A Former (Hurt) Client Thinking of Becoming a Therapist...

I made a general assertion in response to a general question. Also, the accountability problem is a general problem. Thats' the whole point. It's endemic. If you want evidence, look around. It's everywhere. In terms of the impulse to put failure on clients, start with your own post. If you are so concerned about this, maybe start a new thread.

As one former psychoanalyst said:
"Blaming the victim... is the hallmark of psychotherapy."

I don't think it's malicious in many cases. More to do with inability to think independently and critically (and ego problems). And it's about keeping the faith. If the therapy bible says thou shalt blame the client, then you blame the client. If the bible says that a client who refuses to get better is a sinner who must be cast out, then be gone ye sinner! That's what makes therapists so terrifying... their religious-like conviction about the sanctity of their special relationships.

I have no idea why you quoted me or what you are referring to and what you think I am concerned about or why I need to start a new thread. What impulses are you referring to and what is therapist’s bible? Not sure what you mean by impulses to blame a client. Whose impulses? I am so confused on what you are referring to and have no idea what you mean.

I am sorry you finding therapists terrifying. Maybe starting a new thread about your concerns could be helpful. I don’t know.

I see private practise as being the place where the 'silent revolution' could take place.

Plus. Undergoing ones own in depth psychotherapy before beckoning a, therapist of any sort, is a must for me now from what I've learnt from being a client for many years.

This has not been my experience at all. Not with my current T or the previous two. I’m sorry you had a bad experience.

My T has explicitly told me it’s not my fault, and she reiterates it when necessary. She doesn’t want me to suffer and is flexible in her treatment style with me to make things easier. If I’m struggling and her current approaches are not helping, she consults with other professionals for ideas, reads, and/or gets additional training. She said that her clients have already struggled enough. If something she does makes me angry, I tell her and then she apologizes and changes her behavior without getting defensive or placing blame on my reaction. She is patient and lets me know that we can work together for as long as I find it helpful, and that it is my decision when to leave. Once I asked why she’s so nice to me, and she said because I deserve it. She said she remembers what a huge, positive different a kind and genuinely caring T can make because of her own past therapy work.

Kiwi: In my opinion, these are a few examples of things that make a therapist ethical. If you choose to go into this field, I bet you will be well-informed not only by the textbooks and lectures of your formal education, but also by the wisdom gained from your personal experience in therapy, including your awareness of both its helpful and harmful components.

Something that popped in my head is this quote by Ghandi:
“If a few drops of the ocean are dirty, the ocean does not become dirty.”

This is a beautiful post. I am glad that you have such a good provider. She certainly is a keeper!

I'm not talking about therapists apologizing for little conflicts during therapy or being nice. Such things are easy when the therapist is rewarded with money. I'm talking about failed therapy where big questions are raised and where egos are threatened.

I had direct interaction with 12-14 therapists in the wake of therapy failure. I saw how they responded. Consistent subtle blame deflecting or just general inability to engage honestly with the issue of accountability. Disgusting and pathetic. Plus i've read hundreds of client stories where clients are thrown under the bus when the s**t hits the fan. Again it's often subtle.

Also many influential therapists and psychologists promote victim blaming in their writings.

This has been my experience as well. The first thing I always wanted to discuss with a new therapist is the bullsh*t I went through with the previous therapist and how it affected me. I want the new therapist to validate my experience. That would've gone a long way in building trust. It would've let me know the therapist would have my back with any future mistreatment in any other context. And they literally do not engage you when you bring that up! There's a palpable undercurrent of disapproval towards YOU when the subject is raised. The implication is that YOU can't be trusted and whatever the issue was it's certain that YOU created it or that YOUR interpretation of it is exaggerated.

And you know what? This bleeds into other areas of your life as well, especially work. Any other ares where you're dealing with someone who has more power than you and the therapist will subtly blame you or "your childhood" or your "triggers." Never the person in a position of power! This has happened to me over and over.

And I remember being a social work student and having a client during my internship tell me how she was d*cked around at a social service agency and I immediately empathized and told her they shouldn't have done that. Because I understood exactly how she felt! When I later reported this conversation to my supervisor, I was told I shouldn't have spoken ill about this other agency. That out of professional courtesy I shouldn't say things like that. I can't remember exactly what the reasoning was but it was something along those lines. I just remember feeling like I did something wrong.

I know you've had some horrendous experiences with therapists and I'm not minimalizing them but just wanted to point out that many therapists work for free! My second T saw me at an agency for 3 years where she volunteered for free because it was a cause that meant something to her. I never paid her and she never got paid by the agency, plus she had to travel an hour down a pretty nasty road to get there. Some therapists are genuinely selfless, but I know there are those that aren't.

Btw she was an experienced t too, not a trainee!

Yeah, there are some really selfless ones out there. I was seeing a psychiatrist when I was completely broke. After I told him that I was having a hard time paying for the sessions, he got permission to reduce my fees in half from the clinic he was working for. They really wanted me to continue treatment.

So good to hear. Similar happened to me with my first T - the circumstances changing meant that technically I needed to see and pay her on a private basis, but I just didn't have the money. She completely waived the fees for several months, saying that I could pay her back once I was earning more. As it happened she never asked for it even though I mentioned it several times in letters that I wrote. She said we would forget about it. Such a lovely T she was. I was blessed to know her.

Exactly. The client is considered not a reliable witness to their own experience. That's why when therapy ends badly or abruptly, the first thing pretty much every therapist and every fellow client says is... get a new therapist immediately so that you may understand what happened and so that your distorted perceptions can be straightened out. It's assumed the client is either mentally ill, dim-witted, or an emotional toddler.

I went looking for validation also. But it's a no-win situation. Either you get some contrived validation from a total stranger after handing over a credit card, or you get the blame game. Plus external validation seeking is itself unhealthy. Once you start into this, it's a validation vortex. Dear therapist... please validate my prior therapy. Ok, now the one before that. Ok, now my childhood. Ok, now my thoughts and feelings.

That is wonderful. Such a nice and caring person and provider.

Some therapists would work pro bono in
some situations, use sliding scales, defer payments etc but some can’t if they work for a clinic and scheduling goes through the office and payments have to go through the billing department.

I don’t think mine would be able to provide free sessions, not like i asked her or had a need but I can’t imagine how’d she do that. She works for a clinic. She doesn’t charge for phone conversations or texts though, which is actually nice because I barely ever see her so sometimes phone conversation is a good thing

Overall I’d not blame therapists for accepting money as that’s what they do for a living and one has to eat and keep a roof about one’s head. I’d not expect a plumber or a roofer to work for free, and I don’t think a therapist should. It’s a job, people get paid for a job. I do ton of additional things that pertain to my job for free, but I’d absolutely not be able to not accept payments at all. I’d be living on the street and eating out of a garbage can. Most people have to pay bills.

But it’s wonderful that there are therapists who volunteer and sometimes help clients for free or defer payments. Or don’t charge for extras like mine. It makes such a difference for people

Yes, and I can see why they can't offer free services or charge less because they need the income to survive. That is why I understand why many don't accept medicaid or medicare. The pay is so small that they wouldn't be able to live on those small payments.

After my harmful therapy ended, I talked to a lot of therapists.

One guy wanted me to do 3x/week at $135 per ($400/week).

One wanted $220 per session.

One wanted $200 per session. I asked about sliding scale, she said no.

The one I had trouble with now charges $180 per session. She was emotionally unstable, and had no meaningful insights or abilities.

I consulted on the phone with a guy who claimed to specialize in ruptures. He asked for whatever fee you paid your previous therapist. For me it was a low fee (though he turned out to be useless). If you paid an exorbitant fee to your previous therapist, this guy apparently collected that fee.

No doubt there are some generous therapists but on the whole the industry seems entitled, exploitive, and greedy. And unlike other professions, what's being sold is often a sham and can't even be clearly defined.

Also, you have online therapy like TalkSpace where therapists take money from people and in return send "therapeutic" text message responses. OMG.

I don't see what's wrong with that. After all, these people are doing their work and I don't see any reason why they should do it for free. Or do you find it generally abnormal to bill a fee for ones services.

If you don't like their service, I don't think anyone forces you to recruit them. I don't think anyone forces anyone to recruit someone's services if the service and the price are not suitable for them.

There are tons of services in the world that I don't find useful and probably would find some even harmful and so far no one has pointed a shotgun to my head and said that I have recruit these people and pay for their services. I do pay for my therapy though because I find it useful for me.

Exactly, they have to make a living like everyone else. And if the price is enormously too high, people just look elsewhere.

I agree as well.

The part I take issue with are the therapists that attempt to ‘reparent’ for a fee, or otherwise create an environment that doesn’t feel professional anymore. The money can create major issues.

Things got dicey for me when I lost track of what I was purchasing, and found myself addicted and paying exorbitant fees for ‘care’ and ‘love’. I paid nearly six figures over the years to the same woman to get a ‘mother fix’ and it felt quite exploitative after the fact.

This is a straw man. I didn't say anything about working for free.

I gave examples of therapists charging what I think are ridiculous fees (for a vague and potentially harmful “service”).

Sorry, that was just a stating the reality - people (including psychotherapists) work for money. I don't know how is possible to interpret it as a straw man argument.

I'm sure anyone could bring examples of people asking or getting ridiculous amounts for their questionable activity. What is a ridiculous fee and what makes an activity questionable is all on subjective terms and thus cannot really be a basis for any argument.

That's why it makes sense to remind oneself that if you don't like the service or fee, just don't hire these people but there's no reason to expect that other people think the same way. Other people might find the service very useful and the fee very reasonable. And if no one finds it reasonable then these service providers simply cannot operate according to such terms anymore.

Agree, what’s too expensive and what’s not useful is very subjective.

That’s why generalizations that therapists charge too much or therapists provide bad service are pointless as it’s all very subjective. There is no point to deem something too expensive or useless for “everyone”’,

One should decide what’s too expensive for them depending on their paying abilities etc Usefulness is also subjective. Some find their therapist very useful and some don’t, some don’t think fees are too high and some think it’s too much.

. It’s the same with everything else in life, other services, other fees and purchases etc if service becomes universally too expensive and universally useless it will seize existing or will have to change what they charge and what they provide.

Going by how many people (we can see on this forum and I personally know ton of people irl) find their therapist useful and can afford the fee (or their health insurance can etc), we absolutely cannot determine that therapy is universally useless and is universally too expensive

We also have to remember that not everyone in this forum lives in the same country and has the same health care and same regulations. One can of course discuss high cost of health care and mental health care in general, nothing wrong with general discussion about cost, but it would probably need to be a new thread and it has to be country/region specific as again not everyone on here lives in the same country and has the same health services.
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As often happens in this forum, the topic has drifted. It was not originally about whether people found psychotherapy services valuable, or whether or not some therapists are genuinely kind, caring persons, sometimes willing to work for nothing or for very little, and willing to travel long distances in order to help people. The question posed by the OP was:

For anybody who has NOT been harmed by therapy I can understand if this is a foreign concept or idea. Not something that could ever apply to you, and therefore nothing for you to be concerned about.

But in my experience, and that of others, it is a serious topic, seldom seriously considered by people in the profession, or outlined well in any informed consent statements that have ever been given to me.

Outside of one's own experience, I think it CAN BE difficult to define what the harm has been and it has meant in one's life. When other people write about how therapy and/or therapists have hurt them, I do understand. I can empathize because I have experienced similar things. For those who haven't -- yes, I can understand that some objective criteria of some sort might help with the understanding.

But how can I write about my subjective experience in a way that would convey what it meant to me? I think there is a great need for more research that can be objectively discussed in some way, perhaps by professionals who agree on the research methods even if they can't understand, or want to deny, the subjective experiences of those who have been hurt. But it isn't simple, and right now there isn't much good research that I have found.

Unfortunately, I don't see any way that I could do it myself, in a convincing way, either. I have a little background and some training in research methods, but not recently and I don't have any credentials that anybody would take much interest in.

There have been some very good discussions about this issue in this forum, and I think I see some similarities in some stories, which could lead to some interesting avenues for research. Perhaps some people in the field, or considering going into the field, like the OP, can find some insights here, if not concrete objective criteria for what constitutes harm, and where the responsibility lies.

The OP, who knows about harmful experiences in therapy because she had one herself, asked a good question.

I'd like to see more discussion about that, if anybody has anything else they would like to add.

To my mind the ethical/non-ethical conduct and harming vs not-harming/benefitting someone are different dimensions and should be treated as such. The goal of ethical behaviour and ethical standards is to minimize harm but that really means minimizing risk and not making harming someone impossible altogether. Because whereas ethical behaviour only depends on one person - the one who behaves, harming someone involves two people. An ethical behaviour that would not harm one or many people may actually harm someone due to their particular circumstances. That does not mean "blaming" that person but simply stating that due to some idiosyncratic aspects some people might be susceptible to getting harmed in situations that generally would not harm other people. I suppose, you HT, propose to study these interactions?

Conducting research generally depends on several factors: you need to have a researcher who is actually interested in a particular topic and people/researches are often interested in certain topics due to some personal reasons. Second aspect is funding - you need someone who is interested in funding that research. If you yourself are the interested researcher then you can of course consider funding yourself and although I don't think it's totally impossible to do research on your own as a lay person, it is definitely very very difficult. Third, you actually need adequate methods because if you don't have suitable methods and are just able to collect anecdotes then it certainly can point that there is probably something worth studying but you don't really get any results that could be used to generalize anything. So, overall it's a tricky business. The surest thing to start with would be to find someone who is actually interested in this kind of topic.

I think it’s possible to be part of the field in an ethical way (following guidelines, checking your own counter transferences in supervision etc)

I don’t think it’s possible to work in the field and not inadvertently harm someone - even with ethical behavior. If this is something that will keep you up at night, I don’t think the field is right for you. Like the medical profession, it’s impossible to be perfect and things happen even following guidelines. I think a worthy goal is to help MOST people, or maybe help a larger percentage of people than average therapists.

This comment strikes me as condescending and provocative. So I'm not sure what or that it it will add to the discussion for me to comment. Nevertheless, I'll try. . .

I'm old and retired and damaged beyond (much) repair by therapy and life and who knows what. I've done the best I can and tried to find as much help as I could outside myself. I wish it were all over and have for 20 years. I'm not going to act on that because the collective, social wisdom is that would hurt -- be harmful -- to my children. I'm not at all sure about that -- but I can't be 100% sure that my own view is correct, either. So, here I (still) am.

On some other threads I have commented on some things that it seems to me that make some therapy clients more vulnerable to harm by therapy, over and above any harm they went into therapy with. That is a contribution I thought could be useful or interesting. Perhaps you haven't seen those or thought they were interesting or worth remembering. C'est la vie.

That's what I can do now. I'm not proposing to do any more. Your supposition that I was proposing anything else is in error.

To my mind, therapists have an ethical and moral responsibility to listen when people tell them that they have been hurt by therapy or therapists, and to try to investigate how and why what they do personally, and what their professional practices and training incline them to think or to do, which harms some of their clients. Not all therapists are going to do that, but I think if someone wants to be a part of the profession in an ethical way, then that is -- to me -- something they need to consider. My 2 cents.