Very Bad Therapy podcast

[Sylvester McMonkey McBean]

has anyone listened to this podcast? it's relatively new and at the time of making this post, only 6 episodes have been released. it's hosted by two 'young and new to the industry' therapists who want to share stories about clients having bad experiences in therapy and finding ways to learn from those experiences.  so far, i have listened to all 6 podcasts, and for me, the jury is still out on my general opinion about it.

Very Bad Therapy podcast

[disequilibrium1]

I half-listened to much of the first. The bad EDMR experience quickly was countered  by a shill for that modality and a lot of claims that sounded like dodgy neuroscience to me.

Edited July 4, 2019 by disequilibrium1

[Mary S]

I listened to the first podcast. Two things stand out for me:

First,  the "bad therapist" came across as not making any effort to establish rapport with the client, nor explain what the process was and how it worked. 

Second, both of the interviewers and the EMDR "expert" Kurt seemed to be basically considerate people and emphasized that the therapist needed to establish rapport with the client and give the client information so that the client could make an informed choice of whether or not to try the therapy and what was involved in it, and how it might help.

What the latter three emphasize was very rare in my therapist experiences -- some therapists I tried didn't seem to do it at all, and only a minority of the therapists I tried  seemed to make any effort to do it (but didn't do it very well -- although possibly if I had had one of the later therapists earlier, it might have worked out; my early therapy experiences made my mental state worse and made it harder for me to trust the later therapists. My experience was that finding  a good therapist -- for me, at least -- was like looking for a needle in a haystack.)

[Eve B]

Episodes 3 and 4 bring up therapist presumptuousness, defensiveness, and basically just not listening. The context is cultural/racial insensitivity, but damaging communication errors by the therapist can happen with any client. When these professionals talk about and try to teach the 'right' things to do by their clients---how well do their words match the reality of how they actually practice? I think the podcast has potential if they can find more clients willing to speak about their stories of therapy harm.

[disequilibrium1]

Therapists acknowledging harm at least is a good step. There seems so little thought about damage. I also think therapist behavior doesn't have to be egregious by their standards to be harmful to some clients. Therapists seem to make so many automatic assumptions about what's "good for us."

[Mary S]

I just listened to the second podcast. Once I tried a therapist who made so many snap judgments that I quit him after two sessions and thought of him as Mr. My-Mind-Is-Made-Up-Don't-Confuse-Me-With-The-Facts. The therapist in this podcast sounds like Ms. My-Mind-Is-Made-Up-Don't-Confuse-Me-With-The-Facts. She really must have been out of touch with reality to insist so doggedly that the client's sexual identity concerns were caused by the sexual assault, when the former preceded the latter. Duh!

[Mary S]

Another comment on the second podcast: Toward the end, the two hosts talked about trying to achieve empathy for the therapist discussed in the podcast. My guess is that they might have tried to have empathy for the therapist in order to have a better chance of getting their point (their criticism of her) across. But at one point, one of the hosts said something like, "Maybe the therapist's theoretical orientation emphasized pressing when the client showed resistance." My take is that when a theory says to push at a client's resistance even when the resistance is based on facts of the situation (as in this case -- where the purported cause occurred after the purported consequence), that sounds like a theory that is too rigid, too out of touch with the complexity of reality.

[disequilibrium1]

I thought the second episode good—until the “resistance” topic. Unless there is present tense evidence, the therapist rarely will know any more than the client’s reporting. So how can she sort “resistance” from reality?  Maybe  therapists receive  so much training in the resistance hammer that everything looks like a nail. Then validation and acceptance is abandoned for a power struggle, all on the altar of theory.

I find a foundational flaw of therapy is how it abstracts and distorts human experience, too often leaving therapists with their heads up their theoretical nautilus shells.

I recall a friend meeting “resistance” from the therapist when she tried to explore a new direction for her sexuality. The therapist shut her down.

That said, I’m now happy for the podcast and  that two students took this on.

Edited July 5, 2019 by disequilibrium1

[Mary S]

I agree that therapy theories just give therapists a fairy tale world to escape to from the complexity and messiness of the real world. But the client has to live in the real world, complexity and messiness included. Sometimes the therapist succeeds in convincing the client to join the theoretical, fairy tale world, and that sometimes helps the client , at least for a while,  until the real world intervenes and pulls the rug out from under the client's reliance on the theory.

[disequilibrium1]

So much psych writing, as well as my personal experiences, have been around categorizing people and behavior and "explaining" causalities. I think any attempt to explain causality is unsound because we never can definitively know that we're doing such and such behavior because of mother's inadequate affection. Even if it were true, there's no turning back the clock.

And yes, the client has to leave the consulting room and function. I found it a hindrance believing that my inadequate upbringing left me defective and cursed. I would have preferred to understand that every being experiences disappointment, sorrows and shortcoming but gets to create life going forward.

[Mary S]

I just listened to Episode 3. It was really good! I tried taking notes -- I'm not sure I can read them all, but I'll try to mention some things that made a good impression on me (although not necessarily in the order in which they occurred in the  podcast -- my notes were just scribbled wherever they would fit on a scrap of paper).

Quote: "You have to look at things from another person's perspective.'" Yes, this is something a decent therapist needs to do. But so often (in my experience) they don't; they just impose their own perspective on the client -- and that means they create an imaginary client in their mind, losing sight of the real client in the process.

Quote: "Every person is different". Duh -- of course a therapist should have this view -- in this case, "Not all black people are the same" -- but it generalizes to "Not all women are the same," "Not all people in this job category are the same," and (very importantly) "Not all people with this diagnosis are the same". But (in my experience) therapists so often treat clients like stereotypes. 

Quote: "We have the responsibility to educate ourselves  --  it is not the client's responsibility to educate us." One of the better therapists I tried said to me, "You need to teach a therapist how to help you, and that must be a burden to you." I appreciated that he realized he was clueless, but still it was pretty discouraging to hear, especially the "must be a burden" part.

I really appreciated the discussion of "cultural competence" vs "cultural humility" -- especially the view that "cultural competence" seems to be a  pie-in-the-sky (my rephrasing) idea.

Quote: "Let us know if we have gotten things wrong" (Ohmygosh-- How my worst therapist would really lash out when I tried to do this!).

[Eve B]

Should it be significant that trainees are doing a podcast about "very bad therapy"? I wouldn't be surprised if they conveniently sidestep the topic once they've gotten their credentials and established their own practices. And whose to say what's bad therapy vs "very bad" therapy? Not that I see much difference between the two when it comes to the damaging effects, and I still think many therapists are either too thick-skinned or thick-headed to see or accept that they could be the source of the harm even when told directly and honestly by their clients.

[Mary S]

5 hours ago, Eve B said:

Should it be significant that trainees are doing a podcast about "very bad therapy"? I wouldn't be surprised if they conveniently sidestep the topic once they've gotten their credentials and established their own practices. And whose to say what's bad therapy vs "very bad" therapy? Not that I see much difference between the two when it comes to the damaging effects, and I still think many therapists are either too thick-skinned or thick-headed to see or accept that they could be the source of the harm even when told directly and honestly by their clients.

I'm taking it as a hopeful sign that trainees are concerned with bad therapy. It may be that it takes a new generation to effect some change.

[Mary S]

I just listened to Episode 4. Here are some comments:

Some of the things that the client Carol said reflected my own experiences in therapy. For example, she said that she felt shocked or was speechless in response to some things her therapist said or did -- those phrases describe a frequent state I was in in response to things my therapists said or did. She also mentioned something to the effect that things went so fast that she wasn't able to process them in session, but had to spend time afterwords tprocessing them. This was my experience more often than not -- I think in part because "processing" things in real time isn't something I'm good at (I would guess that's an introvert thing), but partly because so much of what therapists do and say  was shocking, and out of the ordinary, for me.

Another thing that I think Carol said (or perhaps it was Carrie) was that the therapist is supposed to be open and listen to the client in the client's own words. That seemed pretty rare for a therapist to do, in my experience. So often they would tell me that I had said something that to me sounded very different from what I had said.

There was also something Carrie said that I appreciated. I don't recall the exact phrase, but it was something like whether or not something "sat well with"  the client, rather that how the client felt about it. To me, asking how I feel or felt about something is really intrusive, but asking how it sat with me, or how it was for me, or how it seemed  to me is much more user-friendly for me -- not as intrusive, whereas asking me how I feel or felt about something is asking me to stuff  myself into a framework that isn't mine -- using someone else's words rather than my own words; really, asking me to be ungenuine, to pretend I'm someone I'm not.

I've got some more notes, but am getting too tired. Perhaps I'll post more later.

[disequilibrium1]

I listened to podcast #3 and found it quite thoughtful. Racism can be a pervasive element in someone's life, from passersby, in institutions, in the family of origin and how it is internalized. Of course it shouldn't be sloughed off in therapy. Psych Central posts and my own experience give me the impression that some therapists are far more interested in dramatizing intrapsychic conflicts than in dealing with actual circumstances.

Perhaps it's not surprising that students take on the topic of poor therapy. In addition that urge the young sometimes have to "compete"  with their elders, they don't yet have the investment of years and the need for livelihood. Their profession has yet to be the hand that feeds them.

[Mary S]

22 hours ago, Eve B said:

... And whose to say what's bad therapy vs "very bad" therapy? Not that I see much difference between the two when it comes to the damaging effects, and I still think many therapists are either too thick-skinned or thick-headed to see or accept that they could be the source of the harm even when told directly and honestly by their clients.

The following might be a reason (a good one, in my opinion) for talking about "very bad therapy" rather than just "bad therapy": There are therapists whose definition of "bad therapy" is "therapy where the client doesn't make progress". The last therapist I tried gave this definition when I asked him what his definition of "bad therapy". It surprised me, so I asked explicitly, "Are you saying that you don't make a distinction between therapy that is not helpful and therapy where the client gets worse?" and he said, "Yes". Since then, I have encountered therapist websites (and as I recall, also some books and papers by therapists, although I didn't locate any in a quick web search just now ) giving that definition. So it makes sense to me for Ben and Carrie to use terminology stronger than just "bad therapy".

[Eve B]

On 7/7/2019 at 12:17 PM, disequilibrium1 said:

Perhaps it's not surprising that students take on the topic of poor therapy. In addition that urge the young sometimes have to "compete"  with their elders, they don't yet have the investment of years and the need for livelihood. Their profession has yet to be the hand that feeds them.

So do you think these trainees will avoid talking about harmful therapy once they've got their own business to protect? Is this podcast more of an attention scheme for them?

[disequilibrium1]

12 minutes ago, Eve B said:

So do you think these trainees will avoid talking about harmful therapy once they've got their own business to protect? Is this podcast more of an attention scheme for them?

I can only speculate based on the apparent dearth of professional interest in harmful therapy. The literature I see skims lightly, and/or is far more concerned with legal liability than the client.

Yes, the podcast is an attention scheme. But if these two launch into their profession continuing their exploration, more power to them. 

Edited July 8, 2019 by disequilibrium1

[Eve B]

On 7/7/2019 at 2:04 PM, Mary S said:

So it makes sense to me for Ben and Carrie to use terminology stronger than just "bad therapy".

I think each client also holds their own different distinctions as to what bad and very bad therapy are depending on their sensitivities to a particular treatment style. Therapists seem to underestimate the harmful consequences of their actions/reactions unless it leads to a lawsuit or suicide.

[Sylvester McMonkey McBean]

i see that there are two new episodes that have been added and i have not listened to them yet. i hope in later episodes they can find and interview more clients who are not professionals already in that industry, like in episode 5.  i'm assuming they approached peers to help with topics until their podcast gains more popularity, but for some reason, i really don't have as much sympathy or empathy for the professionals who have been 'harmed'.  it just doesn't have the same impact for me.   

[Eve B]

Would people affected by very bad therapy experiences trust these trainees enough to want to publicly share their stories on this podcast, though?  

[disequilibrium1]

1 hour ago, Eve B said:

Would people affected by very bad therapy experiences trust these trainees enough to want to publicly share their stories on this podcast, though?  

Though I've discussed my experiences extensively, I wouldn't want them their discussion fodder on a podcast like this. Their "empathy check" seems more to favor the therapist.

[Mary S]

10 hours ago, Eve B said:

Would people affected by very bad therapy experiences trust these trainees enough to want to publicly share their stories on this podcast, though?  

Even if my therapy experiences were good, I wouldn't want to subject myself to having someone interview me about them. In fact, the "being interviewed"
nature of therapy was a big part of what made it more harmful than helpful for me. I remember asking one of the first therapists I tried what therapy was. She said "it''s a safe place to work on your problems" (which sounded good to me) and then "You're the star" (which sounded horrible to me, not at all "safe"). I think I gasped when I said that, because she responded with, "You may not like it; you may not like the process," which was really demoralizing.

[Eve B]

Maybe the only way to avoid this uncomfortable being interviewed-center of attention feeling would be to have a therapist who is easy to get along with? 

[Mary S]

My experience is that most therapists are difficult-to-get-along-with people for me. There seem to be so many conflicts of worldview and values. It so often seems like they have some agenda for me me that I haven't consented to (and that they haven't even asked if I consent to, let alone give any reason why they are pursuing that agenda). In fact, they so often seem not to care about giving reasons for what they do, or, in the rare instances that they do give a reason, they don't seem to care if it makes sense to me. Therapy never addressed the things I went to therapy hoping for help with. It so often seemed like a crazy place, like going down the rabbit hole.