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When we wake up and realize we've been abused by a therapist - and often it does feel like waking up from a bad dream - the first question many of us ask is how and why did this happen to me? How could this happen to me? I'm smart, savvy, not particularly gullible, how did I allow this to happen? We blame ourselves. We feel ashamed. We ask: Is there something wrong with me that made this happen? Did I really want this in some way, and so do I deserve whatever I got? The short answer is no, it's not your fault. It's never your fault. Abuse is always 100% the therapist's fault. It can happen to anyone. Every day we hear from smart, savvy people, sometimes mental health providers themselves, who get abused by a therapist. The blame always resides with the therapist who has violated ethical boundaries, exploited vulnerabilities, and used a patient to satisfy their own narcissistic needs. They have groomed, lied, manipulated, misled, gaslit, and coerced to corrupt the therapy relationship. Sometimes they are sociopaths, other times they are so mentally unstable themselves that they have acted out their own illness on their clients. Or best case, they may just be undertrained, overly confident in their own abilities and experimenting with approaches about which they have limited understanding. All that said, what we bring with us to therapy, what it is normal to bring to therapy, may contribute to our not being able to recognize abuse or incompetent therapy for what it is and to walk away. These factors may also contribute to the intense pain, disorientation, obsessive thinking, and self-questioning that we feel in the aftermath of abuse. What are these factors? 1. The wish for healing and health. We come to therapy because we want to feel better. We want to change and grow and improve. We want the pain we're in to go away. Often we are in crisis and already destabilized by events in our lives. The therapist tells us that he/she is going to help us heal. Often even a therapist who has violated boundaries and corrupted the therapeutic relationship will insist that their behavior is helping us in some mysterious way. If we question or our gut tells us what they are doing is not OK, they may attribute those feelings to our "resistance" or "self-sabotage." They may tell us that we have to feel worse before we are going to feel better. "Trust me and not your own gut instincts," they say. The strength of our wish for healing makes us believe them. 2. The wish to be seen, loved, cared for, made safe. It is a normal human desire to be seen as our full selves by another person, to feel loved and cared for, to be kept safe. The therapy room with its separation from the real world often feels like a cozy sanctuary. We are encouraged to let our guard down, to tell all our secrets, to be vulnerable. For many of us, therapy may be the first time in our lives that the focus has been all on us. The early days of therapy can make us feel seen and recognized for who we are for perhaps the first time in our lives. The therapist's attention, non-judgmental reactions, eager interest in everything we have to say can hold out the promise of perfect love and safety. When the therapist's behavior changes, we may hold on to our sense that the therapy room is a safe place and rationalize that whatever is happening there must be in the interest of keeping us safe. 3. The wish to feel special. It is normal to not want to feel like just one more client in the therapist's roster. We want to stand out. When the therapist starts to cross boundaries-extending sessions beyond the time limit, taking sessions outside of the therapy room, confiding in us, even touching us in a provocative way, we feel singled out. The abusing therapist may even use the word "special" to describe us. They may claim that they have never crossed boundaries before, that it is our specialness making them do it. They may say that they are really in love and risking their career for us. They may say that they want to "reparent" us or that we feel like family. Just as in an abusive family, they may make us promise not to tell. They may say or imply that the usual boundaries are stifling and oppressive and don't apply to special people like you. 4. The mystification of the process of therapy. Many of us come into therapy not knowing what to expect. Historically, therapists have been less than forthcoming about exactly how their methods or techniques work, or whether there is any scientific validity for them. The fact is, there is limited scientific evidence for much of what therapists do, and the way they mix and match approaches makes scientific study impossible. There are also fads in the therapy world, so that a therapist may receive limited training in some new technique and try it out without any supervision or additional training. The more mystified the process, the more we are unable to discern if what the therapist is doing, saying, or requiring of us is helping. Since so much remains unknown about the human psyche and how people change and heal, it is easy to believe that whatever "unorthodox" approaches the therapist is taking must be therapeutic. The abusive therapist may present him or herself as a rebel, a rogue - fighting stodgy institutions and rules that only get in the way. 5. Emotional investment. The longer we are in therapy with someone, the more emotionally invested we become. The more secrets we tell, the more vulnerable we have been in the therapy room, the harder it is to give up and walk away. Even if a therapist is cruel or sarcastic or demeaning, we may feel attached. Since intermittent reinforcement is the most powerful form of reinforcement, the erratic-sometimes nice, sometimes nasty therapist-may be the hardest to leave. 6. When we start to question what's going on in our therapy, the abusive therapist will blame what has happened on our wishes. Didn't we push against the boundaries because we yearned for love that went beyond the limitations of the client/therapist relationship? Didn't we hate when sessions ended because we wanted to stay in the safe therapy cocoon longer? Didn't we press the therapist to reveal personal details? To give us a hug? Didn't we want to "seduce" the therapist? Didn't we try to get the therapist to become the perfect parent we never had? We made the therapist do it, against his or her better judgment, and now, if we tell, we are threatening his or her livelihood, family, survival. It is easy for an abusive therapist to convince us that the blame lies with the depth of our own neediness. 7. The Return of Childhood Feelings. The therapy room with its uneven power dynamic, inevitably brings back feelings from childhood. It is normal to feel sometimes like a child in the therapist's presence, to see the therapist as a parental figure. Some clients report even misperceiving the therapist's physical appearance. They are shocked to see him out of the office and to realize he is not as big or strong or attractive as he seemed in the room. It is normal to re-experience feelings around needs that were and were not met when we were very young. It is hard to protect our interests as adults in the therapy room when we feel reduced to a childlike state. Abusive therapists exploit these feelings. It is not unusual even while being sexually abused to feel more like a child with a parent than an adult with an adult lover. 8. The experience of sexual feelings for a therapist. "Falling in love" with one's therapist or longing to have sex with them is a common feeling. It may feel like "real love" or a more powerful longing than one has ever felt before. The intimacy of the relationship, the idealization of the therapist, the closed setting of the therapy room, even the fact that sex feels forbidden can all contribute to sexual desire for the therapist. Sometimes people who think they are in love with their therapists see them in some other context, the grocery store, for example, and wonder why they ever felt attracted to them. Competent, ethical therapists know how to help a client deal with and make sense of romantic or sexual feelings without acting on them. They do not exploit them. Though we may hear stories of successful marriages that began as therapist/client relationships, 99.9% of the time, they do not end well. They begin in fantasy and unequal power dynamics, and they cannot transform into any sort of egalitarian union. Therapists who marry one client have been known to then cheat on her with another. 9. The lack of experience with healthy, boundaried relationships. Many of us come into therapy never having had a healthy boundaried relationship with another person. We do not know what that is supposed to look like. We may have had major traumas, losses, or deprivations in our childhoods. We don't have an automatic reaction that something is terribly wrong when the therapist starts to behave unethically. We excuse it. It may feel like home, so we do not recognize it as damaging. 10. Even abusive therapy sometimes feels good. What can be the most confusing once we wake up from the nightmare of therapy abuse is reconciling the fact that some part of what happened in the therapy room with an abusive therapist felt good. It can feel good to be special, to be told that the therapist has broken all the rules because his love for you is so powerful, to be held like an infant by a therapist who claims to be capable of re-parenting you. It can feel powerful to be invited into the therapist's home, to be entrusted with the therapist's own secrets. Even sexual abuse may feel physically exciting at moments. Abuse can feel good even at the same time that it feels wrong, bad, dangerous, creepy, nauseating. Even after abusive therapy ends, it is normal to sometimes long for those good feelings, to miss the scent of the therapist's cologne or the sound of the therapist's voice, to long for the illusion of the perfect parent that the therapist provided, or of a forbidden love that broke all the rules. If we can recognize that the feelings and longings we brought into the therapy room are normal, that can help us to stop blaming ourselves for therapy abuse. We can forgive ourselves for what we were unable to stop because our wish for healing was so strong. We can redirect that wish to the process of recovery from therapy abuse. Our recovery may lead us to a better, deeper understanding of ourselves and a greater acceptance of our own needs. We may learn how to say NO sooner when someone is attempting to exploit us or not act in our interest. The volunteers of TELL are available to help you in every step of this recovery process. Deborah A. Lott To return to the list of Essays, click here. |
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