Therapy Can Harm Too

By
-
55
2694

In the critical psychiatry community, we tend to draw a stark line between drug treatment and psychotherapy, with the latter often being promoted as a safer and more holistic alternative, getting at the root cause of our distress rather than just covering up symptoms. Unfortunately, this comes with a tendency to forget that therapy too has strong roots in the biomedical model, and it‘s that framework in which practitioners are trained.

Let’s set the stage. I’m just about to turn 30. We are in the middle of a COVID lockdown that’s gone on for so long, the boundaries of normal life and this new reality of being cooped up in my apartment have begun to blur. The social isolation seems to have caused my anxiety to spiral and I’m shrinking in my therapist’s chair with the physical symptoms of nausea and tingles in my hands and feet that are characteristic of that anxious state for me.

Over the last couple of sessions, the 40-something dude sitting across from me has told me perhaps more of his personal life than I’ve shared about mine. I know his wife just gave birth to a child that’s still receiving treatment in the NICU. I make a reasonable inference their marriage is struggling from the fact that he told me, with surprisingly little concern for decorum, that he got married not because his partner was the person he’d always dreamt of spending his life with, but rather because he was in his mid-thirties at the time and coming off the tail end of a slew of failed relationships.

Last week he also inquired about my sexual fantasies and whether I engaged in self-pleasure now that I was single, and he made sure to emphasize our therapeutic relationship. The discomfort with all this is gnawing at me; it’s tugging at my consciousness, begging to be heard. But I brush it aside. I really am deeply anxious. I’ve not been sleeping much. I feel I need professional help and most therapists in my city have wait lists rivaling the length of the local phone book.

Today we are onto a different subject altogether. My therapist brings up the possibility of taking an antidepressant. I have made it very clear I’m not interested in medication.

So the cajoling begins. There’s a not-so-subtle attempt at shifting blame. After all, we’re down a couple of sessions and I haven’t made significant improvement, which is portrayed as a feature of the severity of my issues. My therapist’s methods are not up for appraisal here. He informs me that all his clients are medicated and that my refusal is suggestive of the fact that I don’t actually want to get better. He assures me it’s better not to read the pamphlet, as those side effects are extremely rare and it would only scare me. He even suggests I may be at risk for suicide without medication, although the thought of ending my life has never so much as crossed my mind.

I stand firm on my no, getting perhaps a bit irate at this point. The tone of our conversation has shifted quite noticeably from when it began some 15 minutes ago, and it’s a lot less one of therapeutic alliance as it is one carrying more than just a smidge of hostility.

He asks if I’ve ever experienced paranoid delusions.

Now I’m really caught off guard. I’m still trying to figure out what about my demeanor or the things I’ve spoken about could have triggered such a comment, as my therapist, his hands crossed behind his head in what I struggle to differentiate is between a gesture of relaxation or superior contempt, lets me know that it is a sign of distorted thinking to have concerns about the effects of an SSRI medication on my brain and body.

I leave our session with a whirlwind of thoughts and mixed emotions swirling around my head. I’m a bit angry. But I’m also scared. The seeds of doubt have been sown in my mind, and watered by anxiety they’re rapidly growing and flourishing. What if I am just resistant to getting better? Around 50 million Americans are on at least one SSRI. That’s one in seven people. In my home country we are rapidly catching up to that prevalence. Maybe my concerns were overblown, after all.

Once again, I can‘t sleep that night. My therapist’s words about how I will end up with an untimely, self-inflicted death, or as the TikTok crowd would say, unaliving myself, are playing on a loop in my brain. A few days later I make that fateful decision. I take a trip to the walk-in clinic at the local psych hospital, leaving with a prescription for the atypical antidepressant Mirtazapine.

Today I suffer from what’s known as PSSD (Post-SSRI Sexual Dysfunction). An innocuous-sounding little acronym that involves loss of libido, genital anesthesia, lack of lubrication or erectile dysfunction in men, and anorgasmia (pleasureless orgasm). My clitoris is so numb, I feel nothing from a Hitachi magic wand on the highest setting. But the syndrome isn’t limited to the sexual realm. It also for many sufferers includes severe emotional blunting and anhedonia. Five years later I look at my family and friends and cognitively I realize the love I used to hold for them, but in my heart and body I feel nothing. Music, once my great love, has been reduced to background noise. I’ve lost all of my interest in movies, as without the ability to empathize with the characters those too have become just a hollow way to pass the time.

There is currently no cure.

I’m now a couple days away from my 35th birthday and while everyone around me is settling down and starting families, I’m trying to grapple with the fact that I will never have a romantic partnership again. Not a day has gone by since I threw that pill bottle in the garbage bin — only to realize the side effects I’d been experiencing on the medication were not subsiding — where I haven’t thought of suicide. Quite ironically, perhaps. I was only on Mirtazapine for three weeks. In case you’re wondering, it didn’t help my anxiety at all,

Much has been said about prescribed harm. I want to tell my story because I’d like to open up a conversation about the role psychologists and social workers play in getting people on psychiatric drugs and ensuring treatment compliance, as well as the lack of professionalism and oversight that prevails in the therapy industry. And because I know, I’m not the only one.

Therapy, as it turns out, can harm too.

***

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.

RELATED ARTICLESMORE FROM AUTHOR

55 COMMENTS

  1. Well, you know you can withdraw. Having dose a bit lower every month, for instance. It can take a year of course. Or more. Having a psychiatrist on your side might also help of course. Since I am an avid MIA reader I advise you (even if you have probably already read it) :
    https://www.madinamerica.com/2024/10/what-helped-and-what-hindered-my-recovery-from-protracted-withdrawal-from-antidepressants-and-pssd/

    Withdrawal is fascinating in a way. Or how a pill supposed to help turns against you because it is probably made to be addictive.

    Report comment

        • Using the word “professionalism” hides many an insecurity.

          I think most people in the mental health field use the term as a smokescreen to make it sound like they know what they’re doing when in truth they really don’t. Curiosity means nothing and humility is an anathema to most of them.

          Report comment

        • Dear Cornelia,
          i am so sad to read about your experiences. As a psychologist as well as a patient of psychotherapy myself, i can confirm that what you experienced with the “above therapist” was not therapy. Please do not assume that there are no good therapists and good therapeutic work and change out there. Its not easy to know who that is, i agree. this may be of some help: https://www.psychotherapynetworker.org/article/tyranny-time/ or https://www.psychologytoday.com/intl/blog/psychologically-minded/201604/how-to-choose-a-therapist

          Report comment

          • Not therapy?

            I have had seven different psychotherapists in the course of my life. Four of them were clinical psychologists – all very highly qualified. They did me huge psychological damage. I had Jungian analysis, psychodynamic therapy, DBT therapy, humanistic and integrative psychotherapy and finally Human Givens therapy. Some of those were practiced by four additional psychotherapists I saw over the course of a horrible traumatic life starting in early childhood.

            Therapy should come with a very, very large health warning. I finally got a decent therapist towards the fag end of my life who having heard my story was genuinely shocked at the litany of abandonment, callousness and engendering of hopelessness I suffered at the hands of the other therapists.

            Unfortunately therapy seems to attract a lot of people who are seeking to work out their own issues through therapy and unfortunately its fair share of psychopaths – it is a very quick path to having power over a vulnerable person and doesn’t take a huge degree of intellect to become a psychotherapist.

            I am sorry for what happened to you Ms Linder. I am also on Mirtazapine and still on it but my libido was finally killed off by Cymbalta a few years previous haha. It is good that you raise the issue of therapy which is so often touted as a safe alternative to psychotropic drugs and medication.
            Not so I have found – not so. Therapists are just human beings and prone to all the cruelties and power seeking of human beings. What sort of a person would think that they could actually help solve someone’s trauma or psychological distress – mainly though not always but mainly someone with a very large ego – that’s a problem.

            Report comment

  3. Whatever happened to good ol’ self-reliance?

    Simple fact: Seeking emotional support from professionals will always be fraught with problems as the psychotherapeutic profession seems to attract more than its share of people with psychological problems of their own that haven’t been dealt with only made worse by a power imbalance that enshrines the professional. It’s a recipe for disaster that will always be there.

    If you don’t want to be professionally victimized, don’t go looking for it. Our modern culture has become so invisibly disempowering that not trusting ourselves has become second nature to most people.

    What’s wrong with having some faith in yourself for a change?

    Report comment

  4. I agree, personally I found psychologists to be some of the least ethical people on the planet. One psychologist I dealt with charged me for her services, fraudulently implying she was working for me, but then she ran off like a manic lunatic to get lies and gossip about me from a child abusing pastor and a pedophile’s wife (neither of whom knew me), according to her own medical records.

    Decades later I was attacked by a second psychologist, who hacked into my computer, and handed me the most appalling take a percentage of gross thievery contract, combined with an appalling conservatorship contract, all disingenuously dressed up as an “art manager” contract. I refused to sign his appalling contract … many, many times. And finally I had to report him to the police.

    Definitely some psychologists have less than zero ethics. I’m sorry about what happened to you, Cornelia.

    Report comment

  5. Psychotherapy implicitly teaches people to depend on professionals more than themselves.

    Quit confiding in someone you have to pay, and guess what? You just might find the person you really need, WHICH IS YOURSELF.

    It’s time to stop looking to therapists for comfort or answers. Way better to grieve privately and give yourself pep talks than seek out emotional bloodletters that charge a pretty penny.

    Report comment

    • I see what you’re saying about learning to trust yourself, but I disagree with the whole “pull yourself up by your bootstraps” mentality, which to me comes off as lacking compassion. I don’t know if that’s how you meant it, but generally, the “bootstraps mentality” itself strikes me as uninformed about mental health issues, even if well-intentioned. Humans are social creatures; we are meant to depend upon one another. Shaming people for wanting guidance, support, or help through difficult times is a step in the wrong direction, in my opinion. However, I do agree that the power dynamics of therapy that entrust someone else as the “expert” in your life can be very dangerous.

      Report comment

  7. I was so sorry and devastated to read your blog. What happened to you is outrageous. Therapists who come from a deficit-driven viewpoint (regardless of their methodical orientation) can do so much harm!

    You are absolutely right, psychotherapy can harm as well. In more than one way.

    Daniel Macler has some good conversations about the downsides of psychotherapy. Here is one of them, focusing on psychotherapy within the American (NY) system:
    https://www.youtube.com/watch?v=f0Fi32LbXHA

    And here is one I am watching right now… critical thoughts of psychotherapy in general.
    https://www.youtube.com/watch?v=G2-p4A7Bl6s

    I wish more practitioners, both doctors and therapists, would be more critical and careful, and more honest about the harm-benefit profile of their interventions, and equip their clients to have a good critical view themselves.

    Report comment

  8. I can’t quite believe what I’m reading. Certainly the portrayal is of a therapist who seems to be showing far more signs of psychological dysfunction then you as the person seeking help. It is insanity. I think human conversation, real caring conversation, is helpful, but therapy itself is an economic relationship and a social process which is processing you, the victim of stressful social circumstances. The only thing that would have been more insane would be to prescribe you a pill for the stress of a sudden and abrupt change in social and psychological circumstances. Really humanity as a whole is barking mad, and just as psychiatry cannot be reformed, being rotten to the core, so too our socially conditioned consciousness and society which has destroyed everything worth living for. cannot be reformed: we must start again. So lets bring on the apocalypse. No point in waiting till your children graduate or your sister has her baby. If there was not an approaching apocalypse that would still be apocalyptic for Mother Earth who is all but spinning off her axis as we speak.

    Report comment

      • The whole “therapy” shebang imo amounts to a commercialized trauma bond. In other words, a disaster waiting to happen.

        Trauma Bond: a relationship where there is a power imbalance and a cycle of reward and punishment. The abuser is in a position of power over the person being abused and alternates between hurting and soothing them.

        Report comment

        • “Commercialized trauma bond” – ouch! Well observed Birdsong. I must admit I’ve seen evidence of this power play of reward and punishment and also one of implcit judgement in what the therapist allows you to talk about or what she or he wants you to go into. Often there’s a implicit judgement or affirmation, or a play of judgement and affirmation by the therapist and it’s always been loud and clear to me (I’ve had therapy twice and other kinds of support many time and it’s always the way). I think you and I are into a destructive critique about this because we need people to see the utter worthlessness of the whole thing. This is scary or impossible to accept for most people but obviously you and I have a sense that there is hope, just not in these ‘professional’ approaches. It’s a human approach, and for me a truly human approach embraces the natural and spiritual dimensions without them necessarily being a conscious intellectual concern. Anyways, you won’t be popular with the therapists (me neither probably)!

          Report comment

          • So happy you see what I see, No-one! It’s taken me a lifetime to find my voice and to finally have it validated by someone I respect as much as you feels truly remarkable 🙂

            Psychotherapy is one big power play hiding in plain sight. It’s nothing more than an elaborate cat and mouse game, and I think you and I both know who’s the cat and who’s the mouse.

            Report comment

    • yes – looking forward to the end of the species too. The late George Carlin spoke it well – the planet will be fine without us and will shrug us off like a flea. He said some very funny things about us as a species – no animal (not going to use his words) engages in necrophilia; no animal would put a man into a bag with a monkey, a dog and a snake and throw it into a river like the Romans did – yet human beings – the ones with the direct line to God would – says it all as far as I’m concerned.

      Report comment

  9. This is a sad commentary on a therapist. I have no doubt about its truth. As a therapist myself I often check in to see how they are doing in the process. While self-disclosure can happen as a therapist it is not always recommended but sometimes can’t be avoided but he overshared and sounds like a creep. Sadly I have worked alongside many a terrible therapist

    Report comment

  10. Everyone I know including myself has been damaged and financially overspent by therapy.
    It has caused some to believe things not true, others to discover things better left unknown, dependance on therapist, and sometimes an affair .
    Under extreme cases , medications can help, mostly they have you tired, and unmotivated.
    I found my answer in both eating healthy and in a relationship with Christ.

    Report comment

  12. Thank you for sharing your story. Your courage will undoubtedly validate others with similar experiences, myself one of them. I left therapy because every time I expressed emotions, not outbursts or extremes or unrelated to circumstances emotions, but any emotions that caused my voice to quiver or, worse, tears. I had made my stance on SSRIs clear on multiple occasions. It had taken years of work prior to therapy through journaling and mindfulness to feel and label and understand my emotions. I was raised in a family that did not permit negative emotions. They were grounds for punishment. We had one rule to which there were no exceptions, “Put a smile on your face or come back when you can.” Having a therapist respond to these healthy expressions with “now are you ready to consider taking something,” was frustrating and confusing. In just those few words she told me a) that she either wasn’t listening or didn’t care what I had said so many times before about SSRIs, b) that emotions are so bad they must be countered with medication, and c) it’s not what’s being done to me at home that is the problem, it’s my reaction to it. As I sat silent in front of my therapist wondering if her own relationship with emotions prompted this insistence on being medicated, she gave me the answer. She said, and I believe her, that she hated seeing me that way. No wonder clinicians site the effectiveness of SSRIs. They eliminate what makes them feel uncomfortable. Our emotions are important functional indicators about our state of being. Alarm bells to the suppression and injustices we are subject to. Fitting then, that there exists a means of and by white men to silence the alarm bells signaling problems with the imbalance of power they hold. Life of impossible dilemmas. Lose yourself to conform, or lose your liberties and more not to. Freedom is a loaded word that exists with a positive correlation to deception. I envy the blissfully ignorant and woefully unaware.

    Report comment

  13. So many red flags in how that therapist acted, you could write a film about it.

    I am currently disengaging myself from therapists who consistently misunderstood me. Its a painful process as they were also exceedingly helpful at times and then so badly off the mark as to be insulting.

    It’s an area that is very under reported.

    These drugs are evil. Sorry you were so badly damaged.

    Report comment

  14. I am sorry you had this experience. Could be worth reporting to the licensing board, but depending on the state, they may think what he did was ethical. It was not. I have encountered so many terribly wounded therapists and the current iteration of groups like TIPP (therapists in private practice) who refuse to see clients who didn’t vote like them is just disgusting.

    Report comment

  15. Amerika ist ein verrüchtes Land. Es ist sehr schwer, gesund zu werden wenn man in einem verrüchten Land wohnt. Sind sie meiner Meinung? Nach einer fürchtbaren schizophrenischen Psychosis habe ich mit 22 Jahren Amerika für immer verlassen und das hat mein Leben gereten. ich wohne seit 56 Jahren im Exil. Alles Gute.

    Report comment

  16. Hello Cornelia, I do not know if you will get to read this, as it appears I am often censored by madinamerica. I am a retired trauma therapist who for years was aghast at the lack of ability of some professional peers. One such criteria for my disdain was therapists who talked more than listened. That is a huge red flag. One comment by a colleague stands out. He was glad that this HMO had an 8 session limit because after that he “ran out of things to say”. Then of course there is just a lack of knowledge about how people work, how family dynamics work, and how trauma effects people. Please take time to research EMDR self-help. There are programs that can help you and are often sited as more effective than in office therapy. MadinIreland has highlighted my work and it has been accepted most favorably. Try looking at Se-REM therapy (Self effective -Rapid Eye Movement). It is offered as a public service, and if you write to me here I will provide it to you for free.

    Report comment

    • Thanks for your feedback. It seems that the education one gets in a psychology degree is not that good. There is a general lack of knowledge about what you say. Also, it’s probably harder to understand trauma if the therapist hasn’t gone through it personally themselves.

      Report comment

  18. What a terrible life-altering “treatment” you were cajoled and coerced into accepting. This happens not only in mental health clinics, but under the guise of physical health under the care of your friendly general practitioner. I was injured by ECT so badly at age 38 I was no longer able to work and am still on disabilty in my 60’s. My experience with atypical antipsychotics effectively stole 17 years from my life while doubling my weight and damaging my thyroid. And now my GP is doubling down on statins that make me feel horrible and blood pressure meds that have reduced my sleep to 4-5 hours per night. Like you, I am not anti-medication. What I am against is when doctor keep throwing one medication after another, and adding more to treat side effects of the first medications, and voila! Polypharmacy! And many of the medications are only mildly effective. My psychiatrist used to switch my medications constantly, looking for the “most effective” ones, which meant I was in constant upheaval of either getting used to being ON them or used to being OFF of them. Only recently have I adopted a more sane strategy of investigating all of these medications thoroughly online before taking any of them, and refusing almost all of them. Why would I want a few extra years of life on medications that make me agitated, irritable, fatigued, ravenous, foggy-brained and with joints so painful it is hard to get out of bed. I would rather have a higher quality of life and less years. And my doctors tell me the negative side effects are “nocebos” — meaning I only experience them because I expect to. Go figure. As for therapists, I have certainly seen my share who were highly unstable and ill-suited to the job. But I did have one jewel in the bunch who saved my life. And she didn’t do it with medication, she did it by acceptance and good listening skills.

    Report comment

  19. I feel for you, Cornelia, and what you experienced. All too often, I find the harms of therapy aren’t discussed enough. The level of vulnerability shared with a therapist who is ill-equipped to be understanding and compassionate can cause many issues. I also agree with the idea that therapists are considered to be the “experts,” and this leads to an unbalanced dynamic within the therapeutic relationship. Clients should feel empowered to speak up during therapy but often this isn’t the case due to the power imbalance rooted in psychotherapy.

    Report comment

      • I hear you and ideally all therapists would recognize that we are the experts of our story and to remain humble. But unfortunately, this isn’t the case with all therapists and why it’s for those who are harmed to be able to voice their experiences and concerned. To continue to create change and advocate for better practices.

        Report comment

          • I have read that some 90% of psychologists (and no doubt the great majority of other mental health practitioners) base their diagnoses and therapies on the categories of sham disorders listed in the DSM, which some of its compilers, and the NIH itself, have dismissed as a pastiche with no demonstrable scientific validity. Why, then, should anyone involved in this sordid racket masquerading as a legitimate profession be credited with–and paid handsomely–for groundless knowledge, questionable skills, and largely feigned empathy?

            Report comment

  21. Hello Cornelia,
    I am a retired trauma therapist who has at one time worked in an outpatient setting with other therapists. I was often shocked at their lack of understanding of human psychology, family dynamics, and the effects of trauma. Perhaps the worst characteristic, (like your experience), was the therapists that talked more than listened. This is a red flag. One psychologist said he was glad about the limit of sessions imposed by the HMO, because he “ran out of things to say after 8 sessions”.
    If you would like to do more of your own work at home, you can do EMDR self help. I will be happy to send you a link for a free download. This program is helping both individuals and therapists in 33 countries. You can read about it, and hear samples at:
    Se-REM.com. You can write to me at: [email protected]. Best wishes for you, David B.

    Report comment

  22. So for the sake of everyone out there who is prescribed psychotropic medication, please be advised that since 2012 HHS and its subordinate agencies have been cooperating with pharmaceutical companies and health systems to CONDUCT ePCTs otherwise known as EMBEDDED PRAGMATIC CLINICAL TRIALS. That means that the physician will only be obligated to get “assent” and not informed consent to use you and your data for clinical research. There are significant incentives for otherwise competent professionals to engage in unethical, illegal and oftentimes abusive clinical exploitation of naive patients. Unless patients spend thousands of hours a week researching medical journals they will never realize that their medication regime is a “dose optimization” protocol or a phase IV trial for fda “approved” medication. These studies are incredibly cynical and will cause an enormous medical and economic crisis.

    The year 2019 kicked off an NIH collaboratory ePCT demonstration program that embeds protocol for standard of care comparison effectiveness trials. Patients are randomized into either regular care or an alternative protocol. Unless you are involved in academic medical center research and training programs you won’t notice that your best interest may or may not merge with the interests of your physician. Please be advised that you must look out for yourself. The only precedent for this medical practice so far in the US is the Veterans Administration.

    Report comment

LEAVE A REPLY