In her first session with a new therapist in San Diego, Elise, 37, immediately felt turned off. Not because of anything the therapist said, but because of the fact that she was riding a stationary bike during their conversation.
Maria Danna, 35, was alarmed when her therapist in Portland, Ore., “vigorously shook a maraca at my face” in order to “pick up the energy I was giving off in session.”
And Carson, who sought help from a psychiatrist in Ohio for severe postpartum depression and anxiety, felt troubled when the doctor sent her thousands of text messages and eventually revealed his sexual feelings for her.
Therapy is transformative for many people, regardless of whether they have a mental illness. But what do you do if your therapist is unprofessional, inept or even abusive?
Last year, The New York Times asked readers whether they had ever had a bad experience with a therapist, and we received more than 2,700 responses.
Among them were examples of ethical violations, unprofessional behavior and interactions that were simply bizarre. (Some readers who shared their stories asked to be referred to only by their first names to protect their privacy.)
It’s difficult to know how often these types of incidents occur. No federal agency regulates psychotherapy. And although state licensing boards are supposed to hold therapists accountable, the process can be flawed, and there is a high bar for disciplinary action
“I was in the middle of explaining that I felt invisible in my family,” wrote Melissa Petty, 71, of an incident that happened more than a decade ago in Dallas. “I looked up and the therapist was asleep! I found a new therapist immediately.”
“There’s a bit of a joke in the field that every graduate cohort has at least one to two students that everyone else has serious doubts or concerns about,” said Eric Jones, a therapist in Santa Ana, Calif. “We are ethically obligated to gate-keep the bad ones from licensure, but it’s not a perfect system. I’ve fired or reported several myself for problematic conduct.”
While in Dr. Jones’s experience the good therapists far outnumber the bad, he and other experts urge patients to trust their gut if something seems off.
Dr. Jonathan E. Alpert, chair of the department of psychiatry at Montefiore Einstein in New York, says the therapist’s “North Star” should be a patient’s or client’s health and continued growth. If it isn’t, he added, then “something is wrong.”
When a Therapist Gets Too Close
Therapists are supposed to maintain physical and emotional boundaries with clients. Violating those boundaries might look like regularly disclosing intimate personal details; touching a client inappropriately; flirting; offering gifts; or trying to establish a social relationship outside of the office.
If a therapist is flouting professional boundaries and you’re unsure of what to do, one place to find support is the Therapy Exploitation Link Line, or TELL, a peer support network that helps those who have been harmed by therapists or who are concerned about their therapist’s behavior.
Deborah A. Lott volunteers at TELL, offering guidance that she would have appreciated back in the ’80s. At the time, she was 28 and had sex with her therapist, whom she said had offered her both wine and cannabis. He begged her to come back to therapy. She did, temporarily, before finally cutting off contact.
“Once you’re emotionally dependent, it’s very hard to get out, even if you know that things are not going right,” Ms. Lott said. “This person has all your secrets. You’ve invested time, money, energy. And they’re telling you that it’s your problem. There’s a lot of gaslighting that goes on.”
What she now knows is that an ethical therapist would never have a sexual or an emotional affair with a patient.
“The patient could be naked and begging for sex,” said Jan Wohlberg, a founder of TELL, and “it is always the responsibility of the therapist to set and maintain safe and therapeutic boundaries.”
When a Therapist Abandons Professionalism
A number of readers who wrote in described therapists who were chronically late, ate during a session, failed to inform them of fees, missed appointments or ghosted them. And more than 130 people said their therapist fell asleep during therapy — sometimes going so far as to start drooling or snoring.
“I was in the middle of explaining that I felt invisible in my family,” wrote Melissa Petty, 71, of an incident that happened more than a decade ago in Dallas. “I looked up and the therapist was asleep! I found a new therapist immediately.”
Some readers shared stories about therapists who provided unnecessary services or trendy treatments that they didn’t seem qualified to offer.
Erin, 30, who lives in New York City, said that she was surprised when her therapist instructed her to watch lights dart across a narrow tube.
It’s a type of stimulation used during eye movement desensitization and reprocessing therapy, or E.M.D.R., a treatment that aims to ease the distress surrounding traumatic memories.
But Erin was in therapy for pandemic-related anxiety, not trauma.
Repeatedly the therapist asked, “Is it working?” Erin recalled, all while their Zoom connection kept cutting out. “It was a wild, wild experience.”
When a Therapist Can’t Be Bothered
Leah Odette, 44, who lives in Long Beach, Calif., visited a new therapist for help with anxiety and was unexpectedly greeted by a dog. For some clients a pet might be welcome, but not for Ms. Odette.
She explained to her therapist that she had a deep fear of dogs, but Ms. Odette said her concerns were quickly dismissed. “I pretended to calm down and reached down to pet it but it snapped at me,” she said. “The therapist blamed my anxiety for the dog’s reaction.”
Other readers said their therapists either didn’t appear to be listening at all or didn’t have anything helpful to say about the experiences they shared.
“During my last session, the therapist quite literally just stared out the window, not making eye contact with me the entire session,” said Emily, 34, who lives in Pittsburgh. “I ended our relationship via email that evening.”
When You’re Disappointed in Your Therapist
If something untoward has happened or your therapist simply isn’t the right fit, it’s important to find someone new — it won’t benefit you to stay in a situation that is neither healthy nor productive, said Jessica M. Smedley, a clinical psychologist in Washington, D.C.
And if you feel as though an ethical boundary has been crossed, you can report your therapist to their licensing board.
There are some situations, however, that might not be so black and white. Say you typically feel safe and supported by your therapist, but there’s one thing that keeps nagging at you: She once fell asleep in session. In that case, you may want to try talking through your concerns.
Then take note of how he or she responds.
“A therapist who reacts defensively to that or is not able to take in that feedback and change is a therapist that somebody shouldn’t continue working with,” Dr. Alpert said.