Psychotherapy inherently flawed?

I am not therapy's biggest fan and I have no idea how or why most people do it the way they do, but my partner is one of those who greatly benefits from it - both internally and externally and although I don't understand how or why it helps her, I do know it does. She adores her therapist and looks forward to therapy and so on. Boggling to me - yes, but for her, it has changed her life in some very positive ways and helped her deal with some seriously messed up parents and the ill after effects of being raised by monsters.

If by "like" you mean equivalent to, i agree. But there are obvious close parallels and harm done in therapy often echoes early attachment relationships. Sure belief has a lot to do with it, but so do unconscious drives, impulses, longings, and the very structure of therapy. And also if the belief is prevalent and that belief is causing harm, it is still a basic flaw in the system as it stands.

Maybe not in terms of physical presence, but in terms of psychological presence seems it is not uncommon for the T to be a dominant figure in the lives of no small number of clients.

What does material harm or resources have to do with therapy on any level? Clearly the harm is psychological and emotional. Termination put me into a dangerous spiral including suicidal states. And this is directly related to early life attachments and basic survival needs, material or not.

Who said anything about T can never terminate, or indefinite availability, etc? Those are unreasonable extremes. I am just looking for basic accountability. Some aspects of therapy cannot be easily codified or measured, but are still critically important.

Source?

Of course. The only questions of importance are how often is it happening and what are the long term outcomes for clients who go through it. Just to say that it's impossible to avoid settles nothing.

Yes, transparency would indeed save many from negative thought about themselves! Thank you, stopdog, for expressing that.

But not all T's obsfucate. Mine doesn't. She is very transparent about hte process and her ability to help.
Do you poll her about therapy?!

*joke!*

I know what she is like when the therapist is away for more than a week.

I disagree that the level of harm echoes early attachment relationships. When a mother rejects an infant's needs, this is a pressing survival concern. When a therapist rejects a client, all this objectively means is that they will need to find another therapist if they want to continue treatment.

It is adaptive for an infant to suffer greatly from parental abandonment, it is not adaptive for an adult to suffer greatly from termination of a service, because the pain is disproportionate to the actual loss. A reasonable adult reaction may be to grieve, but not to suffer greatly or become desperate and suicidal because therapy ended. In fact, a healthy adult may realize that the therapy, with the way it existed, was not productive, and be glad they learned something about themselves and others in the process.

I don't think one can say that the failure of a T is proportionate to the harm the client experiences, because this is not true, just like the idealness and perfectness of a T is not proportionate to what the client experiences in the grips of transference. The therapy provides only minimal contact, minimal relational capacity and minimal life involvement. It is narrative that embellishes the meaning of that involvement. Narrative can even be mutual between T and client, that still does not make it proportional to the reality.

The intensity of the feelings is not created by actual events that happened in the therapy (note, the level of intensity of the feelings is not created by those events, I'm not saying there are not real actions that bring up those feelings.) But the intensity, that is created by a subjective interpretation of those events' meaning, which then brings up old feelings.

Therapy cannot create new, more intense feelings than the old feelings that one has already adapted some strategy to cope with, because dependencies of the same magnitude do not actually exist in therapy, an adult is objectively not as helpless or powerless as a child, and the therapist never actually becomes the parent, takes on the responsibilities of, or acts in nearly the full capacity of a parent. The original abandonment is where the intensity comes from, so the feelings are a re-experiencing of the original abandonment, not an accurate response to termination of services with a single provider. Those feelings flood back into consciousness because as an adult, they can be processed and dealt with in more adaptive ways, which will then free the individual from their subconscious influence.

If the feelings legitimately could not be coped with, then they would be dissociated away again, like they were in the first place, because that coping mechanism was already adapted long ago to deal with those feelings. However, if the client continues to perceive that they have really experienced a loss as great as a mother abandoning her child, and that they are powerless, and the only recourse is for the "mother" to return and make it better, then the feelings will persist.

I do think that, for a therapist to prolong a therapy in which the client is clearly not seeking therapeutic goals, and the T does not know how to help the client seek those goals, that is unproductive, and is proof that the therapist is not competent enough to reliably provide the duties of a therapist to the client. But a T who is not competent enough to treat a specific client is also not competent enough to repair the situation, and in that case a referral is actually a responsible thing to do.

I know my T felt just as powerless as me when she referred me, and that was why she referred me, and at the time, it did not occur to me that it was better this way, or that she was actually doing the right thing for me, because beyond that point, she would have been unstable and ended up hurting me worse. I only wanted her to take me back because I was taking all the responsibility for our therapy anyway, and all the responsibility for its failings, and her own reactions. Well, with the way she felt, I wasn't going to be able to stop doing that, so it would not have gotten better. Even in the reverse situation, if the client is taking none of the responsibility for the therapy outcome, and putting all the responsibility on the T, there is nothing that T can do because nothing will be good enough, because the client is holding the T accountable for the contributions of both the T and client.

Amazingly clear and accurate. Everything I was thinking and could not put in words

IF clients were able to do all these things they wouldn't need therapy in the first place. I find this post to be very client blaming which seems typical of most people and therapists. It used to bother me but it doesn't anymore. It just solidifies my belief of how therapy distorts reality.

I don't think judging people because they have had positive experiences witb therapy is very fair. Doing so implies that one knows more about another's situation than the people involved.

Try looking at the debate from another prespective. Many people people have had back surgery, for example, and benefitted greatly from it. Others had nothing but problems following the same surgery. It doesn't mean all people will or won't benefit from back surgery, however. What will make the difference is the competency of the surgeon, the root cause of pain or injury (which doctors often don't know or get wrong), a patients overall physical health going into surgery, individual resilience, compliance with recovery protocol, and so on and so on.

Point being, people's perspectives are largely based on their own experiences and rarely represent an absolute truth. It's ones own truth, and your use of the service is often based on this, as it should be. However, implying that people with different opinions (that are as strong as yours) are in denial or somehow being victimized may be as "cultish" as those you claim to be.

I'm not judging anyone. If they take it that way it is on them. If me having strong opinions about therapy is cultish then so be it. LOL. It's just MY opinion. I also assume others are only giving their opinions and I don't allow that to negatively affect me.

Do you think people who have had bad therapy experiences get judged in a negative way?

If someone believes therapy helps them then great for them. I'm not sure why anyone would feel threatened about their therapy because of what someone says on an internet forum. IF the therapy is that good then criticism of THERAPY should not bother them.

It wasn't intended to be client-blaming, rather, IMO it is client-empowering. A therapist does not own your life or your emotions. They can't fix the problem, but they can help you see where the problem is and hopefully, what to do about it. I believe that all adult clients are able to do this, but it takes time, and commitment (to getting better, not commitment to seeing a particular therapist), which if the client does not have, they simply will not get better, no matter what the therapist does. It is the client's actions and behavioral changes that actually must solve the problem.

This makes sense, but if people could figure these things out would they go to therapy in the first place? And you're assuming therapists are ethical. There are many who are not and end up harming clients.

There are many therapists who seem to have no idea what they're doing. How is the client supposed to figure this out?

They do not have to be able to figure it out for themselves, they simply have to be willing to try again with another therapist, who can help them look at what happened. If they no longer trust therapists, that is understandable, but limiting, just like it would be limiting to say, stop seeing doctors because one doctor botched a procedure. There are no guarantees because humans are fallible.

My posts were mostly intended to be about cases where the T terminates the client because they do not think they can continue to provide services to the client. But if the termination was malicious, that would be all the more reason that ending that therapy was in the client's best interest.

Therapy does not always have an ideal outcome, but that is not because it is therapy, it's because it is a human relationship, which simply cannot always have an ideal outcome. It also is not perfect, and hopefully is always improving, but making the best of imperfect circumstances is life as well.

And sometimes it does not matter how hard or how much the client works - therapy still fails.
I really dislike the blame the client for therapy failure mindset and I think it lets the therapist off scott free.

MP, we had some productive and interesting dialogue not long ago. I appreciated it. So I say this with respect… your last couple posts are demeaning and patronizing, as much as any I have seen here, and I imagine anyone harmed in therapy would feel that. Why? Because they are written in such a way as to suggest thoughtfulness and understanding but contain all sorts of veiled insults and presumptions. There is a subtext that seems to say -- here is how I overcame my difficult therapy, now pay attention as I explain how you can do the same. If someone posted in this manner, but with a message that was critical of therapy, there would be outrage.

You seem to have undergone some transformation in your view of your own therapy, which is great. But to preach in such a drawn out and moralizing way about what you consider the "proper" way to view the experience of harmful therapy is just not cool.

Suggestions that therapy relationships aren't that different than others and are just a "s**t happens" sort of reality seems really odd to me. Therapy should at least aim for "first do no harm". If it fails there with regularity, it is not legit. People are paying large sums of money, unlike in social relationships. If we hold therapy to no higher standard than social relationships, I cant imagine why it should exist. And the sort of harm inflicted by bad therapy has a uniquely perverse, disturbing character.

You are equivocating and rationalizing about an experience that, for many, is emotional and visceral and psychological. If therapy experiences could be sorted out through intellectualizing and rationalizing, you wouldn't have people losing their minds and feeling lingering harm for years. Trying to make sense of destructive therapy by considering it objectively is like trying to soothe a crying baby by giving it book to read about psych theory. I have the sorts of awareness and self understanding that you are promoting, but I still am suffering greatly. Therapy conditions us to take a bullet for the process and see that our suffering is self-created and we just need to try again, and again, cuz the process is beyond reproach. My suffering is in part self-created, but therapy itself also inflicted suffering that is absolute and not just relative. Anyone who suggests otherwise is playing a dangerous and invalidating game. It's what most of the other T's that I tried did. It was cowardly and perverse.

As for therapy-childhood links, the entire biz speaks in a language that makes plain the connections between therapy dyads and mother-infant dyads -- regression, transference, attachment, dependence, etc. There are whole therapy approaches that even attempt various sorts of "re-parenting".

I substituted the pseudo-friendship, of therapy for real friendship. Of course in time you understand "this isn't a friendship" I'm an object, a diagnoses, and a paycheck. Paying someone to simulate a sort of emotional intimacy ended for me when my therapist wrote a diagnoses for me that she didn't believe I had. The betrayal of that act when she knew I was sensitive about labels was the end of any possible therapeutic relationship. She said "I don't agree with him and I think it is inaccurate but he is my supervisor". I realized she didn't understand me at all and that a "friend" would not have thrown me under that diagnoses bus when she knew that it could only wound me. Paycheck in the end won out of over a personal ethic.

Friends and people with a lived experience are a source of healing. I like the analogy here of an emotional prostitute thinking it something more than that was my error. Lastly, my sister is truly emotionally abusive person, she should have been arrested for child abuse when her children were younger. She became a therapist that uses her clients insisting that they worship her. She gets away with it because initially she is so comforting and then she begins to tear her clients down as only a skilled therapist can. That splitting process is pretty devastating if it comes from your therapist

I dont find what you said empowering at all. Nor disempowering. Rather i find it to be a gross distortion of reality. If someone has made numerous attempts at therapy, and has come away feeling consistently harmed or just not helped, the empowering thing to say would be -- you deserve better, consider the myriad other ways there are to heal, not least your own internal resources. The message that is pounded incessantly is that therapy is some sort of prerequisite to overcoming life's problems.

I tried other ways to heal after being tossed around by a few mentally injurious therapist. I also, tried medications. Unfortunately, none of those things HEALED ME from my childhood wounds, except another go at therapy, and some psychodrama thrown in.

Maybe, people can share what other ways they know to heal from these deep wounds, as oppose to just putting a band-aid or tourniquet on it. I did that for years, but there was gangrene festering below the dressings. I do believe there has to be other ways, but have not heard their stories. Anyone willing to talk of the successes?

magicalprince, your description was exactly how it went for me. I gained my power back in therapy, and continue to feel empowered as I journey on in this inherently imperfect world.

Well, I can't take responsibility for the subtext, because AFAIK I didn't write one. I at least believe I empathize with the position you are in, and my posts were extrapolated from my own experience, my motivation being that they help me to consolidate my own perspective and help me know how to move forward in my own healing. I do disagree with your interpretations, but I am not preaching, because I have no gospel to confer to you or anyone, because they are just my thoughts, and if you don't find them helpful for you like I find them helpful for me, or other people seem to have found them helpful, then that is perfectly OK as well.

I agree with some of the points you made and disagree with others, but I'm finding it difficult to respond, because your interpretation of my post doesn't feel accurate to me, and I'm also struggling to understand specifically what you are communicating here. In the first place, I have no power over whether or not therapy exists, or on what terms it exists, and my only interest is how I can make the best of it as a client.

Of course your feelings are your valid and genuine experience, but I personally don't think that your feelings mean therapy should not exist or can't be helpful to most people.

Well, if someone tried therapy and found that it is not for them, I would think that's helpful for them to know and at least they tried. Personally I would encourage you or anyone to do what actually works and helps you accomplish your goals.

For me, one of the inherent flaws of therapy is how much of its thinking is simply invented and adopted at whim. Who can anyone legitimately know or prove the genesis of emotions for every single human being? Who stands with a measuring stick to gauge proportionate responses to events? Who knows what manipulations occur? Who even knows what goes on in anyone else's room? It seems someone concocts some notion, puts in it a journal, and if promoted sufficiently it gets accepted as Truth.

Yep thats exactly how it works.

But you have no idea what my position is. I shared with you only a fraction of the picture. This is one of the things that drove me from therapy -- everyone so eager to solve other people's problems, even with only scant knowledge and understanding. I see it replicated on PC. How is this healthy?

I never said any of those things. I simply raised the questions. However you did say that therapy is helpful to most people, but i am unaware of any way to validate that. My feelings are not important and my own therapy experiences are not very interesting. My perspective has as much to do with reading books and blogs and forums like this. My own destructive therapy was certainly revealing but more so was the way the next dozen therapists responded to me when i said their colleague traumatized me. A sort of informal study into how honest and forthright the biz is. Grade: D-

I dont mean to be hostile because we obviously share some common perspective and i agree with some of what you sau, but from my point of view it is dangerous to interpret another's deepest s**t.

Bud, I am not trying to fix your or anyone else's problems, only to share what I find helpful in fixing mine. As I said, I don't believe that even a therapist can fix a client's problems, or erase a client's deep wounds, only be there with you for some time along the way. Lately, I feel more grateful than ever to have had that while it lasted, and I am excited to find more of that in my life, and I can only hope other people will also be able to find the positives where they exist.

One of the reasons I insist that a therapy relationship is just a normal relationship is not to hold it to a lower standard, it is to appreciate that someone, imperfect, but someone, tried their best to be there with me in my most painful moments, when I had lost so many other connections and was so lost to myself. I'm glad that was available to me because if it had not been I wouldn't have had the strength to even reach out to someone in the first place. I got hurt but not in a way I couldn't survive, and learning that I could survive was actually a powerful lesson to me, that I was not helpless anymore. Applying that lesson is the real struggle but knowing it's true makes that possible.

I genuinely feel sad that you're still hurting, because if it's like what it felt like for me, I think it must be really awful. I just hope you will find what you need to recover.

Formal mindfulness- and insight-based meditation practice was a success for me, for a while. Eventually a series of traumatic losses plus chronic illness made it unworkable. But i think it is as powerful as anything out there. And interestingly some draw parallels with both therapy and parenting, in that you can use the observing part of consciousness to offer the other parts the sort of "quiet attunement" (as someone called it) that a parent or therapist might provide. And practicing so called choiceless awareness can be revealing.

That’s sort of been my experience, may be getting there with current T, may just leave and not try anymore.

The difficulty has been horrendous. Some of that was the original wounds that I was numbed from in childhood.

But some has been infection and wounding and making life more horrible provided by the therapists.

My therapist thinks the main problem in the U.S. is that the system can’t force counselors and therapists to do their own therapy. And those counselors may have their own deep wounds which they haven’t dealt with effectively, may not (fully) know that they are there.

Which is why I like the example/analogy I gave – probably too long – about Semmelweiss and the then-strange order he gave to physicians in his hospital to wash their hands before examining patients after they had been doing autopsies.

Just imagine a surgeon going into a deep physical wound, no anesthetic (because getting to feel pain is sometimes part of what's needed), dirty knife. I didn't know about that possibility going into therapy -- I just thought therapy was the thing to do to help me with problems I was certainly consciously willing to face. (Little did I know, yes, because I was dissociated. But I didn't know about that possibility, either.)