24 Signs You’re In Bad Therapy

Bad Therapy Is Bad For Your Health

As a therapist in NYC, a city with so many therapy options, it bugs me when people are in bad therapy. My biggest concern with patients who stick with bad therapy isn’t only that bad therapy turns people off to therapy, making it less likely they’ll try again and get good help, but it also lowers their expectations. Even when they reach out, they’ve been trained to expect very little and that becomes a real obstacle in tackling big issues. Patients ask for less help, expect symptom relief and “support,” at best, rather than being open to the idea that these issues might really transform with the right help plus work.

Your Therapist Needs You To Speak Up When You Feel You Aren’t Getting Good Therapy

Patients in therapy are vulnerable. Therapy has largely borrowed and extended from medicine with physicians casting themselves as sort of modern day high priests. The claim is they are wise, mysterious and see things others don’t. It’s all hogwash. I’m pretty smart and I know some stuff–I talk to people all day about their pain and problems. But I also respect that the patient and I need to sort out the task at hand together. This therapist mystique can sometimes make it tough for patients to see that they’re just not getting the right help. They may think, “Perhaps the therapist knows something I don’t? Maybe it’s me?” The therapist’s unavailability might also feel familiar, mirroring how many people have also been in a patient’s life.

Therapists need patients to speak up when they feel they aren’t getting good therapy or the therapy that they need. In spite of the ways our profession has fashioned itself as all knowing, we do really have to figure this out together. I hate the idea of people being upset and not telling me. That doesn’t mean therapy with me is like ordering off a menu–sometimes I may push back, but in those instances, I have the chance to make the case as to why something is so important. I think about therapy as two smart people (or three or more, when it comes to couples, family or group therapy) doing hard work. Speaking up is another way of inviting collaboration. Of course I also may not be right for you! In that case, let’s sort that out so we can get you the right help.

How Do You Know If You’re In Bad Therapy?

So how do you know if you’re in bad therapy and should speak up or run for the hills? Below I highlighted 24 signs you’re in bad therapy, set up as dialectics to show that the opposite extreme isn’t always better when you’re in bad therapy:

1. Your therapist talks about sex without thoughtfully gauging your buy-in.

Your therapist seems to avoid the topic of sex or changes the subject when you bring it up.

2. Your therapist seems to suggest he or she doesn’t know how to help you. He or she stumbles a lot, seems lost, or appears unsure of how to proceed

Your therapist always has an answer and never leaves room for doubt or uncertainty.

3. Your therapist talks about him or herself unselfconsciously in ways that don’t seem grounded in the work.

Your therapist is hard to read, rigid, closed-off, or passes judgment in response to a question about their person or history.

4. In your work together, there’s an emphasis on the past, but you’re often left feeling like you don’t know what to do with that.

Your therapist insists that the relevant work is on the here and now and that the past is irrelevant. The past, for him or her, is simply best left behind.

5. Your therapist doesn’t seem to have a plan. The work appears ad hoc and unclear where it’s going.

Your therapist is resistant to letting the work wander a bit to see where the work might stumble that could be beneficial.

6. Your therapist’s values are asserted or offered unfiltered as the truth or right way to go without leaving any room for moral doubt.

Your therapist pretends not to have a point of view. They believe that therapy is apolitical and their point of view doesn’t belong in the therapy room.

7. Your therapist easily blames other people in your life. He or she takes your side every time.

Your therapist never seems to take your side.

8. Your therapist seems like a mess themselves.

Your therapist always seems so put together that they never show any vulnerability.

9. Your therapist tells you to focus on the good side of hard things and to concentrate on what’s working, even when you’re struggling with a frustrating or painful situation.

Your therapist is always gloom and doom.

10. You don’t feel welcome in your therapist’s office. It feels cold and clinical.

You feel like therapy is easy.

11. Your therapist often recommends books and resources to compensate for not knowing what to do themselves.

Your therapist resists any help you seek outside of treatment, whether support groups, faith-based groups, AA, medicine, community support and even, friends. He or she looks down on these resources and asserts that only he/she or therapy can help.

12. Your therapist is overly pathologizing, relying heavily on labels and diagnostic language.

Your therapist is afraid to use clinical or diagnostic language. Instead, he or she minimizes diagnoses. (Classic examples of this often come up with Borderline Personality Disorder and Autism Spectrum Disorders).