Healing from therapy trauma:

Most therapists are good people who are competent, kind, ethical, and qualified when it comes to helping people with mental health or relationship struggles. Licensing and ethics boards also exist to help protect clients from being harmed by therapy.

But therapists are human too, even if the role they’re in seems to hide this at times!

And every now and then, unfortunately, a client may come across a therapist or therapy situation that damages them in some way. Sometimes this is not due to any negligence or fault on the part of the therapist, but occasionally this is.

In cases where a therapist violates a client’s boundaries or confidentiality in a major way, or abuses the client, the client can walk away from the experience with serious trauma symptoms or even full-fledged PTSD. This type of trauma is often the worst type of trauma a person can go through, because it involves betrayal by a trusted authority figure whose job was to help while they were in a vulnerable position in relation to the therapist.

In other cases, a therapist may simply mishandle a client’s needs in a given situation.

Therapists also sometimes have personal reactions to their clients that can make it hard for them to stay objective and do their best work in some cases. Ethical therapists do sometimes make mistakes even while practicing in an ethical way, and this can’t always be avoided (nor should it be, because part of what  heals in therapy is repairing ruptures or disappointments), but these therapists tend to seek consultation at such times and to make it clear to the the client that they share some responsibility for what is going on in the relationship and for working to make it right. On the other hand, there are sometimes therapists who have trouble acknowledging their blind spots and/or blame any problems in the therapy relationship on the client, which can be somewhat of a red flag for the client.

Sometimes a client can push a therapist’s buttons in a big way, and even though it’s not the client’s fault for doing this, and it’s the therapist’s job to handle this professionally, sometimes therapists slip up or get defensive. Sometimes a client can feel very traumatized or hurt if this happens, especially if it seems to be a repeat of negative experiences the client has had in past relationships.

Therapy can also be traumatic due to a misunderstanding with the therapist, or to the fact that the therapist seems to have so much power and authority in the relationship, which can be triggering in its own right, because many of us carry wounds from past experiences with authority figures or from not having had enough power.

If a therapist has criticized you; said things that made you question yourself in a way that was destabilizing; acted inconsistent about boundaries; or abandoned you in some way, you may be walking around with therapy scars.

After a negative therapy experience, it can sometimes be so so hard to trust again!

This makes sense of course.

After all, how can you know that the next therapist will be different, or that you won’t be hurt again?

The therapy relationship is an attachment relationship, and when we become attached to someone who is in a helping role, it can activate our brains in specific ways. What I mean by this is that there are specific brain networks that get turned on inside of us when we begin to trust a person who we feel can comfort or protect us during experiences of threat, emotional danger, sadness, or fear.

Part of what happens in attachment relationships is that our brains make it hard for us to think clearly if there seems to be a possibility of being hurt by or losing access to the attachment figure.

Feeling rejected by a therapist; worrying about being abandoned; waiting in between sessions when it feels like the therapist is not accessible; or trusting a therapist if we’ve been hurt by attachment figures in the past, can all lead to difficulties with processing emotions and interactions with the therapist in an accurate way.

Attachment anxiety can also lead a person to go into profound states of depression or despair if it feels like there is a threat to the relationship.

For these reasons,  becoming attached to a therapist can be highly triggering to some people, especially if the therapist does not handle the client’s attachment in a healthy way, or if the client has past experiences of trauma or rejection in attachment relationships (for example, with one’s parents in childhood).

There are some things you can do, however, to protect yourself from attachment trauma in therapy.

First of all, you can share only a little bit of yourself at a time, and wait and see how the therapist responds, before deciding to trust the therapist with everything you think or feel. In this way, you allow the therapist to earn your trust a little bit at a time, and also to get to know you a little so that there is less of a possibility of the therapist misunderstanding you early in the therapy, before trust is built.

Titrating the pace at which you open up to and trust the therapist can also help slow you down from becoming too attached too quickly, before  your body and mind actually know whether you’re emotionally safe in the relationship. In addition, going slowly will allow you to see if your therapist seems consistent and dependable; responds in a way that is non-defensive and predictable; and accepts your need to develop trust in your own time and your own way.

Therapists who are secure should not have any problem with you expressing fears about trusting them, or taking your time to warm up.

Healthy therapists are also able to separate their own emotions from your emotions (you should be able to sense this pretty easily) and will be able to not take it personally if you bring up a fear or concern.

In addition, it’s okay to leave a therapist if something doesn’t feel right. I have noticed that people seem to question themselves so much when it comes to the idea of leaving a therapist, especially when they can’t tell whether or not they’re being helped by the therapist, or if they feel unsure about whether they feel comfortable with the therapist or not.

In my opinion, there are lots of therapists out there (i.e. someone for everyone!) and it shouldn’t feel like a lot of work to know if you feel comfortable with your therapist!

Therapy also shouldn’t lead to you questioning everything about yourself or to constant self-doubting thoughts either (unless you have OCD or anxiety tendencies that lead you to ruminate about and overanalyze things in general). In the absence of having a longstanding pattern of sabotaging all of your relationships due to past relationship traumas, or needing a lot of time in general to warm up to new situations, if something doesn’t feel quite right, it’s fine to look for another therapist…without overthinking it.

You also don’t owe the therapist an explanation. Yes, it’s nice to have that closure and to give the therapist feedback or some information about your decision to end therapy with them, but it’s not required, and you don’t owe it to the therapist to do so. I have worked with a number of people who took way too long to walk away from a therapy situation that wasn’t working for them, because they were afraid of having to tell the therapist about wanting to end! (Of course, please do cancel any scheduled appointments within the window of the therapist’s cancellation policy or you may be charged for the session, which is reasonable).

Also, even though sometimes your wish to leave therapy may be a sign of resistance (especially if you just began talking about deeper or more difficult material in your sessions…in which case your subconscious may be trying to protect you by pulling the plug on therapy), or might be the result of a misunderstanding, there are some therapists who are not healthy enough to talk to about one’s concerns. It’s important to trust your gut on this, or at least to talk it over with an objective third party. You can also always go for a consultation with another therapist! Sometimes it can do wonders to talk with another therapist about your current therapy and to get another opinion about whether the therapy seems to be going well or not. The most important thing is not to doubt yourself just because a therapist is a therapist!

I have worked with a number of clients who came to me after having had a difficult, traumatic, or unhelpful experience with a previous therapist. It truly can be hard to start again if you’ve been hurt. But there are definitely ways you can be more cautious the second time around, and sometimes having a therapist help you process the experience can help you be open to another try…

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Secrets in Relationships- Good or Bad?

Most of us can remember the delight and hushed tones with which we told (or were told) our very first secrets, and perhaps the pain of exclusion at the secrets we were not told in our earliest friendships as well. Secrets become their own kind of emotional currency early on in the relational world, often signalling the status of a given person’s specialness by virtue of the “Secret’s” quality of selectivity. Being “in the know” versus “not in the know” can painfully or excitedly (depending on which side of the deal you sit) mark the difference between those who have the power versus those who don’t. And, in fact, secrets can be thought of in many ways as a type of developmental achievement, being as they require at least a rudimentary sense of triangular dynamics in relationships (i.e. that two people can share something to the exclusion of a third party), often thought of as the precursor to one’s ability to develop an observing ego with which to step outside of oneself and observe one’s subjective experience objectively. “Getting” the concept of secrets also requires the understanding that one can keep something private in his own mind, which in some sense assumes a grasp of the aspect of “mentalization” that one’s mind is invisible to others.

Developmental experiences aside though, are secrets actually a good thing or a bad thing when it comes to intimate relationships?

Those who have suffered the trauma of a betrayal by a partner can certainly attest to the painful and damaging aspects of being on the excluded end of another’s secrets, lies, or hidden affairs. Believing that we are special and exclusive to another, as well as that our secrets are safe with them and theirs’ with us, only to find out that someone else’s presence was intruding on that exclusivity all along, is certainly traumatic and deeply disturbing to one’s sense of safety and trust in relationships. That being said, once the initial sense of betrayal cools off, it often becomes clear that one partner’s infidelity or cover-ups were in fact a signal of a need by both partners to bring hidden wishes and desires for closeness out into the open with each other. In fact, perhaps we might also say that it is the secrets that one keeps from oneself that do the most damage to a relationship. Only once we own our own secrets can we choose to share them with our significant others. Of course, sharing our secrets- whether after a betrayal or in the context of safety in a relationship- puts us on the line emotionally and can make us feel vulnerable; it is the sense of safety and mutuality in a secure relationship that allows us to take that risk and to trust that the risk is worth it. Relationships that are marked by insecurity and lack of safety may not be the best places to reveal our innermost selves.

Past traumas and betrayals can also affect one’s judgment about whether sharing secrets in a given relationship is a smart idea or an unwise one. A history of trauma, betrayal of trust, or indiscriminate inter-generational sharing (such as when a parent burdens a child with keeping secrets from the other parent, or when a parent repeatedly exposes too much vulnerability to allow for healthy idealization by the child) can lead to a general sense of ambivalence about whether and how to disclose private thoughts, feelings, and experiences in relationships- even in relationships with trustworthy people who seem to have our best interests in mind. Such developmental experiences can alternatively lead to indiscriminate sharing with others who may not be safe but who rather shame us for our secrets or respond in otherwise unhelpful ways. Learning how and when to share a secret (even vis-a-vis one’s therapist, for example) becomes a part of the therapeutic learning process.

And then of course comes the question of when it might be better to keep a secret inside because it will hurt the relationship or the other to know. Some feel that a really close relationship means that there should be no need for any secrets at all; others feel that some things are best left unsaid. Each of us has to establish our own relationship to the concept of privacy. Questions to ask oneself might be, “Will this disclosure cause unnecessary pain to my partner?”, and “Can the relationship at this point tolerate the knowledge of this secret?”. Past mistakes, previous romantic relationships, and deep traumas might be secrets worth thinking about before sharing.

Another good question to ask oneself is whether a secret feels like it can be kept inside- containable inside oneself- or whether there is a compulsion to tell the other/confess in a way that does not feel like a choice but rather like an urge. Holding this urge and exploring it further can be important when it comes to making a good decision about who and when to tell- as well as how to tell. Sometimes we feel so ashamed of our secrets that we share them in a way that invites the opposite response of the one we need. Working through one’s own shame may be a good first step before deciding to share or not to share. Of course, holding private secrets out of fear can also come at a big cost. We might feel guilty for hiding, burdened by the need to keep things inside, and afraid of the effect that exposure might have on our relationships and sense of self. Feeling like a fraud often accompanies an inability to share the things we are most ashamed of. It can indeed be hard to tease out whether secrets are helpful or harmful to a relationship; secrets can be a glue that bonds us to those we are closest to, or a dangerous weapon of betrayal and hurt.

So, are secrets good or bad? I guess, like most things in life, it depends on the context. What do you think about the secrets that you hold?

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