Signs of a bad therapist

There's yet another gray area, and I'll readily admit to being caught in it. And that's when there's a collusion between therapist and client to BELIEVE great change is happening when indeed it isn't. It's easy for a charismatic figure to leave us exhilarated. I see this in myself at ceremonies and special occasions and in the delirious audiences on Oprah. But then the holiday weekend is over, it's Monday morning, time to put out the garbage and clean the dishes, and life again returns to what it was.

I've also known acquaintances in my real life CONVINCED they've been oh so therapized, when they're only deluded. They remain angry, tactless, self-centered and unskilled. I've had them "play therapist" with me (particularly outrageous when it happens face to face) scolding me about inadequacies and instructions for my needed improvement. I wonder if therapy only gave them more moral authority to insult, control and domineer others.

Of course, all I know and observe is my small corner of the universe.

I see this too as well. People who think therapy is helping yet they seem so angry and self centered and seem to be okay with insulting and harming and controlling others. Maybe it is helping them in some aspects of their lives, but I try to avoid these people.

Therapy protocol can be an extremely poor teacher how to interact outside the consulting room. Yet I've seen people who begin to treat others like their "patient." It's utterly inept and obnoxious.

This post really kind of hits home for me right now. I've seen several therapists in the past decade, and the one I see now is the only one I've been able to really open up to. I like him, and in a lot of ways he's a good fit for me. But I'm frustrated with him and with his therapy because he only practices psychoanalysis, specifically a mix of Lacanian and Freudian psychoanalysis. So basically I talk talk talk, and then together we analyze analyze analyze. We never talk about practical everyday solutions, and I feel like I need some kind of guidance in that respect. It's a very narrow rabbit hole.

I've been seeing him for a little over 2 years, and in some ways I have gotten a lot better but in other ways I have actually gotten worse. I started seeing him for four reasons: 1) my depression was out of control, I could barely function or connect with people. 2) I have a sexual dysfunction that I haven't dealt with. 3) I am a binge eater, and my relationship with food is out of control. 4) I really wanted to write again. Writing used to be my greatest passion, but now I feel nothing for it.

My depression still exists, but it is wayyyyy more manageable now, and I actually have good days sometimes. I've also developed more sophisticated perspectives of myself, and I have learned how to understand my mind more. My relationships with my family, friends, and boyfriend have all dramatically improved. Those that are closest to me say they've seen a big change in how I approach the world.

However, I still suffer from that sexual dysfunction and I still haven't taken any steps to dealing with it. I haven't written anything in these 2 years. And I have gained a significant amount of weight since I started seeing him (50+ lbs at least). And worst of all, I still hate myself to the point that I can barely tolerate being myself.

I feel very sad and pathetic for it. It's like with all this help he gives me, I STILL can't get it together.

I've talked to him about this, about how frustrating it is to get worse. And he says it's just part of the process, and that it has to get worse before it gets better. And maybe that's true but it seems so unfair and pointless sometimes. I can't say that all the analysis hasn't been helpful, but sometimes I wish we would just approach things a little differently. Also he has some Freudian theories that I just personally do not believe in.

I'm at a point where I really just do not know what to do. I want to quit, but I don't think I'm ready to quit. I have an extremely hard time opening up to people, so I am not sure if I would do better with a different therapist. I just can't shake the feeling that something is wrong and that I need to change what I'm doing.

By that logic most therapists would be out of a job.

Can I get an amen?

My T doesn't proclaim to know what's going on in my brain. She has said that she only knows what I tell her.

I don't have a problem with that. But the issue for me is that some object to any sort of general statement or supposition about therapy that is critical. As if even attempting such a thing is wrong. And as if such a thing somehow invalidates their own therapy experience.

If I had a positive therapy experience in the future, I would acknowledge that and be grateful. But knowing what I know, I would still maintain that the system is probably more harmful and insane and exploitive than not. I don't see these two things as mutual exclusive.

I was thinking about this today. To me a sign of a bad therapist is when they cannot admit when they are wrong or when they don't know something and it might not necessarily come across as arrogance but they use being a "professional" to pretend to know what is best for a client.

Oh god, that is a huge part of what turned my last therapy into a catastrophe. My insecure and unskilled therapist could not bear the thought that she had a made a terrible mess of things. So she panicked, like a dear in the headlights, and fell back on her presumed authority. Started giving orders, bossing me like I was a child, deciding everything for me.

That is a great point I think. My T has just managed to convince me that we are actually exploring this together, that because each person is different I think, that it is 'new ground' as she said. She apologised when she did something 'wrong' and we talked about it. I think if she said that means we can and will work through all of this together. My previous, and very bad, therapy experience was a 'do it my way or the highway' experience and it didn't end well, I guess hence my slight wariness now, but I have to trust, I see no other way.

The therapist who abandoned me after 7 years seemed to know just enough about different mental illnesses to be dangerous. He'd been practicing for over 25 years, but wasn't really that good. I just didn't realize it. And he couldn't admit that he didn't know how to help me.

See, this is part of what scares me. How do you identify these therapists who have been in practice long enough that they *should* be good, but aren't?

Therapy is expensive, it costs time, money, and energy. It stirs things up and can be destabilizing. How do you figure out, relatively quickly (say within 3 sessions) that someone is not going to be able to help?

I've seen so many not helpful therapists. I'm trying to find a helpful one, but I'm starting to feel like a lost cause.

(Sorry, your comment spoke to me... because I was hoping that by focusing on potential therapists who had more than, say 15 years or so of practice, that I'd increase my chances of getting someone good!)

I definitely agree that T's who don't admit to their faults or mistakes, or the fact that they aren't God and don't know everything is very dangerous. I feel extremely lucky that my T goes out of her way when she feels like maybe she overstepped...

It is hard and so expensive. After my horrible ending with the bad therapist who i stupidly saw for 7 years I saw another one for about 7 months (it ended because he moved away) and he had only a couple of years of experience. He seemed so much more caring and open and accepting and humble. I think if it hadn't ended after that amount of time it might have been more helpful to me. I don't know. I live in a very rural area and there just aren't any therapists now to see.

I wish there was some way to get better matches.

Me too, Puzzle Bug. What's even harder... there seem to be so many ways that therapy can go wrong. My last T was probably a great therapist. He wasn't defensive, and he was willing to admit when he didn't know things. He did his own ongoing therapy and supervision, despite being in practice for more than 20 years. He wasn't a blank slate, he was willing to answer questions, but also careful to not use my therapy for his own therapeutic needs.

But he wasn't a good therapist *for me*. I felt like he shut me down sometimes without meaning to, and even though I tried to bring it up, we never really got to the same page. And, he didn't have any real training (afaik) with the stuff I needed, so that made it harder.

I do think that, if you can mange (I find it hard), asking hard questions up front to see how they react is one way to determine how much of their own work they've done. I saw one (for 2 sessions) who, when I asked her about "phase oriented therapy" - she responded with, "I've been doing this longer than you've been alive." OMG! I wasn't even trying to trip her up, somebody had recommended phase-oriented therapy to me, and I hadn't heard of it, I was hoping she could talk to that. Had she just said, "Hm, I've never heard it called that, but here's how I work in phases..." I could have lived with that. Even if she had just said, "weird, I've never heard of that. Sorry, I can't help you there."

But she took something that wasn't intended to be an attack, and got incredibly defensive. Big red flag for me. I really need someone who has a bit more internal stability and non-reactivity (I'm reactive enough, I need a stable person as my therapist!). That was actually one thing that my old T really had going for him, he projected super stability, like a big, un-moveable rock!

I'm really sorry to hear about the 7 years with the bad one. It really is hard to know. My first therapist... again was a terrible match for me (but hard to say if he was a terrible therapist in general). Terrible counter transferance going on, he thought I hated him , but he kicked me out after a year... so I guess, as awful as that was, it's good that I didn't stick around longer.

Glad you got to see the better one, sorry it ended... I can't imagine how much harder it is in a rural area. I'm in a large metro area, and still feel like it's slim pickings to find someone good.

Did you see the article posted awhile ago about the therapist who had a therapist-referral service (up near NYC, I think)? He personally met with and knew everyone that he referred to, and met with potential clients to find out not just their logistics (insurance, time preferences, etc) but to get to know them and their issues, so he could basically be a matchmaker. I think he had a success rate around 97-98% ! I wish we had someone like that here, it would be SO worth!

Thanks...

In my experience the system is set up to make it difficult for the client to know much about the therapist beyond superficial stuff like education, basic approach, length of time practicing. Really knowing who the therapist is both professionally and personally is an uphill climb, more difficult than in real life. Most therapists I have been to were a closed book (while I was expected to be an open book). I was only able to identify that last therapist was bad news after harm was done.

BTW, seems to me that being in practice a long time could be a good or bad thing. Private practice strikes me as a sort of alternate reality. It's just client and therapist, no outside intervention, strange rules and customs. And over time, in the absence of checks and balances, I can imagine some therapists develop distortions about their work. I'm guessing that they also get little serious feedback from clients, so perhaps not much reality testing.

From my experience, I'd suggest not to pay much attention to how long they've been practicing. Experience in and of itself doesn't mean much if the person doesn't learn the necessary lessons from it, and many people don't learn no matter how long they do it, just like many people refuse to learn any life lessons. I've known plenty of those who have the same level of maturity in their 60-s as they did in their 20-s and who refuse to learn anything.

The best thing to do when you are screening a therapist is to do some work before you even start shopping.

You have to define your goals for therapy. You have to have clarity about what you want to achieve to be able to see clearly if the person you are interviewing would help you to do that.

You also have to decide how you want your therapy to work, what things you want and don't want a therapist to do and be very clear about it when you interview them.

I know it's a lot of prep work to do and many people would resist doing it because they imagine that it's a therapist's job to define goals for them and to navigate the therapy process because they are "experts". With that kind of idea about therapy you'd always be looking for the "right" therapist and would never find it.

Just like people are dreaming about finding The One a.k.a the ideal partner to spend the rest of their life with when the reality of life is that there is no such thing as The One. If any partnership is to work, the limitations of each person have to be accepted and discussed openly. You put your needs on the table and ask the other person if they could meet at least some of them, and if what they offer is good enough for you the relationship stays, if it's not good enough it ends. There is no right or wrong outcome. As long as you are fully aware of your needs and know what you can and can't accept you can choose whatever you want.

I didn't mean to equate therapy relationship with partnerships but, I believe, the major principle of being conscious of your needs can be applied to any relationship.

Back to therapy, the tough reality that needs to be accepted is that every therapist will be very limited in how much they could offer, that's why you need to get as specific as you can as to what your needs and your goals are. Also, when you make it about very specific things, the therapy shouldn't take long. It wouldn't solve everything you need to solve but it doesn't have to. Our needs change all the time provided when we grow.

I think I remember that article. I do wish there was some better way of finding a therapist. I think finding a good match is really rare and when therapy goes really bad it can be so damaging and hurtful. I also wish therapists would be more upfront about how they might not be a good fit or how therapy can be harmful for some people.

Budfox: Thanks. I agree that it can be hard to know much about the therapist. And, some clients don't need that... in some cases, that actually works to their advantage. But, some people *do* need to know, at least a little.

Did you see this article, by Ken Pope: Therapeutic Relationship As The Foundation for Treatment with Adult Survivors of Sexual Abuse

Someone posted it here awhile ago (and I'm so sorry that I can't remember who shared it originally, as I reference it frequently!). What I thought was fascinating is that he talks about how, for some people, the traditional dynamic of a neutral therapist is actually damaging, and replays family dynamics (that rings very true for me). Sometimes, the therapist needs to actually step forward to meet the client.


This is what happened, I think, in my early therapy. My last therapist (who I shared the article with) was better about this... when I shut down, he was good at (verbally) reaching out in a non-threatening way, and helping get me back in the room. You'd think that would be a fairly basic therapist skill, but most of the ones that I've seen were not able to do it well or at all.


I understand your point about career duration not really being helpful, but I think that there has to be something you gain from doing something over and over. I don't think a new therapist would be in a good place to really handle my issues... I think they'd get stuck very quickly. I really want someone who has dealt with my issues a bunch, so that they're efficient and know what's typically helpful and what things mean.

(I should say, I deal with some dissociative issues... it's been hard, because some therapists don't seem to believe in dissociation at all, and others think they can treat anything, but have no experience with it and don't really know how to approach it.)

It's all very frustrating, and hard to deal with when you're already feeling like crap.

Ididitmyway: Thanks, I appreciate the good advice. It's really hard when you're struggling with depression though... goals just feel... ugh. Very hard. With the last therapist it was very weird, I actually had some good initial goals, we discussed them, he wrote them down... but then what happened afterwards felt like it had no relationship to the goals at all. It was like, "OK, now that we have that out of the way, let's talk about something completely different." Later, he asked about goals again... I reminded him that he wrote them down (and I had put a lot of thought into those initial goals, but didn't have them memorized!). He lost them! He said that he didn't lose them, but he moved them to another folder (because my folder was too big!) but still... he didn't have them to reference. What the heck? I'd think that would be an important page to keep in your working notes! *sigh*.

Thanks Puzzle Bug... that's a good point about therapists being more upfront about how they might not be a good fit, although I see how they may not know. My last one thought for sure that he could help (although he did have the humility to later say, "that's part of my own stuff, I think I can help everyone.").

Thanks, no have not seen that article. From the excerpt, I understand what he is getting at. I do find it interesting. But to be honest i can no longer get past the strangeness of trying to heal through this kind of engineered relationship. It feels like such a manipulation. It's not spontaneous nor mutual. I dont know how one can ignore that, once you understand what is going on. I guess it works in some cases. I sometimes think it could work for me if I could find the right therapist, but seems such a remote possibility.

If a therapist does adopt significant neutrality or camouflage (seemingly most do), the client is going to have a tough time knowing to what extent the therapist is mentally or emotionally unstable (seemingly quite a few are).

That's how I feel about it, and, generally speaking, I cringe from even hearing the word "relationship" when it applies to what's going on between T and client, as well as "intimacy". I don't understand how interactions in which only one party is expected to share personal material can be called "intimate relationship". Intimacy doesn't exist if there is no mutuality. I think, it's just common sense and common knowledge across all cultures.

When I started my first therapy, it didn't even cross my mind to seek "relationship" and "intimacy" with a therapist. I was looking for a consultation with a professional. That's all. I thought, I'd explain what my current problem is, they'd give me their professional opinion about what's going on and what I can do about it, I'd take their input, chew on it for sometime and decide what makes or doesn't make sense, what to accept and what to dismiss. That's it. Until this day, I believe, I had a pretty healthy idea of what psychological assistance was supposed to be like.

The reality turned out quite different, and I still feel I was sucked into some kind of a grand game I never signed up for, not consciously for sure. The therapist convinced me that we had to discuss what's going on in our "relationship" because that was supposed to be some major healing method. My fist reaction was "Hah? What relationship?" I wasn't seeing my meetings with him as a "relationship" of any sort. I was there just to get his professional input, and, by the way, I thought it would be given to me during one meeting and no further consultations would be necessary.

But no, he insisted that we had a "relationship" that was "both intimate and professional" and that this "relationship" was, arguably, to become the focal point of my therapy and the main agent of my healing. I couldn't wrap my mind around what he was saying for some time, but, finally, I decided to trust his "expertise" and bought into that "relationship" BS, which resulted in a trauma.

I consider what was done to me emotional seduction and manipulation a.k.a emotional abuse and I find it very tragic that these methods are normalized and are quite common in therapy practice. Since, "Tha Relationship" became the major topic of discussions in sessions, All the REAL issues I'd been dealing with in the REAL world were dismissed and neglected.

Well, the story can go on and on.. but I made my point.

I get what you are saying, and yet my last therapy was intensely intimate. That was in part because her boundaries were somewhat sloppy. But even without that, I still think it was intimate, though certainly not in a healthy or balanced way. Just meeting together regularly, in private, in a small room with no windows, in close proximity, talking about deeply personal stuff.

But many theorists and therapists do say that the relationship, or therapeutic alliance, is the main thing. Some trauma therapists say that relational healing with a therapist is what helps trauma survivors. Not saying I agree, as I find it bizarre conceptually, but many claim this. The model of therapist as psych consultant, strikes me as odd too. I dont know how a stranger, regardless of training, is going to have insights into my deepest issues. I dunno, the whole thing is so disorienting and confusing, because of the fundamental ambiguity inherent in mixing personal and professional.

Same here. All of it.

When you catch him/her seeing your "friend" behind your back. THAT'S A BAD THERAPIST AND A BAD FRIEND.

Well, who are we kidding here, no "friend" would ever do such a cruel thing to another "friend". That's NO FRIEND I'd want.