Survivors of Unethical Therapy

IDIMW--Deepest condolences for your loss. May your father's memory be a blessing.

I agree. What my T's Code of Ethics did was give him a way to get rid of me without feeling he'd done anything wrong. Not so much a Code of Ethics as a Code of Excuses.

I’m a double-amputee. I’m having a finger amputated next week.

I’m responsible for the loss of my legs and the future loss of my finger.

Regardless of my promise to stop smoking after my first heart attack and open-heart surgery, I continued to smoke. Regardless of my promise to stop smoking when my son was born, I continued to smoke.

Years and years passed and I continued to smoke.

I had two more heart attacks and two more open-heart surgeries. I continued to smoke.

My toes began to die. I continued to smoke.

My right leg was a complete, above the knee, amputation. I continued to smoke.

My left leg was amputated ‘below the knee’ — around my ankle. I continued to smoke.

My left stump was amputated above the knee. I continued to smoke.

Four years ago I stopped smoking.

My legs won’t grow back. The majority, but not all, of my physical ailments are due to smoking for over forty years.

I’m not really upset about losing my finger. I just worry about losing them all.

I’ve known too many paraplegics in my life. Maybe it’s because I live with the invisible-people, most of the paraplegics that I’ve know have suffered the loss of movement because of being shot in or close to their spinal cords.

Am I a ‘survivor of cigarettes?’

Are my friends ‘survivors of bullets?’

I only want to say that we are sometimes responsible for what we do and where we choose to be. That is certainly not true for those victimized by harmful/unethical therapists.

I would like to ask, though, why you felt that you had to stay with the harmful/unethical therapist? I think that’s a legitimate question that should be more cathartic than painful? Kinda like gettin’ down to the real soul?

Wow. That’s weird.

In my state — maybe more liberal than most — you must be licensed to even practice counselling and must have, at least, a BA.

To become a licensed therapist requires an MA.

To become a licensed psychologist requires a PhD or PsyD.

State Board of Medical Examiners for psychiatrists, of course.

Even if I’m stating the obvious, let me say that...

I do not doubt that anyone here writing of neglect, harm or unethical treatment by a therapist has, in fact, suffered neglect, harm or unethical treatment by a therapist.

I would suggest that those without recourse to counsel might file a complaint with your State Board of Health or other licensing body. At the very least, your therapist will be examined for violation(s) of State Code. If found guilty of violation, his/her license will be revoked.

This may be of no help for past instances but could surely be of help to those currently suffering from, or those in the future suffering from, harm, neglect or unethical behavior by counselors, therapists or psychiatrists.

Every code of ethics are different but mostly they all have a common denominator: first do no harm. We all know that’s not the case and many therapists do lots of harm, unintentionally and intentionally.
I disagree that therapists are not held accountable. Here in Ireland they have recently brought in mandatory reporting, which I completely disagree with because this causes lots of harm to vulnerable clients who don’t want to report, that decision is simply not theirs anymore which is completely counterproductive to the therapeutic alliance.
Well, since this has been introduced it means any therapist who doesn’t report abuse and is later found out, say a client left a therapist and went to another, the new t heard abuse and reported it then the old t can be brought to court and charged. They will spend six months in jail and not be able to practice again.

Mona, does that include abuse of minors only, or also of adults?

If this applies to adults, I would say that's an example of therapists being made accountable to the criminal justice system, but not to their clients.

It includes both minors and adults Mostly. It includes physical, sexual, emotional and any type of abuse even retrospective abuse has to be reported and investigated. It’s a mess!

Oh that's awful!! Why not just tell women in abusive relationships that they are no longer allowed proper therapy. That's going to be the upshot for many of them.

If this is in the ethical guidelines, it just shows how little such documents truly consider the needs of clients.

Are you in the U.S.?

Most states have licensing boards for counselors, therapists, psychologists and (of course) psychiatrists. If you can’t afford legal counsel — my first suggestion — a report to your State examining board (usually your board of health) should get quick results. There shouldn’t be a ‘statue of limitations’ for damages.

Just a thought,

You know, I reflected on it a lot later and I realized what was so hard about it for me.

Me, I grew up in a dysfunctional environment where the bottom line was, my voice did not matter. I was forced into a lot of things I didn't want to do and if I said that I didn't want to do them, my reasoning would be invalidated and I would be forced anyway. I was never encouraged or even allowed to exercise my own judgment.

So in that environment you learn, rather than communicating and saying what your needs are, you learn to size up what other people are capable of and figure out what their motive is. If you don't want someone else to force you into something, you have to make yourself unforceable, because you know that "no" will not be respected. It's dog eat dog, it's a battle of wits, people play games and manipulate, so there is no basic level of trust where you believe in the goodness of others, instead you just do everything you can to prevent them from being able to harm you and abuse you.

When a person with that background goes into therapy, they are critically vulnerable. What happened for me was, I ended up developing feelings for my therapist. But like I had learned in my childhood, I can't say what I want, I can't say what I'm experiencing or feeling because if I say it then it can be used against me. Yet ironically the whole point of therapy is to get back to the heart of what you are experiencing.

So thanks to that environment, eventually I wanted to say it. I thought, maybe this situation is different. And I started to feel, against my own fears, like I should say it, I should try to talk about it and I should try to learn to trust another person to act in my best interest. I was even being told that this is what therapy is for, it's okay to be vulnerable here. Everything about that environment and her behavior, was compelling me to become vulnerable, as if it would be okay in the end.

But that is not what happened. As soon as I opened up about what I was feeling, she immediately changed, became anxious, and shut me out of my own therapy until I agreed to end. 2 years of building that relationship, gone in a flash.

That was retraumatizing for me because it left me with this feeling of, "damn! I knew it! I should have never opened up. I should have never said what I wanted." But then, the whole point of going there was to learn to open up. It was just like being back in my childhood environment where I was powerless and my voice simply did not matter. I tried to explain myself to her and she did not listen, she shut down all lines of communication. She had her bottom line, her own personal "ethics," and it didn't matter what I said or what it made me feel. Suddenly it was all falling on deaf ears.

When I looked back on those two years, I realized it had actually always been that way. I had spent that whole entire time reliving my unhealthy childhood patterns, telling her only what she expected to hear and not what I wanted to say. I had never known anything different. So at no point in that experience did it matter what I want. At no point did I have a voice, or any agency. And it had nothing to do with ethics, it had nothing to do with me at all. I ended up in a relationship with an unhealthy therapist and the only thing I could have done about that would have been to realize it sooner and end the relationship sooner. But the target demographic of this service is literally people who have been groomed from a young age for compliance in these types of abusive situations. So that is messed up. Beyond me realizing what was happening, there was nothing in place to protect me from that situation. The thing is, me and my therapist, both of us were unhealthy people. We protected ourselves from each other like unhealthy people do. But the situation was set up so that, if it failed, it still benefitted her. Unlike an unhealthy friendship or an unhealthy romance, this situation was explicitly rigged to fall in her benefit, no matter what.

It could seem like, oh, she realized this situation was abusive to me, and she ended it. That's ethical, right? But that's not true. Because at any point in time, if I had started saying my genuine feelings and experience, I would have been ousted in the same way I ultimately was. So from the very first session, there was a double bind where either you do what the therapist expects of you, you follow their unwritten rules, and they get your money, or otherwise, you don't do what they expect of you, and they drop you and keep the money you spent on reaching that point. The condition for termination is not "you broke this clearly written and agreed upon rule," rather the condition for termination is just "the therapist feels like terminating" and that is accepted as a valid reason. Well, they feel like terminating, of course, at exactly that moment where a client decides to try and exercise their own agency. The ONLY focus of that kind of therapy is on what the therapist wants.

So that situation is set up to be fundamentally exploitative of clients who literally grew up being groomed for that same exploitation. And there's nothing whatsoever that is preventing that from happening. It's the equivalent of a rehab facility that sold drugs, or an orphanage that was trafficking children. In any other field this kind of thing is always explicitly illegal. In pyschotherapy it has flown under the radar because mental health itself has flown under the radar in modern society. I just wish someone was listening to the voices of the people who have been through this and experienced it and came out saying, this hurt me in a way that nothing else has hurt me before, this is seriously wrong, this nearly drove me to suicide, this ruined my faith in humanity. I'll always remember being that person and finding that nobody understands, nobody is listening, nobody cares, except other people who have been through it themselves.

Therapists, their ONLY RESPONSIBILITY is to always put the needs, and most importantly, the experience of the client as a first priority. And quite a lot of the time, that's just not really happening, and worse, there is nothing preventing it from not happening. So much focus is put on sexual transgressions but in any case, the transgression is occurring for a very LONG time before it ever becomes overt, and in many times when it never does become overt (other than an overt abandonment.) It's the covert, subtle, hard to prove transgressions that really need to be paid attention to. Those aren't any one behavior, any one word or phrase or statement by the therapist. They're an ongoing attitude of the therapist ignoring or minimizing or otherwise exploiting the experience of the client. That attitude is insanely harmful and there needs to be accountability for that.

That was incredibly well written and expressed magicalprince. I can see how what happened hurt you in a core way in which you'd always been hurt growing up, and that is just terrible. I am so sorry. I also feel that my therapist's rejection of me hurt me in a core way, in that for years in my childhood I felt defective, unworthy, disgusting, and so on, and his recent coldness implies I must have been correct about that.
Yes, this seems to be the case. There is apparently no expectation that therapists should protect client autonomy at the end of the relationship. Nor is there any acknowledgement in the ethical guidelines of how badly clients are hurt by forced terminations.

The idea of "unconditional positive regard" is foundational in a lot of different schools of therapy and different modalities, but is entirely incompatible with sudden therapist-initiated terminations.

There's so much of value in your post that I don't think my reply can do it justice, but thank you for writing that.

Yeah... it's not solely the forced termination itself that creates the harm. It's the constant lingering fear, while the therapy is still ongoing, that that termination could be coming at any time and I somehow have to control and change my behavior in order to please the therapist so that they will not terminate me. My self-expression is only valid as long as it mirrors what the therapist expects me to express. This is the fear we grew up with and also the last thing we want to be true.

And then being in that position, and having it finally happen... at that point, the termination is just serving as proof of what was there all along. It sends the message to the client that "you were only valid as long as you didn't say this thing, or didn't express that feeling." And this is in an environment that is set up to explicitly favor the beliefs of the therapist over the beliefs of the client. That's why it can be so harmful, not just a reminder of childhood traumas, but a unique subsequent trauma itself.

My case went before the review board in my state and was in the therapist's favor. The psychologist admitted the bullying but argued it was to "challenge" me. But he also argued my response him as "transference," as if he had magical powers to read my mind. That told me that his outrageous behavior is deemed perfectly in-bounds practice by the psychology profession. A journalist, researching the process in another state, compiled statistics on complaints and outcomes. He told me only a tiny fraction are heard and of those, only a tiny fraction are decided for the client. Big Daddy Therapist is the credible Ultimate Authority; the client is deemed unstable and implausible, apparently.

Magicalprince, amazing entry. I resonated with everything you expressed. I understand and am going through the same thing. I know the hurt. So sorry you have gone through it as well.

The termination didn't scare me much. What terrified me was not being heard. I really needed someone to hear and not judge me. The only time I felt heard was whenever I resorted to acting exactly how the therapist/psychiatrist expected me to, even though it wasn't what I was feeling at all. I hated doing this, because it went against everything I believed in. I remember feeling awful and guilty about it a lot. Sometimes I wondered if I had Munchausen syndrome, because of what I was doing and saying (I know this contributed to my horrific ordeal with misdiagnosis).

When I was in hospital I learned that SI was the way to get heard. Now I am living with the scars because I experimented with it when I was a teenager. I cannot forgive myself for this.

I remember feeling this as well. It screwed me up. I longed to be real with them and around others outside of my family, but all I got was grief, because I was quirky and challenging. Back then all I really did in sessions was contest my diagnosis and lie about symptoms I didn't even have. I was obsessed with my diagnosis and I talked about it constantly.

Before I entered this industry I didn't feel like this. Nor was I a liar. Everything I believed in and stood for got lost in the mess. Apparently it wasn't okay to be a bit different. My flawed personality needed an overhaul so I could conform to society and be and feel like the majority.

Therapy can really screw a person up.

I find most professional ethics topics only center around major obvious transgressions like sexual exploitation or dual roles. Much discussion is about defending against legal actions as opposed to concern about harm to those in the clinicians’ care. And I see almost nothing from a client viewpoint or even a real-world common sense viewpoint.

It’s been a while since I read this book. But I recall it was recommended for exploring the dynamic leading to sexual exploitation, actually more harmful than overt transgression in the author’s view.
https://www.amazon.com/Sexual-Abuse-.../dp/0802081061

It’s crazy, I have to warn clients before we even start- if you disclose any abuse I will have to report it. Talk about silencing women and abuse victims. It’s absolutely crazy. It does so much harm and as a client before this came into action if it happened my t went and reported my abuse I would have been very angry, distrustful of her and the system and very suicidal.

I agree with everything you have said here. I can’t agree or disagree with your experience but I wanted to add I experienced something similar with my first t. It was so heartbreaking, she was always whittling on about how it’s ok to say anything and how she practised unconditional positive regard but neither of those were true when I told her I loved her. She couldn’t wait to get me out the door.
I started my training to be a t after this because I wanted to learn more about how people fall in love with their therapists. It is barely mentioned in training and I have done training with 6 different schools. Of course I brought it up and was always reminded of ethics and of course I argued what about the client? It went to deaf ears.
As far as I can see there is a huge problem with discrepancy. There are two messages t s are fundamentally thought that contradict themselves.
Self care and unconditional positive regard. A lot of ts see self care as protecting themselves against any lawsuits or wrongful or unethical behaviour which of course doesn’t allow for unconditional positive regard.

I was actually shocked by the amount of ts who I met who would throw clients under the bus to protect themselves. It made me physically sick and I have lost faith in ts over the years and sometimes I question everything about therapy. I bring it to supervision all the time and my supervisor like that I question everything and have my own personal ethics but sometimes it hurts so much to see people practice who have no self awareness and do not care one iota about their clients. It gets too much at times and I lose hope. I have met some really lovely ts too who would go to jail for their clients so it goes both ways.

Thanks for sharing your experiences. Yeah, I think it's difficult, because therapy is creating this power structure and so if a client is not given the respect that they are supposed to be given by default, then the only choice, while in that therapy, is to adapt to whatever behavior is rewarded or punished in that environment. Much like children learn to adapt to the rules of their home environments and learn what their parents will approve and disapprove of. It's just a fact of human psychology that people adapt to their environment. It can be really hard to resist these factors when you are put in a position of powerlessness.

Therapy is presenting this system to people, disadvantaged people who really need help, in this kind of "take it or leave it" way, you play by their rules or you're out, and it's cutthroat, and it does change people, it does cause people to behave in ways they never thought they would behave, which can devolve into the dynamics you see in cult-like organizations or pyramid schemes, etc. It wasn't supposed to be this way, therapists are not supposed to be mercenaries. Not all therapists are, the problem is that the ones who are, are completely unchecked.

I know that was the case for me, I found myself obsessing over small things, little details I never cared about before. I found myself becoming so conscious of how I was presenting myself and how I was being received. So conscious of the subtle interplay of emotions. And it definitely changed me. It made me weird. I don't like the way I was back then. I was very lost, even though I had perfectly good intentions.

Thanks, I appreciate your sharing your insider experience with this issue.

It seems like this is the common factor people are finding in this problem... that question, "what about the client?" Is frequently the last consideration. Which is so wrong when this field is only supposed to exist in the interest of the client. Granted, you even have professionals like your first therapist, and like my therapist, who fully intend to be serving the client, and they still create these harmful situations. Because they are serving their idea of the client, a notion of a person who fits into their model of what their job means, and not the individual(s) that actually sit in front of them. So what they are doing is they are asking their real clients to match their idea(l) of a client, they are not adjusting their ideas to match the reality, but the client is a real person, not an idea, not a meta-case. Treatment should have firm principles that also adapt to the circumstances of each individual, whatever they are.

And it's just like, whether or not the client will have a good experience, it's so dependent on who the therapist is. There is so much power and control put into the hands of one individual and it's a level of power that most individuals are just not capable of wielding responsibly. Not even if they tried, it's not even necessarily about them being bad people, they just simply are not capable.

When you talk about self care being about protection from lawsuits etc, it seems like the focus is all on remaining in control, maintaining the bottom line, the survival of the industry itself, and none of the focus is placed on prevention: actually understanding why these things are happening and how you can prevent a client from reaching the position where they want to file a lawsuit.

I feel like that prevention mindset, I mean, that's supposed to be the focus of this field in the first place, this is supposed to be about understanding people, understanding behavior and mental health. And so often it's the exact opposite. I can only imagine how heartbreaking it must feel to see the state of this system from the interior when you yourself have been failed by it.

All I can think is, something's got to give. This is really unsustainable. I want to believe at least that much. There is a lot of injustice in this world, that's a fact of life I guess, but there's something especially gross about injustice that is posturing itself as a source of healing and a reprieve from pain. I like to believe that humanity is better than this, and that empathy and humanity win out in the end.

I agree.

Abusive relationships and trauma are very complex. Look up trauma bonding or even the repetition compulsion. It happened to me. I could ask why I ever went back to therapy again after the initial trauma and I can say I forced myself to go because I wanted to heal my trauma and I wanted to challenge the belief that every therapist was unethical. Unfortunately for me, my individual therapists were extremely unethical which led me to researching what is called Institutional Betrayal; a common issue in healthcare.

Not everyone responds to abuse in the same way. Learned helplessness and the fawn response to trauma and danger or threat is quite common in trauma survivors. They also happen to be extremely vulnerable and at times, easily manipulated. Therapists learn what their vulnerabilities and triggers are and some will intentionally manipulate them to keep them around. This is especially the case if a client has attachment issues. Therapeutic relationships can grow into extremely unhealthy tangles of drama similar to romantic relationships; leaving the relationship hurts and so does staying. You ask why would anyone stay with an unethical therapist; perhaps that is something you will never understand until you are caught under the spell of an unethical therapist... Why so some battered housewives protect their abusers and stay with them? Why do healthcare professionals continue to work in and stay quiet about all the unethical and illegal abuses in the healthcare system?

My guess is fear plays a role, albeit, not the only role.

Thanks,
HD7970GHZ

I think it's fair to say that my last therapist didn't intentionally keep me in an unhealthy relationship, but the tangle of her (unresolved ) trauma and learned responses and mine apparently could not be resolved, she felt, and she terminated the therapy. I was willing to go forward to try to "fight it out", but she was not willing/able to do that. So that termination felt like a personal rejection as well as professional incompetence, to me. Perhaps that was a matter of the "bad fit"? But how on earth could I have had any inkling of that going in, when clients are so 100% encouraged to "talk to your therapist about your feelings". Again, from my perspective, it is a scam that I could not have found out about except by going down that road and being conned.

OK, maybe, that repeats things from my family of origin, where I, along with the rest of the family, and in order to "belong" in some sense with all the rest, kept up the con that we were all, or mostly, "good".

Maybe it took me being conned by therapy, for 55 years off and on, in order to fully "get" that? And to see/feel how punitive in my family it was not to go along with that program, that if/when I spoke my truth I was, and would be, rejected? A life/death situation -- really, I can consciously feel/deal with it now, but could not for so long. And, of course, it's not really life or death now but as as child, to be rejected, . . .or, for me to shut up and put on blinders for the sake of survival. . .a good, if difficult to reverse, choice at the time. Some may criticize that or have made another choice. But for a 5 year old, on her own, to try to survive, that was the one I made.

So then. . .as entrenched as my pattern was, would/could I ever have seen the con in therapy if I hadn't read comments here on PC from people who did not have the attitude that therapy was all good, all the time, which the therapy profession, and general society, still seem to promote? And that I could have a chance to survive if I didn't choose to see my family, or therapy, as "all good". I am still working hard at that dilemma. I can survive physically without being accepted by my family or anyone else, for that matter, but it's a horribly miserable existence that I still have little knowledge or confidence about how to do differently. And nobody in the mental health profession that I can find even seeing or acknowledging that part as an issue.

As I see... So much of you have been there...

Also me.

lunatic_soul, what your T did was absolutely unethical and even T's would see that straight away. It's explicitly stated in the last code of ethics I was reading that they cannot end therapy for the purpose of pursuing a sexual relationship. You still came to him as a T, and then he did this to you -- that is very wrong.

I'm sorry you're suffering like this.

I hope you can find help from a good T. If your current one isn't helpful I hope you find another soon who can help you.

I am so sorry for your loss. I apologize for not responding sooner to this. I hope you are taking good care of yourself.

Thanks,
HD7970ghz