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Selecting a Subsequent Therapist You probably feel on the edge of devastation. You have been betrayed in the most horrific manner. You probably do not have any coherent idea about what has happened to you and what went so very wrong. Most people who have been abused by their psychotherapists desperately need help to survive such traumatic abuse. Not all victims of such abuse choose subsequent psychotherapy as their route to becoming survivors rather than victims. If a victim dares to seek subsequent psychotherapy, the first order of business is finding a psychotherapist who is safe and effective. This is no easy matter when one is overwhelmed by trauma. The ability to trust one's own judgment has been destroyed in most victims. "I chose my abusive psychotherapist", a victim is likely to reflect. "I trusted that therapist, and look what happened." Why would any sane person take him- or herself back into anything that even remotely resembles the site of devastation? Just thinking about a psychotherapist's office may trigger overwhelming trauma. And then thinking that one would be alone in a room with a psychotherapist and vulnerable to being abused again can be terrifying. Never again rings loud in any sane person's mind. With one's life rapidly crumbling, desperation that is not yet despair allows some victims to hope maybe somewhere there could be someone No matter how you chose your subsequent therapist, you must assess some basic things from the outset: How can you find someone safe?
You may want to begin by speaking to a victim advocate who has
already become a survivor of such abuse and
get names of psychotherapists who have been
shown to and effective. Going
to one or more of these suggested therapists on a consultation basis
may help you clarify what it is you're seeking. Does this psychotherapist really know about the nature of trauma? It is not absolutely necessary that the therapist be experienced in this particular realm of trauma; however, it is imperative that the psychotherapist know the nature of trauma and what happens to a person when their world has been destroyed and their ability to trust themselves has been destroyed. Whatever has taken you to therapy in the first place has now been made worse by the destructiveness of this abuse and now you are totally overwhelmed by trauma. This may be new trauma on top of previous experiences of trauma, or it may be the first time you have ever been traumatized. Either way a victim of this abuse is massively traumatized, and your subsequent therapist must know that she/he must stand for reality in a quiet yet firm way. She/he must be able to be with you and your overwhelming emotions, able to distinguish such overwhelming loss, rage, self-hatred, and self-loathing from all other forms of emotion. Your subsequent therapist must validate from the outset that you have been abused and be clear regarding the abusing therapist's obligation to have set and maintained safe boundaries. Eventually your subsequent therapist must help you to see how your previous therapist has taken advantage of the power that resides with all therapists. Your abusive therapist has used this power over you to manipulate you to his/her advantage. This manipulation surely has taken many forms of which sex is only one. Your subsequent therapist must be able to use the power that comes from being the one with the expertise to help you feel safe. Since you have been abused, you most likely will not feel safe for a long time. Daring to feel hope, the only reason to seek subsequent therapy, is not at all the same as feeling safe. Your therapist should be able to let you test his/her trustworthiness in countless ways while you slowly learn to regain trust in your own judgment. Your subsequent therapist should be able to accept that you are unlikely to trust him/her and that there is no reason for you to do so. In fact, there is every reason not to do so. Your subsequent therapist must not impose on you his/her agenda with regard to your abuser but rather should empower you to act, when you're ready, on your own behalf. Your subsequent therapist must not only be willing to allow you to talk about your therapy with outsiders and seek consultations when anything in your subsequent treatment makes you uncomfortable but should also encourage you to do so. Your subsequent therapist should be informed, from the outset, that you wish to hold open the option of taking action, including filing a lawsuit, and be comfortable with that possibility. If you go to a subsequent therapist who makes you uncomfortable in any way, insist on talking about and exploring what has happened. Insist on an explanation. If this is not forthcoming, you owe it to yourself to leave and move on.
S. Kim, Ph.D. Trying Therapy Again after a Difficult or Harmful Experience Sometimes, people go to therapy hoping for help and understanding, but instead find themselves feeling let down by the process, misunderstood or harmed. A negative experience of therapy can feel jarring, painful and in some cases, even traumatising. Returning to therapy after a harmful experience may be a very difficult decision; it is likely that you will feel cautious about forming another therapeutic alliance or putting trust in the therapeutic process. If you are thinking about trying therapy again after a harmful experience, here are a few things to consider: It's good to shop around If you have a choice of therapists available to you, it might be helpful to contact more than one for initial conversations to see who you 'click' with. Many counsellors will offer free or low-cost initial sessions, or a free telephone conversation. Take advantage of this, and trust your instincts - if the relationship doesn't feel right, you don't have to go back. With this in mind, meeting new therapists might be a difficult or stressful process. Listen to your feelings, and only do what feels okay to do. You can talk to your therapist about your fears You are likely to go into the new therapeutic relationship concerned that the same thing will happen again here. Talking to the therapist explicitly about what you need from them may help you to feel more comfortable in the relationship. If boundaries are a particular concern, it is okay to ask your new therapist about their boundaries. Do they answer email between sessions? Do they offer hugs? It is also fine to tell them about things you found unhelpful in the previous therapeutic relationship and have a discussion about whether your needs are compatible with the new therapist's way of working. Starting therapy again Returning to therapy after a harmful experience can be particularly difficult because often, whatever brought you to therapy in the first place will be unresolved, so harmful therapy is unlikely to be the only issue bringing you to seek further therapy. I think it's important to be aware of how complex and multi-layered this set of feelings can be, and to offer yourself patience, particularly in the early stages where the feelings around your previous therapy are likely to feel very raw. As therapy progresses, you are likely to experience a natural movement between wishing to talk about your previous therapy and the other issues in your life; it is important to trust in what you feel you need to bring and to talk about what feels right for you. My experience is that, as time progresses, therapeutic needs shift, and harmful previous therapy may become a less central part of the work. This takes time, and there is no right or wrong timescale for this type of movement to take place. Grief People often describe the loss of a therapeutic relationship as feeling like a bereavement, and however your last therapeutic relationship ended, it is important to acknowledge that any feelings of grief towards a former therapist are a natural part of dealing with a painful loss. If the harm you have experienced in therapy relates to a sudden, unexpected termination, these feelings of loss may be particularly acute. If you are thinking about returning to therapy after a difficult experience, remember that all of the the feelings you are experiencing are valid, and a good therapist will provide a non-judgemental space to express them. Other sources of support Therapy can be one means of support for dealing with a difficult experience of therapy. There are other resources that clients might find useful if they do not feel that further therapy is appropriate, or that some clients may wish to draw on in addition to therapy. TELL (Therapy Exploitation Link Line) offer support via email to people who have experienced harm in therapy. In addition, many clients seek support from online forums or in-person support groups, as well as family and friends. If you have concerns about a current therapeutic relationship If you are currently in therapy and you have concerns about any aspect of what is happening, you can contact the BACP's Ask Kathleen Service who can offer confidential guidance and information to help you. TELL (Therapy Exploitation Link ine) also offers support to those currently experiencing problematic therapy. Erin Stevens MBACP MNCS (Accred), PG Diploma, MA Psychotherapy Trying Therapy Again After a Horrible Experience You probably feel on the edge of devastation. You have been betrayed in the most horrific manner. You probably do not have any coherent idea about what has happened to you and what went so very wrong. Most people who have been abused by their psychotherapists desperately need help to survive such traumatic abuse. Not all victims of such abuse choose subsequent psychotherapy as their route to becoming survivors rather than victims. If a victim dares to seek subsequent psychotherapy, the first order of business is finding a psychotherapist who is safe and effective. This is no easy matter when one is overwhelmed by trauma. The ability to trust one’s own judgment has been destroyed in most victims. “I chose my abusive psychotherapist,” a victim is likely to reflect. “I trusted that therapist, and look what happened.” Why would any sane person take him- or herself back into anything that even remotely resembles the site of devastation? Just thinking about a psychotherapist’s office may trigger overwhelming trauma. And then thinking that one would be alone in a room with a psychotherapist and vulnerable to being abused again can be terrifying. “Never again” rings loud in any sane person’s mind. But with one’s life rapidly crumbling, desperation that is not yet despair allows some victims to hope “maybe somewhere there could be someone safe.” “But how can I find someone safe?” You may want to begin by speaking to a victim advocate who has already become a survivor of such abuse and get names of psychotherapists who have been shown to be safe and effective. Going to one or more of these suggested therapists on a consultation basis may help you clarify what it is you’re seeking. No matter how you chose your subsequent therapist, you must assess some basic things from the outset:
If you go to a subsequent therapist who makes you uncomfortable in any way, insist on talking about and exploring what has happened. Insist on an explanation. If this is not forthcoming, you owe it to yourself to leave and move on. Wanda Needleman, M.D. For information on this author's perpetrator and an illustration of a case in which a licensing board took a case seriously and acted to protect the public, see:www.certworthy.com/daniels.htm To return to the list of Essays, click here. |
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