Talking Therapy Episode 40: When Therapy Makes a Patient Worse: Part 1

Hosts:

Producer:

Alan Kian, MA, York University
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Marvin Goldfried is a distinguished professor of psychology at Stony Brook University, where he helped to develop the graduate program in clinical psychology—he is the cofounder of the Society for the Exploration of Psychotherapy Integration. Allen Frances is a professor of psychiatry and chair emeritus at Duke, and was chair of the DSM-IV task force.

Marvin describes the evolution of his psychotherapy orientation as psychodynamic, behavioral, CBT, and eventually integrative. He practices, teaches, and supervises what works clinically using direct and indirect evidence base.

Allen describes his approach to psychotherapy as “whatever works” or “no one size fits all”. He was trained and taught at the Columbia University Psychoanalytic Center, but remains equally interested in brief, supportive, cognitive, behavioral, interpersonal, and family therapies.

Please enjoy this week’s episode!

[sookiebyun]

When I ended my sessions with a therapist because he was unprofessional, he sent me this text: For the record, I knew you weren’t gonna last very long doing therapy and I knew there would be some situation that would come up where you would either have a difficult time with a boundary I would set or something that would allow you to discontinue therapy. Please know that you need long term therapy because you’re dealing character - logical (personality). If you ever wanna resolve these issues you’re gonna have to commit to weekly therapy for years. Unfortunately, at this point I’m not willing to work with you anymore which includes the future.

Preceding this text, I cancelled an appt. 3 days in advance. He accused me of playing little games and ‘acting out’. He gave me an ultimatum and bullied me. There was no way in h*ll that I would ever speak another word to him after that. When he said, “At this point…” I had already ended the session beforehand. He wanted to make sure I felt rejected.

[patticakewtf]

Most therapists I’ve had are unqualified to deal with ptsd and don’t know what the fuck they’re doing. And they are too arrogant to admit it

[cadmantheaviator]

Good video. You guys get it. I’d just add that while I was feeling tortured by the application of theory and got really depressed and confused I was doing loops trying to rationalise why the therapist wouldn’t engage on my feeling it was all harming me. The wish to leave on terms with some kind of mutual acknowledgement kept me trapped. In the end I accepted I was not going to get a safe exit so left feeling really vulnerable. Not just a feeling of failure but a deep sadness and a profound feeling of being destabilised.

[AnnaPrzebudzona]

So, you say that there must be chemistry? Well, it was chemistry that kept me for months in an ineffective therapy that was only feeding into my emotional dysregulation, magical thinking and masochistic tendencies.
I think that some therapists might be actually really good at igniting the so-called chemistry. I understand that the chemistry factor can be very helpful in building the therapeutic relationship, commitment, motivation, etc. But it can also be used as manipulative technique by ”skillful” therapists. After seven months of intensive therapy that cost me several thousand euro, there's no significant change neither in my symptoms nor in my life. And, for the love of God, I can't decide whether I was in therapy with a really good con artist or a rather incompetent therapist relying on his arrogant confidence.

[cadmantheaviator]

I spent a year trapped in a group analytic therapy I said I didn’t want to be in. It eroded my self belief and led to years of research and hellish soul searching. I always say it was like Kafka’s The Trial. How would I have known? Indeed. The stress of the whole thing really burned me out. Because I had to learn enough about what might have gone wrong and why the therapist was so determined to let it drag on while blaming me. All quite depressing rabbit holes to go down.

[bizarrebroz]

I think the number is higher. Most ppl just don't tell their therapists that they made them feel like shit

[marlene]

I've been harmed severely by a therapist as a 14-yo to the point I almost lost my life. Still struggle with the trauma after many many years ... Never received a compensation and later therapists had exactly that approach that again it was my fault, not the professional adult who overstepped my boundaries completely...

[balancedbeinghealing]

Your channel's great! Thank you for your content!

[HesGotaGun]

I always love hearing therapists get shittalked. Worthless scam artists to the last man

[Malin]

Thank you for this. Made me see things a lot clearer. And it is so true with patients feeling dependent on a therapist and not being able to walk up and leave when it’s making them worse. Probably one of the reason people is in therapy in the first place.

[davidmorgan]

I have come across my fair share of terrible charlatans 😮

[albussnape]

Thank you for addressing these important factors! Please do a series on these, including the damage that a therapist’s indoctrination into insidious “parts of self” approaches can cause terrible harm to clients. Would be immensely grateful.

[HesGotaGun]

You have to actually know about real life to legally distribute drugs. Shrinks are about as well regulated as Baptist ministers lol.

[intrapsych]

How can a patient tell if they have a bad therapist ?

[ecrmwrn]

Don't release the patient when treatments fail we are really struggling