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I’m a psychotherapist – you wouldn’t believe the horror stories I’ve heard

Following a rise in lawsuits from patients harmed by therapy, the government is facing calls for the counselling sector to be regulated – Eleanor Morgan says it can’t come soon enough

Wednesday 13 November 2024 14:36 GMT
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Dr Michaela Dunbar on transforming your love life with the help of psychology

I shudder when I read the bios of therapists and life coaches on social media who say they “offer a safe space”. Who am I to assume that someone will experience me as safe?

A felt sense of safety with a new person you’re sharing your innermost thoughts and feelings with takes time. Engaging in therapy can kick up the silt of our unconscious. As we become less of a stranger to ourselves, we can disrupt the psychological homeostasis we had maintained before we sought help. This can be painful and disorientating, and requires great care.

So it would be a reasonable assumption that all therapists have to be registered and regulated by a professional standards body. Dismayingly, this is not the case.

In the UK, there is no law that requires a therapist to be licensed or registered with an organisation. While art, drama and music therapists are all protected titles, the less-specific titles of “therapist”, “psychotherapist” and “counsellor” are not.

The field is not a completely unmonitored Wild West. We have two main regulatory bodies, the BACP and the UKCP. Both have strict requirements for membership – but, theoretically, anyone can decide to call themselves a therapist and set up a practice, and see clients online or in their home.

Which is partly why, right now, the government is being lobbied to regulate all therapists practising in the UK.

The prospect of enforcing a statutory regulation has been discussed for decades – Blair’s government even published a white paper. But a rise in lawsuits by patients alleging harm done during therapy, including sexual assault, has brought the matter into sharper relief.

As a practising psychotherapist, I say: good.

Over the years, I have heard many startling stories of people’s experiences with therapists: clients being encouraged to disclose details of traumatic abuse in a first session, then being ghosted by the therapist; therapists outwardly flirting; therapists being seemingly blind to a client referencing a suicide plan…

A client might not be consciously aware that an abuse of power is happening with their therapist. I have been that client.

In my twenties, I began seeing an older male therapist recommended to me by a close friend who also saw him. I was experiencing debilitating anxiety and had no idea how to carry on with the business of living. This man helped me immensely – the humanity, humour and validation he offered me in his living room was the first time I’d ever felt truly witnessed in my distress. I wrote about him in my first book.

My thoughts and feelings have since changed. In the long process of training as a therapist (as if the learning ever stops), I have realised just how egregiously this man breached professional ethics.

I had never been to a private therapist before; he was my only reference point. My denial and repression defences “protected” me from facing reality, because I felt genuine care. But, in session, he would routinely discuss my friend’s life with me in detail, and mine with her.

He would make crude references to sex. His level of self-disclosure was off the chart. He gave me a nickname, which I cheerily went along with. He called me at random times, often to talk about articles I had written.

I stopped seeing him because something had started to feel off. But he still called.

When I stopped answering, he’d call under a withheld number and leave long voicemails. I didn’t report him then. I didn’t know I could – or should. Besides, I liked him. I was vulnerable, with an as-yet untapped well of childhood trauma bubbling over inside of me. I felt like I needed his support and continued to attend of my own volition.

I didn’t consciously feel unsafe then. Now, I feel deeply uncomfortable writing about him. His intentions were muddy. He abused his power.

With no statutory regulation, practitioners can effectively work in silo. But with an ever-increasing number of people seeking mental health services, this regulation would ensure that therapists must meet clear and verifiable standards of training, ethics and practice.

We need a regulatory body, separate from the current membership organisations, whose job is to monitor and enforce professional standards. This would give the public more confidence in our profession. It would also provide more protection if people are abused by rogue practitioners.

We are behind the curve. Given the nature of our work and the very real implications for people’s lives, this is not where we should be.

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