The Problem of Subsequent Therapists and Language Deficits
One of the most difficult aspects of being the victim of abuse by a trusted professional is to know how to find assistance. Many want to find a therapist to help them, and at the same time believe it was lack of enough knowledge of what is good therapy that got them into such trouble to begin with. The latter issue is both true, and not so true, as I will attempt to explain in this paper. Still, in the aftermath, what to do next? If assistance from other therapists is sought, it is critical to know how to judgeand quicklythe capacities of subsequent therapists to help. There are many questions: What should they know; how should they act? What are the signs of danger? Why are therapists who are predators so difficult to recognize by victims, friends, and authorities before, during, or after they become exploitive? If trained therapists can also be victimized by other therapists, how is it they can also be blind until too late? And why are so many therapists incapable of being “subsequent therapists?”
One problem concerns how patients and clients (hereafter I will say “client”) understand therapy. A common assumption among clients is that psychotherapists are alike in their training and skills. That includes having an objective view of problems brought to them. After all, we have the physician treating the physical body as the most obvious yardstick with which to compare them. There, the most common complaints, e.g., a cold, the flu, a broken bone, or appendicitis, are treated using similar protocols (at least we believe so), unless the physician claims to be an “alternative healer.” When it comes to the “mind,” however, hundreds of theories are practiced with the same certainty as when treating the bodyand many are at least partially the concoction of the therapist. Sometimes validating the theory becomes the objective, and the client is molded to fit the theory. The problem that initiated coming to therapy is never well understood. Indeed, many therapists believe the client is an unreliable witness and reporter, and therefore has little or no idea why she or he is coming for help. (I believe neither party may be able to see beyond societal horizons to know the real causes of distress in modern humans, but that is beyond the scope of this paper.) Those working from a transference model set out to make themselves the new object of the client’s concern. And for reasons I will discuss, many therapists are truly unable to understand the nature of abuse by professionals, and the extent of damage it causes, even if trained in professional ethics. In this they are, like most others in society, including friends and family, not equipped to see well enough the harm caused. This poses a great problem, not only for finding a therapist to help, but also for prevention efforts in the training of therapists.
Many trained psychotherapists have themselves been victimized during their own ventures into personal therapy. Knowing what “good therapy” is does not guarantee avoiding harm. In the words of one, a licensed clinical social worker, “My training did not help me at all. I felt myself split in two. One partmy feelings, my intuitionscreamed at me to get out. I obsessed constantly, had headaches, body tension, stomach upsets, sleeplessness, and feelings of great anxietymixed with feelings of adoration. It was the same chemical response as falling in lovewith the wrong person! The other partmy rational thinking parttold me to stay, that I was ridiculous to think ill of her, that of course she was a good person, and exactly who I needed to help me. Unfortunately, I stayed with the part that named what was happening as beneficial. It was the part that talked to me in words, and I believed in the words.”
So what’s wrong with words? Lots, and especially if there are not enough of them. We use language to think with, and as the only way most of us have to frame and see reality. This benefit to us can also be the heart of the problem. As the social worker later analyzed with me, she did not trust her intuition, and the language she had did not include adequate words and concepts for this sort of abuse. An explanation for this comes from linguist George Lakoff who says that metaphor underlies language, and without metaphors, words and stories that create pictures in our mind, we cannot see or hear a new concept. Without language to describe something, it can be as though it does not exist, or something else exists in its place. I believe knowing more about what this means is of crucial importance in knowing how to judge a subsequent therapist.
Cultures both expand knowledge and limit it through the words they have to use. The language we learn in childhood guides our thinking and assumptions. As students know, learning foreign languages opens the door to expanded ways of seeing new concepts. When it comes to therapy, whether trained as psychotherapists or not, in our society we have a lack of words to conceptualizedescribe, see, and understanda rapacious, malevolent, self serving “healer.” Where there is a void, we fill in with what is readily available. As we apply the idea of “physician” to therapists kindly, uniformly trained, and scientific in approach to problem solving, our minds attach familiar metaphors of goodness to therapists of all ilk. Only those we see as having personality or gender “differences” are we likely to reject. Once accepted, even the most abusive become surrounded by pictures in our mind of “good shepherd,” selfless and wise teacher, and kindly country doctor, so when things go badly, we do not have ways to see well enough to understand. Lacking metaphors of a “bad shepherd” and language and concepts coming from that picture, there are wide-open spaces in our conceptualizing mind for predators, disguised as healers, to cause harm. Victims typically are confused over feelings for the perpetrator and filled with self blame. They accept responsibility for what happened, want to protect the perpetrator, and this creates ambivalence about every aspect of the problem, including what is needed to heal. If the exploitation becomes sexual, the most available descriptor is “affair.” An affair requires mutuality, an equal power relationship, which is not true in a therapy relationship. More confusion. It is no wonder that the one person thought to really “know” the victim, i.e., the perpetrator, is reached for, over and over, as the only person to repair the situation, the feelingsin a continuing cycle of abuse, until something interrupts it. The ending often comes as abandonment by the therapist, or withdrawal for a variety of reasons by the client. And even then, the urge often is to somehow to return to the perp, as though an explanationor a good telling off!will make things better. The basic goodness and skills of the therapist or therapy model is seldom questioned.
Language, properly applied, is also a safety neta web of understanding between people. When it is missing, we can fall hard, unsupported, into a barren land. No wonder there is such despair, isolation, and feelings of abandonment. Without language we cannot effectively communicate with others. Without communication, we feel truly lost. With few exceptions, other therapists have the same limitations of concepts and supporting language as anyone else. Knowing the rules of therapy is not enough.
So an appropriate subsequent therapist (or wise friend, if available) who can be helpful is probably a rare person. The good news is that there are some who know what to do. Armed with information I did not have in my initial search, but gained when I found someone who was helpful to me, the ability of a person to help, or not, may be ascertained. I discovered the appropriate helper gives immediate support through comfort, validation, information, and willingness to hear the problem described, over and over as needed, while the victim tries to frame it in ways that can be understood. A powerful response of outrage at the offending therapist is validation required to help the victim build pictures in the mind, and from that, the language to break through barriers and build a new conceptual basis for understanding. This outrage should continue rock solid throughout all future sessions. The appropriate subsequent therapist also needs to be ready to assist in ways the client feels are beneficial to redress the problem, be it filing formal complaints, undertaking lawsuits, trying to change applicable laws, writing books, and engaging in other creative expressions for telling the storyor none of the above. In not all cases is taking action beneficial to the victim. Only the victim can decide that question.
For me, the route to finding appropriate help was not direct. What went wrong is as instructive as what went right. When I found myself in an abyss of profound suffering and isolation, like the protagonist in fairy tales, I sought a helper. I made a list of several therapists in my locale, all unknown to me, to interview. Three identified the issue as one of ethical violations but were only mildly troubled by that. Instead they each, in their own ways, thought I should work on myself, what I had contributed to the problem. It was a sort of a “making lemonade out of lemons” approach, rushing straight to the benefit I was going to reap from the experience if I just learned more about what was wrong with me. One talked about “transference” as though it was somehow my fault. My transference had overpowered him, his counter-transference too strong, I heard offered as explanation to excuse him, and also to simultaneously please me, that I had been that important to him. One, a psychiatrist I persisted seeing for too long even though I felt no relief, thought medication and accepting self responsibility were the answer. She said angrily in the third session that my insistence on wanting to talk only about the other therapist after she had told me in the first session the problem was that the other therapist was “limited” and “unethical” (assessments of him that astonished me) showed my inability to work on my “real issues,” which she concluded began when I was a baby. Another said that to understand what happened I needed to enter into past life regression. She said the therapist probably was a figure in my many past lives I hadand seeing that would heal me. That certainly contributed to the wish I already had that he was a “soul mate”another acceptable metaphor in our society, and one that almost inevitably fans the flames during exploitation. All seemed to want to rush me towards the goal of forgiveness of myself and the offending therapist as an appropriate goal of therapy, the answer to feeling better.
Today having heard the stories of people in various stages of recovering from abusive therapy, I know that these counseling directions may not give adequate help, and if not helpful, may be harmful. Many theories of the mind may be entertaining and/or stressful enough to divert from the problem, and that can seem helpful. But they may not contain within them the ingredients to build a strong enough ladder to use to climb out of the chasm. We need to emerge with practical information and emotional balance to see the world with clearer reality needed to not be again so easily deceived by more con artists, wolves in sheep clothing masquerading as helpers and healers. Without that, the painful experience may serve only as one more set-up for further harm.
Many victims say they are helped the most by staying out of therapy. They prefer being in a mutual support group of others with similar experiences. As support groups most likely are not available locally, the TELL web-site was created by survivors to give that sort of aid and comfort to others in the worldwide community via the internet. As neither option was available to me twelve years ago, luckily I eventually found a psychotherapist who could help. Although I refused from her any theories of the mind or psychological skill building techniques and training used on me, she seemed to me more likely to help me than a friend (even if I could have found one who could have comprehended the situation and supported me) because she WAS someone trained in various theories of the mind, and her opinions as an expert were important to me. In this, I was still of the belief that only experts can helpas I was still within the same cultural framework that set me up to be abused, rather than outside it. She helped because as a feminist she did not maintain artificial boundariesincluding the need for me to see her as an expert or call her “Dr.”but was able to maintain a climate of mutual respect with me, even when at times I angrily lumped her into the category of offenders.
So the best “therapy” I eventually found was what might be seen as “no therapy” even if with a therapist. We might well wonder how a few separate themselves from the pack to see more clearlybut that is beyond the scope of this paper. It is enough to know that it DOES happen, and that is fortunate when we can find them. Dr. Brady was immediately angered by what happened to me and was not worried that because of my past experiences of harm from psychotherapists I would have “transference issues” with her. She fully obliged me when I told her I needed a sounding board, someone to hear what happened to me. When I rudely demanded that she “sit down, shut up, and keep your theories to yourself!” she patiently heard my complaint repeated and elaborated upon, twisted and examined from one side to another as I attempted to more fully find language to express the inexpressible, and to seek answers for the question so important at the time for me: “Why did he act this way?” She was a rock to cling to in turbulent seas of bewilderment and emotional distress as she asserted continually that what happened to me was not my fault, that the responsibility to keep things safe was in the hands of the therapist, and fault lay one hundred per cent with him.
Each person I know who persists in seeing through to a greater view of reality emerges with new strengths. By telling my story, and then writing chapters for a book about it, slowly I began to do the work of retrieving and adding to my intuitive (for lack of better language) powers, powers which few of us in our culture ever use well. These powers are damaged by living in a general societal environment of lies and illusion, where language is used to deceive, and not enough to explicate. In a climate of deceit we are left with our intuition in shreds. We wonder if we are like Humpty Dumpty; can we ever put ourselves back together again? I came to realize that, as Bill Clinton described himself, he exploited because he could. Exploitation is about societally sanctioned power and control. It is not about love. As the power of acquired language increased to describe the indescribable, that once burning question about motives became irrelevant. It was replaced for me with a much greater understanding of the need to see through deception using “common sense” and intuitive nudges, and to seek out truth as it grows in isolated clumps; recognize and cultivate it. This is not a small effort. Our culture today seems against it. If that were not so, there would be adequate language to guide us.
“Grooming process” is an example of a metaphor around which constellates the various behaviors that should set off warning lights: making the client feel special through confiding in her, not charging, giving prolonged sessions, and other favors. Sometimes old metaphors can be applied to new realities. “Foxes guarding the chicken house” is a metaphor many have found to describe the difficulties of getting professional and licensing boards staffed by psychologists, psychiatrists and other forms of psychotherapists to adequately judge and censor an exploitive colleague. We need more metaphors concerning abuse of power and betrayal of trust by leaders to better see the truth.
Those who gain concepts to push aside barriers to seeing reality have a fresh take on life. My tiny infant grandsons, twins born two months prematurely, are a metaphor for this. Now four months later, they still approach the world waving fists so tightly held that the effort to pull apart a thumb to suck is a challenge, even as they work on it persistently. Those fists are like tiny buds, attached to a growing base of awareness, curiosity, and knowledge that will expand and contract for them through language. As their hands open as blossoms, so will their ability to touch, to hold, to experiment and otherwise experience the world with tender, vibrant, sincere vitality. It is our hope for us, too. It takes time.
Readings for broadening understanding:
Lakoff, G. (1990) Women, Fire and Dangerous Things. U. of Chicago Press. Describes how language dictates how we think.
Singer, M.T. and Lalich, J. (1996). Crazy Therapies. What are they? Do they work? Jossey-Bass.
Smail, D. (2005) Power, Interest and Psychology. PCCS Books, London. Describes social influences on individuals, their communities, and on the practice of psychotherapy.
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