The manipulative and harmful nature of psychodynamic therapy

After my rather diverse experiences from psychotherapy and with some distance to those experiences I find much of the psychodynamic therapy to be manipulative.

I foremost talk about the "blank slate" therapists whose basis for therapy is to foster transference. The transference concept, when the therapist specifically constructs therapy around it, is nothing but manipulative. Transference can happen in any relationship and spontaneously and a client could fall in love or hate with a therapist even if the therapist don´t foster the concept.

But that´s not what I talk about. I talk about those therapists who in a conscious way act differently from what´s seen as "normal" courtesy and "normal" interaction between two people.

I talk about those therapists, I´ve met those myself, who for example

Never smile when greeting a client
Starts and stops sessions at the very minute
Don´t answer to any kind of questions about themselves
Refuse to share simple things about the weather or similar

Then they defend all this by telling the client it means "good boundaries" or that it´s for the client´s own good. They wait for their client´s reaction just to be able to "interpret" it. Well if it was just "good boundaries", then so many clients hadn´t went to forums like PC and others and talked about all those "problems" with transference.

I feel sorry for clients who "feel in love" with their therapist and long for validation but that validation won´t be there as that would be to act contrary to their theoretic belief. To put a kind word to something would for them be like "ripping the earth".

I see so much harm in therapy after reading about it for years and I can´t see this type of therapy is anything but manipulative to the client. I hate everyone of them who caused me harm and I´m sad when reading about others who experience similar things.

Oh dear. I have one of those therapists.

My T would agree with you. He tears up hearing me talk about previous T’s that either created fake transference or those who were so distant. All of them blamed me or my trauma for the lack of progress. Current T is the opposite of everything you listed. He is genuine, warm, compassionate, open, human, REAL... and I have healed so much more in significantly less time and, most importantly, with far less pain and anguish. There are a few good ones out there. I just wish I could clone mine and pass him around PC some days when I hear about all the bad T’s.

Well said, Sarah. Hope things are going OK with the counselor?

I'm going to try just-a-counselor again next week. On her website she listed "life transitions" as something that she helped people with and that's something I'm dealing with so I'll see next week how it goes. If it doesn't work, Oh, well.

My therapist definitely conformed to these criteria in the beginning of my treatment, which is also quite logical because he did not know me and we had not developed any kind of relationship yet. To me these criteria sound very superficial and judging the book by its cover.

I have found my T to be totally non-manipulative, very compassionate and caring, and at the same time always willing to fight for me, even with myself.
- He would probably smile to me now while greeting if I would bother to smile to him first (which I don't - I normally choose to not to greet him at all).
- He still starts and stops the session exactly on time. The consequence is that I never have to wait because someone else's session runs late because their session ends exactly on time as well.
- He now sometimes does answer questions about himself when he feels that it is appropriate. I sometimes test him though - I ask a question which I don't want him to answer and see whether he gets it and refrains from answering. Nowadays, when in doubt, he asks me whether I want an answer or not and he only answers when I explicitly say that I really want the answer.
- I don't know whether he would refuse to say anything about weather or not - maybe not, if it's not excessive. But I definitely refuse to spend my session time on such superficial topics and I respect him for not initiating such waste of time from his side.

Thanks here today. How nice you´ve find another counselor to try even if she´s "just" a counselor then. Have you spoken to her on the phone or so?

I haven´t started with my counselor yet, I´m seeing her next week after the Christmas holidays.

As you say, you can give it one or a couple of tries to see how you feel about this counselor. I hope it´ll work well for you. :-)

I spoke with her over the phone a few days ago. She seemed pleasant. I feel cautious but somewhat optimistic. I'll know more after I meet her.

Sarah, are other types of therapy available in Sweden that might help that you haven’t tried? CBT, that sort of therapy? Of course you may be done with therapy of all kinds, and that is OK too.

"Never smile when greeting a client
Don´t answer to any kind of questions about themselves"

These are two things I would not like in a therapist (or anyone, for that matter) either. I can also say I would not tolerate someone never answering any question about themselves - it is totally unnatural, IMO abnormal for social interaction, unless the person is severely impaired.

Sounds like you are joining the "club" here on the forum of people who did not find therapy useful and/or found it harmful. I think it is a perfectly valid position and anyone should be free to express them views and experiences. I can't add much more than what I had already said several times on your threads: you have a conclusion, good time to move on and try other things for your mental health, self-improvement, whatever your interests are. I personally wouldn't even experiment with counselors for a while, they will likely be just another experience of sitting with another person, talking about your concerns, and maybe feeling dissatisfied with who they are and how they interact. Why not explore completely different things for a while and maybe come back to counseling a bit later?

Hoping for the best here today. :-)

Thanks. No, one key error to our public health care system is that our National Board of Health and Welfare limits what care is given to whom to such an extent that good care is given only those who can pay themselves. When it comes to different kinds of depression and anxiety they state that short-term CBT (10 sessions) and antidepressants should be the first choice. That is, most people never get to choose between different kinds of therapy, nor do they get the opportunity to see a therapist for a longer period of time.

Thanks. Yes, I think there´s a bit of a "movement" against therapy as it is people who advocate for therapy and defend therapists' actions. I don´t mean only at PC but in many other places as well. But nowadays people are much more enlightened and they share their stories in a more effective way now than before the "internet era".

I agree it could be useful with a break from counselling but as I need to see a counselor to be able to get my sick leave and then my welfare, I can´t just stand without "treatment". I need to see someone, if it´s the woman I´ve now seen for a year or someone else, I must be registered in some way.

I would agree with this. It's unnatural and, for many people, not at all a constructive form of "treatment". But, just like in everyday life, I also think that many Ts are not even aware that they are manipulating. Certain things have been nailed into their minds during training and sometimes they follow/repeat them blindly, completely disregarding diversity and that it is not going to work with everyone. Well, too bad for them because they are losing business due to it, in a good case. In a worse scenario, they upset clients who are already pretty rattled to start with.

I don't think all psychodynamic Ts are that rigid though, it's probably more a characteristic of some old-fashioned psychoanalytics. I've only tried one who claims to be a "modern psychoanalyst" and even that was mostly a useless, manipulative endeavor. It was also a particularly unhealthy T though, so probably that made the experience much worse. But if you are repeatedly having the same kind of unsatisfying/annoying experience with different providers, I think it is fair to conclude that a method may not be a good match for you.

True, they most likely do not greet their friends this way. But you are not a friend; you are a patient. It's a professional relationship. So they treat you in a more formal way and they stick to the scheduled time.

If you feel psychodynamic therapy is not for you, though, that is certainly your decision to make. What do you think might work better for you personally?

I didn´t mean a therapist should act like a friend towards a client but I exemplified how they act in relations to meeting with a friend just to show how constructed and unnatural their behavior is.

I've often come back to the humanstic and rogerian tradition when I´ve been given questions about what kind of therapist I think would work. I also always get back to the fact that we in Sweden don´t have a public mental health care system which offers several types of therapy and therapists.

I totally understand where your coming from with the therapist not smiling or greeting the client and being unwilling to engage in small talk. I don't mind sticking to the time as it means appointments run on time. I wouldn't want a therapist to waste time but just an opening comment to break the ice. Anytime I've been for treatment for a physical ailment, the doctors and nurses always put me more at ease in this way, which is especially important if the patient is nervous about the treatment or procedure. They do this for everyone, not just for those with mental and/or emotional difficulties. In light of this observation, psychoanalytic or psychodynamic therapists seem almost punitive with their refusal to engage in a normal human exchange. It is not surprising that this triggers feelings in the client and they want to know about these feelings, so yes, they do orchestrate the situation. I think most people without mental and emotional difficulties would be peed off if they found themselves in a situation where a healthcare professional behaved in this way. Therefore, I wonder how it cannot be flawed to analyse the client's reaction and come to the conclusion that it is abnormal and a sign of their "illness" when the majority of people would feel the same way.

I'm sorry, SaraSweden, but the problem you're experiencing is not limited to Sweden.

I live in North America and short-term CBT (10 sessions) and group therapy are the standard here for people without insurance, too. It's less expensive, evidence-based, and more readily available for the multitudes of people who have mental health issues.

Imagine how unavailable mental health services would be if they attempted to provide long-term psychodynamic therapy to everyone? Who would pay for it? Is it realistic that a large number of people would be able to access it, or only a select few? Is that fair?

I live in Canada where we have "free healthcare" (so the saying goes), but that doesn't include therapy. When I wasn't working I saw therapists who accepted sliding scales or government funded services, which were often short-term, group centered, and CBT based. I got out of it what I could. Even now that I'm employed, my employer covers only $25 off each session up to a maximum of $200 in a calendar year!

Try group therapy. You can't always get what you want, and expecting the government to pay for long-term psychodynamic therapy it is unrealistic.

Isn't Yalom an existential therapist and a big proponent of group therapy? I think his approach might be different from psychodynamic therapy, so you and feileacan might be talking about somewhat different things.

Yes! My secondary therapist specializes in working with people with intense emotions (which includes people who have been diagnosed with borderline personality disorder), and she and I have talked about how the blank screen is terrible for sensitive people because we read rejection where it isn't there. Same thing for CBT because it can feel super invalidating. Childhood emotional neglect is very real and can have long-lasting effects. Have you read Running on Empty and its sequel? I also found a pretty good DBT for depression workbook that helps somewhat with emotional regulation, among other things.

It's too bad that you don't have the ability to access anything that isn't CBT or psychodynamic therapy. Something more relational might help you open up a little better. There is still often an awkward phase at the beginning of any therapy relationship, and I think therapists tend to warm up and adapt more readily once they get to know the client, so it can be hard to know when to stick it out and when to throw in the towel. Hopefully you find something (therapy or otherwise) that can help you move toward where you want to be in life.

You might prefer CBT therapy if you don't like "blank slate" therapists. Why don't you give it a try? Especially as this is what the government is offering you.

I very much understand your frustrations with things like the way your therapist greets you and the lack of small talk. I pretty much stumbled upon my psychodynamic therapist a little over 2 years ago and picked him because I liked his website, but really had no idea what psychodynamic therapy was all about. I was immensely frustrated with the lack of greeting, smiles and small talk, and I even sent him a link to a 400 page textbook written by a professor of psychodynamic therapy at Columbia University. Despite this, he did not change his ways which made me wonder if perhaps he wasn’t very smart. I cannot tell you why I stuck with him, but maybe it was because I was too lazy to search for someone else. I spent at least a year, probably longer, being angry, skeptical and passive aggressive with him. I’m not sure how or when it changed, but our relationship has evolved into something completely different. I am apparently super slow to trust, but I do mostly feel like this person gets me on a level that is far more than just small talk and smiles, and is more than I could have imagined really. He does, by the way, smile when I enter and when I leave, and he does reveal more about himself than he used to, but he’s careful not to guide me and to make sure it is entirely about me and not him. That is still pretty scary to me sometimes. That being said, I completely understand that this type of therapy is for everyone. This is just my story.

Hello SarahSweden, just wanted to thank you for this thread and your comments. I agree with you about the manipulative aspects certain types of therapy. I am still attempting to recover from what transpired in past therapy and I too feel for anyone else who has been wounded in this way.

Do you have partial hospitalization/Day Treatment Center programs in your area? This might be good to try. You would get a lot of support and therapy from a program like this.

Thanks. Yes, I agree to that. They see it just like part of their method and they don´t reflect much upon how some clients might experience some of their actions. What I experienced was that even if I did explain to them how I experienced some of the things the did, they still didn´t want to change anything or at least try to understand my reactions.

I agree not all psychodynamic T:s are the same. I saw one some years ago and she had a much more kind and soft approach, she had a relational orientation. By that I now asked for a relational psychodynamic therapist and even if this latest one had such an orientation she was very different from the one I saw several years ago.

Did you find a new T who could help you with those negative experiences you had had earlier?

Thanks. Yes, as you I think there should be a comment or two about some "everyday thing" like the weather or similar but not engaging in longer conversations about things that don´t concern my issues. There´s a good point in the fact that doctors and others try to make the patient feel more at ease before starting a treatment or an examination. But with therapists like those, that seems impossible.

As you also say, many people would react negatively to such encounters but some therapists seem to find it useful to act in a very different way from how people "normally" act. I see there´s a point in keeping boundaries of course but to stretch it as far as I described in my original post, I see that simply as a way to create a distance between client and therapist.

Ok, so we know my T can be a little to the far opposite of the reactions you are getting but... one of the things I really like is that he does greet me by name in the waiting area (often I am the only one there). He also tells me something little about his day or his weekend which obviously doesn’t break confidentiality. It is usually something really little, last session it was that he forgot to grab a drink before he left his house so he was going to grab a water and be in. I guess he can be more relaxed because he is in private practice (I never had any luck finding good T’s at clinics). There are two other T’s that work out of that office but I have only seen one of them. Just before he went on vacation last time they both came out to see who’s client was there. He said it was Omers but if you want her you can have her. The other T just about panicked! We had a good laugh. So obviously there is room for T’s to be more warm and ingaging.
Like I said, I have always had a harder time in a clinic setting and found them to be more cautious. Perhaps more out of concern about other staff saying something than a problem towards the client? I have also never gotten counseling outside of the US so perhaps some of it is cultural or different rules/laws?
I know it would really bother me too even more now that I have had a T that is so personable. Will they even respond if you say something first?