Candid comments from a T about therapist failures

"Often it is not the difficult patient but the difficult (untrained and/or unaware) therapist that's the problem."
--Mark Sehl PhD

He also talks (7:30) about therapists being motivated to enter the field because of their own early life deprivations in terms of of narcissistic gratification. Being a therapist means being the center of attention.

Therapists are very arrogant and narcissistic for the most part. I get sick of being blamed for therapy failure.

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It's getting late here, so I'll have to view the video tomorrow, but I definitely agree with the quote.

since he is a psychotherapist does he consider himself a narcissist??

No doubt he thinks he's the exception that proves the rule.

I wonder if narcissistic therapists are drawn more to some types of therapy than others? Attachment stuff would seem attractive to such people.

I dunno, but in some of the other videos I watched he seems quite self aware and talks at length at about his own projections and countertransference reactions. I'm sure he has at least some delusions of grandeur but he appears to be more honest and open than most.

Therapists are human. I do a lot of reading about psychotherapy issues, typically technical journal articles for other therapists. Many of the articles touch on the therapists' own attachment styles when working with clients and what types of adjustments the clinicians need to make to keep the client foremost in the session, etc. Everything I've read has given me quite a new perspective on therapists and how much we don't think about how like us they may be.

Seems to me that as a group they are perhaps more screwed up than the general population. I've never been to one who talked at all about their own neurosis and how it might impact therapy. They say nothing. So when a guy like the psychologist above acknowledges this deception, I take notice. He is saying quite clearly that therapy usually breaks down because of the therapist's own problems, and the client is held responsible. To me it is not trivial that a therapist still in practice acknowledges this.

For me this highlights why I appreciate my own T so much. She's very careful and conscious of bringing any attention to herself or her own stuff. Any time she brings up anything personal on her side, she preps it and makes sure it serves my purpose, not hers.

Perhaps, I'm not in touch or not discerning enough. My feeling is that I've been (and am) incredibly fortunate. I have a very well-trained, competent, passionate T who is quite mindful of her/his reactions to me and what I say. I would not expect her/him to openly address her/his own neuroses to any client at the beginning of therapy, much less explain to the client how it might affect therapy. Part of the reason the therapeutic alliance works - or doesn't - is the trust or faith clients place in the T to deal with their (client's) problems and get them through unscathed. If we all expect our Ts to be perfect and never make errors of the human condition, why do we put ourselves at risk in any relationship? I do expect my T to be aware of her/his own issues and how to avoid letting those issues impact me or my therapy. There's a thread on PC now (or lately) that was a perfect example of a T making an error of judgment and how the T handled the situation (sorry, can't recall the subject of the thread).

Maybe requiring that all psychotherapists undergo a certain length of time in therapy themselves would help alleviate potential therapist errors. Or, for clients entering therapy, states/countries should require all clients watch videos like this one.

What do you think would keep therapy failures from happening?

Then by definition the client is in a state of blissful ignorance about the stability and reliability of the person in whom they are placing so much trust. It means that full disclosure and informed consent are skipped in favor of implicit trust and faith in a stranger.

I came through ruined, precisely because my T disclosed nothing of her own problems, AND because I assumed she could be trusted.

Abolish the profession. Or, more realistically, never ever allow a therapy relationship to progress over long duration without some sort of 3rd party involvement or oversight. If two people with significant mental/emotional problems are locked in a room for months or years, and one of them thinks the other has no such problems, and nobody else is involved… oh my.

I believe that because therapists are human they are inherently flawed. They do not have all of the answers, nobody does. I don't believe that most ts hurt their clients intentionally or maliciously. It happens because like most relationships there hidden agenda s and dynamics at play. If a t is not aware of their needs or desires they can do a lot of harm. Because of the secrecy surrounding therapy and the confidentiality of it, this can be the cripling part for vulnerable clients. They sometimes don't realise they are being used and abused by therapists and don't think anyone will believe them when they tell. I think the secrecy and confidentiality protect bad therapists and enable unethical behaviour.

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I refuse to continue in this verbal brawl. I'm extremely sorry that you had such a bad experience and are continuing to feel the pain. I may be the next person posting about a bad therapy situation, but for now, I don't believe that most psychotherapists are inherently bad.

That was a very validating video for me. He described my ex-T exactly.

It was validating for me too. I've "been there done that" for seven years. I really thought I had a good therapist like so many people here think they have good therapists. It ended up damaging me very badly. I see it happen to others often. Just because a few might be helped doesn't mean the ones who are harmed should be overlooked and ignored. Anyone could end up hurt by therapy.

No one is overlooking or ignoring the ones who have been harmed by therapy. We all condemn bad therapists, and no one here is saying that all therapists are good. But when I come across people who are slamming the whole profession, saying it should be abolished etc., I actually feel offended on behalf of my two very competent, compassionate and highly qualified therapists who have helped me so much since I started working with them.

You know, I have come across people who have said things like, "I had a really bad experience with a person who was mentally ill, so now I don't like/trust mentally ill people." And imagine if someone were to take that one step further and say that we should all be institutionalised because if one mentally ill person does something bad then we must all be bad. There are also plenty of employers who won't hire a mentally ill person because they had a bad experience with a mentally ill employee in the past. How is that fair?

It makes no sense to me to condemn an entire group of people just because you had a bad experience with one of them.

If only "a few might be helped," and presumably that implies that the vast majority of people are harmed by psychotherapy, then indeed it is a nefarious business.

I don't see evidence of that, however. I see evidence that some clients are harmed, certainly. And some people pay for treatment that doesn't change things one way or the other, in essence wasting their money, and that is a form of harm.

But to imply that the vast majority of people receiving psychotherapy are harmed by it flies in the face of all the evidence I've ever seen.

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Could you share some evidence, some studies that state that? Please offer the evidence you've found. Thank you.

Oh and what you think is a competent therapist today (because i used to think that about mine) could turn out to be totally incompetent and unethical tomorrow. It does happen more than you'd think.

I used to be of the same mind as many here that people who condemned therapy were wrong, but since I've been there what I went through I see things more clearly (for myself).

And I do condemn the whole profession. It needs work, overhauling, something to protect vulnerable people so they won't end up so much worse.

But of course I guess it is the client's fault if harm is the outcome.

Extraordinary claims require extraordinary evidence. Who's making the extraordinary claim here?

There are literally hundreds of studies showing the effectiveness of cognitive behavioral treatment for depression, anxiety, and other conditions. I will be happy to post citations for meta analyses tomorrow.

When can I expect your evidence that psychotherapy harms the vast majority of people who seek it? Quite an extraordinary claim.

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It possibly does happen more than I think. It definitely happens more than I would like. I just don't think it happens most of the time.

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I think it would be hard to have studies to show how many people are harmed by therapy - the studies done touting its worth are usually done by those who have a stake in it being seen as beneficial. Also - it is hard to measure why those who quit do so since those guys are not supposed to call up and harangue clients into coming back in - plus - those guys often (in my experience and from the books those guys write)do not believe or agree with clients who say therapy was harmful - instead they blame the client for not doing it correctly.

Exactly. Thank you.

I haven't make extraordinary claims anyway.

Where did I say it harms the vast majority of people who seek it? Don't believe I've said such a thing so no need for ME to prove anything. Thank you very much. LOL. You're the one who brought up "evidence."

Some articles (take or leave 'cause I don't really care. LOL)

What Research Can You Believe? | World of Psychology

Both Talk Therapy And Medication May Be Less Effective For Depression : Shots - Health News : NPR

https://www.psychologytoday.com/blog...rly-impossible

The abolish comment was only half-serious. I don't condemn all therapists. I don't even condemn the whole profession, but the more I read and hear and experience the more I go in that direction.

BTW, I didnt just have a bad experience with one of them. It was a succession of them once I became a "problem client".