gaudior: (be the change)
Note: This entry is not meant to discourage anyone who might be thinking about getting into therapy. For there are many excellent and helpful therapists out there, and even the people complaining about them often said "while this therapist was awful, my current therapist is great!" But I am hoping to learn more about how to be better at my job, and knowing what not to do is very useful.

So, yesterday I spent some time Googling the phrase "terrible therapists" and seeing what I found. This list featured a number of the main ones that people mentioned, including the therapist:

*falling asleep during the session
*talking too much about him/herself, especially about his/her trauma
*touching the client and/or trying to make the relationship sexual
*showing up late
*taking phone calls or otherwise letting him/herself be distracted during session (worst story I found online: the therapist had locked her mother (who had Alzheimer's) in a car just outside her office, and watched her mother over the client's shoulder-- and at one point, ran out of the session to go sit in the car with her mother, who was trying to unlock the door. Dear GODS.)

Other things people mentioned in online discussion forums included the therapist:

*imposing his/her religious views on the client (whether Christians wanting the client to pray with them, or therapists who do things like "turned down the lights, lit some healing herb incense, and started to waft it around the room.")
*telling clients something along the lines of "cheer up, it's not so bad! You're young! At least you didn't get raped! You can get over these feelings if you put your mind to it!" etc. Which are sentiments which might be supportive if said with empathy-- but the way these people describe it, it sounds more like a denial of their pain or their right to their pain than an offering of hope for their eventually feeling better.
*sitting in silence, particularly at the beginning of the session (Interestingly, this is a technique which has often been recommended to me by supervisors. The idea is to let the client guide the session without the therapist's imposing his/her ideas. But I think that if you don't explain that that's what you're doing, and why, it just leads to people feeling socially awkward and uncomfortable, as many, many, many people on the forums complained about feeling).
*not giving advice/feedback to people who want it
*giving advice/feedback to people who don't want it
*giving bad advice, or overly simplistic advice ("imagine your anxiety as a piece of feces, and flush it away down your toilet! Now it's gone!") or advice that clearly won't work for this person
*seeming to not remember what the client told him/her about in previous sessions
*not recommending medication when it would be useful
*insisting on medication when it would not be useful, or to the exclusion of other treatments
*criticizing the client-- implying strongly that the client is in pain because there's something wrong with him/her, or because s/he is choosing to be
*refusing to work with a client who self-injures, or who will not sign a suicide contract (this is also something supervisors have recommended to me. It's in part a way to prevent liability, and to prevent therapist burn-out. Which are, like, worthwhile, but people on the forums seemed to find them really unempathetic.)
*not investigating possible medical causes of physical problems, but insisting that they are psychological
*insisting that s/he is right and the client is wrong
*seeming overly formal, distant, and/or anxious
*seeming to play "games" to make the client admit something, show anger, etc.


An overall theme I noticed is that a bad therapist is one who seems to not "get" you, and to not care about you-- whereas someone who honestly does care and understand can be forgiven lapses. Best example is therapists crying; some people praised their therapists for tearing up when the client talked about something really sad, as they felt that it meant the therapist was really with them, really empathized, cared and understood. Other people criticized their therapists for crying, as they felt this meant the therapist "had issues and could not listen to some one elses' in a professional manner"-- that the therapist was crying about his/her own pain, not the client's. Similarly, a therapist with good rapport can (and, I believe, often should) respectfully point out when a client's behavior is contributing to his/her situation-- but it must be done from a stance of "hey, person I care about and respect, want to hear about a way you could have more power and control and make your life better?" rather than "this is all your fault, and that's why I'm better and smarter than you." And a good therapist will usually know the client well enough to judge which way s/he will take it, and be sensitive to that.

But what else am I missing? What bad experiences have people had with therapists? What would you recommend a therapist do or never do?

--R
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