Abuse of Clients in Therapy

It would be an understatement to say that abuse in therapy is a taboo topic among professionals. The ignorance about the extent of client abuse by therapists goes beyond just not talking about it in professional circles, there is a complete denial that such phenomena exists. The most common response you would get from mental health professionals if you bring this up is the dismissive comment that this is a problem of some “bad apples” in the professional community who do not represent the entire profession.

Nothing can be further from the truth. I am not aware of any official statistics on all the instances of inappropriate, unprofessional and unethical behavior by therapists ( I would love to have this data), but if you go to any online mental health forum where people share their therapy experiences, a good half of all the stories would be about therapists who either behave unprofessionally, unethically or use questionable methods that don’t seem to be therapeutic at all.

The most disturbing thing of all is that the absence of a requirement to adhere to strict standards of scientific validity of methods allows many unethical therapists to abuse clients without breaking any formal rules of conduct and simply through emotional and psychological manipulation. Such abuse almost never gets exposed not only because all interactions between the therapist and the client take place in the secluded private space with no witnesses, but also because, under current standards of practice, therapists have a lot of freedom to practice any way they want.

My personal experience in therapy, the numerous stories of other therapy clients I’ve heard, what I have witnessed and experienced in my professional training – all that left me with no doubts that abuse of clients by therapists is a systemic problem of big proportions and cannot be dismissed as individual failings of some “bad apples”. This is not a “bad apple” problem.

This is a problem of inadequate professional training not rooted in facts and thorough research, this is a problem of a lack of screening and testing of those who enter the profession, this is a problem of poorly developed methods and structure of therapy with little scientific validity behind them, this is a problem of a politico-economic system that doesn’t guarantee mental health care services as a right and that puts practitioners in the position of having to reconcile their personal and professional integrity with the necessity to survive in the brutal market system, this is a problem of patriarchal dominance that the mental health profession is still under and patriarchal values that still covertly influence its common practices and a whole host of other things. The list can go on and on which makes this problem very big and complex, the one that needs to be approached from many angles.

Since the problem is big and complex and the suffering it causes to many people is severe, I have to break it down to many aspects and to address them one by one.

This post is just an introduction of a big theme on this website different aspects of which will be discussed in other posts. There is, however, a couple of things I’d like to add here.

First, I have no patience for those who try to silence the victims of abuse by therapists by accusing them of bigotry against therapists as a group whenever a victim says that abuse of clients is a systemic problem.

If you happen to be one of those who confuse criticism of the system as a whole with making a generalization about all members of that system, let me explain the difference to you.

Generalizing something to the entire group of people means that I assert that EVERY SINGLE MEMBER of that group behaves in a certain way. If I was negatively generalizing therapists on the basis of their ethics, I would believe that EVERY SINGLE THERAPIST without exception is unethical. Thus, if I met someone who is a therapist for the fist time, I would immediately assume that he or she was an unethical individual without even getting to know him or her as a person.

When someone criticizes a system, they point out certain ways in which a particular system has been functioning traditionally that don’t serve well those who interact with that system as well as the insiders of the system. Those systemic flaws allow a lot of bad and destructive behavior to go “unnoticed” and unchallenged while many people who belong to the system may themselves be decent and ethical human beings.

It’s quite possible to be a well-intentioned and ethical person and to be a part of a dysfunctional system at the same time because you may not see the system as dysfunctional. It is possible to be an ethical individual and to practice non-effective or harmful methods because you were taught in training that the methods are good and valid. It is also possible to demonstrate great ethics in your practice while turning a blind eye on something questionable your colleagues are doing that you would never do.

Criticizing mental health profession as a system is not the same as saying that all members of the profession are unethical. It is to say that the systemic design of mental health services greatly undermines their effectiveness and often leaves consumers in worse conditions they were before they received services. It also creates a safe space for those who are unfit to practice to behave in ways that harm their clients. The fact that many ethical therapists choose to be a part of such system is an indication of their ignorance, not an indication of their lack of ethics.

I find it interesting that it’s very unlikely that someone would call you a bigot if you criticize our political, economic and social systems. No one so far has accused me in making a generalization about politicians or people who work in a financial sector when I criticize political parties or the banking system.

I also doubt you’d be called a bigot and accused in making generalizations about Catholic priests if you talk about sex abuse in Catholic Church as a systemic problem of the Church.

In those instances and in many others, people seem to understand the difference between criticizing the system and prejudging everyone who is a part of that system. That understanding disappears for some reason whenever the mental health profession as a system is discussed.

This accusation of bigotry is completely illogical and, as such, it is an ad hominem distraction from the topic that is very uncomfortable for many people to discuss honestly.

The second thing I want to mention here is that, just as I detest the denial and the dismissal of the reality of client abuse in therapy, just as I detest the accusation of bigotry as an attempt to silence critics of the system, I also detest the real bigoted attitude that some client abuse victims seem to have developed towards all mental health professionals. While I completely validate their traumatic experience and recognize it as abuse of which they were victims and while I completely agree that the system is broken, I find it very unfortunate that those people didn’t use their experience as an opportunity for spiritual growth and that they chose to completely and permanently identify with their pain and rage instead of following the path of recovery and healing.

None of the above mentioned attitudes is helpful in trying to understand the problem as complex and as big as abuse in therapy, least of all in trying to find solutions. This is why I don’t want Therapy Consumer Guide to become a battlefield for fights between pro- and against- therapy warriors. None of these two extreme positions offer solutions to a national mental health crises of monumental proportions our country has to deal with.

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2 Responses

  1. Ellie

    I’ve been emotionally abused by a shrink before. The last straw was three months ago when I finally cut her off. It still hurts to this day though, the pain of it.

    I was disappointed in my ADHD testing results and thumped the papers on the couch next to me in frustration. She looked back at me while standing checking her phone and was clearly flustered and annoyed and a total disapproving mom and was like “we don’t do that here. You know how you insist you don’t have aspergers? That’s aspergers behavior right there!” Among other shit.

    And no, I didn’t meet the criterion for aspergers or autism.

    Other shrinks I’ve told have all been appalled by that and one said that she could be reported for it. The friends I’ve told were all like “holy shit what”

    • Marina Tonkonogy

      Hi Ellie,

      I am sorry you had this experience. There are various ways therapy can go wrong. In order to minimize harm to clients there has to be a public acknowledgment of systemic problems and a broad discussion of how to resolve them, which is something we don’t have, unfortunately.

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