Bad Therapy: What You Didn't Learn in Grad School

Bad Therapy: What You Didn't Learn in Grad School

by Deb Kory

Psychologist and Psychotherapy.net content manager Deb Kory pulls no punches in critiquing what is missing from our training programs, and calls for more authenticity, humor and humility in the ways we teach and learn to practice therapy.

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The Problem with the "Great Masters"

Going through graduate school training, we were barraged with examples of “good therapy” from every well-known therapist of the last century. We learned unconditional regard from Carl Rogers, the empty chair technique from Fritz Perls, the nature of deep intrapsychic conflicts from Freud, the collective unconscious from Jung, group therapy from Yalom, EFT from Sue Johnson. We were treated to endless case studies of poor souls trudging through the morass of their unmanageable lives, whose problems were deftly transformed by analysis, exposures, emotion-focused “interventions” and, when all else failed, that ineffable “therapeutic alliance” the great Masters of therapy seemed to so effortlessly form with their clients.
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Deb KoryDeb Kory, PsyD, is the content manager at psychotherapy.net.  She received her doctorate in clinical psychology from the Wright Institute and has a part-time private practice in Berkeley, CA. She loves both of her jobs and feels lucky to be able to divide her time between therapy, writing and editing. Before deciding to become a psychotherapist, she worked as the managing editor of Tikkun Magazine and published her writings in Tikkun, The Huffington Post and Alternet. Currently, she is working on turning her dissertation, Psychologists: Healers or Instruments of War?, into a book. In it, she describes in great detail the historical context and events that led to psychologists creating the torture program at Guantanamo and other "black sites" during the War on Terror.
After trying to understand what was supposed to happen in therapy for 7 years - I left the therapist. The final exchange was: Me: Why do you treat me like an idiot? Therapist: Nothing I say is magic. And thus the lack of understanding I had tried to fix for 7 years was sealed.
St Topper
Love the article, gave me a great laugh, I still have a stupid smile on my face thinking about the chance encounter with the Dick Guy. I am relatively new to counseling, and still in an awkward phase, but your article gave me hope and dread. Hope that people in this position can be brutally honest and human, and dread that I have a long career ahead of me to get things wrong and have to face the music and keep at it. Thanks.
KG
The stigma of therapy has as much to do with the inadequate abilities of the therapist as the 'crazy' client. Having the extra credentials and certifications don't necessarily guarantee a good therapist. It can simply mean that they're good at academics and writing thesis papers, and also the extra degrees mean that they can charge a higher fees for their sessions. I think therapists who only promote therapy's benefits and avoid acknowledging the dark side of their profession are self-serving and just out to keep themselves in business. I've been through a string of different therapists for brief trial periods, and among other incidents, I've even had one who didn't care enough to refund my credited session before he moved to Minnesota. Human imperfections are a given, but it shouldn't be used as an excuse to cover up lack of professional responsibility on the part of the caregiver. It then becomes difficult to believe in the sincerity of the therapist's 'care' when they get paid whether they fail or not whereas it will be the client who will suffer the most from the bad therapy, both financially and emotionally. High-mindedness and being too humble are both ineffective. Psychology is a subjective science, and it really is the client who ultimately will teach these therapists, for better or worse, not the training institutes.
Eve B
I am a lawyer by training and after working for 5 consecutive years like hell in big, I completely lost it and, because all my colleagues had a therapist, went into therapy. I now know and understand that I immediately started care taking this therapist from the first moment I walked in, something I had been doing with everyone in the law firm, juniors, seniors, clients, screamers and bullies. First the therapist just wouldn't believe the reality on the floor in big law (great to work on your feeling of not being heard), then she just felt to bring the message that probably my dad had borderline and all my problems were due to having endured an attempted kidnapping as a teen (something that was really not on my agenda to talk about), then the next session she said: "I'm closing my office because I'm moving states. Let me know if you need sessions to close this off, but I'm sure you don't, thank god, you are not like my other patients, you can't imagine what they put me through!" I felt soo shocked I couldn't say anything and after that fell in to a complete deep and huge depression. Comes in a nice therapist with whom I feel comfortable but she is about to leave on pregnancy leave. Up to the next, hard on myself as ever, I thought well I have a problem with men in the firm, let's go see a male therapist. During the first session, indicated that I was hurt after what happened with the first therapist, his response, well surely that's due to something with you, and then I had said that I just came for a test session, but at the closing he said, "well when can you come next time". I felt so locked in and compelled to answer that I agreed to go again. For two years I went, went through incredible panic attacks each time I went, couldn't speak because the fear blocked my throat, felt like I was hanging against the ceiling and looking down. In the end I bought him a nice book as a gift and finally dared to say that I hated coming and was leaving because it was only doing me bad. And I still appreciated all the energy that he must have put into listening to me. Caretaking maxed out? I know that's my issue, but wish therapist didn't play into it!
HP
Thanks. I think one problem is that NO ONE but the therapist and the client know what goes on in that room. I will never go to a therapist again, because I have found so very few that are good, and many damage their clients even MORE. Many spend the session telling ME their problems; if I point this out, they say nothing, or just say 'it had to do with the topic YOU brought up'. They are NEVER wrong, according to them. One hated men; another was anti-Semitic (I am Jewish); two refused to say they couldn't help me & my boyfriend, would say NOTHING during sessions, and blamed that fact on US; (but loved taking our money). There is even more . . . I have had enough. The Licensing Boards should do something about these horrific therapists. They only discipline them if they sleep with their patients.
Helene
Yes, yes, and yes! Too bad no more of your colleagues have stepped up to the challenge and added to this blog. I used to be a computer programmer and looking for and accepting our mistakes was just part of the job. If we didn’t check and look for mistakes, we couldn’t correct them. So, yes, I’m a geeky person by nature. And therefore trusting. And therefore got hurt, over and over, because I couldn’t understand how and why therapists wouldn’t be looking out for their own mistakes and wanting to correct them when they happened.
Melanie
I love this - it got me very excited as I was just having a conversation earlier on today with the receptionist at our practice who asked me why all psychotherapists were just so god damn weird!?!? I'd love to read more of your blog but I can't find any more on this site...?
K Merrick
I think if we are going to truly be respected as a science and a profession, it is imperative to consider the ugly side of psychotherapy, and supervision....and training...and continued training. I appreciate your thoughts.
James D. Slover, MA, LPC, NCC
This is a good addition to the discussion of psychotherapy. I hope you continue with a wide variety of examples -- and how things might have gone better. Meanwhile, I'd like to point readers interested in the effort to do no harm to Tony Rousmaniere's interview with Michael Lambert on this site. It isn't the final word, but is a worthwhile part of the effort to reduce the incidence of harmful therapy.
Mary S.
Dr. Kory, the psychotherapeutic profession has always, from its inception, been more about dominance and money than it has been about altruism. There are FAR more mediocre-to-bad therapists than there are good ones, and one can literally go broke moving from therapist to therapist in search of a competent, kind, compassionate individual, without ever finding one. It is the nature of your profession. When the APA is ready to give me a "house credit" for all of the money I've wasted - not spent, but wasted - on members of your profession who should never have been granted licenses, I'll consider resuming the search.
JDE
Thank You! I am in my first year of practicum with a really crappy supervisor and I am crying every week at my fate. Hoping it just can't get any worse than it is!
DM
Amen! "Otherwise, it seemed that the collective ego of the therapy profession was a bit too fragile to handle its own dark side." It's about time!
FJA
Perfect! Having been in the business for a very long time I have seen many sides of it from the arrogant 'love me because I'm the healer' to the many by the book new therapists coming into the field that have all the answers for the client and no questions for themselves. What a great idea, how odd it hasn't been considered before this.
Kate Shannon, Psychotherapist
Great topic and it definitely needs more open discussion. I'm in training for my LCSW and have had my fair share of lousy therapy experiences, but also a few great ones that inspire me to do the same. I want to learn the good, the bad, and the ugly of therapy in the hope that I will at least "do no harm" and at best, be a help to those who entrust me with their journey.
AGP
This is a courageous and often accurate portrayal. Thanks for writing it.
Alison Crosthwait, Psychotherapist
I graduated in 2008 and passed license exam 3 years ago. Yes, I am a novice. I am frustrated with therapists who believe that they are so awesome and wise! They never make mistake when I made many. I really appreciate you writing this straightforward blog!
Niparpon Johansen, LMFT, ATR
Really interested in this subject. I look forward to hearing more.
Michelle Rogers, LMHC
Dr. Kory nails it in this article and provides a much needed echo chamber for many therapists who have had similar experiences. This article is a great read and helps therapists challenge themselves to become better.
Shemena Johnson, LMFT
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