as well as healers of all stripes).

So, yes, we bring out the perpetrator in people who like to fancy themselves healers… and that ain’t no pretty thing.

No, it’s really a very ugly thing since those who fancy themselves helpful do not want to see how they can harm so very badly, and so they deny it with force and vigor, hurting us all the more.

More could be said, but this is feeling finished for now. I’ve written more on this topic here:

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  1. Hi Monica

    In Sept. of 2015 I resigned in protest from my job in community “mental health” after 23 years; I wrote a blog about this at MIA a year and a half ago. I still have a small private practice where I do therapy/coaching/helping or whatever makes the most sense (at this moment in time) to describe my relationship with people I work with.

    I always read and learn from your writings and in this case take the message as a very truthful and sobering assessment of the perils (for those people vulnerable enough in life to share their secrets with a stranger) inherent in my role/work as a so-called “therapist.”

    Over 10 years ago I briefly saw a therapist for a family issue (the person seemed like a very nice man) but I felt very uncomfortable with the entire process, especially with the issue of “trust.”

    There are less than a handful of therapists that I have worked with over the years that I had ANY trust in the quality of their ability to work with people in a counseling relationship.

    If anyone plans on doing this work with any level of integrity and safety for those they counsel, they need to constantly expose themselves to all types of survivor narratives and System criticism of the Medical Model that we might find at websites like MIA and Beyond Meds.

    If one is not continuously exposed to this form of education then they WILL NOT be able to help people very much, and most likely will end up harming them. AND each person doing therapeutic type work must make sure they are CONSTANTLY engaged in a form of self-interrogation regarding their own personal agenda and the actual nature of the inherent power differential in their therapeutic relationship.


  2. Monica you brought me back. Thanks for your words.
    As both a survivor and a retired LISW I share your perspective in some ways.
    I worked in the field for over twenty years before being pulled into the system by uninformed family, all of us traumatized by ongoing criss issues, uninformed friends, and “helpers” who really didn’t help.
    The worst was the trauma of hospitalization.I knew what a decent looked,acted,and felt like. These units were prison- nothing more-nothinging less.
    As a professional, I worked assiduously to treat the relationship as a team effort.
    I took time to establish trust and when something bad went down I told the truth of what I had control of and what I didn’t. So if abuse was acknowledged I told my client the law – prepared them for what would happen and had them listen to my call to the abuse hotline. I tried very hard to let them know it would not be easy and keeping on telling their story to the safest folks they could find.
    I was only there to help them learn to cope with life independently.
    My job as I saw was to put myself out of business.
    I tried hard to have a mutual respect relationship. I learned many things from my clients and sometimes was in awe of how they maintained.
    My issue with the MH professional writings is -at times- you can feel the defensiveness- and I would say fear.
    When one starts out writing- ” I have this- I wrote these books, I have presented these workshops, and most revealing of all – I come from this family constellation – and I am not willing to admit any true hard issues because I am an expert.
    This stance- for me as a reader with both lived and professional experience disbelief, anger,triggered hurt- the stance of power- and ultimately sadness and continued lack of hope that the secret tragedy of MH care will never be totally revealed and change happen.
    I want a dialogue. But it has to be played out on a fair field – a round table like the Paris Peace talks.
    If you read literary critical thinking vocabulary and fiction matters in terms of the power of relationship.
    There are so many people involved in the system that I would really like to hear from. Police officers, aides who work on the units, judges,ect.
    Maybe Robert and staff need to work on some sort of framework for dialogue for all.
    Or some toiols not used now. What about survivor first reads and commentary before a MH work comes out?
    What and how did Bishop Tutu’s commission work?
    Maybe a reading list for potential contributors to read before writing suggested by survivors?
    Hannah Ardnt’s work would be important.
    There are virulent isms all over the MH system from ages and ages ago. It has gotten into the white mean now and U think that is part of why MIA exits. Not the best way but please let’s use this to solve not continue problems otherwise U will not be back.
    Politeness never hurts but the issue of power is fraught and wrought here and U know it might not even cross contributors minds or they just are not sure how or what to say so they go into default pistering mode.
    How can we do this better?

  3. One of the hardest things I had to learn when I first started helping my wife heal was how to accept the vile and vitriol she threw at me. Some of it was earned (after 20 years of marriage), and I had to learn to apologize WITHOUT excuse. Years later as she healed, she was able to see my side of things. But the un-earned stuff was important too. I had to allow myself to accept what was rightly for her abusers, too. Once she got it all out, she was able to heal and move on, but I still have to watch myself, constantly looking for signs that I’m forcing her to do things, even if helpful, that she simply isn’t ready or able to do. Healing is ALWAYS on her timeframe, no matter how much I wish it were faster so our relationship could be more healthy. It is so hard to constantly watch myself AND see things from my wife’s perspective, but I know that only as I do that does she feel the safety to give me complete access to everyone in her system in the healing process.

    It is a fearful thing how deeply I could hurt my wife even when I have the best of intentions…but happily, as she has healed and as all of the girls in the system have begun to connect, she(all of them) is much stronger now, and so when I do stupid and even ugly things from time to time, she’s better able to handle it, though I have also learned to more quickly make amends to the girls who feel the wrongs the deepest…

    • samruck2,
      What you have written is so informative for anyone trying to support someone going through extreme distress. When one receives, as you call it, the ‘un-earned stuff’ in great intensity, it can be so easy to slip into thinking that all negative responses are un-earned, and thus start to provide the type of patronizing help that mirrors the type of help one often finds in the ‘system’. It can be so difficult to tease out the unhealthy patterns in one’s own relationship ( that may have existed prior to the distress, or that may have developed as a result of the distress); from the unearned stuff for which one is simple acting as a safe and trusted sounding board.

  4. Every time it’s appropriate, as often and as fast as one-finger typing allows, I write:
    ….please visit ><….
    Hope this helps!
    Years ago, getting myself extracted from the mental illness system, I came up with a quote that I also use as often as I can:
    "Bad help is worse than no help at all"
    Psychiatry and psych drugs are almost always BAD HELP.
    Dr. Kelly Brogan, and Dr. Peter Breggin, are 2 of the few exceptions which prove that rule!
    And of course YOU, TOO, Monica!
    ~Bill Bradford

  5. Mental Health *experts* *belong* to two *religious* groups, which perpetrate against those, who are crazy. Each Psychologist knows what this means and same is with Psychiatrists. In their eyes, we crazies are mages. They don’t define normality vs crazy *issue* with proper biological explains, but they really define both with few *lines* , from certain religious book.

  6. I’m not part of mad in America / beyond meds OR the traditional mental health system. They both ran near to me, but skipped to the side. I’m far away and on my own. I could also say each was a speedbump in the way for me to find the path for me.