Therapists Spill: When You Have a Bad Therapy Experience
It takes courage to seek therapy. Therapy is a vulnerable act, as you entrust a stranger with your innermost thoughts and feelings. So it can be especially disappointing and distressing when you have a bad experience. It might even taint your view on the entire process and system.
“Just one bad experience can shut a person down, turn them off to a new therapist, and leave them disinterested and even disgusted by the entire mental health system,” said clinical psychologist Deborah Serani, PsyD.
But exploring your bad experience — pinpointing why it was so negative — can help. Below, clinicians reveal common reasons behind bad experiences, along with insights into navigating therapy in the future.
Common Reasons for a Bad Experience
Ethics. Every profession has bad eggs, said Serani, author of the books Living with Depression and Depression and Your Child. Therapy is no exception. According to clinical psychologist Ryan Howes, Ph.D, clinicians may behave unethically and harm their clients by: “having a sexual relationship, breaching confidentiality, extorting money, practicing outside their area of competence, giving poor advice, or responding based on their issues instead of their clients.”
Expectations. Inaccurate expectations can lead to a bad experience. For instance, if you expected therapy to be like a visit to the doctor, you might’ve been disappointed to learn that therapy requires an active role, said Howes, who practices in Pasadena, Calif. If you expected therapy to be like a friendship, you might’ve been disappointed that it’s not a reciprocal relationship; therapy is focused only on you and your issues, he said.
Howes likened therapy to personal training: “the therapist provides guidance and support, but you do the work.”
Fit. Sometimes a bad experience is the result of a bad fit between clinician and client. “Being in therapy is unlike any other kind of professional relationship in that connection between patient and therapist needs to ‘click,’” Serani said. And this connection might’ve been missing from the start, she said.
Psychologist Christina Hibbert, PsyD, also underscored that “just because someone is a ‘good therapist’ doesn’t mean they’re necessarily good for you.”
Therapy type. There are many different types of therapy, such as cognitive behavioral therapy and psychodynamic therapy, Serani said. You might’ve had a bad experience because the type of therapy wasn’t right for you. For instance, if you’re struggling with obsessive/compulsive anxiety, you may need treatment that focuses on changing behavior, not on gaining insight, she said.
Change. Sometimes, a person simply isn’t ready to change, said Jeffrey Sumber, MA, LCPC, a psychotherapist, author and teacher.
“This is perfectly reasonable and the person is not bad or wrong for stating as much to themselves and the clinician…I am a firm believer in all of us taking ‘breaks’ from treatment.”
Therapist’s readiness. Sometimes a client is ready, but the therapist isn’t. The therapist hasn’t traversed the psychological terrain the client wants to explore, Sumber said. For instance, a client is considering leaving a career they feel stuck in, while the therapist has been avoiding his or her own disconnect with the profession, he said.
Time. “On rare occasion, I find that the timing of therapy doesn’t work for a client,” said John Duffy, Ph.D, a clinical psychologist and author of The Available Parent: Expert Advice for Raising Successful, Resilient and Connected Teens and Tweens. For instance, a year ago, he worked with a young man who was swamped with his career. Just scheduling their sessions stressed him out, and he missed or canceled several. He recently came back and his work with Duffy has been productive.
Overwhelm. As clients see their problems, they might become overwhelmed and leave before they feel relief or receive answers, Howes said. With a good therapist, clients can expect both within several weeks, he said.
According to Serani, “When you’ve been traumatized by an experience that’s supposed to be healing, it’s an enormous loss. And the field of psychotherapy takes this very seriously.”
If your bad experience sparked a serious trauma, you can file a complaint, she said. There are two ways to file a complaint, which involve leaving identifying information such as your name and address.
- State level: Leave a complaint with the State Licensing Department Bureau. For instance, this is the site for New York.
- Organization level: If the therapist belongs to an organization such as The American Psychological Association or the American Medical Association, file a complaint with them.
Creating A Better Experience in the Future
Explore your role. Consider how your behavior might’ve contributed to your experience. For instance, consider if you were open and clear in communicating with your therapist, Duffy said. “Consider whether you felt listened to and understood.”
Consider, too, if you were ready for therapy. “You may want it in ‘theory’ but maybe not in “practice,’” Serani said. Again, “remember that there’s no shame or blame if you aren’t ready.”
Learn about therapy. Empower yourself by learning about psychotherapy and the different types of treatments, Serani said. Doing so gives you a better grasp of what you need and where you might find a positive experience, she said.
Ask questions. “Too many clients are afraid to speak up and ask about what they’re signing up for. It’s OK, and even necessary, to ask,” said Hibbert, author of This is How We Grow. She suggested asking the therapist questions about everything from their background and experience in dealing with your issue to how they work and what they expect from you.
Talk about your bad experience. All the clinicians stressed the importance of sharing your experiences with your next therapist. Sumber asks every client about what went right and wrong. “This has been an excellent guide for me in offering a different experience for clients than what they previously encountered.” For Serani, it, too, heightens her awareness to what clients want and need.
Howes suggested clients and clinicians collaborate on a plan for navigating the same issues, if they arise.
Duffy suggested talking about your role. For instance, if you didn’t communicate well, letting your therapist know helps them (and you) hold you accountable in changing your ways.
“I often find that, if you relate a certain way with a therapist, you may well act in a similar, perhaps non-productive manner in other relationships. Attention to this issue can shift from a problem to a therapy issue that can be managed.”
Request a treatment plan. A treatment plan gives clients “a bird’s-eye view of what will be happening over the course of time, what skills will be learned, what goals are going to be achieved,” Serani said. This creates a more positive experience.
Try a trial run. “I encourage clients to tell their new therapist that they would like to try them out for three to six sessions to see if there is a better rapport and whether they feel safe and simultaneously challenged in the new relationship,” Sumber said.
Discuss concerns. Because many bad experiences happen because of miscommunication and misunderstanding, Howes suggested having a direct conversation about any issue.
He shared this example: “In our last session you said something I didn’t understand (or sounded hurtful, or confused me, or didn’t sit well with me), could we talk about that?” Confronting your therapist also helps you become comfortable with confronting other people in your life, he said.
(Howes noted that if talking to your therapist doesn’t resolve the issue, consider talking to their supervisor, if they have one. If this doesn’t work either, it might be time to try a new therapist.)
Reflect on therapy. Journaling or using apps to examine how therapy is going deepens your awareness of the experience, Serani said. If concerns come up, again, raise them with your therapist. “In this way, you can be proactive about your therapy, catching experiences before they become bad or negative.”
It’s understandable how a bad experience may completely turn you off from therapy. But clinicians stressed the importance of keeping an open mind and not letting one negative experience poison your feelings about the entire process.
“Therapy works, and can be effective for most anybody,” Duffy said. Even if it didn’t help with one issue — such as saving your marriage, it may help with others, such as treating your depression, Hibbert said.
“[B]ad experiences are the exception, not the rule, and most people enter this profession with a genuine desire to help people, not to do harm,” Howes said.
Tartakovsky, M. (2018). Therapists Spill: When You Have a Bad Therapy Experience. Psych Central. Retrieved on August 6, 2020, from https://psychcentral.com/lib/therapists-spill-when-you-have-a-bad-therapy-experience/