In in our series about the challenges of undertaking this journey toward healing after trauma, we began by looking at key landmarks along the way that every pilgrim needs to keep in sight (Part 1). These include taking care of our bodies and becoming curious about what helps us find stability. In Part 2 we looked at some myths and beliefs about healing that can hinder our recovery. In Part 3 I want us to consider some things that “helpers” (AKA, therapists, pastoral counselors, counselors, friends, mentors, etc.) do that hinder recovery. If you spot any of these red flags, it might mean you need to have a heart-to-heart with your helper or, if need be, look for someone new to travel with you on your journey.
Before we dive into the underbelly of bad therapy, I want to remind readers that I really believe in therapy. Good therapy helps us understand ourselves, helps us explore parts we have been too ashamed to look at, and helps us gain perspectives and skills to use in our most important relationships. And bad therapy can take away what shred of hope we have for change. It is this reason why I have spent my career educating and training clergy and mental health professionals on 4 continents. Good therapy and help is possible and most of us helpers want to do what is good and right for you. So, let’s highlight here six red flags, behaviors that DO NOT help, so that both survivors and helpers can avoid them.
Making everything spiritual
Not everyone pursues a faith-based therapist or helper. But many do, and for good reason. Faith, religion and spirituality are core features of most of the world’s population. So, it makes sense that we seek helpers who also share our values. In addition, trauma almost always creates spiritual struggles and at least temporary discontent with previously accepted beliefs. Voicing those complaints and questions to and about God are essential to the journey of recovery and will determine whether faith helps us cope or becomes added strain.
However, when your helper uses every opportunity to infer a spiritual meaning and application while you wrestle with your pain, this might be a red flag. Pain is pain, confusion is confusion. It is okay to sit with it, voice it repeatedly, and not make some eternal or mystical application. When a counselor is quick to make a reference to spiritual meaning in your story, it means they are likely not really sitting with you in the ashes of your pain. They might not be as wrongheaded as the story of Job’s friends who jumped to accusations of sin, but pressuring you to accept a spiritual answer to the deeply painful why trauma or what now questions often invalidates your pain and misses opportunities for needed lament. Some call this spiritual by-passing.
The premature offering of spiritual answers, no matter how accurate, often add to the pain of the one who is suffering.
Rejecting your faith or the changes in your faith.
While forcing spiritual conversations is problematic, so also is it when our helpers challenge our faith, changes in our faith, or even question why we have a particular faith or religious practice. You might think this problem is only found among pastoral or biblical counselors. However, I have witnessed many licensed mental health professionals also evidence this red flag. Consider some of the lines I have had clients repeat back to me from their former helpers:
- You can’t believe that about God. He wouldn’t do anything to hurt you.
- If you don’t forgive, you will become bitter and miss out on blessings.
- If you aren’t in church, you are rejecting God’s goodness.
- Yes your abuse is bad, but God says…
- Your faith community is toxic. You need to leave this patriarchal religion.
If changes and discontent in our former ways of construing faith is so problematic, then why are there so many psalms of lament in the Bible? These poems express our deep questions and complaints. In Psalm 42 the writer laments how he no longer leads the worship procession and is now full of questions for God. Does God respond and tell him to stop this line of thinking and feeling? No. Instead, if you accept that the Psalms are given to us by God, then such expressions are invited by God as an act of communion.
Emphasizing techniques while missing the relationship.
There are many therapy models out there in use. Some are general models (e.g., Judith Herman’s three phase model of trauma recovery) and others are more regimented or manualized (e.g., Trauma-Focused CBT). In recent years, there has been a proliferation of EMDR certified specialists. And still many more employ various techniques from many models in an eclectic manner.
When your helper is overly enamored with a particular technique, it can become a problem as they may not be able to recognize when that beloved technique does not help you. When your therapist wants to jump into “doing stuff to you” then it is likely they aren’t really seeing or hearing you. And just because a particular technique has empirical evidence for success, it doesn’t mean it is right for you. Sadly, when a disciple of a model oversells a technique, the real reason may be that it promotes their own sense of competence as a clinician.
When a therapist suggests a course of action or an intervention, do they take time to explain what positive or negative response might happen? Do they find out how you feel about it? Do they check in with you and notice if you are anxious, concerned, or not having a good reaction? If you are flooded during a session (e.g., frozen, overwhelmed, etc.) and your therapist doesn’t seem to notice, show curiosity, or take the time to help you find ground again, you might need to find help elsewhere. If in response to your stress, they fill up the space with more words of explanation or defense, they might not be as trauma sensitive as they need to be.
Pressure to progress, mislabeling your hesitation as refusal.
Therapists love to help people. That is why we do this work. We want to see people get better and we have confidence that healing can and will happen. But sometimes, our motivation to help people also include the hidden desire to feel helpful. This desire can become a demand that the client feels in their bones. “I have to progress and get better or they will become disappointed in me or see me as resistant.”
If you have felt this pressure, take a moment and consider possible roots. Sometimes this fear of being resistant is something the survivor has come to believe about themselves (or, were told by their abusers!). But other times it is a message from their helper. Signs of demands, disgust, irritation, frustration, coercive speech, pouting all point to the possibility that the therapist is communicating to you that you need to get better FOR THEM.
We will explore how to determine if a therapist is right for you in the next post but suffice it to say here, your resistance to an intervention is something to listen to with curiosity. It is the beginning of regaining your voice and power. Instead ask, “What might your hesitation be saying?” Listen to it and don’t immediately judge it. If your therapist does label it as refusal, consider other helpers.
Therapist talking about self a lot.
Who does most of the talking in your session? You or your therapist? When your therapist talks, is it for the purpose of inviting you to explore your own reflections? Or, when they speak, do they share paragraphs and essays about their work or themselves? How much do they talk about their own experiences? Self-disclosure by the therapist is not always wrong. It can be helpful in tiny doses. But when it happens frequently it often distracts from the work that needs to be done by their client.
Therapy is not the place for therapists to talk about themselves (or to sell their own products). Ask yourself, “do I get to talk about the things that are most important to me during my sessions?”
Boundary crossings.
Trauma experiences, especially betrayal traumas, often contain boundary violations and maltreatment by someone who was supposed to protect and respect another. When helpers confuse or cross needed boundaries, this can delay healing or cause more harm. What kinds of boundary crossings do I mean? I have witnessed therapists trying to be all things for a client. They are not just the therapist but also become friend, “parent figure,” employer, pastor, landlord, and sadly, sexual partner. This last boundary crossing—sexual and romantic relationships—is always an abuse of power and a violation of the sacred trust of therapy. It is also a criminal act in most jurisdictions and always an ethical breach.
Most crossings are not meant for harm. A client can’t afford therapy so a clinician barters—provides therapy and in re-payment the client performs some work. A client has administrative skills and so the clinician invites the client to help run his or her business. Another client is isolated and so a therapist invites them to their own bible study group. On the surface these might seem mutual and helpful. But what if the client doesn’t respond well to the therapy? What if the therapist is unhappy with the work completed? What if learning about the personal life of the therapist creates confusion about what is discussed at the next session?
When therapists encourage dual relationships without ample discussion of the possible ramifications, they prioritize their own benefit at the expense of the client’s wellbeing.
I see a red flag, what should I do?
No therapist is perfect, and we all make therapeutic mistakes. It is the response to mistakes that makes all the difference between good and harmful therapies. The question you must ask yourself,
“is it safe to bring up concerns and questions about what happens in therapy?”
Can you talk about the process and raise concerns without your therapist becoming defensive? Most therapists want to provide good care and do not want to do things that harm their clients. So, it stands to reason that many will respond with concern and work with you repair the rupture and find out what works best for you going forward. If, however, you have reason to believe that you will be mis-treated for bringing up a concern, then consider whether it is time to find another therapist.
What comes next?
In our final post of this series, we will explore how to interview for a good therapist and how to determine what model of therapy might be best for you.
For further reading, why do counselors talk about themselves?
Musings on Faith and Psychology 