Editor’s Note: This blog, when first published, told of an unnamed therapist who had “been reported to the ethics board on multiple occasions, to no avail.” However, the therapist was named in a link to a New York Times article, and thus easily identified. This assertion has been removed from the blog, as the New York Times article does not, in fact, name this particular therapist as one who has been reported to licensing boards.
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This may be a strange thing to consider, but your therapist is, first and foremost, a regular person. No matter how many degrees, years of training, or fancy certificates, they are still human. With this, unfortunately, comes the reality that flaws will abound. Sometimes, in worst case scenarios, your therapist may even be abusive.
School doesn’t teach therapists how to, well, handle their s$@#. Used to be that to become a therapist you were required to go through years, if not decades, of therapy and analysis so as to not impute your problems onto vulnerable others. Sadly, this is no longer the norm nor even encouraged in most training programs.
Good quality therapy, which does exist, helps people to better understand their patterns and their positive and negative (and everything between) qualities and tendencies. Such therapy also helps you to gain insight into your long-standing defenses, to realize your underlying impulses and biases, and to work through unresolved trauma and wounds. It is a space that is empowering, safe, and compassion, even while also being challenging.
When a therapist has not gone through this process themselves, not only is it difficult to really empathize with what it’s like to be on the couch, so to speak it is almost guaranteed that the therapist will act out their unconscious and unresolved issues with their clients.
This was exemplified in a recent New York Times article entitled “Is Cutting Off Your Family Good Therapy?” The tik-tok therapist who is central to this story is described as a controversial and popular therapist who is fighting back against oppressive old-world norms in society and therapy.
It is true that blaming the client for their problems, insisting upon forgiveness or maintaining familial relationships, and ignoring trauma are well-documented issues in many practices. However, a full swing to the opposite extreme is just as damaging. What is apparent is that this influencer therapist is engaging in egregiously inappropriate and unethical practices. It is clear that he is striving to be a constant rescuer to his patients, projecting his past trauma onto their issues, and never seeing any individual for who they are, separate from him. His aggressive insistence on a singular form of resolving one’s problems is about control, not care.
Therapists shouldn’t be imposing their beliefs one way or the other. Families may be central and important to some and not so much to others. It is a therapist’s job to help clients learn the skills to identify and stand up to abuse, in their own unique ways. Sometimes that may mean cutting off parents or others family members. Certainly, not always.
The above-mentioned example of an emotionally manipulative and possibly even abusive therapist is particularly disturbing because of just how popular he is. It is incredibly difficult for vulnerable people, especially those with histories of abuse, to recognize an abusive therapist and get out. And this example is normalizing it in a major way.
Such forms of abuse are difficult to identify and therefore also end up being insidious, like an invasive disease you don’t even know you have. There are, however, some ways to tell the difference between a human therapist who makes mistakes (hint: that’s every single one of us!) and the much rarer individual who is recreating abusive dynamics that are detrimental to your mental health.
Therapists Who Make Mistakes
The longer you are in therapy, the more mistakes your therapist will make. There’s no avoiding this and it’s often an opportunity rather than a problem. A good therapist will use such moments to model taking responsibility without excessive shame or guilt, to teach skills to navigate conflict in respectful and healthy ways, and to normalize acceptance of flaws. Possibly more importantly, these experiences of conflict can help you learn in the moment that your concerns and needs/feelings are valid; that it’s ok to express feelings of hurt or anger without retaliation.
If you think of something that annoys you, your therapist will probably do it eventually. However, some mistakes are more common than others, for instance:
Being too forceful in trying to build insight; inadvertently making an off-hand insulting remark; seeming dismissiveness, especially at the end of a session; forgetting important information … on rare occasion; colluding with you in such a way that you both are in denial of something important; becoming defensive in a heated or difficult moment; and invalidating or misunderstanding you.
These are also ordinary issues that arise in almost every relationship you will ever be in. Which is why #1 you can’t avoid them in the therapy relationship and #2 when they do arise, it’s an opportunity to learn how to navigate these moments in a healthy and productive way.
What differentiates a mistake vs harmful behavior is how your therapist responds to these moments. If they respond by ignoring you, denial, frequently turning it back on you and your issues, profusely apologizing to the point you feel you must now take care of them, or gaslighting, then you might need to consider if there is a bigger problem.
Inappropriate But Not Abusive
Like with anything, not all therapists are created equal. Of course, attributional bias will dictate that most therapists will firmly believe that they are the exception and everyone else is the problem. Fortunately, there are some clear objective red flags that indicate a problematic therapist.
Most frequently, you are likely to encounter inexperienced and undertrained therapists who are more focused on fixing immediate problems rather than deeper long-lasting change. These professionals are likely very lovely people who are doing their best with limited resources. Nevertheless, it’s still a problem for you, the client, and just because they are nice or good people doesn’t mean you owe them anything or need to continue in a space that isn’t really helping.
A few examples of this are a therapist who: is more like a paid friend who never challenges you; always agrees with you or tells you what you want to hear; doesn’t have good boundaries (lets session run over, discloses their personal information, is inconsistent with expectations and scheduling); frequently gives you advice; arm-chair therapizes and diagnoses other people in your life; does things for you instead of teaching you the skills or exploring barriers to doing them yourself; makes therapy always feel comfortable and easy; frequently offers sweet platitudes that are meaningless; ignores exploration of difficult emotions and trauma; etc.
If the above issues sound familiar to you, please know that this is not therapy. At best, it’s supportive counseling. Counseling can be nice when going through a tough time, but it doesn’t lead to fundamental change or growth in most circumstances.
More flagrant situations of an inappropriate or problematic therapist can be a bit harder to define or identify because often it’s about frequency and intensity of mistakes more than the act itself. At other times, though, one mistake is enough. For instance, if diagnoses are used to blame you for conflict in the therapy room instead of exploring why the conflict is happening from both sides this is a red flag. Diagnoses should never feel like name-calling, even if that’s often what they end up being anyway. Further, you are coming to the therapy space for help and hopefully your issues are not weaponized against you.
Having said that, sometimes it is your issues that are arising in the therapy space, and they need to be identified and explored. But this should be done in a non-shaming and compassionate manner. If the therapist never takes responsibility or frequently comes across as accusatory/shaming rather than trying to understand, the line might be getting crossed into inappropriate territory.
Some other red flags: falsely guaranteeing some kind of outcome; insisting that some kind of activity or intervention MUST work for you because it does for everyone else; frequently inserting their opinions, rather than trying to understand your perspective or sticking with science and research; recurrently changing schedules, being late, or missing sessions; rarely remembering important information; seeming cold and neglectful; or talking about themselves.
Crossing the Line into Abuse
Overt and obvious signs of an abusive therapist are quite rare and often pretty easy to identify. Sexual harassment, sexual advances, racism, derogatory statements, or conversion therapy are all forms of objective, clear abuse. If you ever find yourself on the receiving end of these acts, report the therapist immediately.
More frequently, however, is the therapist who has not worked through their issues and is acting them out in the therapy relationship. It usually would fall under the loose umbrella of emotional or narcissistic abuse—it’s a lot harder to identify.
Some signs that you might be in an abusive dynamic with your therapist are: you feel bad about yourself within the therapy relationship most of the time; you are afraid of your therapist and they don’t change to help you feel safe; you feel frequently invalidated or dismissed; you often feel you need to take care of your therapist; you never know which version of your therapist you’re gonna get; you’ve come to believe that you’ll be in therapy forever and your therapist has no specific goals to end; or generally feeling something is really off but you can’t talk about it and don’t know what it is.
Here are also some complicated dynamics to watch out for:
- Your therapist shares their own trauma history in an effort to help you feel understood. Not just in a brief moment, but as a central part of the work. This might feel amazing to you – “Wow, a therapist who understands!” But that’s not what’s happening. This is an unskilled therapist who is using your time and your money to insert their issues. They are trying to bond with you over trauma instead of being your therapist.
- You start to view your therapist as your savior … and they agree. It’s normal to feel grateful for ways in which your therapist might have helped you. But it becomes abusive when the therapist needs to be in the role of rescuer; if they reinforce this dynamic instead of building your own sense of self-empowerment. This dynamic overtime will lead to you feeling small and helpless, overly dependent on your therapist, and will become a situation that relies upon you always being in need of saving.
- Finding that your therapist makes you feel guilty, on a regular basis, for your lack of appreciation of them. They may become withholding or cold when you’ve “done them wrong” somehow, like missing or cancelling a session or not agreeing with them.
- They badmouth your family and friends to such an extent that you are solely reliant upon the therapist. Or, like the therapist in the NY Times article, they insist that you cut off friends or family instead of helping you figure out for yourself what is right for you. Isolating you away from any other support system is a common first step in an abusive relationship.
- You start feeling overly dependent on your therapist and they don’t encourage you to seek out support in other relationships or help you learn how to build those relationships. It’s normal to feel dependent. It’s not normal if the therapist doesn’t push back for you to learn how to build a social network of your own.
- They aggressively insert their opinions and leave no room for disagreement. If you try to disagree, you are manipulated into agreeing anyway or left to feel something is wrong with you for not agreeing.
How to Know the Difference
People with histories of abuse are both the most likely to end up in an abusive dynamic with their therapist and also have the most difficulty knowing the difference. The problem is that if you have a history of abuse (i.e., feeling neglected, chronic invalidated or misunderstood, intense fear or dread, chronically criticized and humiliated, etc.) you WILL feel that your therapist is doing these things to you! If you don’t, it is likely that your therapist is avoiding the difficult stuff.
But you should be able to talk about these feelings. Your therapist should be able to take ownership of any ways in which they may be contributing to these feelings, rather than frequently or always putting it back on you. And these feelings should be part of the process of therapy, not made to be bad, wrong, or unwelcome in the therapy space.
In general, if you feel like something is off, it probably is. It may or may not be abusive, but there are enough therapists out there for you to move on.
On the flip side, if you feel like the only way you can do anything is if you keep going back to your therapist for them to remind you of what you MUST do, get out.
Just because someone is super popular, doesn’t mean they are helpful. It could instead mean they are more like a cult leader. Having someone be so passionate about how to solve all your problems might feel good or like you’re being taken care of.
Sometimes, however, what’s happening is that you’re becoming a pawn in the therapist’s own trauma enactment.
Thank you for this. it’s extremely important that folks know this stuff.
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Hi Diane, if your interested to learn more about the topic I can recommend you the peer run website TELL therapy exploitation link line. They offer a section with an extensive list of books and other resources.
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“Therapists shouldn’t be imposing their beliefs one way or the other.”
But one way or the other they do … which makes it’s foolish to claim that they don’t.
Despite what the author claims, she seems to think therapists wear halos.
Psychotherapy is the prototypical example of an abusive relationship.
IMHO.
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As usual, Birdsong, you summarized the issue in a nutshell. Psychotherapists have become a quasi-priestly caste, but equipped with potent neurotoxins and other brain-disabling “treatments” to expel the “demons” of its unwary victims. So-called mental illness is essentially the present-day version of sin, and the DSM manual is the counterpart of the medieval “Hammer of Witches” (a fanciful compendium of the alleged characteristics of women practicing sorcery). Thomas Szasz pointed this out many decades ago, and his observation still holds true.
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Thank you, joel 🙂
It seems to me most therapists have the unfortunate habit of thinking they’re god’s gift to the world.
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Hey Noel – Steven Licardi posted this article and I responded in a series of texts, I’m going to repost them here. I really appreciated this article, it helped me reflect on my own practice and I’ll share it with others.
I read this article shortly before I went to bed and I just reread it again. As someone who works as an unlicensed therapist you best believe I was reading it to check my own behavior against Noel’s critiques of unskilled therapists. I have a ton of respect for her work. Here’s the one thing it’s really making me reflect on:
“Your therapist shares their own trauma history in an effort to help you feel understood. Not just in a brief moment, but as a central part of the work. This might feel amazing to you – “Wow, a therapist who understands!” But that’s not what’s happening. This is an unskilled therapist who is using your time and your money to insert their issues. They are trying to bond with you over trauma instead of being your therapist.”
I definitely don’t share MY trauma as a central part of anyone else’s work, but pretty much anyone who comes to see me knows that I have a wild psychiatric history, and sometimes we take about it. But I do this in a very intentional way, not because I’m “trauma bonding.”
My experience as sometime diagnosed with a “severe mental illness” who spent a lot of really awful time sitting in therapist’s offices is that it can be really painful to describe extreme states that someone else can’t relate to except through a diagnostic lens. So part of my work sometimes involves disclosing things I’ve been through in a very human way.
In Internal Family Systems thinking there’s a big difference between speaking FROM a traumatized part and speaking FOR a traumatized part. You can speak FOR a part once you’ve built a relationship with it, once you’ve heard and witnessed it, and helped it unburden it’s accumulated pain. I teach and model that distinction when I’m working with people.
Finally, sometimes when people have internalized the identity of a psychiatric patient they think that their only role in life is to be “helped” by another person. I find that sometimes (and this is from my peer worker training) that it can be really useful to feel the genuine reciprocity in a relationship, that it can be healing to tell someone that you are being helped by them. This goes against traditional therapeutic protocol but I think, if practiced skillfully, and not from some place of “trauma bonding,” it’s called being a fucking human being. And we need more of that kind of behavior in the therapy room.
Now I recognize that not everyone either wants this kind of relationship with their therapist or that their therapist is skilled enough to provide it, but I think the people who seek me out, and stay working with me, are probably helped by it in a deep way.
I’m definitely open to be wrong and to growing, I’m sure I fuck up sometimes, I’ve only been practicing for 4 years professionally. Before this, I had about two decades of experience in a peer support context that I helped develop and anyone who was around back in the Icarus days knows I fucked up and crossed boundaries, sometimes in absurd and dramatic ways. But live and learn. make amends, keep going. I just know there’s a lot of people practicing “therapy” out there that would never be able to reach people like me with their “clinical boundaries” that end up being an excuse to shut down emotionally and not show their true selves.
I work hard to bring my true self to the therapy exchange.
One final thought: I’m intentionally unlicensed, I decided after 4 years of working in the public mental health system that I didn’t want a clinical license to “diagnose and treat people with psychosis” because I thought the whole model was bullshit. If you have a license, what keeps you accountable is the threat of having your license taken away. What keeps ME accountable is knowing that there are a lot of people out there who know me and know my work and if I act like an asshole and a creep and abuse my power I will be publicly called out and lose my reputation and credibility. Like it or not, this is what it means to be a semi-public figure. I have two regular supervisors with many decades more experience than I do, and group of about a dozen people I can call on if I’m struggling with a situation to help me figure out with to do. I have long term aspirations of training more people to work the way I do, because I think we need more of it in this world.
Anyway, thanks for posting this article and inspiring me to reflect on it before the kids wake up on a Friday morning. I remember when IDHA was first starting out and ai group of us went to Noel’s office in midtown and had a whole conversation about therapy models and strategies for evolving the mental health system. I reference her book Trauma and Madness in Mental Health Services when I’m lecturing, it’s an important book. We need more people having these conversations!
This is what I’ve been up to publicly:
https://undergroundtransmissions.substack.com/p/shaping-countercultural-mental-health
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Hey Sascha,
I was just alerted to your comment so wanted to respond – I really appreciate your comment here and the thought behind it. I too am often sought out due to my personal experiences, and will be honest and open when someone asks. There is certainly a space to be a human being, and, in fact, personally, there’s nothing that irks the crap out of me more than someone who is not just a real person being themselves (within reason) in the room with someone. I didn’t use the word “trauma-bonding” but that is what I was referring to. I’m going to use the IFS description you have here, as I think it highlights the distinction well – it definitely is not concrete, which is why when the line is crossed it’s sometimes so damned hard to identify.
With much respect and hopefully our paths cross again sometime in the near future-
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When I interviewed my present therapist I told her that I want to know nothing about her personal life. After five years with her, I only know she has a grown son and a dog. This has made all the difference with my outcome. When a person is in therapy, it has to be all about them.
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Wow, you did a good job finding the sweet spot between the extremes of a therapist advising a client to forgive family and a therapist advising a client to cut ties with family. You stated that therapists are not trained to deal with their sh*t. I thought it was a given that every therapist had a therapist. I know every licenced massage therapist (LMT) has another LMT work on their body. How else could they keep up with arduous work?
A great deal of psychilogy majors are probably attracted to the field because tvey know first- hand how trauma, mental ‘illness’ , and power imblances can make families miserable. I can’t imagine that these folks would lack insight into their own biases.
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I’m glad this topic is discussed, but I think it could go a lot further. For one, there is almost no restriction on who can become a therapist so long as they have enough intellectual acumen. How do you find out in a first session or information session the difference between a performative good front and a good person? Especially for those with traumatic backgrounds, it’s impossible, and that ends up causing more harm to victims.
Furthermore, there’s an emphasis on not doing harm/abuse by listing bad behaviors, but there’s very little true common ideals to strive for. Priests in the past might strive towards the example of Christ (sometimes with enormous delusion), but there’s little ideal for the profession even though they have become the priests of modern individualistic society.
I have the benefit of travel, so I have two ideals I keep in mind. One is that of the village Buddhist/Hindu priest who is dependent on food donations and so spends some time meditating and aiming for the divine and some time being in the village, simply as a source of presence and support. It is not privatized and they don’t take sides. The other ideal I have is Alice Miller’s idea of an enlightened witness.
Capitalism, individualism and the profit motive corrupts therapeutic relationships in such profound ways. We need signposts of what we should be aiming for.
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There is wisdom in which you speak, Matthew.
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The author goes to great lengths indeed to describe the admirable and desirable qualities of a competent therapist, but noticeably fails to specify the body of knowledge (i.e. universally applicable, verifiable findings based on long-term experiments, tests, and other research modalities that should be the hallmarks of a field claiming to be a genuine branch of medicine) whence he or she supposedly derives the necessary skills and insight to help emotionally distressed people to understand themselves and change their lives for the better. Without such a credible source of knowledge, I simply cannot see what confers upon any of the multitudinous, often conflicting schools of psychotherapy the authority to judge the appropriateness of a client’s thoughts and behavior, or enables them to OBJECTIVELY assess the potential benefits and harms of their prescribed “treatments.” To me, this unsubstantiated, unwarranted authority is far more characteristic of a religious cult than a proper science.
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Thank you for a very well-written and important article. As a psychologist and member of a state licensing/disciplinary board, I wish we had a better way of screening out these types of emotionally abusive therapists. As you write, most clients have little experience at discerning this bad behavior, especially if they have been in abusive relationships outside of therapy. I’d add that it is abusive for therapists to 1) recommend psychiatric medications 2) over-pathologize and tell clients their diagnosis 3) blame the diagnosis/”bad brain chemistry” for lack of progress in therapy when it is really the therapist’s fault 4) practice beyond competency areas 5) not EVER go to therapy themselves. We need to do a better job of policing the mental health field and educating clients about what really makes a good therapist.
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Very much agreed!
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I think the most abusive people are therapists who claim to have “completely worked through their traumas”, an impossible task for anyone no matter how long you live.
IMHO.
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What does it even mean to “completely work through a trauma?” Who can objectively and conclusively evaluate such a process? Is there some laboratory test or other modality to precisely gauge the degree of this total emotional liberation? I know that many years ago Arthur Janov, the founder of Primal Therapy, claimed to have finally devised a scientifically valid, measurable treatment for the cure of neurosis and other forms of “mental illness,” but mainstream psychology has consistently dismissed his arguments. In the absence of any universally accepted, verifiable criteria for assessing a client’s emotional state and behavior, any opinion regarding his or her recovery from a trauma is arbitrary and clouded by the therapist’s own subjective values.
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Agreed. In my opinion, it’s the height of arrogance for anyone to think they’ve outsmarted their own unconscious.
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Another form of abuse is being gaslighted to believe that it is somehow you as the client’s doing for not improving or getting it. You either lacked the insight, did not adhere to the protocol, was resistant to change, non-compliant, lazy with out of session assignments, derived some secondary gain from your distress, it was your personality disorder, you were not quite ready for therapy, you were too distressed and had to be balanced out by psychiatric drugs first, etc. See it for what it is: pure arrogance to keep their ineptitude out of awareness.
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Agreed!
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The therapist in question here is one that I follow regularly. His niche is in childhood trauma. He is very articulate and goes into great depth to educate his followers on what actually happened to them, as most victims of abuse are not even aware they were abused because the family normalizes it He presents cases and thoroughly discusses them from differing points of view. As many, if not most, therapists who specialize in trauma and abuse, he will validate a clients choice to cut off abusive family members, also known as Going No Contact. Any person who has made the decision to go No Contact with a family member or members, has not done so lightly. It takes years and even decades to understand that they are being abused, to try to create healthy boundaries, and to exert every effort to create a reciprocal relationship with the abuser.
Only when the person comes to Radical Acceptance that the abuser will never change, they may then choose to go No Contact, in order to set a final boundary with the abuser.
In my opinion of this particular therapist in question, he has incredible insight and compassion for people who have been subjected to childhood abuse and neglect, aka trauma, because he has experienced it firsthand. Actually, all the therapists that I follow with regard to complex trauma, have experienced it firsthand, which makes them uniquely capable of understanding the emotional distress and cognitive dissonance that are hallmarks of survivors of childhood trauma.
The writer of this article seems to me to be very careless with her opinions.
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I agree wholeheartly with what you say Guinness Girl. I have followed this person for a number of years experience the same.
I think this whole topic would be better understood if as a society we had a really thorough understanding of coercive control and the tactics of abuse and neglect – and then from that understanding, understand the process of healing, which in some cases requires no contact to be safe and to heal.
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While trauma survivors may make good therapists for those who have experienced trauma, they tend to have a confirmation bias that leads them to push a trauma narrative onto clients. I spoke to therapists about my sensory overload, my difficulty with communication, how eye contact was painful (physically, not emotionally), that I experienced burnout that didn’t fit the criteria for depression at all. All my issues were characteristics of autism. But they desperately ignored these or twisted what I was saying to fit trauma. I understand that people who are autistic often experience trauma. But I had a very supportive family even when they had no clue why I was different. I did not need a therapist with a savior complex gaslighting me. Saying I normalized abuse or blocked out or rewrote my history in some sort of denial. It would have been fine if I had told her specific instances that were clearly abuse. But I was there to try to understand what I now know are neurotypicals. And stop being misunderstood simply because I’m honest, logical, and direct. I suffered needlessly with anxiety and frustration due to the trauma llamas.
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“I did not need a therapist with a savior complex gaslighting me.”
Thank you Sheila. I relate to what you say regarding sensory overload, the difference being I also experienced serious childhood trauma.
My tendency to experience sensory overload unfortunately resulted in being even more negatively judged/evaluated by trauma llamas unable (more likely unwilling) to even consider the idea that sensory overload actually exists.
P.S. Whether they gaslight or not, I think all psychiatrists/therapists have some sort of savior complex.
IMHO.
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P.S. Most of the therapists I saw seemed to get very upset or sometimes even angry if I didn’t behave “vulnerably”, whatever that means….it felt as though I were being coerced into playing a really sick game of one-way Show and Tell; I got the sense that witnessing grief was their entertainment and the more intense my sorrow, the more entertained they seemed.
People who like pushing people’s vulnerability buttons are the truly sick ones in my humble opinion.
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Sheila, I came across something on HSP’s (highly sensitive person) that includes really some really good information on how it intersects/overlaps with autism and ADHD:
“Is My Child Highly Sensitive, ADHD, Autistic or Anxious”, from Neurodivergent Insights
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Well written article. Thank you. I have just two observations: 1. The article suggests that any mistake or misstep by a therapist might signal abuse or incompetence. Yet, therapy is inherently complex, and occasional errors or misjudgments are part of the nuanced process. Such issues don’t necessarily indicate overall harm or ineffectiveness in therapy. We work with them when they happen. We must allow some room for imperfect interactions. There is no such thing as a perfect therapist, and ethical boundaries are essential.
2. The article labels common therapeutic issues, like being overly agreeable or making occasional offhand remarks, as signs of abuse. While these behaviors can be problematic, categorizing them as “abusive” is excessive. It’s crucial to differentiate between problematic behaviors and those that truly cross clear ethical lines into abuse.
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This author seems to think therapists are indispensable when nothing could be further from the truth. And wouldn’t you know it, thinking you’re indispensable is the telltale “symptom” of grandiosity….
IMHO.
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This article is good because it touches on the often overlooked and understudied of therapy harm. While it addresses an important topic, I think it would be more effective to generalize the main points. Most articles like this speak directly to clients, but the real problem lies in addressing the systemic issues from the therapist’s perspective and their own regulation and business acumen.
To determine if a therapist is good, bad, or potentially abusive, consider these key points:
1. Rigid Specialization: Therapists who claim to only deal with certain categories of people, such as trauma, what does even mean?, or who refuse to work with certain groups (e.g., those with bipolar disorder, borderline personality disorder, or narcissism), reveal their limitations. This kind of selective practice indicates that the therapist is not open-minded and prefers clients who fit a specific mold.
2. Negation of Certain Groups: If a therapist explicitly states that they do not deal with certain types of patients, this is a red flag. It shows they may lack the competency to handle diverse issues and are not willing to accept clients as they are.
By keeping these points in mind, you can better assess whether a therapist is likely to be a good fit. If they make exclusionary statements up front, it is a sign that they may not have the necessary skills to provide effective, inclusive therapy. The reason this is very important is most humans do not know what is the problem until many years in therapy and sometimes these borderline or bipolar states are part of the development and in need for processing so to categorize humans into unscientific labels says a lot.
The reason one cannot be too specific in human relationship is that a doctor becomes specialist in one area of the body…ear/throat, or heart, or lungs etc because these are very tangible areas of the body, human relationship DOES NOT have distinctions. You may look like you have trauma and processing may go through bipolar states, borderline states or narcissistic states….how does one distinguish?
This is my personal opinion and take if it resonates with you and ignore if it bothers you.
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I find it creepy that the author of this blog, Noel Hunter, refers to one of her colleagues who puts videos on Tiktok not by his name. The fact that she adds that the man? / the woman? is projecting “his own trauma” at the clients and thus is himself an abuser without describing an example of his / her behaviour and explaining how she comes to that conclusion gives another bad example.
But I don’t think it to be surprising. As the daughter of a psychotherapist I’ve known since childhood that it is normal within that profession to badmouth one another behind their backs and to give talks at conferences about each other’s psychopathologies. It was Freud who started this and the profession seems unable to ever stop their working culture. It’s the abuse that they have come to see as normal.
I can only encourage everyone to go on the internet and check out the knowledge that psychotherapists offer there for free. I have myself benefitet greatly. And I want to especially mention the early work of Daniel Mackler on Youtube and his book Breaking From Your Parents. I would have probably gone nuts without the advice and the many stories on how to safely cut yourself off of an abusive family.
I think it is him that we have to credit with making the fact known to a wider audience that some parents or siblings might be so extremely abusive that their victims in order to protect their mental health don’t have another option than to go non-contact. His book is brillant because he not only gives a general idea of the theme but he has collected many different stories such that you get a very lively picture of your situation too. From where you can judge your own situation clearly and then if necessary to break away from your family and especially how to do it safely without experience more psychological abuse.
Another thing: People who are seeking psychological help are competent enough to decide whether one or the other of them really has something valuable for them to share and put into practice.
Here again by doubting the user’s capactiy to judge for themselves Noel Hunter shows behaviour traits that are typical amongst therapists and that are in itself red flags when assessing a therapist.
A good therapist who understands how many of his or her colleagues are sharlatans or worse abusive encourages clients to never ever doubt their capacity at good judgement and always listen to their gut feelings when assessing a therapist. And does not tell them that their judgement is impaired because of the oppression and violence they have experienced. It is wrong. It is pervasive rape culture that is dominant in our society that enables abusers and discredits victims that makes the victims doubt their experience and themselves. If victims of violence have distorted judgement then it is because of rape culture and therapists like Noel Hunter who spread such nonsense with the shady authority of trauma therapy (where’s the evidence?) that is complicit with rape culture.
By claiming that survivors of oppression and violence have their judgement distorted she is actually undermining this capacity of trust of clients in their own good judgement themselves.
RED FLAG – RED FLAG – RED FLAG
RUN!
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“…by doubting the user’s capacity to judge for themselves Noel Hunter shows behavior traits that are typical amongst therapists and that are in itself red flags when assessing a therapist.”
Lina, thank you for incisively articulating the prevalence of abusive therapy culture so often hiding in plain sight.
P.S. Daniel Mackler’s books and videos are absolutely brilliant in the ways he lets people know it’s okay to trust your own gut/intuition.
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My pleasure!
Thank you for your kind reply.
I hope I can write more elaborate about these topics in the future.
I recently managed to get Against Therapy by Jeffrey Masson (1988) at the library. Joel Stern highly recommended it and since his comments are – just as yours – funny and intelligent I went to get it. It is really good to have that book as a reference.
I am glad it is not only from the horrible stories that I learned from my psychotherapist mother and her colleague friends of how abusive their working culture is but it is also very well documented in Masson’s book.
I have also benefited from other books on the topic that were recommended here by other authors. Ayurdi Dhar did an interview with Dana Becker who wrote The Myth of Empowerment. Women and the Therapeutic Culture in America. which I also found interesting even if a bit unclearly written regarding her main insights.
It is my own detrimental experiences with psychotherapy, my training in history, and the work of critics and scholars like the above that I find myself better and better capable at formulating my own ideas about what’s wrong with psychotherapy and the psy-disciplines at large.
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Thanks for your kind words. I have never intended my comments to be “funny,” but at times it can be amusing to observe the patent grandiosity of so-called mental health professionals who claim superior knowledge of and insight into human thinking and behavior, and who unjustifiably wrap their wholly subjective, ever-changing, culturally conditioned hypotheses in the mantle of science and medicine.
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Thank you for your kind words, Lina 🙂
I hope you write more on therapy culture because to me it seems the (inherent) abusiveness of it is rarely acknowledged, much less mentioned.
To me this article is insulting to the point that it seems almost ironic. But at least I now know there’s actually a term for it: “attributional bias”.
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I was researching a bit online and found a great list of books and other ressources about the subject of abuse and malpractice in psychotherapy on the website of TELL Therapy Exploitation Link Line
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Big shout out to Daniel! If he and a few others on YouTube’rs had been around 30 years ago, I could have saved myself some serious the rapist trauma (denial of my interpersonal violence, childhood psychiatric betrayal, and much, much more). Back then all the books I found were either excellent transpersonal or Jungian books, institutional psychobabble, or self help candy. Sometimes when I watch Daniel, I feel like I’m watching a version of myself who had to learn the hard way surrounding both his psychological content and the positions he takes, as well as the manner in which he says it.
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Thank you! 🙂
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It too me a very long time to realize that I was being hurt unintentionally by a warm and kindly therapist.
1) Beware if they are not transparent about their modality and how it works from the beginning.
2) Do not trust that they take confidentiality seriously. It should concern you if they do not directly speak about how they protect you, the client. From discretion in how notes are taken and kept, to with whom they speak- it’s all important and should be front and center at the start.
3) No goals-no checking in to see if they are actually helping- big, scarlet flag.
4) Just sitting there, not engaging in conversation, do yourself a favor and get a pet instead.
5)Doesn’t want you to discontinue after years, but will give no reason as to why— not a healthy relationship.
6) Share a hard, difficult story with therapist who doesn’t respond and wonder why you feel so badly, it’s because that is not what empathy looks like- most would feel badly.
There’s plenty more, but that’s a few off of the top of my head.
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Excellent advice!
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Why thank- you.
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Thank you for this article! It is clear and brings up many good points.
I am not sure, however, about the necessity or wisdoms in expecting therapy trainees to undergo therapy themselves.
Clearly, they do need to have SOME kind of process to enhance their self-awareness and work through their challenges.
But is mandatory psychotherapy the solution?
In my home country, where psychodynamic approach is dominant, candidates are expected to have therapy themselves. Observing the professional culture, I am sceptical this leads to good outcomes.
More likely, I believe it leads to dogmatism and the continuing of poor professional culture. If you have therapy as a professional candidate, and you know that this is a factor in your chances to be accepted to an exclusive training program, you are likely to adopt and internalise whatever modelling your therapist offers you, with little healthy criticism of the process.
I don’t know what is the answer for that. Perhaps mandatory and frequent supervision, plus effective reporting channels that could help the client discuss and understand their experiences in therapy.
A friend of mine is a firm advocate for the client’s right to bring a companion to their therapy session, just like it is with medical appointments. So that therapy is not necessarily done behind closed doors.
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I just think certain individuals don’t have the capacity to do what is necessary to help another person emotionally. It doesn’t matter how much training is provided. An openness and ability to hear what others are saying and feeling and to hear the feelings behind the presentation, to listen deeply and be willing to be humble and to not seek to control the situation – there are a lot of skills and qualities that can’t be taught. The proof is in the results, and I’d have to say the average therapist doesn’t get real results. Most have a few techniques and tricks, and some are inherently destructive and have no idea how to be otherwise. There are those with the skills to be helpful in that role, but they are rare in my observation. And some have advanced degrees and some have been volunteers with 20 hours of training or none at all. The idea that a therapist can be created by proper training is, to me, a pipe dream. Some of it simply can’t be taught, even if the therapist goes through therapy him/herself.
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Amen- well said. Those characteristics cannot be taught- many therapists try to mimic these traits which is so very confusing and harmful for the client.
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I agree with you, Steve. I am not a therapist and would not try to become one. My first order of business is to understand how to encourage my family, to learn from my mistakes, and to honor principles that make sense to me. I desire to live in peace with others, but I can make no guarantees about not offending others. I will not pretend that I don’t have beliefs that may offend others. If others can benefit from something from my lived experience, so be it. They may decide to be as different from me as possible. So be it.
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Steve, coming from this viewpoint, what would you think about initiations that try to bring emotional support back to community members? Things like Emotional CPR or Just Listening Community?
If you are right (which I am not entirely sure about), we need to stir away from professionalised emotional support and find “common” ways to provide it to one another.
https://www.justlistening.com.au/
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Any of these things can be helpful if practiced by someone who has the proper attitude and has dealt with his/her own issues. The big problem is that there is no way to measure therapeutic competence, nor any training that assures it will be developed. Having clients/users themselves decide what works for them seems like the best solution. Dubbing someone a “therapist” because they completed a certain set of courses or a supervised internship with another person who may or may not have those skills and attitudes is simply misleading.
I agree that simplifying and “common-izing” our helping approaches is the way to go.
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I think most harm that is done in the world is most often done by well meaning but ignorant people, with a large dose of self interest in neoliberal systems that maximise and tie people to narrow greedy self interest.
I’ve worked in the industry for years as a ‘therapist’ and in other related ‘professions’ social worker etc, but I don’t like the term therapist and just think of myself as a temporary ally on this confusing, exhilarating often terrifying brief trip we call life.
I am acutely aware and often lose sleep over the fact that no matter how hard I’m trying to be of use to someone I have NO idea how my interaction is being taken in by the other both in the moment and much later, once its been weaved in with the rest of the persons life. You know when the questions and confusions arise, hmm what did he mean when he said this or what was that look about? Etc
It is so common for all human beings to not say what we mean or mean what we say. We’re all ‘masking’, story telling and acting from a deep primordial confluence of entangled influence of biology and environment that another story paints this irrational mess as a self, in control and captain of the ship.
The term ‘psychotherapy’ is so grandiose and like so much else in the field seems desperate to convey something professional or even esoteric. Most of the courses/trainings I’ve done are about cult like indoctrination into a model and its alleged ‘evidence base’
Not once has any training or supervisor ever asked me to question these accepted truths.
I had to stumble across the critics on my own and it was painful and destabilising when I did. Then when I tried to take these new found ‘insights’ to supervision to help make sense they were pushed away, and ignored.
Ignorance is bliss it seems.
I then went on to read all of psychologists David Smails books, Paul Maloney’s the Therapy industry, all of William M Epstein’s books, the illusion of psychotherapy, psychotherapy as religion and psychotherapy and the social clinic in the united states soothing fictions and many many others.
What these and others demonstrate is that none of it has any robust evidence supporting it and time and time again the same statement is written that the ‘harms of psychotherapy are well known but under researched’
Lets not mention the replication crisis either that is still unresolved.
So I do what little I can to try and help always aware that I might be inadvertently harming.
I am also tied by self interest because this is all I have done, spent money on and have a mortgage.
This is a short and more honest summary of psychotherapy, written by a former president elect of the British Psychological Society.
https://www.psychreg.org/why-most-psychotherapies-equally-ineffective/
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Maybe our ability to predict a good outcome for our best efforts to be helpful to someone, given the countless factors within any individual psyche, is much harder than we hoped.
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“This may be a strange thing to consider, but your therapist is, first and foremost, a regular person.”
I think it’s egotistical for therapists to think this is something that people who aren’t therapists need to be told.
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I found the article to be too general to be useful. I will take to heart the potential that an arrogant therapist can be abusive. I do have a model of therapy that generally works and I explain it to the client in the very first session which is free. The client then has the freedom to decide if my understanding of help will be useful to them. To assume that most therapists must have experienced trauma in order to have the foundation for providing help is arrogant.
I realize that many who have experienced trauma and studied psychology to obtain help is often true but not a given.
I sense that the writer of the article comes from a philosophy of psychology and a worldview that is dismissive of alternative views. To me that is abusive to fellow therapists!
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Psychotherapy is inherently authoritarian and victim-blaming. “Many people who wish to impose their definition of reality would deny that they are involved in gaining power. They would say that because of their greater knowledge, wisdom, training and experience they know what is best. The most dangerous people in the world are those who believe that they know what is best for others” (Maisson, J, 2012, Against Therapy, Untreed Reads, p.23).
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All founders of messianic cults make similar grandiose claims. It’s no accident, for example, that numerous German psychiatrists in the 1930s and early 1940s found eugenics and Nazi “Rassenkunde” so congenial (even Carl Jung accepted the notion of the different “Aryan” and alien Jewish collective unconscious, to the detriment of the latter). Psychiatric and political authoritarianism naturally resonate with and mutually support each other.
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“Psychotherapy is essentially authoritarian and victim-blaming.”
That’s the essence of it in my opinion, no matter how skilled, well-meaning or intelligent the therapist. Even the most empathic practitioners left me feeling as though I’d been served a back-handed compliment. In my opinion, it doesn’t make any sense trusting people who don’t find psychotherapy’s “power-imbalance” sickening. I think most are a bunch of mini-gurus living in their own psychological bubble.
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…which imo makes it easy to understand why so many therapists reject “clients” who refuse to be manipulated. (Opps! I meant “clients” who disagree with them).
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What do I think is the biggest red flag? Anyone who proudly states, “I am a therapist”.
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…because if you take the time to think about it, you may start to see the how very desire to be a therapist is in itself an unhealthy one.
IMHO.
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I found this article very insightful and informative. I do think that most therapists do not do their own internal work, which is why so many unhealthy people are in the field in the first place. My first experience with therapy was over 30 years ago and the field is way different now. You honestly don’t even need to pay a therapist anymore unless you want to because there is so much armchair and bad I might add, therapy online. It’s actually quite nauseating to me to see how many bad therapists are bloviating online. Anyway, great article.
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Is gross incompetence a form of abuse? Seems to me that a client might be experiencing gross incompetence without knowing it at the time (for a long list of common reasons, of which I consider myself squarely in this camp-and I doubt I’m alone, if not for all the excellent comments and insights to this blog alone!). But for the life of me I don’t know how to address the sense of betrayal I feel about that incompetence (ergo the sense of being taken advantage of in multiple ways, least of which was economically). So if anyone has any suggestions, I’m all grateful ears!
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I too have felt that sense of betrayal Kevin. I kept waiting for “therapy “ to start- for my therapist to actually have a dialogue with me- I am somewhat ashamed to say, but I waited for ten years.
The financial betrayal- Omgoodness. I even went back and calculated the money paid by myself and insurance, then I calculated compounded interest of my portion had I instead put it into my 401k.
I don’t have anything to give, but it’s been two years since I quit, and I have to say, the freedom really grows once you get over the initial bewilderment and sense of having been deceived.
I have a sense of what caused me to continue to pay for something that was not helping- I mistakenly thought I was broken and this was the avenue to repair. I doubted myself which I no longer do, and I was compliant because I didn’t want to hurt my therapist’s feelings or rock the boat.
I do not believe that I will allow something like that to happen again and that is a strength that I didn’t have before. For me, quitting therapy was the most healing step in my journey. It’s just taken some time away to realize how much better off I truly am.
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Thank you Annie for your kind and thoughtful reply. I am happy to hear that you reconciled the toxic false belief that you were “broken” while you were in therapy; nothing could be further from the truth! Perhaps I may just be cynical beyond repair, but I suspect your therapist did very little to disabuse you of this fallacy, save foster it.
As for being bewildered, bewilderment seems to me a consequence of someone that is either being gaslighted or taken advantage of through various forms of “epistemic injustice” (when someone’s lived social experience leave them at a deficit of essential understanding). And when our bewilderment fades, is when the anger “stage” replaces the “mystification phase”
I just happened to see a You Tube video last night of two psychotherapist talking about “bad psychotherapy”. They read off a couple dozen comments sent to both of them, of which were utterly horrifying and shameful to the profession as a whole. But in the comment section was another 2000 comments of equal to worse examples. The bigger problem to me, however, is that these people’s psychotherapy experiences are only the cringe layer of institutional failure, of which, several layers up, what passes for good psychotherapy is scarcely often more than just a neoliberal transactional relationship that re-socializes the client into a more acceptable (unconscious) false individualism (ergo neoliberal subject).
At 66, I’m having to relearn what it means to be decent human being. Over the first 55 years of my life I firmly believed being honest, honorable, hardworking, kind, intellectually and morally rigorous, respectful of others, and a host of other like- characteristics was the right way to be in this world. But I’ve since learned, however painfully and disillusioned so, that these qualities are mere “presentations” of far more socially valuable qualities. They are money and power, indifference with virtue preening, self-referential opportunism and mindless positivism, moral and intellectual relativism, and dozens of more like qualities. I’m finding that swapping out my life long erroneous beliefs with these new more respectful and socially acceptable “contemporary” values (qualities), is rather a rough hoe. Maybe in this struggle to better achieve these essential contemporary values/qualities, I can find the kind of successful psychotherapy, or otherwise be the successful psychotherapeutic client, that eluded me many years ago? What else could anyone reasonably hope to achieve at $200 ‘plus’ and hour in today’s soul crushing neoliberal funhouse?
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Love this comment.
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To me, it’s as senseless to speak of “good” and “bad” psychotherapy as it would be to praise good and condemn bad phrenology. From a strictly logical point of view, incorporeal thoughts, emotions, and behavior that are not the result of a verified physical pathology cannot be subject to therapy except in a purely metaphorical sense. To claim otherwise is a misappropriation of medical language, unless one subscribes to the discredited hypothesis of a chemical imbalance or to to the currently belief in faulty brain circuits as the likely source of all the mental disorders cataloged in the DSM. Cogent proof of this is yet to be found.
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I meant to say “currently fashionable belief.”
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I think the need/desire to be a therapist comes from an unhealthy place.
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Thank you for covering this. It feels as if it has become taboo to talk about this out in the open!
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