Updated: Mar 27, 2020
Welcome to episode 20, Bad Therapy! Mercedes and I have mostly gathered ourselves here and really dive deep into some truly awful stories of what people are calling "therapy."
WE BELIEVE THE CLIENTS
Sure, clients might misunderstand the therapist. There could be context issues. We aren’t getting the full stories or the other sides. But a good therapist is going to check in with a client before they leave and ask for feedback. A good therapist is going to be sensitive to these things and allow for some clarification. A lot of this seems like irreparable stuff.
Thanks again to the individuals that submitted these responses.
THIS IS RETRAUMATIZING -
“I always thought something was wrong with me, given that I’ve had multiple bad experiences with therapists. Reading all of these replies shows me that I’m not alone. I’m sorry others have gone through this trauma as well.” This sums it up - it’s trauma or re-traumatizing
You’re with someone that you perceive is more powerful, more educated, has degrees on the wall and experience. It’s the neuroception of danger, of being less than, of being the weaker one in the room. But you’re also stuck in the room, immobilized by the anxiety of hurting someone’s feelings, of not wanting to be rude
Sympathetic activation + immobilization = trauma
There’s a gradient here, but these are obviously incidents that are sticking with people and causing them to change their behavior, despite wanting something else. They want help, but are avoiding it out of anxiety
BAD THERAPY STORIES
I have two both from the same person. 1) I came due to work stress and she was friends with the VP at my work and so therefore the things I was saying about my work couldn’t be true. They were.. I'm totally open to constructive criticism, but this was blatant disregard. 2) She told me I was "pretty smart for being so uneducated". She also violated HIPPA and told me my coworker was seeing her.
Therapist should openly disclose these potential issues and reassure the client and also ask their thoughts on the matter and make other arrangements if necessary. It’s not okay to insult clients or to evaluate their intelligence or education level. It’s not okay to disclose anyone on your caseload past or present. Confidentiality is basic.
“The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a series of national standards that health care organizations must have in place in order to safeguard the privacy and security of protected health information (PHI). PHI is any demographic individually identifiable information that can be used to identify a patient. Common examples of PHI include names, addresses, emails, telephone numbers, full facial photos,”
On my first (and last) visit I was told I needed to develop a personal relationship with God and Jesus, and that then I’d feel better.
We can’t insert our values or beliefs into the process. On some level, this is unavoidable, sure. But for something like religion, we need to be asking first. This can be included as a part of treatment in the informed consent.
“Therapist said she couldn’t help me unless I took medication for depression.”
We can’t compel our clients to take medication - what if the client is against meds? What if the parent doesn’t want their kids on meds? What if the clients wants to try therapy without meds or had a bad experience with meds in the past? We can suggest/recommend they be evaluated by a psychiatrist/MD. But if the psychiatrist says it’s not necessary, the therapist should meet with the client.
If the therapist feels they can’t help, that’s different. But saying, “I’ll help you only if you’re getting medication” seems really odd.
“I've had two therapists (I've only gone to see 3 total) literally start talking to me about their traumatic childhoods, as though I was the therapist. Lol.”
Two out of three of her therapists!
Keep your stuff to yourself, Therapeers! It’s their time, not yours. Get your own therapy! They are paying you for a service. Respect that.
Self-disclosure in general is a no-no. Sharing your trauma is a complete distraction from the client’s. It takes them well off their own track of becoming unstuck and puts the focus on the therapist, obviously. They are now concerned or annoyed at you, not in a safe space anymore.
“I went to a first appointment with a new therapist a few years ago and she had me fill out a bunch of paperwork. There was one sheet that I didn’t fill out because it was for the parents of children seeking therapy with her (I’m an adult woman and was seeking therapy for myself). She kept haranguing me for not filling it out and telling me I had to and I kept explaining I can’t because I have no children and was there for myself. She eventually dropped it, but I already felt a bit uncomfortable. I was there to see her because I was interested in EMDR and after explaining a little of my trauma history and getting a little tearful, she told me she didn’t think I was ready to do EMDR and then questioned whether I would really follow through with coming to see her every week. I told her I had never had an issue showing up for therapy before. I left super upset and called her office the next day to let them know I wouldn’t come back. It kind of felt like she was trying to convince me not to see her?
Why are we arguing with clients? This seems like such a simple issue that should have ended with a chuckle and the therapist apologizing with a smile.
Therapists should be listening to a client’s interest in a modality.
Questioning a client’s motivation? Someone who is there and paying? This is so odd.
Clients can be very forgiving. It’s so easy to repair these ruptures that are going to happen.
“Seeing a therapist to try and work through a physically abusive partner. The therapist decided it was appropriate to try and set me up with her son. Then, she obsessively emailed and called me for months. It was a nightmare. Also, a therapist that told me when my Disabled mother calls me, that I should just not pick up the phone. I have never had a therapist that I felt I could truly trust.”
We shouldn’t be playing matchmaker or breaker. Of course not setting up with our adult children. Stop solving the client’s problems. Be a listener. Be supportive. Clients have the capacity to solve their own problems, our role is not to do that for them. They are the experts in their own lives and we need to trust that they will get to where they need to be
Boundaries - “It was a nightmare” and recommending she not answer the phone from her disabled mother. Provide options, do some problem solving, pros/cons, process feelings about the decisions, and then trust.