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Whose Therapy is it Anyway? Recognizing Coercion and Control in Therapy

Recently I have edited and written chapters in the critically acclaimed book Power Games: Influence, Persuasion and Indoctrination in Psychotherapy Training. This book is a description of the structures, methods and applications of dictatorial and authoritarian training many therapists experience. As with any such doctrinaire approaches, there are causalities strewn along the way. Sometimes they are the therapists and all too often they are the people these therapists see in their practice. Unless mental health professionals are able to titrate, question, challenge and mute the misuse of power I describe, the services they offer are contaminated by the same fundamentalist, inflexible thinking.

The book I am currently writing, Whose Therapy is it Anyway describes patients experiences and revels some of the means by which therapists insist upon what is proper, healthy and worthy. The aims, hopes and dreams of patients are upended and dismissed if not to the liking of the therapist. Therapy is no longer, but instead is replaced by re-education or indoctrination.

So what are some of the signs to watch for?

  1. An aggressive, demanding and righteous stance by the therapist spells trouble. Such a stance is often characterized by challenge, impatience and at times ridicule.
  2. The provocative use of language which is demeaning and dismissive has no place in psychotherapy. The purpose of such language is to precipitate a crisis so the patient becomes more amenable to change as directed by the therapist.
  3. Sessions dominated by what the therapist deems important, and any contrary views that might challenge this dominance are interpreted as resistance (non- cooperation with the therapy process) or more dangerously as self-indulgence, are potentially terribly harmful.
  4. A heightened emotional quality to the therapy hour is to be viewed with caution. Feelings can be inflamed with a “more is better” expectation. Thinking, considering, reflecting are inimical to emotional re-experiencing.
  5. The use of touch to soothe the patient after or during an emotional discharge or difficult session often reflects a blurring of appropriate boundaries. Such techniques foster dependency and compliance. The attitude seems to be “there, there now that wasn’t so bad was it? And daddy (or mommy) still loves you.”
  6. Personal language is stolen. Certain words or phrases that reflect complexity, metaphor, symbolism, abstraction, or challenge the theoretical stance of the therapist, are banished. Self assertion is apparently encouraged but contained within narrow, rigid boundaries i.e., “you can disagree with me if I agree that you can disagree.” Such therapy is a confusing mix of smoke and mirrors, ripe with contradiction and desperately driven by the therapist’s need to be right and in control.

If you, the reader have additional examples or personal experiences you wish to share, please email me or send a letter to my office. I will keep any such correspondence strictly confidential. Finally, anyone in or contemplating therapy may want to remember that it is first and foremost your therapy.