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Can Therapy Do Me Harm?
More people are recognizing the importance of mental health treatment and working to remove the stigma it used to have. Public figures from podcast hosts to movie stars talk about their experiences in therapy and rave about how much it helps them. Friends and family who wouldn’t have dared to confess it even a decade ago now casually mention that they’re in therapy.
As a growing number of people identify therapy as an essential part of their self-care toolkit, it can start to seem like everyone should be in therapy and that you should sign up with the first therapist you can find. But like most things in life, it’s a little more complicated than that.
Yes, most people can benefit from the right kind of therapy at the right time in their lives. Yes, it’s more likely that therapy will do good than harm. But the dark secret in the mental health world is that therapy can cause harm.
People who've been to a bad therapist can tell you: bad therapy is worse than no therapy at all.
A bad therapist can shut down your healing process instead of helping it along. Bad therapy can even be destructive, either re-traumatizing you or causing new psychological harm.
The bad news is that something as well-intentioned as going to therapy can backfire. The good news is that you can learn how to recognize when something isn’t right.
Read on to learn how to spot the warning signs and walk away from a therapist who isn’t helping you.
What Harm Can an Unethical Therapist Cause?
The worst thing a therapist can do is take advantage of a client for personal gain.
Even though most therapists are drawn to the field because they are caring people who want to empower and help those who are hurting, therapy is no safer from the worst human motives than any other profession.
Therapists are in a position of power over their clients. This is why there are so many rules therapists must follow, including rules against having social and sexual relationships with the people they treat.
Unfortunately, that power imbalance sometimes attracts the wrong people to the field. While most therapists respect these rules, there are a few who actively seek to take advantage of their clients.
What Are the Warning Signs a Therapist Is Unethical?
When a therapist is unethical, there are usually signs that they are. For example, it’s a red flag when your therapist:
- Touches you inappropriately or makes sexual advances.
- Asks you to meet with them outside of the office for a social or sexual encounter.
- Ignores what you tell them and continues doing something after you’ve said it makes you uncomfortable and have asked them to stop doing it.
- Tries to enlist you to support their personal, political, social, or business interests, such as trying to get you to pay to see them give a talk or to vote for a political candidate they support.
- Tries to control your behavior outside of the office, such as pushing you to go on a certain diet or to break off contact with family members.
For more in-depth information about these and other red flags, you can read our article “Don’t Even Think of Going Back to a Therapist Who Does Any of These Things.“
Keep in mind that there are some gray areas when it comes to navigating the delicate and subtle boundaries of the therapeutic relationship.
For example, you don’t necessarily have an unethical therapist if they forget you told them you don’t like to shake hands or if one day they offer a more spirited critique of your partner than usual. Even good therapists have bad days.
And good therapists can also be misunderstood. Most modern therapists offer feedback and suggestions that can be misinterpreted as commands or directives, so be careful not to jump to the conclusion your therapist is trying to control you. It’s a good idea to talk to them about your concerns and seek a second opinion if you’re not satisfied by their answer.
Ultimately, it’s important to trust your intuition. Most therapists are good people with good intentions, but not all of them are. If things don’t seem right, don’t assume you’re wrong.
Predators are sometimes drawn to the mental health field because of the power their position gives them over vulnerable people.
One way to avoid predators in any field is to tell your loved ones what’s going on. It’s a major red flag when anyone, especially a therapist, tells you to keep something that they did a secret.
However, there are no gray areas if your therapist is trying to get you to have a sexual relationship with them. Not only should you never go back to a therapist who pursues sexual contact, you should consider reporting them to the board that licenses them.
It’s not unethical for a therapist to find a client attractive, but to act on that attraction means they’ve forgotten or cast aside their most important professional duties to honor their clients’ needs and not abuse their power.
Even if you're not sure a therapist is crossing the line, listen to your intuition and walk away when your gut tells you something is wrong.
It’s important to feel comfortable with your therapist. If a therapist makes you uncomfortable, it may not be because they’re unethical, but it’s probably still not worth it to keep seeing them if the feeling doesn’t go away after a few sessions. Even if the only issue is that they’re a bad match, you’re not going to get much out of seeing someone you can’t trust.
What Harm Can a Bad Therapist Cause?
Being a therapist might seem simple and natural, but to do it well, therapists have to do many things that don’t come naturally. For one, they have to leave all of their own baggage outside of the therapy room. This means they need to refrain from judging their clients according to their own personal beliefs, chatting too much about themselves, and giving too much direct advice.
To do their jobs well, therapists have to figure out how to guide you toward your own innate wisdom. When a therapist has the patience to let you realize things for yourself, it allows your insights to have a deep and lasting healing effect. It’s so easy to get any part of this process wrong.
To be good at what they do, therapists must avoid sitting in judgment of any of their clients. Instead, they need to be able to put themselves in your position and understand how it feels to be where you are—and how hard it can be to change.
Many therapists are drawn to the field because they’re naturally empathetic and are able to pick up on other people’s feelings from subtle, intuitive cues. A therapist can never have perfect understanding of your experience, but a good therapist can do more than theorize about how something might have affected you.
Some therapists who weren’t particularly sensitive when they were younger can learn how to hone their empathy, but some never quite develop their empathy enough to respond to clients in an effective way. Failures of empathy are triggering and can be re-traumatizing when repeated, especially when they come from someone you trust.
Another kind of bad therapist can waste your time with interventions that have no effect by using you as a guinea pig to test their pet theories. While there are some predators who intentionally experiment on or manipulate others without regard for their feelings, most bad therapists who do this do it because they don’t know better. They overestimate their own insights and truly believe they are helping you.
How Can I Tell When I've Got a Bad Therapist?
It can be tricky to identify a bad therapist because even good therapy can make you feel worse before you start to feel better. For example, if you’re depressed because you haven’t fully grieved a loss, or if you know you need to change some habits you’ve become attached to, it can feel pretty bad the first weeks you start to process those feelings or try to let go of those habits.
An important element of therapy is projection, when your reactions to your therapist have more to do with the way they remind you of other people than with them. A classic example is when you react to a therapist as if they were your mother or father. When this starts happening, it can actually be a sign that therapy is starting to work.
The important thing is to trust your instincts and to talk to other people about your experience. People who’ve had good or bad experiences in therapy can help you understand how the process works, but be careful—other people have their own filters, prejudices, and blind spots. At the end of the day, if therapy has been making you feel worse for a long time and you don’t feel like you’re healing, it may be time to walk away and look for a new therapist.
What Happens If I Choose the Wrong Therapist?
Sometimes therapy goes wrong even if you’re seeing a therapist who’s helped other clients. This can happen when a therapist isn’t a good match for you or when the style or method a therapist uses isn’t what you need.
The good news is that good therapists know how to recognize when they’re not a good match for you. When they see that you need a therapist with expertise or training that they don’t have, they will usually help you find someone who does.
If you feel like it’s not working out with a therapist, tell them. You’ll learn a lot from their response. The good therapists will either adjust their approach so they can meet your needs or help you find another therapist. The bad ones will likely have a bad reaction and confirm what you already suspected about them.
Cultural Competence Is Key
Having a therapist who doesn’t understand your cultural background is one of the factors that can lead to therapy causing harm instead of doing good.
The sad truth is that therapists can be racist, sexist, homophobic, or otherwise prejudiced against particular groups. Even when they’re not, failures to study and learn from history can translate into failures of empathy.
Though many therapists are taught the histories of oppressed groups and the social injustices they have faced, not all listen or understand. Far too many people judge and blame people on a personal level for struggles that reflect our failures as a society—some therapists included.
Sometimes the reasons for a mismatch between you and a therapist can be personal. Just like you can project, your therapist can project, too. And when a therapist isn’t aware of or hasn’t dealt with their own issues, they can inadvertently harm their clients.
For example, if they have unprocessed pain or trauma related to a family member who had an addiction, they may project that experience into the therapy room and judge or react harshly when you or other clients talk about issues or experiences related to substance use.
If a therapist you've had a good relationship with suddenly starts making you feel judged, it can be a sign that they are reacting to something they haven't dealt with in themselves.
When this happens, it’s a sign a therapist has personal work to do. And it’s probably not worth sticking around until they do it.
Subtler problems can arise when a therapist is trained in a technique that isn’t right for your needs. For example, while cognitive behavioral therapy (CBT) is generally an effective therapeutic technique, it’s not effective for everyone or in all situations. While CBT can often control symptoms, it can’t always heal the deeper wounds underneath the symptoms.
For another example, if you have a history of trauma and your therapist isn’t trained in a trauma-informed approach, your work with them might be ineffective. Many people labor unsuccessfully in therapy for years until they finally try a technique like eye movement desensitization and reprocessing (EMDR) that starts to unlock their trauma.
Keep in mind, though, that the reverse is true as well—if you don’t have unprocessed trauma, techniques like EMDR might not help as much as other techniques more suited to your needs.
How Can I Choose the Right Therapist?
No matter how much research you do, there is no guarantee that the first therapist you interview will be the right one for you.
However, research increases the chances of getting a good match on your first try. For help with what and how to research, you can read the following articles on OpenCounseling:
- How to Choose a Therapist
- How to Choose an In-Network Therapist
- Using Your Intuition to Choose the Right Therapist
- The Five Steps to Background Check Your Therapist
- What Different Kinds of Therapists Are There?
- Which Therapy Method Is Right For Me?
These articles explain what to look for in a therapist, give you action steps to take during your research, list questions to ask a potential therapist, and help you understand some of the terms and information you might find on a therapist’s profile.
How Can I Avoid Ending Up With a Bad Therapist?
There’s no foolproof way to avoid bad therapists. The ones who mean to be bad take pains to hide it, and the ones who don’t mean to be bad can go a long way on the benefit of the doubt their clients give them.
That said, there are steps you can take that will reduce your chances of ending up with a bad therapist (or one who’s bad for you).
How Can I Background Check a Therapist?
Three steps you can take to avoid bad therapists are:
- Learn a little more about therapy before you start looking for a therapist. For example, read about the methods therapists use or the ethical standards they are expected to follow.
- Research potential therapists by reading their online profiles, bios, websites, and blogs. You may also be able to find reviews of them that other clients have written.
- Interview potential therapists on the phone or in person before you commit to seeing them for more than one session. Note how their responses to your questions make you feel.
For a detailed guide on these and other ways you can research and vet therapists, you can read our article “The Five Steps to Background Check Your Therapist.“
Finding a therapist who’s the right match is a lot like dating. You can learn a lot from a person’s online profile but you don’t get the full picture until you meet someone in person.
Fortunately, it’s rare to have to see a dozen therapists before you find the right one. That’s because therapists have to meet a lot of qualifications just to be able to legally practice therapy. The licensing process makes it harder (though not impossible) for bad therapists to stay in business.
In fact, not only do therapists have to prove themselves with years of work and study before they can even get a license, they can lose their licenses if they don’t follow the rules. Clients who’ve had bad experiences can file a complaint with the therapist’s licensing board. If the complaint is serious enough, and the board’s investigation shows that it’s valid, the therapist can permanently lose their license.
For More Information
To learn more about how a therapist gets (and maintains) a license, you can read our article “How to Verify a Therapist’s License.” You’ll also learn what can get a therapist in trouble with a licensing board and how to find out if they’ve ever had a complaint filed against them.
For more information on how the complaint process works, including how to file a complaint and what happens if you do, you can read our article “Filing a Complaint Against a Therapist: When, How, and Why to Do It (and Why Not to Do It).”
For more information on how to combine license verification with other ways to research a therapist, you can read our article “The Five Steps to Background Check Your Therapist.“
What If I Get Therapy When I Don't Really Need It?
Perhaps the most confusing issue of all is figuring out exactly when or whether you need therapy. While therapy can help with everything from everyday relationship conflicts to severe psychiatric disorders, it’s not a cure-all.
Of course, therapy can help with personal growth even if you don’t have a mental health condition or problems at work or home. The issue isn’t so much that you might get therapy you don’t urgently need, but that you might invest in therapy when you might be better served by investing in something else—because you have a problem therapy can’t fix.
There’s a quote people often misattribute to Freud: “Before you diagnose yourself with depression or low self-esteem, first make sure that you are not, in fact, surrounded by assholes.”
Even though Freud didn’t say it, it’s still a good point. If someone is mistreating you, whether at home or at a toxic job, therapy will at best help you cope in the short-term. At worst, it can put you in danger if it keeps you from walking away from the relationship or situation that’s harming you.
Of course, good therapy can empower you to recognize and walk away from abuse. But if you leave out—or your therapist misses—key details that reveal what’s making you feel the way you do, you can end up focusing your sessions on “fixing yourself” and falsely affirming the perspective of your abuser that something is wrong with you.
Depression and anxiety are not always triggered by brain chemistry, past trauma, or personal hurts. Sometimes they’re a natural reaction to external circumstances. For example, we live in anxious times, and therapy isn’t going to do as much for your anxiety about social and political issues as taking action to make a difference.
Of course, this doesn’t mean you shouldn’t take care of yourself if you’re having to endure stressful circumstances that are out of your control. Therapy can help. It just means that sometimes your pain is pointing you to something outside of yourself that you need to fix and that nothing will get better until you fix it.
It’s good to make the decision to start therapy carefully, but if you’ve come to OpenCounseling, you’ve probably spent some time thinking about and researching therapy and know it’s what you need. If that’s the case, don’t let the fact that therapy can go wrong stop you.
Give it a shot by using the tools on OpenCounseling to find an affordable local therapist or by trying online therapy at BetterHelp (a sponsor). Just trust yourself and be willing to walk away if things don’t go well. It’s not your job not to hurt a therapist’s feelings. A good therapist will understand and respect your efforts to find the right match, and a bad therapist isn’t worth your time!
Stephanie Hairston is a freelance mental health writer who spent several years in the field of adult mental health before transitioning to professional writing and editing. As a clinical social worker, she provided group and individual therapy, crisis intervention services, and psychological assessments.