Beware of Bad Therapy

By Zalman Nelson, LMSW

Recently, an acquaintance who was looking for professional help for a personal issue told me that “any therapy is better than no therapy.” But is that true? Is any therapy better than none at all?

What makes therapy good or bad? Let’s first define therapy.

Also known as psychotherapy or counseling, therapy is a method for treating emotional, behavioral, mental health, situational and/or relationship problems through talking and personal support. It is practiced by different types of mental health professionals to address issues ranging from dealing with everyday life challenges to coping with more serious events, to managing serious mental illness. They use a variety of approaches and techniques to help clients alleviate emotional pain, facilitate personal growth, and enhance their character.

Regardless of a therapist’s training and personal approach, the core of therapy is the same: the healing relationship formed between therapist and client.

Granted, therapy may superficially seem like a plain old conversation—one person is sharing about their life while the other listens and responds; but this differs markedly from other relationships like parent-child, friends, intimate partners, work associates, etc. In therapy, the relationship itself provides healing and serves as a tool for change.

Why? Because what most often drives people to seek help in therapy is a lack of success in developing and maintaining gratifying interpersonal relationships. Some lack the experience and knowledge how do it, others get overwhelmed by their personal issues, and many suffer with both. The caring connection of a therapeutic relationship should provide a haven for the client. The therapy session may be the only place where a person with vulnerabilities can feel safe in sharing difficult thoughts and feelings. As the therapeutic relationship develops, the sessions become like “dress rehearsals for life.”

Here’s the main point: the experience of being accepted and supported by someone who gets to know you well is hugely affirming. In other words, it’s the therapeutic relationship that helps the client accept himself and heal. And that’s why a primary focus of therapy is: building a safe and trusting therapist-client relationship, that is characterized by genuineness, positive unconditional regard, and tuned-in spontaneity. This relationship is dynamic and ever-evolving, fueled by the issues focused on and faced, in a way that is individually tailored to the client. The relationship with the therapist itself is restorative of other relationships that may not be so successful in the client’s life. Sometimes a person feels as if he or she has never been truly listened to or “heard.”

Knowing what therapy is, now we wonder: what makes it good or bad?

Not only is there no real conflict between Chassidus and Psychology, Psychology cannot truly function without Chassidus. The Tanya is the only place where the psyche, our inner world, is clearly described. And since Psychology means “study of the soul,” the practitioner needs to know what he’s dealing with in order to truly succeed in providing clients with long-lasting healing, support, and help. There are no successful Psychology techniques out there which cannot be explained—and, thus, better understood and implemented—by a Tanya-based understanding of the soul.

Moreover, cultural sensitivity is a basic tenet of good therapy: to form a trusting relationship with a therapist, you need to know they get you and understand you. Hard for a Gentile or non-observant Jewish therapist to know where you are coming from, and provide support and guidance you can trust to be in harmony with Yiddishkeit.

Pick A Therapist, Not A Therapy

When it comes to medical issues, you may need to pick a particular approach. Regarding therapy, however, a certain approach to treatment might be appealing to you or maybe you know someone who had success with it, but it is generally not the best way to pick a therapist. In fact, if your therapist is too identified with one particular type of therapy and insists on an approach before they have gotten to know you, that can be a red flag.

Of course, the therapist needs to be professional, credentialed, licensed, and competent. Beyond that, the core of therapy is forming a trusting therapeutic relationship with the therapist, so, the therapist needs to be fully available to you at the set times designated: genuine, present, and tuned-in. Combine that with the fact that every client’s circumstances are unique, and you can see why it has been said that a therapist needs to create a new, practically customized therapy for each client.

Any conduct that is unprofessional, inappropriate, or unethical means that you will not get your therapeutic needs met with this individual. Moreover, a negative effect may result. The therapist may not have “worked himself out.” If that is the case, you need to move on to another therapist. The various licensed therapy professions—psychiatrist, psychologist, social worker, etc.—all have codes of ethics which clearly describe how your therapist should conduct him or herself.

As you vet a potential therapist through recommendations or assess your therapy experience as you go through it, notice if the therapist:

* Talks too much about their own life, or in a way that is unrelated to the issue and benefit to you in some clear way.
* Gets defensive if you ask them questions about their expertise.
* Seems manipulative or pushy.
* Demands fees that are grossly beyond the “usual and customary” rates for the location of the therapist/therapy (and considering years in practice).
* Blurs the line between therapist and client by being too friendly, suggesting social activities, or using you for your own professional skills and talents?
* Is arrogant and a “know-it-all”
* Is confrontational or argumentative
* Seems too rigid in not allowing you to change the direction of the discussion

And what if you just generally feel uncomfortable or you are not sure the therapy is helping? It’s OK. There is no contract or rule forcing you to continue working with this candidate.

Ask yourself some questions: Do I feel safe and comfortable? Is it easy to make small talk? Can I feel warmth and humor in the therapist’s style? Is the therapist down-to-earth and easy to relate to? Discuss your concerns and experience with the therapist and notice how they react. It is a good way to gauge the quality of the therapy and therapist’s professionalism. Ideally, they should be comfortable with having honest conversations about your progress and be willing to try different approaches or techniques if something is not working. In addition, be honest with yourself: is discontinuing with them a means of avoiding therapy by finding fault with the therapist?

If you assess a therapist and find them inappropriate or not a good fit, move on. Bad therapy is not better than no therapy. But good therapy can make a world of difference—for people suffering from severe emotional disturbances, as well more common challenges such as: relationships, stress-management, coping with health issues, career changes, parenting, body image, work-life balance, life-transitions, and more. Put simply, there are plenty of things in life that leave us feeling anxious and overwhelmed, and it is normal to feel sad, lonely, afraid, or nervous. The sooner you seek good help, the sooner you are likely to experience some relief.

–Zalman Nelson is a freelance writer and therapist. He maintains a private practice focused on teenagers and their parents. He lives in Israel with his wife and children. Reach him at ZalmanNelson.com