It takes a certain level of insight and courage to enter therapy. Insight to recognize that you need help that you cannot get on your own, and courage to make yourself vulnerable enough to open up to the therapist so that he or she can help you. Very often, the reason people seek therapy in the first place is because they have been abused or victimized and are trying to move beyond that pain into growth.
Therapists know this. They understand that in order for therapy to be successful, clients will need to open up to them in a way they have perhaps been unable to do with anyone else. For this reason, the therapeutic environment needs to be a place where the client feels safe, and is safe. He or she must be able to trust the therapist to put the client's well-being first.
For many clients, dysfunctional relationships in their past not only led to the need for therapy, but made it difficult to establish personal boundaries. Trained therapists are aware of this, and often must help clients establish appropriate boundaries for their own physical and emotional safety. Most therapists are dedicated to helping their clients in this way. Some, however, take advantage of both a client's vulnerability and boundary issues to further victimize the client. Some abuse, like forcible sexual assault, is obvious. But other types of sexual or emotional abuse are more subtle, such that the client may not even be certain that she or he was actually abused. Even in these circumstances, a therapist's actions can cause deep and lasting harm.
It is important to recognize, first of all, that psychologists, social workers, psychiatrists and other professionals who perform mental health therapy are bound by ethical rules that dictate how they may interact with clients. Behavior that, in another setting with different people, might be acceptable, can become abusive when it takes place between a therapist and client.
A common example is a romantic relationship. Let's say you begin therapy. During the course of therapy, you realize you are attracted to your therapist. (This happens more often than you might imagine; therapists are usually trained to watch for and appropriately manage this occurrence.) You indicate your interest to the therapist, perhaps on more than one occasion. Eventually, you enter into a romantic relationship.
This may not sound like abuse; after all, you initiated and pursued it! But the nature of the therapeutic relationship means that to enter into a romantic relationship with you is inappropriate and likely detrimental to your emotional and mental health. You may have been willing to enter the relationship, but it was literally the therapist's job to set boundaries and to help you set boundaries for yourself, including referring you to another therapist if needed. Under no circumstances is it appropriate for your therapist to become romantically or sexually involved with you—and your therapist knows it.
Here is a (non-exhaustive) list of other behaviors which may be abusive:
It's not that discussing sexual issues in the context of therapy is forbidden; sometimes, it is necessary. But it should never be done in a way that seems as if it is to serve the therapist's interests, rather than yours. It may be hard to trust your gut, but if something makes you feel uncomfortable, that is worth paying attention to.
Abusive therapists are often able to get away with their actions because they are not clearly or obviously abusive. Sometimes, however, those actions rise to the level of medical malpractice. You may also be embarrassed or ashamed about what you consider your participation, and feel uncomfortable asking someone else if what you experienced was abuse.
If you think you may have experienced abuse, we encourage you to talk to an experienced, ethical, Oregon medical malpractice attorney. An ethical attorney will not pass judgment on you, but will be able to help you sort out whether what you experienced was abuse. If it was, and if you decide to take legal action against an abusive therapist, an experienced attorney will be able to recommend support resources for you to help you through the legal process. You may find that the act of standing up for your rights and speaking out against your abuse is, itself, healing and empowering.
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