“There are certainly destructive therapist, mentors, professors, and experts, who don’t serve their clients and students well. Instead of inspiring and nurturing strength  and heath, they bring others under their control, make them weak and dependent, then humiliate them.” – Frank Tittman, M.D. (1993, p. 194)

If psychotherapy were required to have a warning label listing its potential health risks like the ones on drug labels or tobacco products, it would say something like this:

Warning: Psychotherapy has been known to create the following health risks for patients:

• Aggression
• Social Anxiety
• Hallucinations
• False or implanted memories
• Psychotic episodes
• Conflict & family disruption
• Homicidal tendencies
• Self-injurious behavior
• Conflict & family disruption
• Estrangement from family, friends, and peers
• Major depression
• Borderline personality disorder
• Disassociative personality disorder
• Suicide
• And so on.

The dangers of talk therapy

Psychologist Scott Lilienfeld estimates that up to 20% of people who receive psychotherapy are harmed by it. (Begley, 2007) Others (including us) would put the numbers far higher. Here are some things that can go wrong:

Thoughts can harm as well as heal

Whether it be depression, anxiety disorders, PTSD or any other mental condition, all psychological illness boils down to a problem in one’s thoughts and beliefs. Psychotherapy is a process of repairing a person’s thoughts and beliefs to improve emotional health. But in the same way that flawed or irrational thoughts about your past experiences and current situation are what cause you distress, so can thoughts or ideas that a therapist implants. Unfortunately, there are too many therapists out there who promote destructive beliefs rather than constructive ones that would reframe a person’s experiences in productive ways. Therapists may inadvertently plant ideas that cause patients more pain and impede their recovery process. Many therapists flat out promote ideas of victimization and catastrophic thinking that research continually shows will cause lasting harm rather than healing.

To quote one of our other books, “psychologists are like wizards: they come in both the good and evil variety.” There are many good wizards who promote thoughts that heal, but also many bad wizards who practice Dr. Phil-style pop psychology, which usually consists of promoting their own incorrect and antagonistic beliefs about a situation that only exasperate a patient’s problems. Good therapists heal through reconciliation, realistic thinking and flexible beliefs, but bad ones can play the role of mental rapist, and can do more to destroy a patient’s mental health than any existential trauma ever could.

Dr. Pittman provides the example of one therapist who told his client that the man’s wife had “castrated” him because they had recently moved to a different city so that she could take a better job. “Paul wisely walked out as he realized this therapist was trying to make him feel like a victim of powerful women: He knew that accepting such a definition of the problem would damage both his character and his marriage,” (Pittman, 1993, p. 261) Unfortunately, therapists are renowned for planting destructive ideas such as this.

Psychological or behavioral therapy can result in false diagnosis

Therapies can sometimes result in a false diagnosis, which can lead to negative labels, unnecessary intervention, or drug regimens that are capable of harming a person.

False memory through suggestion

You might remember all the hype in the 80s and 90s over “repressed memories” of sexual abuse. If this all sounded a bit fantastical to you, it’s because it was: Therapists were implanting false memories through suggestion that destroyed the lives of thousands of people, including their patients. It was psychology’s episode of the Salem witch trials, and will forever serve as a black mark on the field and a precautionary tale going forward. Unfortunately, many of the quacks behind these atrocities emerged unscathed (unlike their patients) and are still practicing today.

Decades of research consisting of thousands of studies has continually shown that memory is highly malleable and easily molded by suggestion. (McGowan, 2009) For example, even among otherwise competent adults, 25% of people will fiercely defend an intentionally implanted false memory of a childhood experience as true after a single exposure to the false memory, even when delivered through rather subtle means. (Loftus, 1997) Humans are readily convinced of experiences that never occurred, and we are constantly working new information into old memories that was not a part of the original memory.

More dangerous than memories which are outright inventions (dreamed up experiences that never occurred) are suggestions which rewrite events that did occur, if only because these false memories are far more common. For example, let’s say you’re talking about an argument with your husband. While recounting that experience, a therapist asks if he was mouthing cusswords under his breath as it was occurring. That suggestive question alone is enough to create a false memory that your husband was indeed doing this during the argument, causing you to miss-remember this experience in a more negative way whenever you recall it in the future. Competent therapists will be careful to avoid creating false memories, but less-competent ones can create many problems through subtle manipulations of memory such as this.

As David Burns states, “therapists from all schools of thought have been notorious for interpreting patients’ experiences in terms of preconceived notions that may have little or no experimental validation. If you don’t “buy” your therapist’s explanation of the origin of your problems, this is likely to be interpreted as “resistance” to the “truth.” In this subtle way your troubles get forced into your therapist’s mold regardless of what you say.” (Burns, 1980, p. 239)

There is no regulation against harmful psychotherapies

There is no FDA or CDC for therapy to protect consumers from harmful therapeutic approaches, so therapists are left to pretty much do what they like. Despite the fact that mental treatments can be just as dangerous as physical ones, there is no government agency that regulates psychologists and ensures they are using science-backed approaches. As a result, snake-oil treatments are rampant.