Psychodynamic made me worse

What if someone has weak ego strength?

No, what I described is the therapy making someone worse, and your insistence that it's not possible still perplexes me.

Yes, it's also possible for therapy to make someone feel worse for a time or be difficult to handle but actually be helpful and healing. But like anything powerful enough to help people, therapy can cause harm too. Sometimes because of something not entirely connected to the therapy technique itself (like boundary violation or abuse by the therapist) but it can also be a therapist doing "acceptable" things that are bad for a particular client (like insisting on delving into topics that destabilize someone, and not paying attention to signs that they need more support right now and less uncovering), or using psychodynamic technique poorly (like gaslighting someone by labeling every disagreement a defense).

There are definitely situations where discomfort in therapy makes people want to discontinue prematurely and to their own detriment, but no one is helped by insisting that a particular therapy can't cause harm. I'm currently in therapy that's intense and difficult and painful but that I'm confident will ultimately be rewarding and healing, and I'd be worse off in the long term if I quit. But I've also been in therapy that made me feel like crap because it was harmful and bad for me.

I would like to know how having a weak ego strength contributes to being harmed in therapy too! That’s blaming the client and also shaming them for being hurt!

This is a key question. From my research I do not think therapists know very well how to help with this. And from my personal experience with therapists, they certainly did not know how to help me -- or, if they thought they knew cognitively, they certainly couldn't/didn't do it in "practice".

This is a big part of why I think that therapy was harmful to me. My "false ego" at least held things together. Tearing it down or, another way to put it, encouraging it to fall apart, without anything to replace it, without any clues about how to build an "authentic ego", or help it to generate itself -- all that was damaging to my ability to function in life for many years. And I don't get a chance to get those back.

We have to be aware that anything that causes ongoing stress and anxiety has the potential to ruin health and well-being, your gaslighting notwithstanding.

To be honest I don't know. The student therapist who was aged 37 unrelated information. But showing he wasn't some late 20 year old.
All he told me it was psychotherapy. My new therapist told me what he did was psychodamnic therapy.
Which I wad never told by the student therapist.

All he told me the student therapist was to sit with your feelings. How if I feel down to wrap a tight blanket around me and look at a giltter jar. There was no focus on any of the therapy sessions. It was just sit there and talk. But my new therapist will write down whats our agenda to talk today.

When you say analysis what do you mean?

Psychodynamic therapy definitely made me worse because it literally taught me how to be a depressive. Instead of focusing on using my strengths to build a future, therapy habituated stagnation around my deficiencies, victimhood and life's negativity. That was in addition to the enfeeblement enforced through subsuming myself to the guru-performance of the therapist.

Instead of helping me with social skills it taught me to expect the world to cater to poor victim me, just like the therapist did.

I personally don't believe in the steam valve theory of releasing memories or emotions. I thrashed, cried and remembered every rotten thing. I did not once run away, not talk or back away from the worst pain imaginable. I didn't want prescriptions because I didn't want to blunt anything. I did this while maintaining executive full-time jobs. But rumination only led to my more rumination.

Tana Dineen explores this in Manufacturing Victims.

I don't know how anyone can characterize those who find therapy damaging because how can anyone know the inner workings of the universe? This is one of the main criticisms I have of the psychotherapy field. Royal decrees are issued about causalities no human being could possibly divine.

This is exactly what it was like for me when I was in the children's hospital mental health program. Everything about me was bad and needed to be repaired. Dependence was emphasized and so was the (mis)use of the emergency department. All this along with misdiagnosis and medication made me I feel worse.

It is still hard to believe that I let myself get lost in that ****. That was the only time I ever let myself get vulnerable like that.

Bad therapists are like tool makers. They make all the required tooling for a production run.

Well-said. #MeToo

I got involved in therapy when I was 15 and was starving myself. "The family" couldn't ignore/deny that and I went to a mental hospital. Mental illness is a good way, probably, to characterize what was happening with me, but the consequences and effects of "treating" me like that were not understood, and still aren't. They offered an alternative identity to the "perfect", hostess, eventual wife, mother caregiver that I was expected to be -- or else. And of course I was not those things, and wasn't that interested in that kind of life anyway. Didn't suit my temperament.

Being a "mental patient" was a way out. I took it. Didn't know any better, and wasn't "helped" to know better, either.

I agree with misbella's criticism about focusing on the negative in some dynamic therapies. I don't think it is the case for all Ts who claim to practice psychodynamic but definitely for some. This is one of the reasons why I grew to dislike psychoanalysis, for example. My analyst even projected lots of negative stuff onto me and tried to convince me that was my life experience. Almost like trying to create false memories for me, based on his dogmas. I also very much dislike when Ts excessively emphasize whatever bad things our parents did to us. Of course there can be truth in it, but when exaggerated, I think it is shifting blame, reinforcing the perception of being victims of circumstances, instead of focusing on individual adult responsibility and how to try and create the best life with whatever backgrounds we have. People with conditions like depression, anxiety and low self-esteem already tend to focus on the negative too much and deny their own strengths and successes. Therapy that dissects those things endlessly will likely reinforce it even further and make it even more ingrained. Then there is the focusing too much on the client-T relationship, especially conflicts, in some cases and the clients real life goals get lost.

I know someone who was in psychoanalysis and reported that years of her therapy (3x a week!) were mostly a gigantic never ending grief about all the things she did not have in her childhood and in her personality. The therapist tended to challenge her using that mechanism, e.g. how could she be more successful with that traumatic background and upbringing, she will never meet her ambitions because emotionally is just too broken. She seemed to like that T a lot, saw and called her as her "new mom"... a strong maternal transference to yet another negative mother figure! I was in close touch with her throughout the years of that therapy and I really never saw much improvement in her life and emotional coping, more just endless cycles of trying to get better but sinking back into deep depressions, lack of responsibility, unreliability, procrastination, rinse repeat. One might say that this person is probably too far gone, maybe that's true, but the years of intense therapy of that kind did not seem to help her at all (I knew her also before), more the opposite when viewing it with more objective measures. But she was very attached to the T and did not even consider leaving - she clung to that attachment and all the grief about her past instead of really working on improving her life, and destroyed some great opportunities for growth and success by neglecting real life and responsibility, alienated many people who tried to help her and rescue for a good while, etc. So, ultimately, her therapist's feedback became a self-fulfilling prophecy.

Also, I think many therapists adamantly express how much they dislike labels and pathologizing but, ultimately that's what they do. Even the T that I liked a lot as a person and who advertises his work as firmly rooted in the present told me repeatedly that I was so unusual in so many ways, he was unable to use his normal techniques with me. Also once that I probably have such a complex set of predispositions that, unless there was some kind of medication affecting all those different things at once, I will never be normal. I am not a negative person in general and did not feel hurt about that comment but found it rather odd from a T, even if it is true, the way it was phrased. He also said when I quit therapy with him that it may not be a good decision - again, all those predispositions will likely need more long-term attention and I have a strong need to investigate things, it will not do good to deprive myself from that. But why should I deprive myself? I can do it myself, with friends, colleagues etc as much as I like. The truth is that I am doing much better without therapy (now >1.5 year) and am dealing with my *** instead of thinking, fantasizing and talking about what should be and overanalyzing everything the way I habitually used to. Psychodynamic therapy appealed to me a lot at first because it is supposed to do just what I already love to do and tend to use as an escape and distraction, sort of a form of self sabotage on its own.

"Research by Lester Luborsky, a clinical psychologist at the University of Pennsylvania and author of ''Who Will Benefit from Psychotherapy?'' published this fall, provides more reason to treat the matter with some urgency. He has found that up to a tenth of all patients may actually be harmed by therapy - their problems get worse or they end up frustrated or unhappy with the course of treatment."
https://www.nytimes.com/1988/10/09/m...t-and-why.html

''Patients need to be reminded over and over that when therapy is working, there will be times they don't feel it is helping them at all,'' says Luborsky. ''It is those times that can be very fruitful, if you talk them over with your therapist. What may seem like the low point in therapy may actually turn out to be the most productive.''

I love this logic. The most negative is the most positive, and the person most affected is the least qualified to assess it.

Thanks for mentioing.the book
I will read that book

I agree - I see that a lot here too. "It's gets worse before it gets better". What happens when it gets worse and stays worse - for years? The client is supposed to "just hang in there".

I think another thing to consider is, therapy doesn't even have to obviously make you worse to be harmful. It just has to not make you better. Getting stuck on a solution that doesn't solve a problem already IS making things worse. There's an opportunity cost associated with this as well as a financial one, to say nothing of the other resources depleted in the process.

Therapy can have a way of breaking the feedback loop. When someone goes into therapy, they are saying "I need to solve a problem." If therapy does not do that, then fine, sometimes solutions fail and you learn. What causes real harm is when a solution fails yet is not learned from. Bad therapies keep people stuck in a cycle of non-solutions. They are spending potentially unlimited energy solving a problem that never gets solved, that definitely IS making the situation worse. In my mind, that is the definition of a bad situation--one where there is a problem that cannot or will not be solved.

ETA: On the other hand, you can make the argument that if the client doesn't specifically know what problem they are trying to solve, they won't know if it is being solved or not. Sure, there's always a way to frame it as if it's the client's responsibility, therapists often say things like "you have to WANT to get better. You have to take an active role." Some therapists even go so far as to specifying who their "ideal client" is. Well, the thing is, paying the fee for therapy is already implicit proof that you want it. You want it, you just don't know how, and what you're supposed to be paying for is for someone else to know how. When the therapist doesn't actually know how, this whole situation falls apart.

The way I see it, therapy can only be said to actually "work" in the situation where a therapist, or the therapy structure itself, actually possesses the ability to one-sidedly CAUSE the client to get better. Most therapists definitely do not possess this ability, so most therapies cannot be said to "work."

For example, if you go to a doctor, and you say, I have pneumonia, that doctor will prescribe you antibiotics and those antibiotics will force your body to recover faster. There is the issue of compliance vs. non-compliance, e.g. not taking the antibiotics, but the equivalent in therapy is more like, not showing up for appointments. So long as the client is compliant, therapy should more or less always work, or I would question its legitimacy.

Exactly. Totally nuts.

It's a built-in contingency and it's doublethink...
If you are feeling bad, therapy is working.
If you are feeling good, therapy is working.
Therefore, therapy is never not working.

This was exactly true in my case. I only knew myself as a square peg, feeling on the outside looking in. Life didn't feel like it was working. But how do I break that down into actual goals? The therapists couldn't figure that out any better than I could. All they saw was the eager compliant, polite client; they didn't see my social or career dynamics.

Over the years I've felt better with time and experience. First I realized maybe no one lives inside a Pepsi commercial; everyone fake it to some extent. Then I felt more competent and assertive through accomplishments. And I've accepted that I'm fated for an out-of-the-mainstream life.

I thought I was "working hard" at therapy, but it only set me backwards. I sincerely wanted to change and I did, with therapy an obstruction rather than an assist. Therapy definitely was an inaccurate feedback loop.

I´m just now considering ending psychodynamic therapy. I´ve been in therapy for almost tree years and not really improving. In fact, my symtoms of PTSD are worse, and especially so the last year. Life has become a living nightmare because of all the intrusive thoughts, the fear and the stress. I´ve also experienced depression like I never before. And my OCD, which was very, very mild in the beginning of therapy, is now (since the last 18 months) really bad.

My therapist tells me this is natural and happens in all psychodynamic therapy. Sort of a "dark night of the soul" or a "healing crisis". I really kind of like my therapist and I´ve - up until now - felt safe with her. So I trusted things would get better, for years. It´s just that its been going on for so long. And the last year has been awful. She also told me in the beginning that therapy takes time, but that I most likely would feel better within a year. It´s now been three years!

I´ve never really questioned the therapy up until now. Instead I sort of blamed myself for not being a good och strong enough client. My therapist tells me that I should be able to expel the intrusive thoughts in my head by just telling them no! It never really worked for me. I also blame myself for not being able to calm my hypervigilance and catastrophic thinking, which can go on for days or even weeks. Perhaps i´ve not done a good enough job att emphasizeing with and taking care of my "inner child". My therapist tells me, this is key. A week ago though I added the natural supplement L´thenine to my diet, and 50 % of the intrusive thoughts and fears went away. I was able to function again.

I can also relate to how therapy, at least my therapy always focus on the hurt, the problematic and the negative. You sort of learn to be depressed. And the constant victimisation of self. Therapy has had its benefits thoug, i think. I´ve learned to recognise destructive people and relationships and keep away from them. But then again for me it´s also been the case that I tend to over ruminate over everything destructive and not focus on the positive. My therapist tells me that when we first met I was more of a "girl", and that I´m now a "woman"! Maybe there is som truth in that, but it has also come with I high price I think. And personally I certainly did not feel like a girl before and I´don't feel like a women now. Before I started therapy I was working out regularly, fixing my house, renovating, always keeping tings clean and tidy. These last years I´ve been so tired that every chore has become a struggle.

A few weeks ago when I was feeling especially low (my mom was admitted to the hospital and another close family member was also sick) she told me that there was no order in my life and that I should make I plan for my life (she now introduced CBT). In five years time, she said, I might be healed enough to be able to get into a relationship. That was a red flag for me! Although I was low at the time, felt hopeless and had no confidence, it still felt unrealistic. Actually it made me mad. I´m not that crazy and I´m not that hurt. I did make a plan for my life, and I decided that I wanted to feel better, get out of the living nightmare and depression. These last weeks I have been thinking about the therapy and that maybe it is making me worse. Reading your thoughts on the subject made me feel empowered and less alone.

Marywill, I relate to much of your experience; therapy only dropped me in a ruminating stew with no outside world benefit. It made me hypersensitive to others’ slights, but gave me no effective tools for coping except distancing.

I think the fallacies in my case were both the negative thinking and the therapist acting like a guru, a magical authority who knew everything about my life and life in general. It wasn’t until I got distance that I realized that no human being possibly could have the knowledge they claimed.

Incidentally an early responder to my blog is from Norway. I understand she contributed to a journal and is a mental health activist. I revised this post to paste her link.

PS best wishes for your family’s health.
PPS I found Sigrun’s blog in Norwegian. I believe she translated some to English for those of us who don’t speak it, or we can use something like Google translate.
https://stomm-blog.blogspot.com

An article from Sigrun
Tidsskrift for Norsk psykologforening - Når terapien skader

And the English translation
Google Translate

my experince of psychodynamic T was eerily similar to yours marywill. i spent many years not getting any better and actually was becoming worse in my overall symptoms and dysregulation. for the first time in my life, i started self harming to cope with the overwhelm of what therapy was bring up, including the transference and counter transference from the rocky relationship with my ex-T. although there were some positive outcomes and progress from therapy. especially in the beginning, it eventually got to a point where i felt i was spiraling downward, becoming increasing hopeless and suicidal.

all you wrote here resonated with me, especially the part in bold. the longer i tended to stay in what started to feel was an unhealthy and unhelpful therapy relationship, the less 'living' i felt i was doing with my life. i felt hopelessly stuck and wanted to move forward with my life. psychodynamic T definilty was not helping me with the 'moving forward' part. it was at this time that i knew i needed to try something different and i discovered neurofeedback therapy and how helpful it was for truama, especially developmental truama or CPTSD. for me, along with the encouragement and never ending support from my spouse, doing the NFB was successful in helping to calm many of my trauma symptoms, especially my emotional dysregulation and self harming. i finally started feeling good enough about myself and gained the courage to work towards ending therapy.

i've been out of therapy for over a year now and feel pretty content about my life. i feel like i experince a life that is pretty damn close to 'normal' and can honestly say that i finally have learned how to fully accept, embrace and love myself. i don't have the same fears i use to have prior and during my therapy experince.

good for you! a similar anger and frustration is what strongly motivated me to seek a change and to start finding better ways to help me get unstuck from the muck of misery that my life had become while doing psychodynamic therapy. just know that you are not alone. i wish the best for you and encourage you to find the way to help you start moving forward in your life.

Thank you koru-kiwi and missbella for sharing you experiences so similar to mine. It was such a relief to read : ). My therapist told me a year ago I need at least 150 hours of therapy for long lasting effect and improvement. Well I´ve almost had that many sessions and I´m feeling nothing of the kind. Reflecting back, I think one year of therapy might have been enough. Not three years. The last two years I have really developed a nasty OCD and the intrusive negative thoughts are awful. I have a hard time trusting people and I always believe that the worst is about to happen in any given scenario.
When I´m at work I usually feel better (although not good), but at home alone the nasty thoughts take over. I can also relate to really starting to self-destruct, especially this last year!

I´ve told my therapist that I need a break and I´m now two weeks out of therapy and I´m at peace with my decision. I´ve confided in a few close friends and their support of my decision to no longer se my therapist has been great. This helps a great deal whenever I feel doubt or I am unsure about my decision. The last weeks before ending therapy was so bad, especially the hypervigilance, I felt I could never, ever relax.

I feel that for at least the last year therapy has been more of a hiding place than I place where I go to learn how to deal with life in a constructive way. And I also wonder what is has done for my ability to form close, trusting relationships with other people. For I long time now I have felt that I was only able to trust my therapist. Everyone else would let me down or would not understand. She was my closest relationship and I told her everything. Maybe this is helpful at some point, but not going on for years and perhaps shutting other people out of my life.

I also wonder if the relationship with the therapist really can be seen as a “real relationship”. At one time, when I was feeling like no one liked me, she told me “But I like you” and I can “re-parent you” (because my mother was lacking in some aspects). And maybe she does and maybe she can! But the thing is, I pay her a lot of money every week to be in session with her and for her to say that. Being in relationship with people who really care about you with your best interest at heart, without me paying them, that is true healing.

Marywill, I think the "evidence" is that you feel better now that you've left the relationship. May you continue to feel better.

Though Sigrun hasn't responded to my blog in a while, I notice she has a contact form on her blog if you're inclined to try to reach her.
One blogger, disillusioned by therapy, wrote about the virtues of real life healing.
https://trytherapyfree.wordpress.com/

i did similar...i took a 6 week break and leading up to that break was the most chaotic time ever for me. i was spiraling downward, hitting rock bottom, becoming suicidal. i knew if i did not stop, take a step back and catch my breath that i was probably going to end up dead. my ex-T overall seemed quite oblivious to what was going on at the time, even though i tried conveying it countless sessions prior. he pulled away, became defensive, and seemed to take it personally when i took the break. it was quite 'freeing' when i took that break. as if i could actually breath again and was not struggling day in and out to stay afloat. when i returned, i told him i wanted to cut back my sessions from twice a week to once, which definilty helped. it provided me more time between sessions to actually get a break from the chaotic intensity so i had more time to actually start living a life again instead of living session to session.

this is so spot on! therapy was 'sold' to me as a way to replicate authentic relationships with those in the real world. that the healing i would experince in therapy would provide me with the opportunity to learn how to have connecting and authentic relationships with others. i now see that statement as rubbish and bull cocky!! the truth is, therapy is a one sided, non-reciprocated relationship. how do we learn to have authentic relationships when the therapist can not and will not reciprocate on the level that some of us need them too, to learn the relationship skills we never fully learned growing up? i've come to realise that most people in the real world will never be as vulnerable and authentic with me as i was with my ex-T and those i have tried to be authentic and vulnerable with usually vanish in the end because they are too scared to go to those levels of vulnerability. it's a disheartening and disapointing realisation to come to terms with. the only person i have been able to do this with is my husband, but we already had established a pretty close and vulnerable connection prior to my issues that brought me to T. the only thing T did in this regard is to help my husband understand me better because i was finally understanding myself and was able to communicate that to him.

i hope your break goes well and provides you with the opportunity to really reflect on what is going on in therapy for you and what it is that you are wanting and needing from this relationship with your T. all the best

An interesting article, thanks