Inadequately Trained Therapists Pose a Risk to Childhood Trauma Survivors

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Recovering from childhood trauma is a long and difficult journey that can be aided by a mental health professional who is well-trained in the dynamics associated with addiction and abuse in the home. Unfortunately, such training is not a required component of mental health curricula, exposing survivors to the risk of misguided (or even dangerous) advice from the professionals in whom they have placed their trust.

We are sisters who grew up in a home with addiction and abuse. It wasn’t until we were in our late 20s that we broke through our denial about what we had experienced and started to name the problems in our family. We begged our parents and brother to move into recovery and to work with us to create healthier patterns of relating. They refused, so we two began to work together and look for ways to recover from our traumatic childhood. We read books on dysfunctional families, which helped us understand some of the key dynamics in our childhood home and how they affected us—dynamics such as denial, isolation, and fear. We recognized the pattern of “triangular communication” in our family, where all information flowed through our mother so she could keep a lid on the dysfunction. She had also routinely pitted us against each other; since she encouraged us to talk to her, rather than directly to our siblings, she was free to tell us anything she liked. She often told half-truths, or flat-out lies, to us—keeping us stirred up against each other and loyal to her, first and foremost.

We saw ourselves in the roles typically played by children in homes with alcoholism. Ronni, the oldest, was the “hero,” the perfectionist who tries to draw attention away from the problem by excelling. Jennie, the youngest, was the “scapegoat,” the kid on whom the family dumps all of the psychic garbage and labels them “the problem.” We recognized our brother, who was between us in age, as the “invisible child,” who recedes into the background and makes no demands of the parents. Searching for other avenues of healing, we attended 12-step groups, such as Al-Anon and ACOA (Adult Children of Alcoholics), which helped us to see how common our experience was, and to know that we were not alone. Beginning to tell our stories in these safe spaces was the first step in releasing some of the shame we carried as survivors of childhood trauma.

We also sought therapy. Jennie had some prior experience with counseling, having seen different mental health professionals a few times, beginning in her early teen years. More recently, she began seeing a counselor after her first daughter was born to help her cope with post-partum depression and the constant berating from our mother, who told Jennie that she was an incompetent parent and had no business having children. The level of abuse she was experiencing at the hands of our parents, even in adulthood, was extreme—they tried to undermine her marriage and told her, at every opportunity, that she was ruining her life with all the “poor” decisions she had made. In one sense, Jennie was lucky; this time, she had found a therapist who was well-versed in the dynamics of addiction and abuse. There was no objective evidence for any of the claims our parents made about Jennie, and her counselor immediately recognized the dysfunctional dynamics in our family—particularly, how Jennie was still being targeted and scapegoated by our parents. The counselor provided tremendous support and validated her experiences—as well as her interpretations of them.

As a result of her work with this therapist, Jennie was the first to talk about the “alcoholism” in our family; it took Ronni much longer to move through the stigma of that term and realize that it was an apt and honest description of our father’s behavior. Ronni was also more shielded from the ongoing abuse. Because Ronni lived hundreds of miles from the rest of our family, she was not on the “front lines” of the continuing abuse in the way Jennie was, nor did she see much of what was happening with her own eyes. Our parents had always hidden their abusive behavior from the outside world—now they were even hiding it from other members of the immediate family.

As these dynamics between Jennie and our parents intensified, Ronni came for a visit and Jennie brought her along to several of her counseling sessions. Ronni had recently written letters to our parents and brother, laying out the problems as we saw them, and pleading with them to agree to alcoholism treatment and family therapy, a move that only enraged them. We still felt desperate to do something to help our family. The counselor helped us plan a last-ditch effort to move our family into recovery—an intervention with our father. Unfortunately, we were not successful, and our parents’ anger escalated further. At that point, we decided that we could no longer be in contact with our parents and brother (who sided with our parents and remained in denial); the harm they were causing us and our young children was too great. Ronni returned to her home and, within a few months, decided to pursue counseling as well.

Ronni was not as fortunate as Jennie in her choice of counselors. This therapist was not as well versed in the dynamics of homes like ours. Ronni could talk to her about the situation, and the counselor provided a different perspective than talking to her sister or her husband, but this counselor did not provide the same level of understanding and support as Jennie’s had. Ronni attended weekly sessions for seven or eight months but felt that she wasn’t making much progress. What troubled Ronni the most was that her counselor kept saying, “You don’t have to break ties with your parents. You don’t have to cut them off completely. You can just work out a different kind of relationship with them.” Ronni thought, “Haven’t I told you enough about what they’ve done to show you why this step was necessary?”

She had already shared how our parents were physically and emotionally abusive to us growing up and continued to be. That there had also been molestation in our childhood home. And that we had seen these patterns very clearly being repeated with our children. Our parents had already decided that Jennie’s second daughter would be the new scapegoat—before she was even two years old. Still, Ronni’s counselor kept pushing her to reestablish contact with our parents, and Ronni grew upset at having to continually justify why she thought that decision would be unhealthy—even dangerous—for her and her young daughter.

Over the years, Ronni has looked back on her counseling sessions and tried to make sense of them by saying, “Maybe what the counselor was trying to do was to empower me. Maybe she was interpreting my decision as ‘you feel too afraid to be around your parents, but you’re strong enough to do it.’” This is possible, but it is not an adequate explanation. We had already done much to stand up to our parents, proving that we were not afraid of them. And the problems in our family were very serious. Our parents had already begun to seed the harmful dynamics from our childhood into the next generation, with our very young children, who we realized were now at risk of serious abuse.

Our parents were strongly encouraging us to beat our children to discipline them—the way they had beaten us. We knew we were never going to do that. In fact, it was our desire to be good parents that caused us to question our upbringing in the first place. And it was our continued desire to protect our children and break the intergenerational cycle of trauma and abuse that drove us early in our recovery. We wanted to protect our children, but we also wanted to protect ourselves.

Even as adults, our parents were continuing to cause us pain. And once we cut all contact with them, they spiraled out of control—the way abusers often do. They started stalking Jennie, attending her church, spreading lies about her, and attempting to turn other parishioners against her. They went to the organization where Jennie was receiving counseling, met with the director, and tried to have Jennie’s counselor fired, saying that she had planted Jennie’s “delusions” that her childhood was abusive. Ronni had relayed all of this, and more, to her counselor; still, she pushed Ronni to resume contact with our parents. Finally, Ronni decided to discontinue counseling. She did not seek the help of any other mental health professional after that.

We feel it’s important to share our story and the contrast between our two experiences because it shows the danger that inadequately trained therapists pose to survivors of childhood trauma. Jennie was supported by a counselor who understood well what we had been through; Ronni struggled with a counselor who did not seem to understand the seriousness of her situation and repeatedly pushed her to take action that Ronni knew, at her core, to be wrong.

Unfortunately, Ronni’s experience is not unusual. Yet there is no requirement that training for mental health professionals include instruction on the dynamics of addiction and abuse in families. This is shocking, because at least 25% of children in the United States are traumatized by such experiences. The trauma does not end with adulthood, and the dynamics are often perpetuated across multiple generations. Under these circumstances, adult children have every reason to be concerned about their parents and the damage they continue to do.

Survivors have every right to protect themselves and their children, by walking away from toxic, abusive people, even if they are family members. Especially if they are family members. No therapist should undermine a survivor’s healthy instinct for self-preservation or cause them to doubt what is likely the most loving and respectful choice they have made for themselves on their road to recovery.  Cutting off the relationship isn’t always necessary, but therapists need to understand that it has to be an option. Ensuring that all licensed therapists and mental health counselors have the knowledge necessary to properly support survivors of childhood trauma should be the standard for the profession.

 

Editor’s Note: You can read Ronni and Jennie’s full story in their book, Healing Begins With Us: Breaking the Cycle of Trauma and Abuse and Rebuilding the Sibling Bond.

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

10 COMMENTS

  1. These aren’t inadequately trained therapists. Therapists have specialties for a reason. Furthermore, therapists don’t tell you what to do; its a natural progression of assisting client to come their own outcomes. And if you don’t like a certain style, find a new therapist. Shop around. Don’t expect magic from human beings and cast stones.

    • You are making generalizations about therapists. Some of them very much DO tell you what to do. There are also plenty of inadequately trained therapists out there, or therapists whose own issues make them dangerous no matter how much training you provide. Since there is no agree-upon means of helping clients in the first place, it’s pretty presumptuous to assume all have “adequate training” and know what they are doing. There are competent and incompetent people in every profession. Why would therapists be an exception?

  2. As a psychotherapist, I ask clients at intake what other therapists they’ve seen and, boy, the stories that come pouring out of really lousy therapists. I do know there are times when I’ve had to guide a client toward a decision that is self-protective (in severe abuse situations), but I do try to let the client do the deciding as much as possible. And I DO support cutting off toxic family relationships! The lack of graduate training in chronic relational trauma, family dysfunctions, and the impact of sociopathic/narcissistic parents is appalling. I do a lot of family and couples therapy and many are referred to me. Prior therapists never spot the narcissistic/coercive/abusive partner and dynamics, leaving the victim to suffer with “anxiety and depression”, which is really the result of emotional abuse. Leaving an abusive relationship is often the best way to treat emotional issues that are often labeled and drugged in the current system.

  3. “Ensuring that all licensed therapists and mental health counselors have the knowledge necessary to properly support survivors of childhood trauma should be the standard for the profession.”

    I agree, but unfortunately today, the DSM “bible” billers can NOT even bill to help child abuse survivors – unless they first misdiagnose them with one of the billable DSM disorders.

    https://www.psychologytoday.com/us/blog/your-child-does-not-have-bipolar-disorder/201402/dsm-5-and-child-neglect-and-abuse-1

  4. Although I agree inadequately trained workers in any field generally lead to poor outcomes, I’m not in agreement that the issue here is lack of training or exposure to childhood trauma dynamics. Instead, I think the issue goes back to the “inadequate” therapist asserting the therapist’s values rather than exploring the client’s values, desires, and needs. Also, it seems as though the ineffective therapist neglected to focus on the client’s fear-based decision making as it related to the decision to cut off the parents or not.

    The more effective therapist would have tried to help the client understand that a helpful avenue of exploration would be to understand the extent to which the reported abuse shaped the client’s anxiety about making a decision making, especially as it relates to decisions about the client putting themselves first (i.e., protecting themselves from further abuse/negativity).

    As we work with humans, there are an infinite amount of scenarios and abuse. A therapist cannot know them all or have experience with all of them. Therefore, in my opinion, we should be falling back on how helping a client understand how a situation developed, how it’s maintained, and how to work towards improving the situation within the constraints of the client’s values, safety, and reasonable consequences of consideration.

  5. No one recognised the trauma I faced daily in school, home and everywhere else. I couldn’t follow along. I heard bits and pieces of some sentences. I learned to endure hours of sitting in a classroom having no idea what was taught. I endured agony as my parents condemned me for being a lazy G. D. bum. I couldn’t read past the third grade level. My mother came to class and sat next to me all day to try to figure out why I wouldn’t apply myself. She reminded me many times to pay attention, which I would do, for about 2 seconds. No one was there for me, to be a source of comfort as I lived in hell day after day, blaming myself, hating myself, despising myself for not doing what I was supposed to be doing. I had not the faintest idea, at all, that I wasn’t paying attention. I did believe strongly, deep down, if I could hate myself enough, as I deserved to be hated, I would be able to pull through all the disgraceful things I was and I was doing, and become a good student.
    One loving, accepting, warm-hearted adult present in my life over those years would have saved me from the harshest side of imprisonment in a concentration camp by myself–without family.
    One mom or dad-like figure who said, “It’s okay. You are a good boy. You are a wonderful little boy” would have eased the pain.

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