Even though the ways how patients could get emotionally abused may vary from case to case depending on the victim’s and the perpetrator’s respective profiles, there are some common signs of therapy abuse that I would like to cover:

MT: Before we explore the signs that indicate a possibility of abuse in therapy, let us talk about what could serve as potential reasons for the therapist to emotionally abuse the patient. Abuse in therapy happens when the therapist uses the relationship with the patient to fulfill his or her needs instead of attending to the needs of the patient. Some therapists feel a need to experience a full psychological power over their patients; others want to see themselves as patients’ rescuers, best friends, loving parents or lovers. In most cases, they are not conscious of their true intentions and are confident that they act in their patients’ best interests. At the same time, patients who have a history of being abused, neglected and invalidated get easily seduced by the special treatment they get from an abusive therapist. They misperceive therapist’s inappropriate behavior as loving and caring, only to realize it much later that they were exploited and betrayed.

This firsthand experience of being abused in therapy made me want to educate the public about potential problems that people may face when seeking therapy. Therapy is meant to be a healing experience where patients entrust their emotional well-being to a trained professional. A therapy room is a place where you get vulnerable because this is a part of therapy process. Unfortunately, there are cases when this vulnerability gets exploited and I would like to raise public awareness of this problem.

On my path of becoming a therapist, while studying in graduate school and working with clients during internship, I was also undergoing my own therapy. I have a firm belief that all therapists should undergo their own therapy in order to minimize the interference of their personal issues with their work. My own therapy experience left me with mixed feelings ‘” I had been able to work through a lot of my personal stuff, but, at the same time, I had also been emotionally abused and traumatized.

1. Feeling addicted to your therapy and therapist

You would not stop thinking about your therapist. You feel that he or she has become the most important person in your life. You feel worse when you skip a regular session like an addict who did not take a regular drug dosage. Whether you are in the best student rehabs or in an institution offering recovery and detox, make sure not to get attached to personals. Keep everything specific to you as it is you who needs to get detoxed and recuperate. A certain dependency on the therapist is normal. By definition, if we are being helped by someone we become dependent on this person because he or she gives us what we need. However, when normal dependency turns into an addiction, it is a red flag that the person might be abused by the therapist. In any case, it is certainly important to explore what is going on between the therapist and the patient when such addiction becomes obvious.

2. Feeling preoccupied with the therapist

Something goes wrong between you and your therapist during the session and you completely fall apart. You spend all of your next session trying to fix this problem instead of focusing on the areas of your life that you and your therapist really need to work on. This starts happening more often and, at some point, the therapy starts revolting around your relationship with the therapist and your own needs get neglected.

3. Crazy making

Your therapist implies or states directly that any conflict or miscommunication that arises between him/her and you is due to your emotional problems and has nothing to do with what the therapist does thus denying any responsibility for his or her own behavior. Since the therapist denies that he or she might contribute into the problem, you feel invalidated, start doubting yourself, continuously try to justify yourself to your therapist, which in turn contributes into your preoccupation with the therapist and the vicious cycle continues.

4. Feeling isolated and disconnected from family and friends

Usually this sign comes as a direct result of the first two issues. Family and friends are no longer as important to you as they used to be. Your therapist has replaced them all. You start to neglect your family responsibilities, and your relationships with your family members begin to deteriorate. You start avoiding spending time with other people because you feel that others do not understand you as well as your therapist does.

5. Continuously feeling worse

As the next chain reaction, you continuously feel worse. You lose interest in activities that you used to enjoy, feel ashamed of your dependency on the therapist and your helplessness to break this addiction. You feel that your therapy is not working, but you do not find the strength to break away from it. You may feel depressed and even suicidal.

6. Tendency to deny the abuse

Abuse in therapy is hard to recognize because it may not feel bad for a long time. In fact, it may feel very good that the therapist relates to you as a friend, a parent, or even a lover. It could make you feel very special and that is what we all want, isn’t it? Realization that you are being abused by the trusted professional brings a great pain that comes from feeling betrayed and a shame that comes from the erroneous belief that you had the power to prevent this abuse but failed to do so. After all, we were taught that, as adults, we are in control of our lives at all times! Unfortunately, we do not have sufficient education about power imbalanced relationships such as therapist-patient, teacher- student, priest-parishioner, mentor-mentee etc. In those relationships, one person has more psychological power than the other one, but this power comes along with responsibility to maintain the parameters of the relationship. Sadly, many people, including the abused patients, do not see it this way and believe that the patient is equally responsible for breaking therapeutic boundaries. It results in the victim’s tendency to deny that abuse is taking place.

7. Feeling that your case is absolutely unique

This one goes along with the tendency to deny abuse. The truth is that every life experience is unique. That doesn’t mean that there aren’t any common traits between them. Every marriage is unique and yet some marital dynamics could apply to virtually every marriage. As I mentioned, abuse in therapy might not feel bad for a long time. On the contrary, there is a part of this experience that feels like a drug that puts you in an ecstatic state. But, as every drug, it has a stage of withdrawal when you feel horrible until you take your next dosage. The same dynamic exists in inappropriate relationships between therapists and patients. The emotional “high” that patients experience in those relationships makes them feel that their experience is unique, that what is happening between them and their therapist is “real” love, not abuse. The tricky part of this whole issue is that genuine love and abuse may not necessarily be mutually exclusive, which makes this matter even more difficult for many people to understand. If you have experienced any of the above signs in your therapy, think it through, talk to someone about it to get a fresh perspective and possibly get a second opinion from another professional. The earlier you are able to recognize the abuse the easier it would be for you to get out of it! JW: What are the potential dangers of abuse in psychotherapy? MT: Abuse in therapy differs from other kinds of abuse because it is not always easily recognizable. Therapy is meant to be a sacred place where showing vulnerability is not only allowed but is also a necessary part of therapeutic process. Patients often admire and idealize their therapists as they might feel that they are loved, cared for and even rescued by them. These feelings are common and normal and can even help people heal, if the therapist handles them appropriately. As I mentioned before, therapist-patient relationship is a power-imbalanced one and the imbalance of power in that relationship is sky-scraping. When the therapist responds to the patient’s feelings in the way that serves his or her own needs instead of the patient’s healing process, that constitutes the abuse of power. The therapy setting then becomes toxic and dangerous for the vulnerable patient. In these situations, patients are often not able to identify the therapist’s seductive and inappropriate behavior as abuse. On the contrary, even if they heard about other cases of abuse in therapy before, they are confident that their case is unique and special. With time though, this confidence fades away as more and more signs of abuse are becoming obvious, and patients get overwhelmed by a sense of betrayal and a profound trauma that comes as a result of it.