TU41: The Dark Side Of Therapy – Recognizing When The Therapeutic Relationship Goes Bad

Therapist Uncensored Podcast - A podcast by Sue Marriott LCSW, CGP & Ann Kelley PhD - Tuesdays

IN THIS EPISODE: The Dark Side Of Therapy: Recognizing When The Therapeutic Relationship Goes Bad Show Note Queue Darth Vader music… we admit it, not all therapy is good therapy.  Ann Kelley and Sue Marriott discuss the potential negatives in the therapeutic relationship – focusing on how a client might distinguish between good therapy, that’s tough at times and a genuinely dysfunctional relationship.   The difference between healthy dependency and one that erodes your sense of self is unpacked, as well as the idea of safe vulnerability that leads to change.  Finally, they name the truth that one can feel held hostage by the therapist and the darker more harmful effects that can happen when therapy goes bad.    Timeline  0:00 – Intro/Podcast Conference  2:48 – Recap on Episode 39 Therapeutic Relationship  3:41 – Introduction to dark side of therapy 4:12 – Types of discredited therapies: Conversion Therapy (coercive therapy that intends to change someone’s sexual orientation) Good therapy intends to assist self-exploration and colorful self expression  5:16 – Repressed memory therapy – Not helpful therapy and has potential to have traumatic outcomes.  6:12 – Sometimes therapists abuse role in exploitative way – Make sure your therapist is licensed and accredited  7:17 – What is good therapy that is hard and what is a dysfunctional relationship? It can be hard to tell the difference. Those who have experienced relational injuries and then begin to feel safe with the therapeutic relationship might feel unsafe and begin to evoke and enact what they need help healing. Therapists want to help you listen to your gut.  10:12 – Go for the connection in the therapeutic relationship and talk about relationships and attachment. Having a new experience where patient can unfold and be more themselves and be understood & recognized for who they are is in essence, therapy. Beginning to know what you think and feel already begins work on trauma.  11:51 – One of the dangers of working deeply especially with trauma is if it moves too quickly.   Sometimes the patient can feel like they’re being held captive by the therapist or acting as a narcissistic extension of the therapist  12:47 – Narcissistic Extension – Therapists as humans have their own needs and desires to be helpful but the client can potentially feel need to satisfy and gain approval from therapist in power differential.  15:43 – Therapists are in a position to keep clients hostage through barring the door by making clients feel guilty or shamed for trying to leave – Therapists need to understand desire to leave and affirm right to do so. Exploration is good but guilt and shame is something else.  Respect boundaries of patient.  Allow them to explore the urge to leave or to act and leave.  If it was wrong move they will figure that out and return on their own accord to you or someone else to resume.  22:12 – Sometimes clients can be difficult but this is healthy and normal. Discomfort directed at the therapist or expression of suicidal ideation can sometimes lead to a premature end to the therapeutic relationship. Therapist-initiated termination is a huge risk and always complicated and potentially harmful.   24:31 – Boundaries are important to talk about in the therapeutic relationship. No romance, sexuality or bargaining. Letting the boundaries slowly slip a little bit and eventually crossing the line can be extremely harmful to clients. Doing something like stopping a session on time despite making ground or even just collecting payment are healthy, loving professional acts in the relationship.  28:43 – Basic goal for patients in therapy: you should be getting better, not feel shamed intrinsically from relationship.  One can expect positive, challenging, growth-enhancing language from therapist.

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