When Therapy Harms

The notion that psychotherapy can harm may be novel to the lay public and the professionals alike, or so it seems due to the lack of a broad public discussion of this issue.

Nevertheless, people do get harmed in psychotherapy, and those instances are not as uncommon as we would like to think. Normally, it’s assumed that the harm is caused by the small number of unethical professionals, the “bad apples”, who do not represent the entire profession. Therefore, the problem is not considered systemic. My experience of being on two different ends of the therapy process, as a client and as a professional, and the stories of those, who were harmed in therapy, say otherwise.

If you want to see the real extent of this problem, I encourage you to go to any online mental health forum and scroll through all psychotherapy related discussions there. You will see that the number of people, who report feeling worse since the beginning of their therapy is well over 50%.

With such a great number of complaints, it is delusional to continue to insist that harm in therapy only happens in some exceptional cases when the practitioner is either immoral or incompetent. Such exercise of self-delusion is dangerous and irresponsible, as it perpetuates the harm and discourages many people from getting professional help when they really need it.

It’s important to understand that clients get harmed not only when therapists do something outright illegal, unethical, immoral or grossly incompetent. Significant harm may be caused by such trivial things as a failure to recognize that the client’s issues are outside of one’s scope of competence and a subsequent failure to refer them to another practitioner.

It could be caused by the lapses in judgment on the therapist’s part. This happens in many situations:

  • When, in an attempt to resolve the client’s problem, the therapist may blur the boundaries between the individual, family and couple’s work;
  • When therapists fail to inform clients about the limits of their expertise pertaining to the client’s issue and also (very important!) about the limits of the accumulated expertise of the entire profession on that issue;
  • When therapists fail to recognize how their personal beliefs and personal experiences affect their work;

..and many other instances.

Therapists can and DO harm unintentionally often and in many ways. (Read more here.)

Unintentional harmful acts are, in fact, committed so casually and so habitually by professionals that  the theory of “bad apples” cannot apply. The commonality and the pervasiveness of these occurrences can only be explained by the major flaws of the professional training, which is a systemic problem and a complex one too. It consists of many dimensions and caused by various factors. (Read more here).

If you have been in therapy for some time and feel worse than before you started it, it may be comforting for you to know that you are not alone. While feeling worse may not always and not necessarily mean that you are being harmed, because the occasional emotional discomfort and even pain are a natural part of a healing process, if the suffering has become chronic and, worse, if you feel that your health and well-being are deteriorating, it certainly should set you on alert and you should ask yourself if your therapy is really therapeutic. If you are questioning your therapy and your therapist, read through other related posts that may help you find the clarity you need starting with “What Causes Harm In Therapy”.

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