I will say it again for the record, this is not a condemnation of any one theory of human behavior, but rather the way some therapists choose to practice and implement valid theories in invalid ways.
What are the clues to look or listen for in a therapist to avoid?
"Out There" or " X-File" type comments meant in all seriousness are real Red Flags. Give the therapist the benefit of doubt to see if they were using metaphor, which they should explain clearly or if they were joking. Sometimes we all say things that are only funny to us and not others.
Examples of Red Flags:
Lack of Candor
Impossible Claims
Disembodied Unconscious
Fast and Loose With the Facts
Transfer the Transference
“Two Faced”
Protecting You From Yourself
Shows Disregard for Abandonment Concerns
Fails to Keep Up To Date With The Current Research, Standards of Practice and Laws
Indiscriminate Use of Aggressive Debt Collection Methods Such as Collection Agencies
Candor, or the lack of it - Is it important to you? It is to me. What would you do if your therapist truly believes that to be candid with you would be to patronize you? I know at least one therapist who said just that and there are too many who seem to agree with that statement. I think they have things mixed up. So ask your therapist about how candid he/she will be with you. Now of course if they are not candid they will not tell you, but watch their eyes, body language and listen. Does it sound like psychobabble?
Impossible Claims - Many therapists are generalists. That is we treat a variety of people and types of problems. However, beware of any therapist who claims that they can treat anyone and everyone with just about any problem. And if they claim that can treat everyone with only one theory or approach that is another reason to get away fast. Such therapists are like a child who just received a toy hammer for their birthday. They need to nail everything. Don't get nailed.
Disembodied Unconscious - If they say, "Your unconscious is telling me... etc. Or, your unconscious is speaking to my unconscious. That's" Out There". I mean that is really "Out There''. Hope that they meant it as a metaphor. If so they should explain it that way. Your unconscious or anyone’s unconscious does not have its own vocal cords or sensory organs. It does not speak. The auditory part of the therapist's brain is hearing voices and it's not your voice. In addition, you have no way to refute what your therapist thinks your unconscious is saying. You cannot even get a second opinion. You cannot win. Stay away.
Fast and Loose with Facts - If your therapists says something like, I interpret things, say whatever pops into my mind, and don't worry about facts. ..... I accept that I do interpret and judge. That is how I make sense of the world especially the people world, think about that statement. Think about it real hard. You will be judged, not on facts but by whatever pops into your therapist’s head? What more can I say? Except to consider the following example.
Therapists often make interpretations of our behavior and statements. If they make interpretations that fit us, it can be helpful. If they interpret in ways that have nothing to do with us, they can cause harm. Sometimes a great deal of harm! Some therapists can't seem to help themselves making interpretations. They do it to patients, colleagues. Its one of the reasons why therapists have such a poor track record in relationships themselves. They can't stop interpreting and they are wrong more often as not.
Suppose you told your therapist either in an individual session or in a joint or marital session that in your marriage relationship sexual fidelity is important but not as important as other types of fidelity. There are many people and cultures that hold that view. The therapist then says, based on little else, “It looks to me, like you're looking for an excuse to cheat”. Based on nothing more than that! You try to explain that that is not what you were saying, but this therapists adds, “..but I don't buy it”.
Some therapists will make interpretations about you but, it may have more to do with their fears and needs. Do they make any effort to understand you before they make such judgments? The sad part is it's like the joke that therapists are preoccupied with sex that everything you say in a therapy session is about sex. With some it seems that way. They are like that kid with the toy hammer. They have to nail everything. It’s no joke if you are in the receiving end of their hammer. Immature children should not play with hammers unsupervised. The danger of making interpretations about unconscious material is that you never know whose unconscious is coming out. It could be theirs and not yours.
A useful interpretation in therapy is based on at least some facts. it's not concocted out of the air. It requires gathering facts, and the therapist’s skill, experience and feedback from you to see if it's on the money. Most important, it requires your consent to have your thoughts interpreted. Otherwise, it is dangerous. Some therapists are like surgeons who will cut into anything close by when nothing is wrong or when their interpretation is not requested or needed.
Would you have any trust in such a therapist? If your therapist wrote that in a record about you, could others believe it, even if it were not true? Try to explain that to your spouse. The expert thinks you are looking for an excuse! When in fact it may be the expert is desperately looking to sound knowledgeable or even funny. When you confront such therapists, they have ways of avoiding the issue. You are resisting some will say. You are in denial. When truly pushed they might back off and claim they were joking. That gets difficult. Suppose they were simply making a joke that, you did not get. How do you know for sure? Therapists often use humor to lighten up the mood. A good joke is hard to miss; a bad one needs advanced warning. Humor often comes in the context of a situation. What if however, you over heard them to say on the same subject:
‘Yes, I could forgive an extravagant purchase easily. even a bankruptcy...but sexual infidelity. never...relationship over. or, Whether they divorce or not is not the point. Many stay married even though they are miserable and the marriage is basically over. Most of the women I know are in marriages and are unhappy, but they don't want to go through all the trouble of divorce.”[1]
So, if someone takes a second mortgage on the house and buys a Mercedes sports car, drops a bundle at a casino or goes off for a month at a fancy fat farm, without mentioning it to their spouse that is just a minor extravagant purchase, no problem. But a ‘nooner’ in a motel is the end of a marriage? Fortunately, statistically people are not as down on marriage as some marriage therapists. Many people don't just see things as that black and white.
But whose needs are being met by therapists who make fast and loose interpretations. Odds are it’s not yours. You be the judge.
Transfers the transference - A therapist says, “Your objection to my raising my fees is symbolic of some deeper transference issue.” Right! Look, your therapist has every right to set any fee he or she chooses unless he/she voluntarily signed away that right such as to a managed care company by contract. You on the other hand, have every right to object, negotiate and/or not buy what your therapist is selling. It’s business. Don’t let anyone tell you otherwise. Test it and see. Pay your therapist in “Monopoly” money and ask him or her to discuss its symbolism and what it means to him/her till the cows come home. See if he or she buys that. If they don’t, why should you? It will also check whether your therapists really worry about some facts. Bet they do.
"Two Faced"- How consistent is your therapist in their statements and actions? Now, to be clear, I am talking about their professional life only here. I do not think your therapist’s personal life matters that much. Try not to pry. I know some cross-dressing therapist in their private life who are among the most respected I know professionally. I would send family members to them without hesitation. What I am referring to here is do they say or proclaim things that they don’t practice themselves? Do they ask you or others to behave one way but they are exempt? Do they for example:
Do they talk behind people’s backs such as gossiping about other patients or even other colleagues?
Do they say things to you about others that they would never say to that other’s face?
When they do, do they expect you to keep such gossip confidential?
Confidentiality covers what you say to a therapist in a therapeutic relationship. Or, what one colleague would share to another professional about you, a patient, as part of a conference. However, it does not prevent you from telling the world or compel you to general secrecy. If the therapist does not understand the principle of confidentiality i.e. what it is; when and where it applies, how can they keep confidences you share with them? Also, what could they possibly be saying about you when your back is turned? Odds are a lot and it will not usually be good. Run
Protecting you from yourself - This example needs a caveat. Sometimes a patient does need to be protected from him or herself. If you were going to harm yourself or someone else or expose a child to neglect or abuse your therapist must do what they can to protect. But, that should be the exception, not the rule. In general, you should not need protection. Or if a minor, the major responsibility rests with the parents except under extraordinary circumstances, as mentioned above. Therapists can be overprotective and encourage dependency rather than promote independence in several ways.
If you choose to end therapy or switch therapists, it is not always resistance or that you are not motivated. It may be you no longer need therapy or you want a change. Assuming resistance encourages unnecessary dependency. You will never be over with therapy with such a therapist until they say it is over. In addition, that may be years and years.
If your therapist will not give you access to any part of your record, ask why. If you cannot get a straight answer without psychobabble or gobbledygook, RUN. If they keep “secret notes” sometimes called “psychotherapy or process notes” even from you, again ask why. If they tell you it’s necessary to keep them secret because if you were to see those notes you might feel judged and abused, tell them just knowing that you have such secret notes leads me to question if I have been abused. Tell them to fork them over and you will be the judge of that. Or, perhaps some time down the road, someone else will get access to those secret notes and they will assume that everything is true. Try to prove them wrong.
Shows disregard or Ignorance for abandonment Concerns - Psychotherapy is a professional service and in that sense your therapist is a businessperson. They are selling you a service and have every right to make a living and charge and collect fair fees for services rendered. However the difference between psychotherapy, medical service, and other professional health services is that a health care professional cannot "abandon" you simply for financial considerations alone. Nor can your therapist provide you with less than they honestly think you need, or a service that is not designed to suit your needs simply because you can't afford what you do need. It's a serious dilemma, but one that goes with the territory. If you find your therapist abandoned you, you have recourses.
Fails to keep up to date with the current research, standards and laws -I think that is self-explanatory. Anyone who does not keep current meets the definition of an impaired therapist.