For all its many benefits, the experience of therapy can also be traumatic; sometimes, that’s hard to see until it’s already too late.
Therapy can be an extraordinary way to work through feelings, resolve issues, gain in self understanding, and make meaningful changes in one’s life. Therapy can also be a powerful vehicle of healing for those who’ve endured trauma of one type or another. But there can be times when a person’s experience with therapy is less than positive. There can even be times when the therapy experience inflicts its own kind of trauma.
Traumatic experiences within the context of therapy don’t have to be the result of unethical or blatantly improper conduct on the part of the therapist. Nor do such experiences have to be the result of unrealistic expectations or misperceptions on the part of the client. More often, therapy induced trauma occurs subtly and insidiously, with the full effects of it being realized only after damage has already been done.
Several years ago I received the first of what would come to be a plethora of similar complaints from spouses of individuals receiving treatment for “sexual addiction.” (Note: the example to follow contains no identifying information, contains both deliberate distortions and elements that are commonly reported, and does not reveal specific or privileged information.) A woman in her forties was quite distraught over the fact that her serially cheating spouse had been in sex addiction therapy of one type or another for almost 3 years and things didn’t appear to be getting any better. In fact, in many ways, she felt things were getting worse. She had done her part, to be sure. She had gone to all the “co-dependency” support group meetings, knew the “steps” like the back of her hand, had attended all the conjoint and group therapy sessions when required, and had taken seriously all the things the counselors had advised her to do to assist in her husband’s “recovery.” But she was becoming increasingly bothered by what the therapists were calling the “always to be expected relapses” — such as visiting chat rooms and engaging in other internet-based sexual solicitations — and was also beginning to wonder about how reasonable it was that she continue to wait patiently for her husband to “turn the corner” in his treatment. She also didn’t understand why some of his behavior wasn’t being confronted very hard by his treatment providers. On occasion, she got up the nerve to express her concerns to the primary therapist. But she would be met with statements like: “He’s still in some very deep denial and we need to proceed cautiously lest he succumb to so much shame and guilt that he completely shuts down.” When she’d complained about not being able to confront her husband directly for what she believed were some of his intentionally abusive behaviors, she was told that he was “too fragile at this stage in his recovery” to be pressed on such points. How long was she supposed to wait, she wondered? How much more was she supposed to endure? Why was it okay for her to suffer so much and for him to be doing so little to make things right?
One day, this woman had an epiphany. Perhaps the treatment itself was the problem. Maybe it was well intended, but also, perhaps, it was misguided. Maybe her husband wasn’t such a fragile, deeply wounded soul in the throes of an addiction he couldn’t control, riddled with shame and guilt yet proceeding as fast as he could on his personal road to “recovery.” Perhaps he was in fact more of an unsavory, manipulative character, playing his treatment providers like a violin and exploiting their patience and forgiving nature — a con man rather than a true addict. But if that were true, why all the game playing? She had often suspected such things but was hesitant to afford her intuitions any validity. After all, she was not the “expert.” But after doing some careful investigating, things became clearer. Her husband already had another woman in his sights. He’d been craftily funneling funds out of their joint accounts and setting up house elsewhere. Here she was patiently trying to save her marriage and he was only buying time and stringing her along until he could financially afford to jump ship. He was prepared to leave her high and dry, both emotionally and monetarily. This cad was no mere sex addict. He was a disordered character of the first magnitude. Perhaps worst of all, his treatment providers were his unwitting accomplices.
This woman was understandably angry. She was angry with her philandering spouse, angry with herself for putting up with his abusive ways for so long, and angry with the folks at the treatment center, who, for all of their good intentions, had only succeeded in victimizing her further by helping to forestall the inevitable and unnecessarily both prolonging and adding to her agony. Whenever she even thought about all those times she expressed her reservations only to be told to “hang in there,” she became even more upset. She had gone to these people for help. What she got for all her efforts was only more hurt.
Getting it right with respect to assessment and treatment is, of course, always important. It becomes particularly critical when character disturbance is involved. Failing to accurately assess and appropriately treat the disordered character not only typically ends up wasting a lot of time and money on the “designated patient” but also can inflict a lot of unnecessary pain and suffering on those unfortunate enough to be involved with such a character. As I mention in Character Disturbance [Amazon-US | Amazon-UK](?), sometimes, the perspective a helping professional takes can in itself be a problem. When a heartless conniver is both viewed and treated like a wounded, struggling, insecure soul, it’s the truly innocent parties that often end up being victimized yet again. The first axiom of all good healthcare is: “Do no harm.” And that’s just one of the many reasons it’s so important for treatment providers to know how to recognize and how to deal appropriately with character disturbance.
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