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Emotional Abuse in Therapy

I’ve already talked about a great deal of denial in the mental health community about abuse of clients that takes place in therapy much more often than professionals would like to admit. The available information on the subject is very scarce, and, mostly, the only type of abuse of clients that gets some minimal attention is sexual abuse when the therapist’s misconduct is impossible to deny. However, even those instances are minimized as a “bad apple” problem and not a problem of a dysfunctional system.

While sexual abuse of clients is a very serious matter and deserves a hell of a lot more attention than it gets, another type of abuse that gets completely dismissed and denied and occurs on a much larger scale is emotional abuse of clients, and, while sexual abuse is massively under reported, emotional abuse by therapists is barely reported at all and there are reasons for that. Before I explain why emotional abuse of clients doesn’t get any traction, let us first define what emotional abuse by therapist is.

Emotional abuse in general in its essence is the behavior towards another person with conscious or unconscious intend either to inflict emotional suffering or to use that person’s weaknesses and vulnerabilities to fulfill one’s emotional needs or both.

Emotional abuse, as it applies to the therapy situation, means the same thing but the abuser in this case is the therapist and the victim is the client.

I’d like to make an important note that the abuser’s intention to harm or to exploit the victim for their emotional gratification is, in most cases, unconscious. This is very important to understand because people often believe that if someone doesn’t have a malicious intend to harm then they are not abusive even if their behavior is hurtful to the person who is on the receiving end of it.

One doesn’t have to wish any harm on someone else (at least, not consciously) in order to abuse them. Quite often the perpetrator of abuse not only doesn’t believe that their behavior is harmful to the other human being but, on a contrary, they might believe that they act in a caring way towards the victim. Their level of self-awareness and their conscious intention make no difference. If their actions qualify as exploitative/abusive, this is what matters and this has to be confronted no matter what the intentions behind those actions may be.

Now, here are some examples of how emotional abuse gets perpetrated in therapy. There are four major ways in which abusive therapists perpetrate emotional abuse:

  1. Gaslighting
  2. Power play
  3. Emotional seduction
  4. Abuse of transference

Each one of those harmful behaviors is described in a corresponding post.

People who are unfamiliar with therapy process and even some “seasoned” therapy clients who were lucky enough not to come across abusive therapists often wonder why those who have been abused by their therapists usually don’t complaint to the licensing boards and the therapists’ professional organizations. The reasons are simple.

The most common reason is that emotional abuse is virtually impossible to prove unless there is some tangible evidence like email or SMS correspondence by which the dynamics of communications between the client and the therapist can be analyzed and evaluated. Therapy is a private process that takes place in a private settings with no witnesses usually. A complaint that isn’t supported by the tangible objective evidence will get nowhere. For the most part, the therapist and the client communicate face-to-face, not via email or phone, and so, even if some of the recorded communications may be found questionable from the ethical standpoint, they are not seen as representative of the therapist’s general style.

The other big reason for a victim not to report an abusive therapist is psychological. Despite the superficial understanding that seeking and receiving psychological help is not a sign of “craziness” but a healthy decision to improve one’s well-being, there is a very strong, unspoken bias in our society against those who seek psychological assistance. Whenever there is a dispute between a “mental patient” and a professional who “treated” them, the trust is often automatically granted to a professional even before the facts are presented because a “patient”, by definition, is seen as someone who is not quite in the “right mind” while a professional is seen as an “expert”, the one who is more capable of making sound judgments. Thus, investigators of clients’ complaints and those who evaluate the results of investigations may not be completely impartial from the beginning. Clients are often well aware of the negative bias against them and feel that they would be treated unfairly by the system if they proceed with the complaint process, which will only exacerbate their trauma.

Because of the two reasons above people, in most cases, don’t report emotional abuse they have suffered at the hands of their therapists and continue to suffer in silence. This is why it’s so important to bring this issue into public awareness and to address it as a systemic issue.

 
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11 Comments  comments 

11 Responses

  1. Sue

    Marina, I am sitting here unable to stop nodding my head in agreement with every word–in this post and on this website. I suffered for over two years in an inverted, abusive therapeutic environment until, after three consults from outside therapists I finally left. It was like jumping out of a burning building. I am now with a terrific therapist and have been repairing a lot of damage which includes being on the cusp of filing a complaint with the Board (thank you for that post as well on complaint filing.) I cannot thank you enough for this website which I am bookmarking. My story and my healing process around this bad therapy are here: http://www.thesandbox.life I will be adding your site to my “things that can help” section.

    • Marina Tonkonogy

      Sue,

      First off, I am terribly sorry for that awful, traumatic experience in therapy you had to go through that made you feel like your very survival was at stake. I relate to so much of what you are describing. Leaving abusive therapists (there was more than one in my life) did feel like a matter of sheer survival at some point.

      I’ve just read your story on your blog. It’s absolutely shocking. I haven’t read all the posts describing your awful therapy experience, only the introduction, but what was there is enough to make it clear that your former therapist was someone who should have never gotten her license in the first place. I’ve read and heard many therapy horror stories and they never stop shocking me. There are so many violations in the stories like yours that it’s hard even to begin to unpack it. I really hope that your complaint will result in the licensing board taking a proper disciplinary action against your former therapist that fits her misconduct. But if it doesn’t happen let it be a stepping stone in your healing process. I found that just writing and sending a complaint in and of itself was a healing experience. After I sent out my complaint, it felt like a huge load that didn’t belong to me was lifted off and it was easier to breathe quite literally.

      I am glad you are working with the good therapist right now and that your current therapy is helping.

  2. caroline

    I can completely relate. I have been employed by a therapist for 2 years. I dont know for sure how many people have been psychologically abused by her. She has hummilated me for the last time. I dont know what I can do about it so that she cant get away with continuing to harm others. Also I dont know if I should give a 2 week notice that I’m leaving or just never go back?

    • Marina Tonkonogy

      Hi Caroline,

      The dual relationship that your therapist has forced on you is so unethical. Employing the client while at the same time providing therapy or employing the client soon after therapy was terminated is one of the most exploitative things the therapist can do. I can’t give you a legal advice regarding terminating your employment, but, from the standpoint of professional ethics, the best thing to do to protect other people from the unethical therapist in this situation is to report her to her licensing board. It’s might be a good idea to consult with the medical malpractice or psychotherapy malpractice attorney to see what your options are.

  3. Jennifer

    Yep! This is spot on, in my experience. I am trying to finish up my report to submit to the state. I have also been calling attorneys to discuss my options, however, no one seems to want to touch my case despite having a lot of evidence to support my claims of exploitation and emotional abuse. It is frustrating and disheartening but I refuse to give up the good fight just yet.

    • Marina Tonkonogy

      Hi Jennifer,

      There is no reason to give up just yet. I see from your other post to my other article that you are considering filing a complaint with the board. I don’t know what exactly happened in your therapy, but, in any event, even if the attorneys don’t want to take your case, reporting the therapist to the board is always an option. You can just ask an attorney for a general advice on how to write the report for the board. In my case, the attorney simply encouraged me to file a complaint because he felt that my case was more appropriate for that than for a lawsuit and he explained why. If I’d help you to know more details feel free to contact me privately through the contact form on this website. .

  4. Renee

    This article describes exactly what I am going through. I am afraid that if I report the abuse to the licensing board, they will never believe me because I’m the crazy one. It will bring more trauma. I am also afraid that if I bring up the abuse to another therapist, they won’t believe me or see me as a liability. My therapist won’t release my records to me and has told me that she didn’t treat for what my main mental health disease is. I can only imagine that she wasn’t qualified to treat me. My psychiatrist has been very supportive and is reporting the abuse to the licensing board and is encouraging me to do the same. Reporting her is what I should do, but I still have an underlying feeling that I’m the one who did something wrong My psychiatrist has assured me that what was happening was completely inappropriate. I’m just not sure what to do.

    • Marina Tonkonogy

      Hi Renee,

      I am sorry to hear that you were abused by your therapist. I suspect that whatever mental problems you were suffering from initially when you started therapy, the abuse has, probably, made them worse.

      It’s good to hear that, at least, you are getting support from your psychiatrist. Often, it’s very difficult for people, who were abused by therapists,to find support and validation even among other professionals, who are supposed to be evolved enough to understand what happened. It’s especially rare for another professional to report their colleague to the licensing board, so I commend your psychiatrist for taking a stand.

      As to what you need to do in this situation, it is entirely your choice and, I hope, your psychiatrist will respect that. It is understandable that they want you to report your therapist if they believe that the therapist’s behavior was unethical, but this is not about them and what they want. It is about what is best for you, and no one knows what’s best for you except you. In those situations, I believe, it is best to respect your feelings. If reporting doesn’t feel right at the moment, if you are afraid that the process of filing a complaint will add to the trauma you already have, then maybe this is not a good time to do that. You can do it later when you feel more confident or you may feel at some point that you don’t need it anymore and change your mind, which is totally fine. Most importantly, whatever you choose to do, do it only because you want to and because it feels right, not because you feel obligated to do that or because someone else wants you to do that.

      One thing that stood out for me is that your therapist is refusing to provide you with the copies of your therapy records. I don’t know which state you are in and what are your state’s rules and regulations pertaining to the therapy records, but depending on what they are it may be unlawful for your therapist to deny you access to your records. If I were you I would contact your licensing board to check if therapists in your state have the right to deny clients access to therapy records and I would ask them specifically what to do in your situation when your therapist is not letting you see your records. You don’t need to file a complaint for that because you are just asking a question.

      Once again, I am sorry for what happened to you and I wish you a successful recovery.

      • Marina Tonkonogy

        I had to go back to my post and correct something because I need to be careful when sharing opinions about other therapists’ work without knowing details, especially in matters of legality. I think, the word “illegal” might have been too strong for me to use in regards to your therapist’s denying you access to your records. I know that in my state therapists are required to provide copies of clients’ records upon receiving a formal written request from clients unless they believe that seeing the records can be detrimental to the client’s well-being. But I have no idea what the laws are regarding patients’ records in your state. That’s why, I think, it’d be a good idea for you to contact your state’s licensing board and find that out. How much information about clients’ treatment therapists are required to provide also depends on whether they are a covered HIPAA entity. You can learn more about that from the licensing board as well. A good thing to do before you call is to visit their website and search for information regarding your rights as a patient. If the information you find is not sufficient, then you can call them to get additional info.

  5. Renee

    I so much appreciated what you had to say about it being my decision instead of someone else’s. I do feel pressure that I should back up my psychiatrist, but I feel like it might be prolonging the pain. I have waited to file a complaint because I wanted to think about it. It’s something that I don’t want to decide right now. I know that I will need to work through the abuse with a new therapist, but that feels very odd. And, that might be enough to deal with at the moment.

    She is required to release my records unless it will cause harm to me. I did not request session notes, which she doesn’t need to provide if they could be harmful. I am asking for an overall treatment statement of what she treated me for and any treatment plans.

    • Marina Tonkonogy

      Yes, I thought that she might be required to give you at least some kind of summary of your records, but I wanted to be careful since I didn’t know your state laws. If she is required to do that but didn’t, this may be the basis for a complaint IF you choose to file it some day. As to everything else she had done, I don’t know if you have documented evidence of that or not, because I don’t know the details of your case, so I have no way of judging whether the board will take on your case or not. But I do understand your apprehension about filing. It’s not an easy decision and it often doesn’t seem to make sense if you feel that the chance of getting justice is slim.

      In any case, the decision is a personal one, and, as such, it is only yours and no one else’s. I think, your inclination to work through the abuse with a new therapist or in some other way before deciding whether to file or not is wise. In my experience, it is best to file a complaint with the clear head and with peace in your heart. As long as there is some internal conflict about it, it is best to take time to sort it out first.

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