Does your T tell you about possible 'side effects' of therapy?

Yes. My current therapist has spoken with me about the "risks" of therapy. She is a wonderful therapist in every respect except one. Since we started therapy about 5 months ago she has cancelled twice on the same day we had an appointment scheduled. The first time was no big deal, but the second time was after a really intense session. I very much needed to see her to finish processing the previous, very important session. So...she cancelled the morning of my appt. I thought, Wow, this is weird after she talked to me so intently about "risks". Then I worried about the possibility that she's ill or something.

Anyway. That's my t "side effects" story, lol.

i would not have thought of therapy as a 'drug' when i first sought it out, but it did not take long for me to start reacting and experiencing therapy as if it were actually a drug and i could not wait for my next 'hit'. i was so enmeshed in the relationship with my T, drowning in the transference (and my Ts counter transference) that the relationship was stirring up that all i could do is obsessively think about non-stop was my therapy and what was going on between my T and me. the time in between sessions (i was going twice a week) usually was incredibly excruciating. my T never warned me of this. it felt like absolute madness and looking back, i can clearly see that it was the most unhealthy thing i could be doing for myself to help overcome my past traumas.

i know i am not the only one who has experienced therapy this way...just look at the majority of the posts here that people make about therapy and their Ts. people are completely hooked on it...

I don't think that my therapist, or anyone who works with mental health in the NHS, has ever had the smallest fear that "business will suffer". Over the last few years it has unfortunately become a regular event to hear in the news about someone who took their own life - and more rarely, who harmed someone else - because they were in urgent need of mental health treatment but none was available for them. Even more common is the story of suicidal or very disturbed people being held in police cells because they are in need of a place of safety but there is no mental health bed available in the whole country, or children and teenagers being treated as inpatients for serious mental illness hundreds of miles away from family and friends because of the difficulty of finding a bed and the scarcity of mental health resources. The experience of someone suffering and not being referred to outpatient treatment such as therapy because of rationing of resources via GPs is a totally normal experience for many people and not even newsworthy.

Much more pressing than a worry that "business will suffer" must be a worry that therapists trying to manage in this situation could feel overwhelmed, try to take on more than they can handle out if a natural desire to help, and burn out. I think they are very aware of this danger and of how to be vigilant with regards to their personal wellbeing.

I imagine a possibly similar but much worse impression of being completely overwhelmed by need after the demobbed troops returned home after the First World War, which began the origins of psychiatry as a serious field of medicine in this country I think, and probably in many others. To see so many people completely incapacitated and unable to function in daily life because of the trauma they had experienced must have been a frightening and overwhelming experience - and if course that terrible trauma had been experienced by almost every man of working age in the country. I incidentally think it could have been the origin of trauma passing down in my own family - a great-grandparent joined up in 1914, spent all four years of the First World War in the trenches living side by side with death etc., and then came home completely unable to work or to parent his own children. Which children then grew up, having suffered because of their parent's problems, and had great difficulties in parenting their own children. Etcetera.

Yes, some people experience intense attachment to their therapist when attachment wounds are activated. I know it can be very dangerous and destabilizing when this happens and if it isn't appropriately addressed in the relationship. I don't see that as a "side effect of therapy" so much as an attachment wound that is brought sharply into focus through the therapy experience. Therapy doesn't cause it. It just amplifies what is already there. But I think only a small subset of people have that kind of experience.

You've made a very good point about therapy amplifying what is already there and probably needs to be addressed and dealt with.

I'm not sure, however, that it's a small subset of people who feel the way Amyjay described she felt. I think that many more people feel that way, even though they might not speak out about it.
Many years ago I was in therapy with a psychologist. We had a very strong therapeutic relationship. For the 6 years I was in therapy I pretty much lived for the next appointment. I had plenty of other important and meaningful things going on in my life, but that hour every week was a main highlight.

After all the years of therapy I'm not sure I consciously resolved many issues - but I did feel that my therapist had reparented me to a point at which I felt loved and cared for. I felt like I had finally had a "father" who was stable and secure, and who nurtured and protected me. So that was one HUGE issue to which some peace was brought.

The one thing I wish I could have done differently was that I felt a strong sexual connection to my therapist. I was quite sure that he felt the same way about me.The relationship, thankfully, remained very professional. In no way did I have the courage, however, to bring up my sexual feelings for him. To this day, decades later, I remain confused about those feelings to the point at which I even dream about them sometimes.

What is the best therapy approach to intense attachment to a therapist? Is it therapeutic for a T to become rigid with his boundaries and go no contact between sessions or does it help to have interactions between sessions? I can never understand what helps with this attachment issue.

My ex-t contacted me more than I contacted him for two years and it really helped me. This T allows me to journal to him but will not respond on weekends but respond weekdays and it helps.

I don't really know, I am not a therapist. From what I see and read I think it would be logically best for therapists to not encourage this to happen. I don't think they should encourage dependence on themselves at all, it really can't lead to anything good. At the end of the day the therapist can't be there for a person so from the outset I think the healthiest therapy is one that focuses on building up the clients own resilience and coping and self-soothing abilities and keeps the therapist as somewhat personally unknowable.
I just think the therapeutic frame has to have air tight boundaries that are clear from the start. Its a hard call, because of course there will be a whole lot of clients that would say (and rightfully so) "but there has to be flexibility!"

At the end of the day there is no human endeavour that is without risk.

Theoretically, I agree that it would be good for a T to discuss potential side effects at start, like with medications. However, then comes the question exactly what side effects to mention. I think that is tricky for therapy as people can experience a great variety depending on their individual backgrounds, issues etc. For example, I never had the very common relational trauma/attachment type effect that many people here on PC report but had one that closely relates to my own specific issues, using therapy as a distraction. It really got in the way of both improving my everyday life and effective discussions with the Ts. I only very clearly realized what was going on by the end of my work with my second T and now I don't think it is uncommon at all.

Realistically, maybe Ts could discuss potential side effects in quite generic ways though and emphasize that it is hard to predict what will come up with whom.

She didn't. I wish she had, though. Even after over a year of being in therapy, I'm still going through maternal transference. I've discussed it with her, and she's pretty understanding about it.

Sounds a lot like reliving trauma. The fact that they don't bother to alert people to this possibility... speaks loudly to their shady and reckless methods. And if it goes wrong, they can blame the client, per their training. They are covered on both ends.

I think they also avoid speculating about adverse effects because they know so little about the subject. Look at they say and write. The ones I talked to were almost entirely clueless.

My T just had me slow down/think about if I wanted to continue talking about a subject because she said she was afraid it was re-traumatizing me.

Also, as I was leaving therapy today she said "Yeah, there a ton of wackadoodles out there," in terms of T's.

The only good T I have seen so far is very informed about issues that might arise. He told me in my first session possible emotions that might come up (such as hating my friends, family or him, paternal as well as erotic transference and similar). He told me what we could do in such situations, and he encourages me to talk about such things whenever he feels necessary. If he triggers trauma responses he notices, knows how to calm me down again and knows how to relate it to my past so I don't feel that it's actually him causing stuff.

Of course he couldn't mention every possible response to therapy that's out there. But he mentioned enough that (and kind of said it too) that I felt that whatever I can possibly experience is normal, and that it can always be talked about.

I have never been blamed for anything I've felt or experienced. If I say something hurts me, is not working or that I have a certain reaction to something in therapy, we will work together to make that better and understand it.

i agree with Budfox...the retraumatization due to the activation of the wound/truama because of the therapy or the relationship and it not properly being addressed (by the therapist) is the 'side effect' of participating in that therapy.

I've always felt better and in my opinion improved, when he was a little more flexible and less rigid. How do we foster the right environment for babies to develop a secure attachment in the first place? By keeping them close and responding to their needs... yep, boundaries are important but I feel they are harshly overstated... at least in my therapy. It only replays the cold rejection that I've already experienced. Perhaps I would be better off with a kinder, warmer approach, like person centred therapy.

I have seen 12 therapists, some for a couple of sessions, 2 or 3 for just one session and three who I saw respectively for two and a half years, two months and four months. Not a single one of them ever mentioned "side effects" about therapy. In fact, I have literally never seen on any therapist's website the mention that therapy could potentially not work. And I have read a lot of therapy websites. I think that therapists should absolutely be transparent. But I see two problems with that. 1) that would recquire therapist to be self-aware about the limitations of therapy and as I wrote above, it seems impossible since they are absolutely convinced that therapy always works, it's a religion for them and they won't budge 2) would clients listen? when people hear theoretical risks they often dismiss them because it's theory and they just think "oh it won't happen to me". After all, people STILL buy packs of cigarettes despite the fact that it's well-known that smoking causes among other things lung cancer. The reasoning is: "it won't happen to me" or "I'm not like that".

yes. he has a form that he has new clients sign and it includes risks and talks about the emotional fallout

He has a page about informed consent in his new client packet. When we try something new that could be distressing to me, he brings up potential bad outcomes so that I can make a decision whether to continue on that path (sometimes I do, and sometimes I don’t).

How many people have become suicidal or put into extreme distress because of mental health treatments or therapy, in part because they did not anticipate therapy itself becoming a source of distress? Not much coverage of that in the news (or anywhere). Not saying warnings from therapists about risks would necessarily head off disasters, but could make a difference.