5 red flags when seeing a therapist

Despite the clarion call heard by all new therapists that therapy should be “collaborative” and the relationship centred on an equal footing (no sage in this room), there will inevitably be a power dynamic between a therapist and their clients.

Good therapists — ethical, aware of themselves and their motivations — will strive to ensure that the process is indeed a collaborative process. They will know the authority that comes with being someone others reach out to for help, in often desperate times. They will accept this initial power dynamic, deal carefully with it, and aim to shift the balance as therapy progresses and clients grow in their awareness, insight, and capability.

Being a therapist comes with a seductive allure. There are few jobs where strangers will come to you and offer up their life stories, problems, and dark secrets they’ve spent a long time working up the courage to tell?someone. Chances are, you’re the only other person in the world with knowledge of this particular fantasy or burden. Doctors might see the inside of a patient’s body — therapists get an all-access pass to a client’s soul.

When therapists say it’s a privilege to do their work, it really is. Before each session, I remind myself of the responsibility of someone placing their trust in me — someone they barely know — as they reveal themselvs and hope to be helped in some useful way.

Unfortunately, the mental health field can be a magnet for people with narcissistic tendencies and saviour complexes. I’ve heard some awful stories that left me wondering whether some therapists were conducting an intake session or a first date. In other cases, it sounds as if the therapist has watched a Tony Robbins clip and tried to reenact it in session (“You’re not depressed — you just need some direction in your life!” — reportedly a piece of advice by one therapist.)

Assuming the relevant qualifications, licences, and experience, it makes sense that we would look at mental health professionals and believe them all to be ethical, level-headed, respectful, and self-aware. Sadly, this isn’t always the case. Even psychiatrists with their medical degrees and PhDs are — to paraphrase the renowned psychiatrist Harry Sullivan — more human than otherwise.

Regardless of their credentials, all therapists have human motivations, drives, urges, biases, beliefs, and perspectives just like everyone else. Within a job that’s mostly private and confidential and conducted behind closed doors, the position of authority can be intoxicating for some — especially if they believe themselves to be a saviour of lost souls, or alluring to clients because of their status.

With that in mind, here are 5 red flags you should look out for when seeing a therapist:

1. They tell you what your problem is and provide solutions (or…they imply as much)

A friend of mine saw a therapist over a few sessions who said,?“If I tell you why you have strong conflict with your dead mother, I’m afraid you might not return to therapy.”?(I’ve changed the details but retained the gist.)

This is absolutely unethical behaviour. Therapy should be a curious exploration of what shows up in the client and their world. While therapists might offer?plausible interpretations?of what a client is saying, this example is clearly manipulative. Therapists aren’t experts in your story or your motives and they don’t know what’s best for you. That’s why it’s a collaborative process: you bring the expertise of living your life, and the therapist offers their expertise as a means to help you understand your problems and guide you toward healthier or more effective ways to deal with your issue.

2. They don’t really listen (and they treat you like a puzzle to be fixed)

There are several styles of therapy, but any therapist worth their salt learns how to listen well with genuine curiosity and openness. Clients aren't maths problems to be solved. The work is to understand and guide clients, not try to figure them out like a 4x4 Rubik’s cube. If you get the sense that your therapist isn’t really listening to what you’re saying, or it seems like they have their responses oven-ready long before you’ve finished sharing your point, that’s a sizeable red flag. Your therapist should be interested in you, not thinking about their responses 5 minutes down the line, or feeling like they’ve heard the same story 100 times before. (They haven’t.)

3. They set the agenda and force you into it

Most therapists will have an approach they use to conceptualise your case. For example, an Acceptance and Commitment Therapist might notice you tend to avoid situations or people, or that you’re strongly fused with a set of self-beliefs or rules. Your therapist should explain their approach to therapy. What they shouldn’t do is force you to going where you don’t want to go, whether it be encouraging you to evoke certain emotions, re-live past traumas, or explore your childhood. If something doesn’t make sense to you, feel free to ask the therapist why they’re suggesting this particular direction. If you’re not comfortable at any time in session and aren’t ready to explore, let your therapist know. If they continue to push, they’re crossing professional boundaries by disrepecting your dignity and autonomy.

4. They never check in on how you feel therapy is going for you

At various points in session, I might ask permission to use specific interventions and explain my rationale. I check if it makes sense to the client, and at the end of each session, I ask how it was for them (inviting them to share specifics). After a few sessions, I’ll check to see how the client feels therapy is going. After all, the point is to help people in ways that are useful to them — if the therapy is really going nowhere, it’s a disservice to the client to continue. Change takes time, but clients should at least feel like therapy is heading in the right direction for them. A good therapist will always encourage feedback and check on how the client feels things are going.

5. Sessions are always comfortable

Therapy should offer you a safe space with an empathetic, non-judgemental therapist guiding you through the process. That said, when you attend therapy, there will be times when you have to face discomfort when dealing with your problems, and you will likely be asked to do things that, initially, might feel uncomfortable. Therapy is a bit like exercising: if it’s always comfortable and easy, it won't get you far in terms of progress. If therapy sessions always feel good — if there’s no discomfort, no confusion, no times when you feel stuck — there’s a good chance you’re renting a friend for an hour rather than paying for therapy.