Mary S

I'd leave out "similar to". It was all three.

These comments and the ones you made earlier about how he seemed to be using you for intimacy, and his wife leaving him and finally divorcing him, kept sticking in my mind yesterday. He is really pathetic, not just in being so needy, but in using you to try to satisfy his neediness -- he is a pathetic predator. People like this need to be weeded out of the profession.

That was my experience, too. I asked the second therapist I tried, "What is therapy? She said, "a safe place to work on your problems." That sounded good. But later, she said, 'You're the star" That definitely did not sound safe or helpful for me-- coping with personal attention was a big part of my problem (I guess a weird sort of social phobia). I guess I gasped or something, so she said, "You may not like it; you may not like the process." It went downhill from there. A few years later, I asked another therapist (who was one of the better ones I tried) what "therapy is a safe place" means. He said it meant that what you say in therapy won't get out to others in your life. That sounded like he was saying it wasn't emotionally safe, which is what I had assumed safe meant in the context of therapy.

No, not stupid you -- unethical them.

Unsurprisingly (to me), I woke up in the middle of the night thinking that my response to the Dark Side Podcast was overly positive. That is probably correct – I do have a tendency sometimes to be overly positive. So I’ll add to it now: The types of therapy that focuses on attachment and/or particular types of client/therapist relationship are, to me, inherently problematic (likely to do harm), especially when practiced by therapists who are enthusiastic, interested in people, like helping people and/or passionate about what they do. So the cautionary measures proposed in the podcast are especially important in these types of situations. I don’t think these measures are strong enough to guarantee that the therapists will do no harm, but can help reduce the chances of harm. And it is important that clients be aware of problems that might lead to harm, so that they can take the necessary (but often painful) steps of calling the therapist out and, if necessary, stopping the therapy before too much harm is done.

Thanks for the link. My impression: This does seem to be a step in a positive direction. The opening turned me off – discussion of how the participants enjoy helping people and are passionate about what they do; the usual complaint of “all about the therapist.” But there were several good points: 1. The mention that some therapists are predatory. But this was too brief, and emphasized just accreditation and licensing, rather than discussing the fact that accredited, licensed therapists can also be predatory. It was also good to mention that it can sometimes hard to distinguish between “good” and predatory therapists. 2. The mention of “discredited therapies” was good – but probably could be more extensive. 3. Also good: The therapist needs to have place to go to protect the client from therapists strong feelings in reaction to what the client says. (In my experience, it did often seem as though therapists shot from the hip rather than considering what I said thoughtfully.) 4. The idea of holding client the client hostage (inducing guilt or shame in client for wanting to leave) is worthwhile. I experienced this from three therapists when I said I was going to quit. The first said, “You expect too much”; the second, “I can’t help you if you take everything I say as criticism”; the third, “You’ll never get better if you keep seeking the perfect therapist.” (She was far, far from perfect!) 5. They do talk at times about how “The therapist’s need to help” can interfere with good therapy. 6. The discussion of how what happens when therapists “let boundaries slip” can be harmful for client is good. 7. They give some good advice for helping distinguish between good and bad therapy, roughly summarized as: “Basically it comes down to this: You should be feeling better.” (I’d add: If you are getting worse, then it is really bad therapy!) “Do therapists use your feedback effectively?” “If you experience defensiveness and blaming, then you know something’s going wrong.” “Therapy is supposed to help you build up your sense of who you are.” I think this might have been helpful when I was trying therapy -- perhaps in quitting sooner, but to support my decision to quit therapists in any event.

Probably the thing that most got to me in the article linked above is the phrase, "the work I do is a creative process". This raises a red flag for me -- it seems to suggest that the client may be just a pawn (or a point of departure, or raw material) in the therapist's desire to exercise their creativity. It sounds so narcissistic, so arrogant to me. The comment in question was a response to an article about the "replication crisis" in psychology. I would say that a more appropriate response to that article would be that therapists need to approach their work with more caution and humility -- not with creativity!

Today I came across an online "journal" called Contemporary Psychology (http://www.contemporarypsychotherapy.org/). It seems like a hybrid between a professional journal and a blog. It describes its aim as: "With the professional community of psychotherapists and counsellors in mind, Contemporary Psychotherapy aims to be progressive, inquiring and creative, to encourage interactive debate with its international readership and to address rather than avoid the possibly contentious." I wonder if it would be open to client perspectives. The article that got me to the site is at http://www.contemporarypsychotherapy.org/volume-8-no-1-summer-2016/when-the-therapist-is-ill/. It seems earnest, but also seems redolent with the type of self-absorption that makes me uneasy about therapists. (I got to the article by searching on Sick Therapist, thinking of "sick" in the sense not of physical illness, but of a warped mind. So I guess I got distracted from my original intent.)

My impression is that one of the areas in which therapists are required to have "continuing education credits" is called "Ethics and Risk Management" -- and "risk management" is ambiguous: It could refer to "managing" risk of harm to the client, or "managing" legal risk for the therapist.

The blog does not seem to have a comments section. The organization that sponsors the website that the blog is on describes itself as a faith-based, Christian counseling organization.

Regarding not enjoying the client: I never had a therapist I tried saying he no longer enjoyed the client, but two instances of something similar: 1. The therapist I mentioned earlier (that another therapist had suggested), who said over the phone that he would not care to work with me, because he would not enjoy "being with" me. 2. The last therapist I tried (ten or so years ago) said he thought I was harming myself by focusing so much on how he and I were different; that I should focus more on the similarities. (Sure sounds like "all about the therapist.") He also said once, in a voice that sounded plaintive, that what kept him going as a therapist was the same thing that kept him going as a teacher (he also taught part time at a nearby university): When the client or student "gets it". I assumed he was implying that he didn't get that "positive reinforcement" from me. That helped convince me to quit. (Again, sure sounds like "all about the therapist".)

This person really is off in a fairy tale world. Ending of bad therapy is not at all like a graduation; it's like a divorce.

This sounds like total BS, like the therapist is off in their fairy tale world, confusing their fairy tale of what therapy is with the real world the client lives in. In the real world, therapy is not a safe place -- or maybe just a "safe place" in some weird therapist interpretation. Maybe therapists are trained to hear "such statements" non-defensively, but in real life they often react defensively (in my experience) or dismissively. I guess you could say I've ghosted some therapists -- initially after trying and trying to talk about the problems, with no sign that the therapist seriously considered my concerns. So at some point, it makes sense not to waste the time, energy, and expense of trying to discuss with one more therapist when they don't show any signs of being willing to listen. I should add: I did find one therapist who did seem willing to listen and try to take my perspective into account. I did appreciate his willingness. But he didn't really seem able to help me beyond being willing to listen. I finally said to him (in person; no ghosting on this one), "You're a nice guy and I like you, but I just don't see what you have to give."

I think therapist ghosting of a client could be abandonment, could be negligence, -- or, if a therapist has a contract that explicitly restricts certain kinds of contact with the client, it would be just following the terms of the contract.

Welcome Pam. I didn't even start therapy until 1986, but even then, it seemed that almost nobody would believe my experience was real. I've heard that RET practitioners can really be extreme. And it sure seems that the therapy profession as a whole has more than its fair share of narcissists.

I'm not convinced that they necessarily know how they would like to act during a sensitive session. I'm also not convinced that they necessarily have good ideas of how to act during a sensitive session. For example, the one who said, "Consider me to be something like a computer: what you say goes in, mixes around with my training and experience, and out comes a response," sure sounded like she was saying that what she routinely did was just reacting.

Yes, this crept into my mind later, as did the thought that the therapists really were unreasonably pushy. (I do have this tendency often to focus on the positive at first, then later start thinking, "Wait a minute. I think I was giving that person too much benefit of the doubt."

The therapist quotes here seem surprisingly sensitive to the client's needs --- not at all what I encountered in my therapy experience, nor in most of what I read about therapy. Especially encouraging is that most of them seem to realize (although somewhat belatedly -- this is something that they ought to come out of their training with!) that they need to be careful not to push too much. (I think that sometimes what a therapist thinks of as a miniscule nudge comes across to me as really pushy and insensitive to boundaries, informed consent, and all that other good stuff. So maybe the "ghosting" is an example of what I call "being hit over the head with a frying pan,"which, regrettably, a lot of therapists seem to need to wake up and help rather than hinder.) But, as you say, T's need to also to be sensitive to when they "ghost" a client. And something that seemed left out of the quotes: A client quite reasonably would choose leaving a message saying they are quitting simply because it seems more rational than taking the time and expense of going to an appointment just to deliver a short message.

I recently came across the article The Code Not Taken: The Path From Guild Ethics to Torture and Our Continuing Choices (https://kspope.com/PsychologyEthics.php), discussing ethics in psychology. Its main focus is the scandal about how APA policies supported “enhanced interrogation” policies at Guantanamo, etc., but it also speaks to more general ethical concerns for psychologists. A quote from the abstract: “The controversy … asks whether our lives and organizations reflect professional ethics or guild ethics. Professional ethics protect the public against abuse of professional power, expertise, and practice, and hold members accountable to values beyond self-interest. Guild ethics place members' interests above public interest, edge away from accountability, and tend to masquerade as professional ethics. Psychology's path to involvement in torture began before 9/11 and the "war on terror" with a move from professional ethics to guild ethics. In sharp contrast to its previous codes, APA's 1992 ethics code reflected guild ethics, as did the subsequent 2002 code (APA, 2002). Guild ethics are reflected in the questionable nature of APA's, 2006, 2007a, 2008a, and 2015 policies on interrogation and torture. This article examines tactics used to maintain the façade of professional ethics despite over a decade of publicized reports…of documentary evidence of psychology's organizational involvement in what came to be called "enhanced interrogations." It asks if we use versions of these tactics in our individual lives. If a credible identity, integrity, and professional ethics are not reflected in our individual lives, it is unlikely they will thrive in our profession and organizations.” I had a sense of irony in reading this, for two reasons. First, when I read (in around 2006) a book on ethics co-written by Kenneth Pope (I think it was the second edition of the book), my impression* was that it was more like what Pope here describes as “guild ethics” than what he describes as “professional ethics”. Second, because therapists I tried before 1992 engaged in practices (such as not answering questions about what they were doing and why) that I consider examples of “guild” rather than “professional” ethics. In a section called, “Choosing Ethical Awareness,” Pope writes, “The torture controversy and the choices that led up to it provide a grim inventory of guild ethics, willful ignorance, denial, and discrediting critics. If we call up the courage to take an honest look, do we see those tactics in our own lives? Have we stopped listening to colleagues of certain disciplines, theoretical orientations, or political views because what, after all, do they know? Do we jump to discount, discredit, silence, or avoid certain kinds of criticism and words—both spoken and written—that call our beliefs, approaches, and actions into question? Do we have a safe stock of go-to consultants we count on to give us the answers we want to hear? Do we live our professional lives in the safety of "gated communities" of like-minded colleagues who read the same journals, see things as we do, and aim criticism at outsiders, never at those within the community? If we see at least some forms of some of these tendencies in ourselves, as I'm pretty sure most of us will, and find they no longer fit who we want to be, what can we do? We can start to search out and listen to those who disagree sharply with us and are willing to challenge and critique our ethical assumptions, beliefs, choices, and actions. Luckily—or not—such folk are remarkably easy to find. We can read more widely, opening books and articles that challenge our outlook, our decision-making, and how we like to do things.” Sadly, he didn’t include “listen to our clients.” * Things I remember most strikingly from the book that gave this impression of “guild ethics” are connected with informed consent. First, informed consent seemed to be presented as something that only concerned a written document, not including the notion of informed consent as an ongoing process, where therapists explain why they propose to do something and ask if the client consents before proceeding. Second, the only example of an “informed consent document” they gave in the book was not an informed consent form for therapy, but for filing a complaint. Third, one of their “scenarios for thought and discussion” said (paraphrased from my memory) something like, “You have a new client who has recently lost his sight in an accident and is seeking therapy to help him adjust to this new circumstance. The informed consent form is not available in Braille. What would you do?” I found this astonishingly poorly thought out, since someone who recently lost his sight in an accident would not yet be able to read Braille!

I think Kirsch's book needs to be taken with a grain of salt -- see http://www.huffingtonpost.com/irving-kirsch-phd/antidepressants-the-emper_b_442205.html, where he gives a short version of the book -- and ends by promoting psychotherapy methods for treating depression -- even though the criticisms he gives of clinical trials for drugs also apply to clinical trials for psychotherapy techniques. In fact, the latter are even more problematical for at least three reasons: 1) There is no way that the treating therapist can be "blinded" to the treatment; 2) often the treating therapist is the one who does the evaluation of the effectiveness (so think how (1) and (2) might interact); 3) there is no agency such as the US FDA or the European Medicines Agency that enforces even minimal standards for clinical trials of therapy methods.

In my first post on this thread, I said, "... I became aware many years ago (I can’t find a reference, but I know this is not original to me) that all too often when we have a name for something, we feel we understand it but don’t really understand it. So the power to name brings with it the power to feel we understand when we don’t. And this is in turn the power to close doors to understanding. It can also be the power of denial (that we don’t understand). It can be the power to stuff into boxes. It can easily be applied unintentionally. This occurs in therapy in diagnosing clients (as “labeling” them, as Zur points out), but also in labeling clients’ feelings or motivations. Thus therapists (and also clients) need to be very, very cautious in using the power to name. " I found what seems to be an example of this “give it a name and you feel you understand it” phenomenon in another website of Ofer Zur. At http://www.zurinstitute.com/therapy.html , he said, “I see most depressions as depletion, most anxieties as overwhelm, phobias as being out of control and panic as the psyche's cry for help”. I am not in love with DSM classifications, but at least they have the virtue that you can find the criteria written down somewhere and decide for yourself whether or not they fit your experience of reality. But if a therapist says, “Your problem is depletion,” (or “overwhelm” or “being out of control”), or “Your psyche is crying for help,” what can you do? Maybe Zur believes he understands you, but I would just find these labels unhelpful – and in fact, counterproductive. For me, these are examples of the therapist behaviors that produce the “unintended gaslighting” effect, that seem to give the message that the therapist does not consider my own perception of the reality I experience as worth taking seriously. (To his credit, Zur does say later on the same page, “I will do whatever is clinically appropriate, is likely to help clients and is acceptable to and discussed and agreed to by clients.” My experience is that most therapists do not care to discuss with clients what is likely to be helpful, and do not restrict themselves to what clients agree to.)

I didn't encounter this type of gaslighting, but what you say does seem to fit much of what I have heard others recount about their therapy experiences; that the "therapy relationship"often seems more about meeting the therapist's needs than helping the client. Although perhaps in some instances this might have applied to my therapy experiences -- where the therapist need seemed to be one for power, control, "needing to be right" or dominance, etc.

I have read about gaslighting, and how it can lead to harmful therapy when a therapist uses it. What I have read presents it as something that is done deliberately to cause the recipient to doubt their sense of reality. For some reason, today I decided to search on "unintentional gaslighting," and came up with http://counsellingresource.com/features/2015/08/31/new-form-gaslighting/ , which does indeed describe unintentional gaslighting. The author calls this I think this is (more or less) what I encountered often in therapy, but with a couple of departures from the strict description. First, I didn't so much doubt my reality as I felt "disabled" -- confused by the conflict between the therapists' adamant stance and the reality I perceived around me. Second, I tended to react to the "gaslighting" by a sense of seeing myself as "born to be a second-class citizen" -- which was a big part of what I went to therapy for -- I wanted to learn to have the courage of my convictions, not "submit" to a stronger-willed person. But therapy was mainly encounters with a stronger-willed person. I "submitted" in some sense. i recall once encountering the term "ego distonic," referring to behaving in a way that goes against one's values. I think my sense of worth deteriorated because I so often gave in to the therapists, even though what they said went against what I believed was right.