Psychotherapy inherently flawed?

Psychotherapy is certainly riddled with internal contradictions.

Personally, I have never experienced therapy is inherently flawed, but I do think it can certainly be a problem for various people in various ways. I just don't think that makes it "inherently" flawed. I think that just means it isn't the ideal treatment for everyone.

I wanted to defend my original post, I don't think therapy is inherently flawed all the time for everyone, but I think for people like myself with deep attachment issues there is a nearly inevitable chance you will be severely hurt by the therapy itself and that is never disclosed to you and most often completely unexpected, yet oddly expected by the therapist it seems. It's not just my personal experience but seems to be a shared experience by a lot of us, and the internet is full of professional literature on this subject.

Don't think I am 180ing on my therapist, but maybe I am because of my super fragile condition, overreacting to the love thing. I still think he is great, and I'm sure he is trying, and in many ways I am improving too. That doesn't change the fact that therapy has caused a lot of suffering for me, or that his trying and acting like a "good" therapist isn't often painful, for example when being a good therapist means not telling me how he feels about me, when he means everything to me and I've poured my guts and wallet out to him for years. I've never for example, gone to a massage therapist and come home and cried nearly continuously all weekend. I think there is something inherently wrong with allowing and expecting I will have this one-way feelings from the outset.

I've just joined this thread - and read the first and last post and nothing in between, so sorry if Im repeating anything. But I just wanted to say I pretty much agree with you Petra5ed. What bugs me, is the lack of a warning, the lack of information. I have very similar issues to you (childhood etc). Fortunately I did a lot of research, and have been on these boards pretty much from the start of my therapy.

I don't think it is correct to say therapy is fundamentally flawed for people like us. However, I do think the approach of withholding information about the journey we are likely to take is flawed. I can see how transference is important in therapy for some people, and how it can help to work through these love issues etc. But I think it is absolutely disgusting that T's allow it to happen with no warning. That is flawed. I wish T's would state quite early on in the relationship that clients do often fall in love with their T's (or whatever) and to lay it on the line that the relationship will never be anything more than T and client. I know my T expected me to fancy him pretty much from the outset. I never did thank god! But it did feel like he was almost encouraging me to feel that way - like thats what he wanted. At first I thought 'my god that man has an enormous ego!'

Fortunately I did the research, found out about transference, decided that is not something I want to explore, and so the second I got even the vaguest inkling I might be headed in that direction, I sacked him. I have absolutely no interest in exploring or working through that kind of shiite, as for me that is not what I want from therapy. So - I really feel for you. Im sorry you're going through that. Seeing and reading your pain has made me realise I made exactly the right decision to get shot of him before my feelings ever developed in to anything more.

Not sure how we got onto discussing my own T's vulnerability, but yes of course she was vulnerable. She was hurt by the experience, and even used our last phone call to soothe her own wounds and to get therapy from me. I don't see this as a flaw necessarily since T's are human. For me the fundamental flaw in the system is the fact that her vulnerability and defenses intruded on the process to such an extent that I was retraumataized and the whole thing imploded, with no oversight or check/balances to stop the bleeding. I dont understand what point you are trying to make with the "railing continuously" comment?

So she was vulnerable, but if someone were to argue that her vulnerability and mine were anywhere near commensurate, I would say that is preposterous. And same goes for who held the power.

A nice succinct quote about all the power and vulnerability stuff:
"Therapy patients are as vulnerable to the influence of their therapists as infants are to mothers". -- Sue Elkind PhD

I used your relationship as an example because that is what you have continuously used overtime to make your argument. I too, use my personal experiences when I post. In fact, I was told by the powers that be on PC that is what they want.

In my speech community "Rail = Reproach" I believe that is what you have been doing regarding your former therapist and her profession. You have a right to do that. I pass no judgement. I just stated a fact.

Re: Sue Elkind's quote above. As my therapist told me there is one major difference between an infant/parent relationship compared to a client/therapist relationship: Cognition.

For Me although I am VERY attached and VERY vulnerable with my T I'd never liken it to mother/infant. I'm an adult. I came into therapy with a career, my own coping skills ( some of them really crappy ones, but still), the fundamental abilities the infants and even older children lack---i could refuse to see my T and I would still be fed,clothed, housed, able to communicate, etc eyc---, my own adult relationships ( some of them again, crappy. But still). , my own view of the world etc

To liken yourself to an infant and the T to a mother is to give the T WAY too much power. Yes I was severely abused starting as a very young child( my T says " you were fighting for your own survival from the day you were born). I failed to form any healthy attachment, I didn't.learn object constancy or how to comfort myself in non self destructive ways and I needed a T to help me learn how to attach and experience love and stop trying to destroy myself instead of directing anger at my abusers. But I didn't need her to plan a vacation, buy a car, get a new pet, meet a new friend, try a new sport, buy new business equipment, explore different religions etc etc because I am.also a free adult.

To me the two are nothing alike. My mother tried to drown me before I was old enough to even be able to clearly communicate what had happened to another person. My mother abused me at an age where the only other people I even knew all knew my mother better and would never believe me. At an age where she was literally large enough to kill me. Where she could control whether I got food, whether I could leave the house, where she was in the room with the pediatrician so I couldn't tell that she scrubbed my genitals til they bled.

My T doesn't have anything like that power.

To say a T has that kind of power over an adult is ridiculous and denies the real powerlessness abused children experience

Our stories have some parallels. I emphasized with you, and am so so sorry for all that has happened to you.

I think it is extremely rare that a therapist has that kind of power over an adult client. We are not infants. They are not our parents. Every time I left the therapist office I knew that I had adult responsibilities. I did get into head spaces where I was unadulted, but had to step back in when life called me to be an adult. To deal with it I used emails, extra sessions, phone calls, and a lot of alone tome bring with the feelings. I do admit the my adult life was crappie, but it was that way for me, before therapy.

I agree with you about the power issue. And, I don't accept that psychotherapy is inherently flawed. Just filled with a lot of mystery. What done call malarkey.

I don't think the part some refer to as mystery is the exact same as the parts I refer to as malarky - the malarky, to me, is the deliberate obfuscation and smoke and mirrors about what they do and how they blame and label clients who don't roll over and submit or who want more explanation than those guys want to give because it either exposes them as being dead flat charlatans; or someone who is just stabbing around and guessing and hoping; or someone who is trying to do something at or change the client in ways that the client does not want.
The mystery part, to me, is more like the religion or tinker bell part - where the client is expected, with no explanation or good reason, to simply believe really hard and take the leap. And for some it works. For others it ends very very badly.

Hmmm, at my age you sort of think humanity is inherently flawed so it stands to reason psychotherapy might well be flawed too.

It ain't perfect but neither are people.

I think Elkind is overstating things, but there is obviously a lot of truth in it. The parallels in terms of emotional dependency are pretty straightforward. I believe her clinical specialty is helping clients (and therapists) who have suffered through traumatic ruptures in therapy, so presumably she has seen what this looks like up close many times, and has good reason to say such a thing.

I guess I don't see it. The extreme powerlessness children experience is not paralleled in any adult relationship. Adults have physical, cognitive and emotional abilities children utterly lack. They have money, transportation, and legitimacy to the legal system etc. I've had some awful experiences as an adult but never ever even in the case of sexual assault have I ever experienced the utter powerlessness of a child. The only situation that I could see paralleling that was if a T got a client hospitalized against their will.

I think that is setting the bar a bit low. People come to therapy often because their experiences with the rest of humanity have been problematic or even traumatic. So if that is repeated and compounded in therapy, which might be a sort of final or temporary refuge for some, seems a bit absurd.

Maybe we are down a rathole. The point for me is simply that therapy can induce an emotional dependency that parallels in some ways mother-infant. It's not a particularly controversial notion, since it's all over the literature. And this necessarily means a major emotional and psychological power imbalance.

I experienced it firsthand. This forum and others are filled with accounts of people who are clearly in that place. What is also troubling is that therapy dependency is not always recognized or named, and does not arise or progress in ways that are necessarily natural or healthy. In my view and experience...

I read one of Elkind's articles, "“The Treatment-Resistant Patient: Psychotherapy Impasse and Consultation, Discussion” in The American Journal of Psychoanalysis, Vol 59, No. 2, 1999."

I was turned off by the title, and definitely non-plussed by the article. The title definitely blames the client. I see why she uses infant/therapist, etc. She is promoting that labeling and thinking. Given her location she definitely gets paid handsomely.

ETA: The article states that the clients came in to relationships seeing the therapist as "fathers." She [Elkind] controlled the use of verbiage for the article, and advances it in her profession.

Personally, I follow basically a karmic principle about human interactions. And, yes, my perspective has evolved as I've learned from my own experience.

Like I have said to you before, there are always two sides to the story. There is the therapy that creates the situation, and the client that accepts it. The T that charges and the client that pays. There is the therapist that does not reveal information about themselves, and the client who does not demand to know it. Both sides must maintain a certain balance for any relationship, including a therapy relationship, to exist.

I disagree that therapy is like a parent-child relationship, even if it appears to have those dynamics. There is a serious difference between an emotionally dysfuncitonal adult and an actual child. Any physically healthy adult is capable of emotional maturity, they have the mental resources all in place, they just do not use them correctly, whereas a child actually does not have those resources, and is actually dependent on their caregivers for survival.

It is never true that the T is like a parent to the client when both T and client are adults. If either the T or client believes that that is true, it is that belief that creates the feeling of harm, not the conditions of therapy itself. And by extension, changing that belief can help to change the perception of harm.

Well, let's think about it another way--how, objectively, is the client-T relationship like a parent-child relationship?

The T does not feed, clothe, financially support the client. The T is not responsible for the client's life choices. The T has minimal actual involvement in the client's daily life. The T's services come at a price and that is seen as an equal exchange.

When a T terminates a client, objectively speaking, no material harm is done. No resources are taken from the client. If we say that a T cannot terminate a client, that implies that the T owes more to their client than the actual terms of therapy, basically, indefinite availability and unconditional willingness to provide that client services. The T does not actually owe that to the client, and it is not included in the therapy fee, and there really is no way to guarantee such a thing, because it simply is not realistic. Also, for a T to provide services to a client they wished to not provide services to would make those services ineffective anyway and would further destabilize the relationship.

Not all clients end up being abandoned by their T. Also, Ts who abandon one client do not usually abandon all their clients. Most therapy clients do not leave therapy perceiving that they have been harmed by the process. So we can figure out that therapist abandonment happens not as a direct result of therapy itself, but due to the combination, within therapy, of a specific T and a specific client--a relationship, which, yes, incorporates elements of both T and client's unique personalities, and is more or less successful based on that combination.

It is not realistic to say that a T should be willing to, or even can work with all clients who behave in any manner. It is also not realistic that a T can continue indefinitely to work with a client that they once could work with, if the situation changes significantly enough to be such that the T does not think they can work with that client anymore.

This is not specifically a fault of therapy, it is simply a natural consequence of the fact that therapy is a type of relationship, and relationships involve two humans interacting, and two humans can only continue to interact harmoniously, or at all, if a certain balance is preserved, where both parties mutually perceive that to be the case.

It would be impossible to create a kind of therapy in which a T never abandoned a client. It would also be impossible to create a kind of therapy in which a client never developed expectations which the T could not fulfill. Because these are not therapy issues, they are relationship issues. So that therapy could only exist if the therapist performing it was not human.

The only difference between a therapy relationship and a normal relationship is that a therapy relationship exists with the common goal of providing therapy to the client. If, at any time, either the therapist or client perceives that that is not sufficiently happening, and is no longer possible, then the therapy relationship cannot productively continue to exist.

People do fail and make mistakes, this is also part of reality. Nothing is certain, the only thing we can control is our willingness and ability to learn from the bad experiences to more consistently create better ones.

I have more opinions on this but my post has already gotten really long. But, whether or not this would be ideal, I think it is very hard to evaluate actual objective harm done in these situations because it is not material harm, it is perceived psychological harm, it is inherently subjective, and the motivation to hold the therapist accountable also comes from that same subjective place, whether or not it is valid in any given case.

Beautifully said magicalprince.

agreed. blah blah need more characters.

Very nicely put, Prince. This bit especially resonated with me. Everything I've always wanted to say about the issue but was never able to articulate. Thanks for this!

But it is not impossible or unrealistic in any true sense (other than that they usually do not) for the therapist to explain - clearly and directly and without blaming the client - why they will not or cannot continue to do therapy with the client.
I am all for saying no side need continue if they change their minds but I think the therapist getting to be unclear and all hiding behind all sorts of things they put in place to protect themselves is off.

I am so so so GLAD i got out of the therapy "cult" and can see things clearly now. SO glad. So sad to see so many still in it.

It is good to get out if it is not helping you or if you can't rearrange it in such a way to be useful, but some people do get a benefit out of it. I see no reason to not believe those who say they did benefit any more than I would not doubt those who say therapy failed them. I don't believe it is all or nothing - just as one type is not for everyone nor is therapy itself in any form for everyone. But just because it is not for everyone doesn't mean that it is not right or good for some people.

I'm just giving my own personal opinion. That is all. As most do here.

The first and second sentences in your previous post are your personal opinion. The third goes beyond personal opinion. "I think therapy is a cult" is a personal opinion. "I'm sorry you're still in a cult," in contrast, does not strike me as a personal opinion.

That, of course, is only my opinion.

It is my opinion. LOL. Thank you.