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Psychotherapy Criticism Debate

Whenever one begins to challenge the established, mainstream ideas and practices in any area of life, one will always encounter fierce criticism, which often turns into personal attacks, from those who are invested, either emotionally or financially or both, in maintaining the status quo.

I have been a target of such criticism, which included personal attacks, quite often and, I think, it is time for me to address the major arguments that my opponents present to delegitimize my views. There are three of them, three major oppositional points I keep hearing over and over again. 

Here they are:

1. “She’s had a bad experience in therapy and now she judges the entire profession based on her experience. This is generalization. Just because she has encountered some bad therapists doesn’t mean all therapists are bad.”

2. “She is one of those who haven’t worked through their own issues in therapy and who are now blaming their therapists for their failures.”

3. “She has not taken responsibility for her own choices and puts the entire responsibility for her harmful experience on her therapists.”

I’ll take on each “talking point” one by one starting with the first accusation of “generalizing”.

This is a “straw man” argument because it argues the point I have never made.

I have never made a conclusion based on my bad experience that “all therapists are bad”. What I have been criticizing is the current system of professional training and practice, which uses a lot of outdated theories unsubstantiated by scientific research. 

Any system embraced by the majority of people it contains will cultivate certain attitudes based on the beliefs the system propagates and teaches. As such, the traditional system of psychotherapy training and psychotherapy practice has cultivated certain attitudes among professionals that are not only not helpful but can and often do hurt many people. Does that mean that all professionals who subscribe to the tenets of their professional theories are bad people? Not at all. All it means is that they operate with ineffective, inadequate and, sometimes, harmful tools because those are the only tools they were given during their training years.

The second argument about me and other people, who dare to criticize the system, suggests that we haven’t done our personal work and that we blame therapists in order to avoid taking responsibility for our own issues. This kind of argument is a pure ad hominem personal attack, plain and simple. It is the most popular manipulative tactic designed to divert the attention from the substance of the matter to the personalities of the opponents. The intention behind ad hominem attacks, just as behind other attempts to manipulate the conversation, is to appeal to emotions instead of reason. Emotions are powerful and easily manipulated, unfortunately, that’s why ad hominem attacks and other manipulations commonly known as logical fallacies come up in discussions over and over again.

In my experience and in my opinion, a lot of people, who were harmed in therapy, myself included, have done more of their personal work than those who accuse them of not having done any. They kept giving therapy a chance over and over again and continued to work on themselves DESPITE the fact that their therapists weren’t helpful. If they hadn’t been motivated to do the work from the beginning, they wouldn’t have stuck with therapy for as long as they did despite all the harmful effects they were getting. They have given therapy more than its fair shot, and if the process didn’t work for them, it is certainly not for the lack of trying on their part.

Those, who continue to accuse dissatisfied consumers of not being motivated to do the healing work, intentionally dismiss all the findings of neuroscience and other research done in the past several decades that suggest that traditional psychotherapy methods are, at best, ineffective for working with many people with trauma history. (Read more here “The Difference Between Psychology and Psychotherapy” ).

Lastly on this subject, the type of accusations discussed above are not an acceptable argument, as they have no factual basis. There is no way for anyone to know whether I or anyone else have done our personal work or not or to estimate how much work we have done. Baseless personal accusations are not only unacceptable as a legitimate argument in a debate but also insulting. I do not engage with people who make them, as I consider their tactic a personal attack that has no other purpose but a) to distract from the substance of the discussion and b) to insult.

The third argument suggests that I and other people, who hold their therapists and the entire profession responsible for harming them, haven’t taken responsibility for the choice to stay in harmful situations.

There is a number of reasons why people get stuck in situations that are destructive and that do not help them in any way or why they get into those situations in the first place. This subject is huge. It deserves not only a separate article, but a whole educational campaign, because it involves not only victims of bad therapy, but victims of domestic violence, rape and all kinds of abuse and mistreatment. I am not going to expand into all those areas in this article because this goes outside of the message I want to convey here.

What I am trying to explain here is that, in terms of assigning responsibilities, the reasons why people don’t leave unhealthy relationships and situations don’t matter and it also doesn’t matter whether they take responsibility for the choice to stay or to to leave. Just because the person chose to stay with the abusive therapist doesn’t make the therapist’s behavior any less reprehensible and doesn’t make the therapist any less responsible for their actions. Similarly, just because a woman chooses a wrong type of men to date doesn’t make a man who rapes her any less responsible for the rape, or just because people choose to stay with abusive partners doesn’t make their partners any less responsible for their abusive behavior. The list of analogies can go on and on, but you got the point.

Everyone’s actions need to be judged on their own merit, and minimizing or dismissing the wrongdoing of one person on the basis that the other person could have or should have made a better choice is unacceptable and ignorant.

And, in cases when therapists don’t do anything unprofessional or unethical but still harm clients by using ineffective or harmful methods, the full responsibility for all emotional damage caused as a result falls squarely on the system of professional training and education, as well as the entire mental health community, who, by ignoring the systemic flaws, becomes complicit in perpetuating harm. In those cases, no part of responsibility can be put on a consumer, because they have no choice but to use the existing system.

I have mentioned in other posts that it is not my intention to condemn the system. I understand very well that, as flawed as it might be, it is still better to have it than not to have it until we build something better to replace it. I understand that many people are still better off receiving mental health services, even under the current system, than not getting any help at all. I also understand that the system is a complex and diverse entity that contains a big variety of types of services and practitioners, and that such diversity makes it possible for many people to have good experiences with the system without any harmful side effects.

My criticism of the system is not that it doesn’t have any capacity to help. From my own experience I know it does. My criticism is that its capacity to harm and the existing evidence of harm it is doing to many people is significant enough to be taken seriously, but it is not being taken seriously. Those who don’t accept the fact that many people get harmed by the system are stuck in the dualistic a.k.a “black-and-white” type of thinking when they believe that pointing out what doesn’t work is akin to saying that nothing works. This is yet another logical fallacy that fails to grasp the reality that positive and negative qualities and occurrences can and do co-exist within the same system.

At this time, it is impossible to accurately estimate a ratio of positive vs. negative therapy experiences. This is not the reason to dismiss the overwhelming anecdotal evidence of negative therapy outcomes by attributing those to people “not doing the work” and “not taking responsibility for their choices.” After all, if we want to insist on legitimacy of the existing therapy methods, then we should welcome critical inquiries and scientific scrutiny instead of suppressing them. We should encourage the broad public conversation that would discuss the current mental health research and the current state of affairs in the mental health field, and, most importantly, consumers of mental health services should occupy a big space in that discussion, because, after all, the system was created for THEIR benefits, which makes THEM the best judges of its efficacy.

 
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6 Comments  comments 

6 Responses

  1. Rah

    I’m in a bit of a hurry and I want to come back to this because it touches on a number of important issues.

    Just briefly though, it is very dangerous to have any sort of treatment that by its very nature, can facilitate leveraging and intensifying the power imbalance that exists between all health practioners and patients/clients via pathologising consumers who express misgivings or criticism about their treatment. It cuts out normal feedback loops that might inform researchers and practitioners alike.

    The other side of this problem involves attributing moral virtue to those who “do well”, ie those whose symptoms abate and/or circumstances improve, especially those who praise their treatment provider and the mode of treatment used. Therapists are able to assume, (often without evidence) that their clients progress in achieving their goals is caused by the treatment in conjunction with the amount of work the client has invested in the treatment.

    Like you, I’m not suggesting that good quality, appropriate therapy cannot be beneifcial. However given that this intrinsic difficulty causes a kind of moral hazard for clinicians and researchers alike, you would think that those involved would, at the very least, take this into consideration in evaluating the effectiveness and risks in both treatment modalities and in individual cases, and seek ways to address the hazard, rather than lazily make erroneous and self-serving assumptions about those who express criticism or complaint.

    • Marina Tonkonogy

      Hi Rah,

      Thank you for you comment.

      Can you, please, clarify what exactly you see as a difficulty for conducting research on psychotherapy? Thanks.

  2. Ellen

    Kudos to you, Marina, for allowing people who have been disappointed by a psychotherapist, counselor or psychotherapy in general to discuss their experiences. I want the rights to express my opinion, choose a therapist who works well with me, or choose a remedy alternative to traditional psychotherapy to support my mental health if that works for me!

    I think that you are making real progress, and I personally prefer to ignore the oppositional points and move forward!

    • Marina Tonkonogy

      Thank you Ellen. I really appreciate your acknowledgement of my work.

      I’s taken me a long time to be able to discern when it is and when it isn’t worth it to engage in a debate with someone. I don’t mind discussing differences of opinion. In fact, I think, it’s necessary to do so because for a lot of people my insights seem too “out there” not necessarily because they want to defend the status quo, but because they simply have never questioned what they were told. In those cases of pure ignorance, educating people on how the realities of psychotherapy are different from theories is necessary in order to raise awareness. However, if people are not willing to open their minds to the possibility that their knowledge is limited, if they behave like they have all the answers, or worse, if they resort to personal attacks, at that point it makes no sense to talk further. At that moment I disengage and move on.

      In any case, I wrote this post because I felt that it was time to address this issue. As much as I and other people who have been harmed in therapy would like not to deal with those who don’t want to understand us, we will encounter those people, whether we want it or not, if we discuss this subject on public and even private platforms. Therefore, I wanted to clearly state my position of how to debate these issues.

  3. Ellen

    I suppose I am looking at these remarks from my viewpoint as an individual client. Years ago after my bad experience with a psychodynamic relationship therapist, I encountered a therapist who suggested that issues one and two applied to me (same meaning, I think, but different wording.) I chose to work with someone else, who did not see me as the problem.
    As a client, I did not have the time, money or interest to get into a debate about criticism that seemed unfair and serving the interest of the profession, not my interest. And I did not feel that I would be truly heard by this individual.

    • Marina Tonkonogy

      Sure. Whenever therapy is concerned, people shouldn’t waste time and money on professionals who are either invalidating or who don’t have a clue about what kind of trauma harmful therapy can inflict on a person. I didn’t waste my time and money arguing with those therapists either. What I am talking about here is a public debate which always takes place whenever controversial topics are presented, and, at this time, criticism of psychotherapy is a controversial topic.

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