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Madeline AimesLearning From Bad Therapy with Madeline Aimes
A place for constructive discussion about harmful therapy: the hurt, the recovery and the insights.

Psychotherapy: What Can Go Wrong

Madeline Aimes Updated: May 9th 2011

Like any treatment, sometimes psychotherapy takes a harmful route, and clients often are unaware of caution signals. Here are pitfalls I’ve culled from the accounts of others and from my own experiences.

sad womanUnrealistic expectations: Therapy can’t transform us into another person or make our lives, boundlessly, ecstatically fulfilling. Nor will it insulate us from all pain, slights and sorrows. We can only hope it gives us tools to better handle challenges and avoid many self-created problems.

Romance or sex with the therapist: Any romantic or sexual relationship is a clear violation of professional ethics codes, and can be very harmful. Any flirtation, grooming or seduction takes therapy far from its intended course. Therapists advise leaving before you get hooked if this develops or threatens to occur.

Any other outside relationship with the therapist: Professional therapy is designed to be within the confines of strict, pre-defined boundaries and roles. That means you should not socialize, barter, work or volunteer for your therapist -- in any capacity. “Dual relationships” also are contrary to professional ethics. These activities can seem innocent from their onset, but the price can be emotional harm.

An unrequited or requited crush on your therapist: Some say that this “transference” is healthy in treatment. But here’s the argument: If you have a crush outside of therapy, you receive real feedback from your love object. In treatment, the therapist’s role is to be focused on you, which may provoke an obsession that leads nowhere. This situation could be more harmful if a therapist --even unconsciously-- encourages your passion. Crushes are painful enough without a hoped-for love that never will be delivered.

Having little life other than therapy: Therapy should be a tool, not an existence. If therapy takes an importance that overshadows the other 167 hours a week, something is out of proportion.

Feeling small in the presence of the wizard: Therapy isn’t a mystical initiation or anointment, nor do therapists hold magical, omniscient powers. They are counselors with training and an outside perspective. It can be harmful if we uncritically put ourselves into anyone else’s hands, thinking them strong enough to hold or balance us. If a therapist feels like a “wizard,” consider if it’s from your disposition or if your therapist encourages you by thinking for you or intimidation.

Dependency: This is one of the more discussed risks—of therapy lulling us into such an attachment that we feel incapable of handling challenges without a therapist to shore us up. As soothing as it feels to be supported, overreliance ultimately might turn crippling.

A cult-like change in values: In extreme cases, therapists have encouraged their clients toward life changes that are opposed to their values. Clients have hastily shed their friends, family, or unquestionably followed their therapists’ instructions. Or they’ve felt smug compared to others not in therapy or with this particular therapist. We don’t shed personalities like coats in therapy; we’re exploring new choices within lives we already lead.

Feeling like a child again: It’s tempting to return to the privileges of childhood where we can be irresponsible and singularly catered-to, but this isn’t adult life. This safe-seeming womb can be double-edged, comforting, yes, but also leading into learned helplessness and unrealistic thinking. A childish role moves away from adult competency and real fulfillment.

Blaming and victimhood: Yes, people can be cruel, irresponsible and disappointing, but everyone acts from his own pain and deficiencies. It’s distorted and self-centered to see them as absolute villains. After all, we have our reasons when WE hurt or disappoint people. Turning our tormenters into cartoon villains ignores their humanity—with viewpoints, wounds, needs and flaws not unlike ours.

Self-pity: As a way of bonding, a therapist may encourage us to endlessly review our wounds. This can turn into a counterproductive habit and certainly make us annoying conversationalists.

Obsession rather than action: While self-examination can be constructive shouldn’t it be a tool rather than an end in itself? Reflection toward goals can be problem-solving. Aimless stewing might not move us anywhere, and make us annoying conversationalists. Something’s wrong with me: Is there a human alive who isn’t at least somewhat, narcissistic, fearful, self-sabotaging, angry, moody, confused and even occasionally irrational? These traits don’t mean “something is wrong with us,” no matter how therapists categorize us for the insurance company. Magnifying our normal human failings can leave us feeling like “patients” rather than normal tattered, torn beings.

Accommodating the therapist’s roles: Though therapists should be trained to recognize their own sabotage, unacknowledged agendas can take over. If a therapist needs to be allknowing or dominant, debate you, rescue you, or turn into your parent, supervisor, critic, real-life pal or lover, this folie au deux (shared distortion) can cause serious harm if it continues over time. If pleasing your therapist dominates your treatment, this might be useful to review.

Feeling invalidated: Therapists might believe they know you, but they make mistakes. If you feel accused, contradicted or blamed, or if you feel the therapist is spinning YOUR story inaccurately, it’s time to get the stories straight. If you find yourself between sessions looking for ways to be better understood, and you can’t resolve this in sessions, something may be wrong with therapy.

Feeling bullied or diminished: If your therapist feels like your enemy and turns your self disclosures into ammunition for put-downs, gives you hurtful labels or justifies rude or unprofessional behavior, this is a red flag. If the therapist persists despite your objections, or you sense bullying will escalate if you discuss it, it might be time to leave this treatment.

Your therapist is obsessed with topics you aren’t: If you’re out of synch, question whether the therapist is proposing valid guidance or his own agenda.

Feeling sided against: It’s detrimental if your therapist adds to conflicts rather than assisting understanding. Clients have reported this in couples or family counseling. Clients also have been “sided against” in individual therapy, such as the recently divorced woman who was admonished by her male therapist that she didn't dress provocatively enough to please her husband. If you note the counselor becoming his own source of mischief, it’s important to question treatment.

You have both reached an impasse: If sessions deteriorate into circles of disagreement or resentment, this doesn’t help you, no matter what your therapist labels it.

You can’t leave: You want to stop sessions, and your therapist won’t support your decision. It’s your life and your treatment. You ultimately have to take the reins, just as you would with any medical treatment.

Therapy didn’t help: Unfortunately, sometimes therapy simply doesn’t work. It’s painful if we entered with high hopes, or we feel injured to boot. Many factors can cause this breakdown, and it’s no more our failure than when any other regimen falters. Ultimately we chart our own lives and we can find growth from many modes and guides as we shift to a better road. Being in therapy can have unintended consequences, including strengthening our powers of self-reliance if treatment goes awry.

Web Resources:


Madeline Aimes

Madeline Aimes is a pseudonym for a New England freelance writer. She has been a public relations executive, newspaper writer and editor and a script writer. In recovering from her own damaging experience in therapy, she hopes for constructive conversation between consumers and professionals around this topic.

Reader Comments
Discuss this issue below or in our forums.

Time - Paul - Aug 28th 2014

I enjoyed your article. My greatest fear is that I am not receiving the help I need in my present therapy. In fact, I feel worse, much worse then when I entered therapy. My life is in shambles. Yet a deeper fear I harbor is that I will not be able to handle the pain if I leave my therapist given the depth of dependence upon her that I have cultivated during nearly three years of therapy. My question, then, is: Did you, or have you, fully recovered from the harm you suffered as a result of your experiences in therapy? You wrote at Disequilibrium1's Blog that "you never [were] in crisis." I was not either but I am now. I feel I must quit but feel equally powerless to do so.

professional accountancy - - Jul 21st 2014

Unlike in other professions, there is not reliable professional accountancy of the therapist work, not in Spain. Leaving the patient in her hands; socially, psychologically, and almost broke financially. It was only for the support of my partner, and my previous experience working in mental health nursing in another country that help me to get out of a cult like situation. Years later, I am still dealing with her anger and frustrations, trying not to blame myself for expecting the treatment that as a nurse I sow and deliver, and in Spain I assumed was a common practice.


Fiendish Therapist - Fiona Dougherty - Apr 29th 2014

Blaming and victimhood: Yes, people can be cruel, irresponsible and disappointing, but everyone acts from his own pain and deficiencies. It’s distorted and self-centered to see them as absolute villains. After all, we have our reasons when WE hurt or disappoint people. Turning our tormenters into cartoon villains ignores their humanity—with viewpoints, wounds, needs and flaws not unlike ours.


I agree

My therapist had a personality disorder (sociopathy) and in a strange way he was very naive and endearing but he did actually resemble a cartoon villan -he looked like Dick Dastardly (Wacky Races) minus hat and mostache.

He dressed all in black and when he was up to no good his eyes narrowed and darted from side to side he did look like a pantomine villan LOL


I can laugh about it

About blaming and victimhood - Red - Apr 27th 2014

Sorry,but I believe that you were off the mark about blaming and victimhood. Some people really do fit the description of an irredeemable villain. Some people are so evil they have nothing in common with your wounds and experiences and are not acting out of any prior hurt. If you have ever been physically or sexually abused by a sociopath or sadist merely for the amusement of it, you will know what I mean. What makes it worse is when the therapist tells you not to feel angry at the abuser or blames you for the abuse, because, after all, you are just as bad as your abuser and you need to be fixed or changed. Not the abuser, you and only you.

Bad therapy can happen to you - - Dec 25th 2013

If your therapist thinks that they are qualified to advise you as to which medications you should be taking RUN FOR YOUR LIFE! 14 years ago a therapist told me that I needed to be taking antidepressants and even went so far as to tell me which ones I should be taking. Rather than refer me to a psychiatrist she thought that she was knowledgeable enough to make those decisions herself. She knew that I was Bipolar but still advised me to take antidepressants without any type of mood stabilizer. That is the worst thing that you can do if you are suffering from Bipolar. Within months my entire life was turned upside down and I managed to destroy everything that had ever mattered to me. The hardest part to accept is that it could have easily been avoided. No psychiatrist in their right mind would tell a patient suffering from Bipolar disorder to do that. My therapist apparently didn't know that and my entire life was destroyed as a result. At least she got to feel good about herself by pretending that she was more qualified than she really was.  

great article - - Aug 7th 2013

very useful, to the point and well done piece.  i have been on both sides of the couch :) and you are writing about very important, unfortunately necessary issues.  This should be required reading for all mental health practicioners.  I plan to share it with my clients, too.  Thank you!

If I'm out of my mind, it's alright with me - - Jun 20th 2013

It's been over twenty years since I was involved in an abusive therapeutic relationship.  To summarize, I was referred by my family doctor for anxiety and depression.  The therapist asked my then spouse to come in for a series of collateral consultations.  Fast forward a few years, and my then spouse had divorced me and married the therapist.  There is still a lot of pain involved, and my children have been negatively impacted into childhool.  Expectedly, the state board wouldn't touch it.

Be careful in your choices of a therapist.  I tried to get the both of us out from this man's influence once things started to deteriorate,  which led to a triangulation.  He took her side in divorce proceedings.  What a mess

Great article - Marina Tonkonogy - Aug 3rd 2011

Very clear and to-the-point article, that captures major dynamics of harmful therapy. I could relate to 90% of what is described here. Thanks a lot. As a therapist and as someone who was traumatized in therapy I can see the issue from both perspectives and that makes me appreciate your article even more.


Poignant observations - Jeanette Bartha - Jun 16th 2011

Your articles caught the most important issues regarding the therapeutic relationship - which I don't often see.

I think that by the time love for therapist develops, cult-like associations, etc. the brainwashing has already begun and the thought reform in motion.

That's to say, the patient is being transformed into someone the therapist is molding.

Good article, thanks.



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