Help That Only Hurts: More on Therapy-Induced Trauma

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Gaslighting and further trauma await when a victim seeks help from a therapist who fails to recognize a manipulator’s “crazy making” tactics.

Seeking professional help in dealing with a relationship problem can be a challenging enterprise, especially when a person is doing so for the first time. But it can be an even greater challenge for a reasonably well adjusted person who is looking for guidance in dealing with someone in their life with a serious character disturbance. There are times when a therapist’s psychological and philosophical perspectives and theoretical orientation can negatively impact the process of securing help. There are even times when the therapy experience itself — a process that by its nature is meant to be both reassuring and empowering — can go beyond being merely unhelpful to actually being traumatizing in some way. This is not all that uncommon an occurrence, and it’s one I’ve written about before (“Therapy-Induced Trauma: What It Is and How It Can Happen”).

It’s relatively rare that someone is traumatized in therapy directly as the result of unethical or blatantly inappropriate conduct on the part of the therapist. But unfortunately, trauma in therapy can be sustained in more subtle, insidious ways, and in our age of more prevalent character dysfunction, such occurrences are unfortunately more common. That’s because some theoretical perspectives are ill equipped to deal adequately with the problem of character disturbance and can be inherently limiting and even disadvantaging if their shortcomings aren’t fully appreciated by a therapist. For example, within a “Systems Theory” framework, all the parties to a relationship are viewed as part of a system that tries to maintain the status quo. (A core premise of systems theory is that all systems try to maintain homeostasis.) Within such a perspective, even a person presenting himself as the complainant in a bad situation may easily be thought to be deriving some positive benefit from the way things are and will therefore naturally (albeit possibly unconsciously) resist changes they need to make. While there’s generally at least a modicum of validity to this kind of perspective, in the case where a reasonably well adjusted individual has been hoodwinked into and exploited by a master manipulator, predator, or other character impaired individual, such a perspective can be not only quite limiting but also disadvantaging. It could also be potentially injurious to the victim when it comes to deciphering the puzzle of how a person’s predicament came about and has been sustained.

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Therapists who operate within a traditional framework that views everyone as “neurotic” to some degree and necessarily struggling with various “unconscious” emotional issues that underly their problematic behavior, and are therefore in need of “insight” about those issues to make things better, may fail to adequately differentiate who in the relationship is more character impaired as opposed to neurotic. (See the series on neurosis vs. character disorder.) Such a therapist might not readily recognize — let alone be prepared to properly confront and deal directly with — the patterns of thinking and behaving at the root of a person’s dysfunction. The victim in an abusive relationship might end up saying to herself: “there they go again, doing what they always do to make me feel crazy and now I’m feeling even crazier because it looks like they’re getting away with it.” As I assert in In Sheep’s Clothing, some behaviors are so subtle with respect to the covert aggression inherent in them that they’re hard to spot as the tactics of power and control that they really are. It takes a particularly well trained eye and ear to recognize these tactics. The therapist also has to be both acquainted and equipped with the tools to properly confront and deal with these tactics. (I outline several of these in Character Disturbance.) Otherwise the victim of the abusive relationship is likely to experience the phenomenon of “gaslighting” (see “Gaslighting as a Manipulation Tactic: What It Is, Who Does It, And Why” and “Gaslighting Revisited: A Closer Look at This Manipulation Tactic”). It’s the very essence of gaslighting that the victim is made to feel crazy. They know something’s not right but others have them questioning their judgment. When a therapist fails to recognize a manipulator’s “crazy making” tactics — or even worse, appears to be taken in by those tactics — the victim can end up feeling not only even crazier but also alone and helpless. In such a case the therapist inadvertently becomes an enabler of the abuse and an unwitting co-conspirator in the gaslighting, which can indeed create quite the traumatizing experience.

Recently, I’ve received a rash of correspondence from folks all over the globe who have experienced some sort of trauma as they’ve tried to get help to deal with a troubling relationship. While the circumstances vary considerably, most of the complaints have been along the same lines: they knew in their hearts that there wasn’t all that much wrong with them and that the person with whom they were involved had serious character issues, but those they sought help from neither saw it nor dealt with it adequately. In the end, their only option was to exit the situation and stay as far away from it as they possibly could. Often, once they were away long enough from their crazy making partners, their sense of self returned to a healthier normal. But sometimes the scars of the trauma they’d sustained along the way lingered, making their “recovery” more difficult, and it’s truly sad that some of that trauma had to do with what they experienced when they went looking for help.

All clinical material on this site is peer reviewed by one or more clinical psychologists or other qualified mental health professionals. This specific article was originally published by on and was last reviewed or updated by Dr Greg Mulhauser, Managing Editor on .

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