Therapists, psychiatrists, psychologists, life coaches, and spiritual advisors are all expected to address emotional or spiritual well-being and nurture a person’s healing and positive growth. Most of them are committed to doing just that. Unfortunately, some have darker motivations, such as a desire for power, money, or sex. Instead of using their skills to help their clients, they use undue influence to manipulate and abuse them. Are you concerned you may be experiencing therapist abuse? Have you ever considered the idea of a therapist functioning like a cult leader?
Tactics used by unethical people (including professionals) in the mental health field are often identical to cult leaders. When thinking of a cult, most people might picture an organization—religious, political, or financial—with one leader and many followers. However, manipulation and deceptive techniques used to gain power over an individual can characterize interpersonal relationships as well, creating what is sometimes called a “cult of one.” I have worked on cases involving therapist abuse, in which a therapist has been influencing the individual for 20 or more years, in the process causing grave harm to their family members (especially those who questioned that therapist). The therapist received an excessive amount of money, saw multiple family members at the same time and used information given by one to manipulate others. Some bad therapists not only worked with the patient/client but sometimes also ran groups. Some became full-blown therapy cults, like The Sullivanians or the Center for Feeling Therapy. In 1996, Margaret Singer and Janja Lalich published the book, Crazy Therapies: What are They? Do they Work?
Amy Avalon, who volunteers for the group TELL, is officially retired from her work as a therapist. She joined me to discuss some of the difficulties a client may face in therapeutic relationships. I asked Amy how she had become particularly interested in this subject. She explained that she discovered a therapist colleague was sexually abusing one of his clients—a married woman who was 35 years younger than him.
Therapists’ power differential is enormous because they are seen as authority figures and because the client is usually seeking help to address a significant difficulty. Therapists, priests, or parents, for example, are in a position of power over clients, parishioners, or children. It is never the responsibility of a client to ensure that a therapist behaves ethically. It is up to the professional to set appropriate boundaries and maintain them. However, the purpose of this blog is to offer tools to anyone who has been seeing someone for many years and has not demonstrably gotten better. Like cult leaders, bad therapists keep turning things around on the client, and all issues and problems are because of their past, or their genes, or their bad family– mother, father, etc. They blame the client for being too attractive or merely use their past trauma as an excuse to take advantage sexually.
Despite warnings from a few other colleagues, suggesting that she walk away and ignore the situation, Amy filed a formal complaint. The backlash included threats and intimidation, and character assault.
The therapist Amy reported tried to triangulate her and his client by falsely identifying Amy’s intervention as the problem rather than his unethical behavior. Among many excuses, he claimed that if Amy had been more friendly to him, it wouldn’t have happened, and it happened because his client was seductive. Accepting no responsibility and blaming someone else, particularly the victim, is a typical response by cult leaders to criticism of their behavior. The acronym DARVO is an easy way to explain it: Deny, Attack, Reverse Victim, and Offender.
Many people are not aware that licensed therapists and other credentialed professionals have a written code of ethics. To maintain their licenses, they must have regular periodic training, not just to remain up to date, but to keep therapists committed to ethical behavior. Anyone seeking the services of a therapist, or any related professionals, should check with a State or National Board to be sure they have an active license with no compliance punishments. However, it would be a mistake to assume that having credentials and a license automatically guarantees ethical behavior. To further complicate the matter, therapists who lose their licenses sometimes move to another jurisdiction, continue to practice without one, or use a designation such as “life coach.” An excellent guide to making informed therapy decisions is The Consumer’s Guide to Psychotherapy by Daniel Goleman and Jack Engler. Even though the book is out of print, you can still find and use it. People need to learn how to be educated consumers.
Entering into a therapeutic relationship requires a high level of trust when a person is already vulnerable. Many people look to the expert and assume they know what is best for them. They ignore their conscience or deny their questions and doubts, believing that the professional is in charge and knows best. Even when something doesn’t feel right, people tend to give a therapist the benefit of the doubt. Always listen to your doubts and get a second opinion from another mental health expert. You always have the right to question! You are the employer, and the therapist is the employee! Recognizing the red flags may be difficult at first, but these are a few important ones:
- Therapy should be time-limited, address a specific issue, and move toward agreed-upon goals. A client should not be seeing a therapist for ten years and not be doing any better.
- A therapist should have knowledge about the therapy’s specific focus, such as family work, trauma recovery, or cult indoctrination. For example, if you are exiting an authoritarian cult, and you find yourself having to explain the basics to the therapist, that’s a red flag. If this particular therapist is ethical, they will refer you to someone trained and experienced or pay for an expert to supervise treatment. I have been hired by counselors to supervise them.
- Therapists are taught to avoid dual relationships. They should avoid sharing personal information about themselves, and not invite clients to social events or on a date.
- A therapist should not encourage clients to isolate themselves from significant family members or friends without a clear explanation of the therapeutic reasons. In my opinion, anyone isolating the client from family and friends is using the cult tactic of mind control. If there are real family issues, a qualified family counselor should be engaged. Avoiding family issues for years is another example of therapist abuse or incompetence.
- Therapists should help clients make decisions and choices for themselves and ones in their best interest, not tell them what they should or shouldn’t do. A therapist should never put a client down or call them stupid, gullible or blame them for their pain.
- A therapist should never engage in sexual behavior with a client. Romantic feelings can come up, but a therapeutic relationship needs to be held within strict boundaries to protect the client
If you or someone you know has been seeing a mental health professional and wish to “reality-test” whether it is time to get a second opinion or terminate treatment, Estelle Disch, PhD, has compiled an excellent, extensive checklist entitled “Is There Something Wrong or Questionable in Your Treatment?” If you review this checklist and have even one thing come up, we recommend considering a second opinion.
Amy was motivated by her experience to help victims of therapist abuse, providing information and support through TELL. Amy emphasizes that victims are often very resilient, and once they have the right information, things can turn around quickly. Joining others who have gone through the same experiences is a powerful healing tool. It encourages those who have not yet spoken up to come forward and heal from the abuse.
Amy Avalon, MA, LMHC (ret.), was a private-practice therapist for many years and discovered a long-time colleague was sexually abusing a patient. The experience has made her a passionate advocate for survivors of therapist sexual and emotional abuse. She helps raise awareness of widespread unethical conduct and abuse in psychotherapy by educating and supporting professionals, consumers, victims, and their loved ones. She also helps victims heal, speak out about their experiences when they are ready, and hold their abusive therapists accountable.
She is a responder with TELL (Therapy Exploitation Link Line), www.therapyabuse.org. Of course, over the decades of my practice I am worked with people who have wished to understand what happened to them and heal as well as coach family members and friends how to empower their loved one to reality-test. It is my profound hope that this blog and Estelle Disch’s checklist will be a positive step forward.