How to Know if You Have an Abusive Therapist

Spotting an abusive therapist may not be as easy as you think

Therapy_Abuse_NYC

This may be a strange thing to consider, but your therapist is, first and foremost, a regular person. No matter how many degrees, years of training, or fancy certificates, they are still human. With this, unfortunately, comes the reality that flaws will abound. Sometimes, in worst case scenarios, you may even have an abusive therapist.

School doesn’t teach therapists how to, well, handle their s$@#. Used to be that to become a therapist you were required to go through years, if not decades, of therapy and analysis so as to not impute your problems onto vulnerable others. Sadly, this is no longer the norm nor even encouraged in most training programs.

Good quality therapy, which does exist, helps people to better understand their patterns and their positive and negative (and everything between) qualities and tendencies. Such therapy also helps you to gain insight into your long-standing defenses, to realize your underlying impulses and biases, and to work through unresolved trauma and wounds. It is a space that is empowering, safe, and compassion, even while also being challenging.

When a therapist has not gone through this process themselves, not only is it difficult to really empathize with what it’s like to be on the couch, so to speak it is almost guaranteed that the therapist will act out their unconscious and unresolved issues with their clients.

This was exemplified in a recent New York Times article entitled “Is Cutting Off Your Family Good Therapy?” The tik-tok therapist who is central to this story is described as a controversial and popular therapist who is fighting back against oppressive old-world norms in society and therapy.

It is true that blaming the client for their problems, insisting upon forgiveness or maintaining familial relationships, and ignoring trauma are well-documented issues in many practices. However, a full swing to the opposite extreme is just as damaging. What is apparent is that this influencer therapist is engaging in egregiously inappropriate and unethical practices.

This man has been reported to the ethics board on multiple occasions, to no avail. It is clear that he is striving to be a constant rescuer to his patients, projecting his past trauma onto their issues, and never seeing any individual for who they are, separate from him. His aggressive insistence on a singular form of resolving one’s problems is about control, not care.

Therapists shouldn’t be imposing their beliefs one way or the other. Families may be central and important to some and not so much to others. It is a therapist’s job to help clients learn the skills to identify and stand up to abuse, in their own unique ways. Sometimes that may mean cutting off parents or others family members. Certainly, not always.

The above-mentioned example of an emotionally manipulative and possibly even abusive therapist is particularly disturbing because of just how popular he is. It is incredibly difficult for vulnerable people, especially those with histories of abuse, to recognize an abusive therapist and get out. And this example is normalizing it in a major way.

Such forms of abuse are difficult to identify and therefore also end up being insidious, like an invasive disease you don’t even know you have. There are, however, some ways to tell the difference between a human therapist who makes mistakes (hint: that’s every single one of us!) and the much rarer individual who is recreating abusive dynamics that are detrimental to your mental health.

Therapists Who Make Mistakes

The longer you are in therapy, the more mistakes your therapist will make. There’s no avoiding this and it’s often an opportunity rather than a problem. A good therapist will use such moments to model taking responsibility without excessive shame or guilt, to teach skills to navigate conflict in respectful and healthy ways, and to normalize acceptance of flaws. Possibly more importantly, these experiences of conflict can help you learn in the moment that your concerns and needs/feelings are valid; that it’s ok to express feelings of hurt or anger without retaliation.

If you think of something that annoys you, your therapist will probably do it eventually. However, some mistakes are more common than others, for instance:

Being too forceful in trying to build insight; inadvertently making an off-hand insulting remark; seeming dismissiveness, especially at the end of a session; forgetting important information … on rare occasion; colluding with you in such a way that you both are in denial of something important; becoming defensive in a heated or difficult moment; and invalidating or misunderstanding you.

These are also ordinary issues that arise in almost every relationship you will ever be in. Which is why #1 you can’t avoid them in the therapy relationship and #2 when they do arise, it’s an opportunity to learn how to navigate these moments in a healthy and productive way.

What differentiates a mistake vs harmful behavior is how your therapist responds to these moments. If they respond by ignoring you, denial, frequently turning it back on you and your issues, profusely apologizing to the point you feel you must now take care of them, or gaslighting, then you might need to consider if there is a bigger problem.

Inappropriate But Not Abusive

Like with anything, not all therapists are created equal. Of course, attributional bias will dictate that most therapists will firmly believe that they are the exception and everyone else is the problem. Fortunately, there are some clear objective red flags that indicate a problematic therapist.

Most frequently, you are likely to encounter inexperienced and undertrained therapists who are more focused on fixing immediate problems rather than deeper long-lasting change. These professionals are likely very lovely people who are doing their best with limited resources. Nevertheless, it’s still a problem for you, the client, and just because they are nice or good people doesn’t mean you owe them anything or need to continue in a space that isn’t really helping.

A few examples of this are a therapist who: is more like a paid friend who never challenges you; always agrees with you or tells you what you want to hear; doesn’t have good boundaries (lets session run over, discloses their personal information, is inconsistent with expectations and scheduling); frequently gives you advice; arm-chair therapizes and diagnoses other people in your life; does things for you instead of teaching you the skills or exploring barriers to doing them yourself; makes therapy always feel comfortable and easy; frequently offers sweet platitudes that are meaningless; ignores exploration of difficult emotions and trauma; etc.

If the above issues sound familiar to you, please know that this is not therapy. At best, it’s supportive counseling. Counseling can be nice when going through a tough time, but it doesn’t lead to fundamental change or growth in most circumstances.

More flagrant situations of an inappropriate or problematic therapist can be a bit harder to define or identify because often it’s about frequency and intensity of mistakes more than the act itself. At other times, though, one mistake is enough. For instance, if diagnoses are used to blame you for conflict in the therapy room instead of exploring why the conflict is happening from both sides this is a red flag. Diagnoses should never feel like name-calling, even if that’s often what they end up being anyway. Further, you are coming to the therapy space for help and hopefully your issues are not weaponized against you.

Having said that, sometimes it is your issues that are arising in the therapy space, and they need to be identified and explored. But this should be done in a non-shaming and compassionate manner. If the therapist never takes responsibility or frequently comes across as accusatory/shaming rather than trying to understand, the line might be getting crossed into inappropriate territory.

Some other red flags: falsely guaranteeing some kind of outcome; insisting that some kind of activity or intervention MUST work for you because it does for everyone else; frequently inserting their opinions, rather than trying to understand your perspective or sticking with science and research; recurrently changing schedules, being late, or missing sessions; rarely remembering important information; seeming cold and neglectful; or talking about themselves.

Crossing the Line into Abuse

Overt and obvious signs of an abusive therapist are quite rare and often pretty easy to identify. Sexual harassment, sexual advances, racism, derogatory statements, or conversion therapy are all forms of objective, clear abuse. If you ever find yourself on the receiving end of these acts, report the therapist immediately.

More frequently, however, is the therapist who has not worked through their issues and is acting them out in the therapy relationship. It usually would fall under the loose umbrella of emotional or narcissistic abuse—it’s a lot harder to identify.

Some signs that you might be in an abusive dynamic with your therapist are: you feel bad about yourself within the therapy relationship most of the time; you are afraid of your therapist and they don’t change to help you feel safe; you feel frequently invalidated or dismissed; you often feel you need to take care of your therapist; you never know which version of your therapist you’re gonna get; you’ve come to believe that you’ll be in therapy forever and your therapist has no specific goals to end; or generally feeling something is really off but you can’t talk about it and don’t know what it is.

Here are also some complicated dynamics to watch out for:

  • Your therapist shares their own trauma history in an effort to help you feel understood. Not just in a brief moment, but as a central part of the work. This might feel amazing to you – “Wow, a therapist who understands!” But that’s not what’s happening. This is an unskilled therapist who is using your time and your money to insert their issues. They are trying to bond with you over trauma instead of being your therapist.
  • You start to view your therapist as your savior … and they agree. It’s normal to feel grateful for ways in which your therapist might have helped you. But it becomes abusive when the therapist needs to be in the role of rescuer; if they reinforce this dynamic instead of building your own sense of self-empowerment. This dynamic overtime will lead to you feeling small and helpless, overly dependent on your therapist, and will become a situation that relies upon you always being in need of saving.
  • Finding that your therapist makes you feel guilty, on a regular basis, for your lack of appreciation of them. They may become withholding or cold when you’ve “done them wrong” somehow, like missing or cancelling a session or not agreeing with them.
  • They badmouth your family and friends to such an extent that you are solely reliant upon the therapist. Or, like the therapist in the NY Times article, they insist that you cut off friends or family instead of helping you figure out for yourself what is right for you. Isolating you away from any other support system is a common first step in an abusive relationship.
  • You start feeling overly dependent on your therapist and they don’t encourage you to seek out support in other relationships or help you learn how to build those relationships. It’s normal to feel dependent. It’s not normal if the therapist doesn’t push back for you to learn how to build a social network of your own.
  • They aggressively insert their opinions and leave no room for disagreement. If you try to disagree, you are manipulated into agreeing anyway or left to feel something is wrong with you for not agreeing.

How to Know the Difference

People with histories of abuse are both the most likely to end up in an abusive dynamic with their therapist and also have the most difficulty knowing the difference. The problem is that if you have a history of abuse (i.e., feeling neglected, chronic invalidated or misunderstood, intense fear or dread, chronically criticized and humiliated, etc.) you WILL feel that your therapist is doing these things to you! If you don’t, it is likely that your therapist is avoiding the difficult stuff.

But you should be able to talk about these feelings. Your therapist should be able to take ownership of any ways in which they may be contributing to these feelings, rather than frequently or always putting it back on you. And these feelings should be part of the process of therapy, not made to be bad, wrong, or unwelcome in the therapy space.

In general, if you feel like something is off, it probably is. It may or may not be abusive, but there are enough therapists out there for you to move on.

On the flip side, if you feel like the only way you can do anything is if you keep going back to your therapist for them to remind you of what you MUST do, get out.

Just because someone is super popular, doesn’t mean they are helpful. It could instead mean they are more like a cult leader. Having someone be so passionate about how to solve all your problems might feel good or like you’re being taken care of.

Sometimes, however, what’s happening is that you’re becoming a pawn in the therapist’s own trauma enactment.