Could therapy be harmful

I've been in therapy for about 3 months, weekly sessions. My therapist is taking mostly a psychodynamic approach, dealing with issues related to anxiety and low self esteem. I have a demanding career that requires me to appear confident and in control, and I've learned to do this by focusing on the positive and not getting hung up on negative things that happen. My therapist argues that I'm not letting things go as much as I think I am and that the coping mechanisms I have developed on my own are "fragile". This may have some truth, but I also think I've done pretty well with my method of coping.

Now, when I go to therapy, I rehash my childhood, including frustrations with my parents, which makes me feel like a spoiled child for even complaining at all. I leave each week feeling weaker than I was before. I feel like all these strengths that I thought I had are now interpreted as maladaptive strategies to deal with underlying mental health issues. The longer I spend in therapy, the more problems I think I have.

When I talked to my therapist about it, he said that he thinks that I'm very scared of going into deep depression (which is true). He tried to reassure me by saying that there are really no risks with psychotherapy, which I fundamentally disagree with (and told him so). While I think we have a good relationship overall, I think that he doesn't really take some of my concerns seriously. How much longer should I give this before trying something new? Is it possible that psychotherapy could be bad for me? I realize that sometimes you feel worse before getting better, but it has been 3 months!

"He tried to reassure me by saying that there are really no risks with psychotherapy, which I fundamentally disagree with (and told him so). "

WHAT!?
This may just be me, but I would dump him for this sentence alone.

I agree that the statement that there are no risks with psychotherapy is very naive at best and out and out damaging in and of itself at worse. Even with therapists that don't cross the unethical lines, psychotherapy has the potential to do damage if the therapist is not a good match with the client.

As for the getting worse before better....it took me about 6 months before I started to see enough "betters" to know that things were moving in a positive way. Even with that there have been several periods of regression and in fact, I am either just getting out of a pretty good slide back in depression (the last 2 months) or still in it, just having a good day.

There are definitely risks to therapy. I guess I come back to asking myself how well I was doing on my own and if the risks outweigh my own mismanagement. In my case, the risk of my own mismanagement edges out the risk.

eta: I would be worried about a therapist who doesn't acknowledge the risks or who made a statement like yours did.

There are absolutely risks embedded in psychotherapy even when the practitioner is the most ethical and competent. In my state informing clients about potential risks is a required part of the informed consent before therapy starts.

I would not waste any more time with this guy and would start looking for someone new right now. He sounds incompetent to me. I understand where he is coming from, but his way of approaching your problems is incompetent. Usually inexperienced therapists behave like that when they jump to conclusions about the causes of the clients' problems without given themselves enough time to establish trust and to collect more information. An experienced and competent therapist is supposed to meet the client where they are, not where the therapist wants them to be.

So, yeah, I'd dump him right now and look for somebody a little wiser.

Yes, it can be harmful. And no, actually you don't have to feel worse before feeling better. I mean, worse than you were feeling when you began therapy. Not sure why you started therapy, but it could also be they type of therapy that isn't the right fit for what you need.

Thank you for your replies! I too was concerned about the "no real risks" comment, and when I disagreed with him, he back-pedalled and acknowledged that there were risks (as stated on the consent form I signed). I think it was a careless attempt to reassure me, but even therapists make mistakes. Other things he has said have been helpful. Sounds like this statement about risk is a deal breaker for many, though. For me, I think it might be worth one more conversation about this, and about fit. I really don't want to start with someone new.

Your description of your therapy really reminds me of my first therapy experience. I too felt that it somehow eroded my coping skills and that the therapist did not value my coping skills. I saw that therapist for 9 months and over that time felt worse and worse. I too didn't want to start again with a new therapist. I'm now seeing my third therapist, with this therapist I am finding that I feel good after sessions. She also validates my own coping skills.

I agree that there are risks in therapy and I would confront a therapist who would say that there are none. This wouldn't necessarily be a deal breaker for me if I would have a generally good feeling about the T because I would rather try to understand first what the therapist meant by saying this. If this was a situational attempt to reassure me but generally it would seem that he understands how hard therapy can be then I would let it go. If the person seems clueless and really believes that therapy is totally harmless then I would leave this T as soon as possible.

Regarding getting worse I believe that in some cases it is really inevitable. The experience you describe is somewhat similar to mine. I had built very strong defence systems that served me very well, I had no depression, no anxiety, no emotional problems. I just didn't connect to people and didn't feel to belong to this world. When I started therapy my defences (or part of them) were very quickly torn down. This left me vulnerable to anxiety and depression. Previously I had been able to use work as a regulation mechanism - if there was any threat for emotional disturbance I retreated to work and everything was fine. Now this suddenly didn't work anymore. As a consequence, I became very dependent on my T, obsessing about him all days, barely able to do any work.

This period lasted quite long time, I don't remember exactly anymore, but at least a year or year and a half and it was truly difficult. However, over time I gradually found myself again a bit. I had to develop new coping mechanism but this would not have been possible if the old defences would not have been brought down first. The new coping mechanism are more relational, they involve more other people, e.g. my H, whereas previously I only could retreat to a cocoon. Also, having lost those defences put me into touch with my emotions that for very long time were intolerable to me. But in order to learn to know my emotions there is no other way, the only alternative is to run from them forever.

This is my experience, it might have nothing to do with your experience. But I just wanted to say that depending on what are your issues it might be possible to let go of your old coping mechanisms and tolerate a period of depression before something new and better can start emerging. It definitely isn't comfortable and pleasurable process and it requires a good T to accompany with you but if in this situation you want any real changes in yourself, this unpleasant process might be inevitable. I would reiterate though that a good T is a must in this process.

The challenge I have had over the years is how to find and know a good T. This was exacerbated by the problems I went into therapy with, being cut off from many emotions, not understanding other people very well.

There are lots of good resources about "harmful therapy" and "bad therapy", etc., on the internet these days, so you can educate yourself even if your T hasn't helped you with that.

I had no idea that therapy could wind up hurting me more than anyone in my life has hurt me. It was not the therapy, it more like the THERAPIST!! He was highly unethical, incompetent and plain CRUEL. He went berserk and ruined my life completely.

People on here write about good coming from it but there has been no good for me. Forget about coping skills. None were ever offered to me. I was disgarded with nothing and left with less than I've ever had in my life. The therapist actually had other people hurt me. It should be illegal but I guess he will get away with it because other people turned out to "like" him. They liked him against every logical indication he was nothing but bad news. The worst has happened to me from seeing a therapist and I don't recommend it to anyone.

Absolutely. I found cbt to be actively harmful.

https://www.madinamerica.com/2013/06...an-cause-harm/

https://thepsychologist.bps.org.uk/v...py-causes-harm

https://www.nationalelfservice.net/t...-more-at-risk/

http://theconversation.com/talking-t...-out-for-27433

Read this forum (or any other) long enough and you might get the idea that what therapy does PRIMARILY is cause harm.

Can take many forms: emotional dependency or enmeshment, obsession with therapist, ceaseless rumination, inability to act or decide without therapist input, becoming submerged in an infantilizing and regressive relationship, pathologizing and medicalizing of normal behavior and thinking, self-absorption, shaming or rejection from a quasi-parental figure, abandonment (emotional or literal), betrayal of trust and vulnerability, declining health from psychological stress, loss of perspective as result of being in an artificial and contrived relationship, emotional or physiological dysregulation from unnaturally rigid boundaries and time constraints, and in some cases outright traumatic experiences and abuse.

Therapists who claim there are no risks are either delusional or dangerously unaware.

I don't buy the worse-before-it-gets better argument. That's a convenient loophole for failed interventions. It's not a testable concept. Feeling worse is feeling worse.

I remember in the early part of therapy, feeling really drained by looking at the parts of my life that I don't really like to think about. It's hard work doing that, bringing up a lot of stuff that you try not to think about most of the time, and it's hard also to put that stuff back in the bottle once you start pulling it out.

Three months isn't really a long time at all for psychodynamic therapy. I would say that it's worth pushing through a while longer. The comment that therapy can't be harmful is troubling but if you feel a good connection with the T otherwise I'd give it a few more months.

Thank you for this. It does sound a lot like my experience (at least early stages). I'm still not entirely convinced of the value of "sitting" with my emotions rather than doing something to distract myself or alleviate the situation in some other way. I worry that as long as I remain skeptical, I will not positively benefit from therapy. Did you go through a period of doubt too? How did you decide to keep going?

Thank you for these links. I'm going to discuss some of the concepts with my T, particularly the ideas that excessive inward focus and rumination can be exacerbated in therapy and may be harmful. I can really relate to this.

I think the scepticism might also be a defence mechanism and although it could be true that you don't benefit positively while you have this attitude I don't think you can really do anything about it.

For me, I didn't really have this period of sceptical doubt. I have a very good intuition that I trust and on some level I was certain that I'm on the right track, even though this track felt extremely difficult for a long time. The other thing is that some very young part of me had a hunch that it could get something from my T that it had never gotten from anybody and thus stopping going wasn't even an option to me because it would have meant that this young part would have to give up the hope of ever getting "it".

I also agree with the thought that someone else said before that 3 months in psychodynamic therapy is really a very short time and if you generally have a good feeling about the T and you feel that he knows what he's doing then keep going. But if my experience sounds similar to you then better just be prepared that it might be necessary to finally face the depression that you have avoided for long and it definitely isn't pleasant. Make sure you can lean on your therapist during that time!

What is he implying exactly? That you must take some terrible journey through the underworld, resistance is futile, and he will be your expert guide? If so, on what basis?

Therapists are always pitching therapy as a necessity for "depression". But what precisely are they selling? Does he fancy himself omniscient and omnipotent enough to know where your depression comes from, what it means, and how to mitigate or resolve it? And he can do this with anyone who walks through the door?

Therapists did nothing for my depression. One made it exponentially worse.

It would seem not irrational to be scared of going into a deep depression.

Therapy was harmful for me in several ways:
. Underscoring my wounds and life's unfairness as well as my weaknesses.
. Habituating my self-absorption and ruminating on everything negative. It taught me how to be depressive.
. A child/savior relationship with my therapists which rewarded my pain and learned helplessness.
. The magical thinking that my life and relationships would improve through complaining, busy-work exercises and ruminating rather than action.
. The magical thinking that my therapist was a savant with omniscient knowledge of me and superior knowledge of life.
. Encouragement of unscientific thinking: that emotions could be "released" like a steam kettle or that negative feelings can be diminished through discussing past events.
. Reinforcing a self-image as a helpless, incompetent subordinate to the powerful, wise, magical therapist. Through my therapists' subtexts and cues, I saw them larger than life like a toddler views a parent.
. Living for the my distorted therapy world rather than life.
Here is another skeptic on the subject. (Please don't read if a therapy doubter will trigger you.)
https://trytherapyfree.wordpress.com...y-free-part-1/

I have relieved my anxiety through the years, by pursuing goals, through exercise and yoga, by proving my own competence to myself and simply living life. Therapy only took me backwards.

I think he meant to reassure me that, given my current emotional state and support network, he didn't think I was at high risk of falling into a "deep depression". I don't think he meant that depression was an inevitable or a desirable state. Regardless, this statement concerns me too, because it makes me feel like he doesn't take my concerns seriously. I'm going to ask for clarification.

[QUOTE=missbella;5711846]
. Habituating my self-absorption and ruminating on everything negative. It taught me how to be depressive.

. The magical thinking that my life and relationships would improve through complaining, busy-work exercises and ruminating rather than action./QUOTE]

Thank you for this post. These two points you brought up are pretty much exactly what I'm worried about. Links were interesting.

It's something really serious to think about, not something to take lightly at all, so your concern seems reasonable to me while his lack of concern seems a bit reckless, in all honesty.

I think the side affects or adverse outcomes depend on social and environmental factors, your history, temperment, personality traits, other factors. If you have a supportive family, lower life stressors, good health, money, etc., you might fare better. However, keep in mind that while doing this work, if you lose your job, health, marriage, or something else, it could set you back much further as after your defenses erode, as you might now be living with the mindset from more of a position of vulnerablity rather than strength that defenses once provided. Of course it's ideal for maladaptive defenses to be replaced with healthier ones, but that takes time and I think the outcome has much to do with the skill of the T (yes, they have to work too).

The material that emerges could effect your confidence and your job. A demanding job is difficult while in this type of therapy, depending on your background, but also depending on other aspects of your life, such as health, money, having a partner to help with day to day activities.

Also, keep in mind some people here have 2 or 3 therapists and/or can go 2-4 times a week rather than the usual once a week or once every two weeks others can go. My ability to go only once a week really dragged out the process and I was stuck in depression for way too long and have not quite climbed out of it yet. I was flooded with dissociated trauma, and things happened on top of that, further weakening me. Now I'm very overwhelmed but too deep into therapy to just stop cold turkey. I'm climbing up the mountain, but avalanches keep coming down, and I'm getting worn and weaker.

Be careful. Read about "ego strength" and psychodynamic therapy. Note that the stronger your defenses are now, the weaker you will be underneath. People may disagree with that. Some have defenses like a brick wall, but whether or not they crumble can depend on your therapist/the type of therapy you are in.

I just realized your user name; given your name is WorriedWell23, I wonder if what I said is even relevant to you. If you don't have a history of trauma, neglect, abuse, the side effects may not impact you as much as someone who had very poor parenting with abuse, especially before the age of 2. Preverbal trauma changes the way your mind works, often leaving you with fragmented sense of self, which its much more difficult to get through therapy with. It can be volatile, which can really affect your career.

Hope I didn't say too much.

I've yet to find any professional literature on predictive factors in harmful therapy nor much on the subject at all.

Seems the primary factor is the quality of the therapist-client alliance. Since human relationships cannot be controlled nor predicted, seems therapy is largely an improvised psychological experiment.

Re: OP's concern about therapy possibly becoming harmful, I'd say ongoing psychological stress is a pretty good predictor of all sorts of pathologies. I observe that a lot of therapy relationships are sources of stress and anguish, but it is frequently rationalized as some sort of ritual purification.