Manipulative Therapists

Shirley J. Siegel

Improper manipulation by unethical therapists. The abuse of positions of power and trust by counselors. These are themes I hear expressed by patients and clients over and over again throughout the United States and from many other countries as well.

From a mother in Minnesota: "Our daughter suffers from bipolar disease, and with this latest relapse, refuses to take her medication and instead insists she suffers from Adult Child Syndrome and comes from a dysfunctional family. She spent a lot of time going to [an unlicensed therapist's] seminars, and buying his tapes and books. She refuses to see or talk to any of her family. I feel like she has joined a cult against parents."

From London , England: "In a nutshell, I took both the basic and advanced courses of [the popular psychological training program] in New York City in early 1983. The ultimate result of the 'training' has been really serious long-term depression."

From a Californian: "I am a successful 44-year-old businessman who several years ago, thinking that I had suffered a mild heart attack, sought therapy in order to reduce the level of stress in my life. I confided to my therapist, a female psychologist, that I had become a workaholic, the number one broker in my office, making more money than I had thought possible, but that I was stressed and lonely and feared that I would have a heart attack. She took a keen interest in me, saying that I was more special to her than any of her other group members or patients. She gave me daily advice at no charge. I began to trust completely that she had my welfare and best interests at heart. Some months later we were married." The therapist began verbally to abuse her husband/patient. She spent huge quantities of his money, stayed out late at night, ceased all sexual relations with him, and let her two sons from a previous marriage run wild. Ultimately, the therapist not only removed property from the home but damaged it extensively as well. The husband finally filed a malpractice suit against his therapist/wife and sought a divorce.

From New York: a former client reports her female psychologist used her not only as therapist's "therapist," but got her to do thousands of dollars' worth of work for the therapist's business and then refused to pay for it.

From a Missouri newspaper account: "One woman's 'mom' contract, written by her therapist, stated: 'You have to do what I say and you can have whatever feeling you have- [you can] even say no. But you have to do what I say. I like you and love you no matter what. You have to tell me everything. Love, Mama, and Daddy.' "

Most Americans, including a great majority of mental health professionals, are unaware of the depth and extent of the problem that these cases so vividly illustrate. And many who become aware of incidents of abuse tend to see the problem as less damaging and unethical than it is. Even in the matter of sexual relations between a therapist and a patient, both laymen and professionals frequently see a "love affair" of sorts, albeit possibly ill-advised and wrong, rather than what it is, sexual exploitation plain and simple.

In 1980, seven years after leaving a psychotherapy cult in which I had been enmeshed for a very long time, I helped to found STOP-Stop Abuse By Counselors-in order to help deal with this problem of indifference and ignorance, and help the victims gain redress. It seemed to us that one line of approach would be to have the state register and regulate counselors, essentially monitor the always potentially abusive relationship. After our lobbying and educational work for seven years, the Washington State legislature passed a law mandating the registration of almost all individuals offering counseling for a fee. The law also allows for the certification of master's level counselors. In addition, most mental health care providers must respect the prohibitions of a special 24-point list of impermissible areas of conduct, including, of course, sexual relations.  The law, in sum, is an attempt to bring all counselors into the light and under the rule of law. But in order fully to achieve this, we still need to ensure that all therapists carry malpractice insurance so that victims can collect damages in their civil suits. (Paradoxically, this can be a problem: insurance companies in states where therapist-patient sex is a crime sometimes say that they will not pay damages because the therapist was not covered for criminal acts!)

STOP's activities got much media attention, and we became a national resource-part of a growing informal network-getting reports on the problem from every hand and providing information to those who want to do in their localities what we did in Washington. We also provide references to expert witnesses and attorneys experienced in litigating lawsuits brought by victims of unethical therapists. And we speak in a variety of public and professional forums, as well as on media panels and talk shows, to publicize the problem and urge reform.

Granted that most therapists are ethical, honorable human beings, many, unfortunately, are not. And so we say to anyone who will listen: enforce the laws that are already on the books and introduce new legislation where it is needed. Register all unlicensed therapists and hold them to a code of ethical behavior. Require all therapists to carry malpractice insurance. And perhaps most important of all, make literature on "How to Choose a Health/Mental Health Care Provider (and spot signs of unethical behavior)" a part of every health education course in the nation.

Shirley J. Siegel was founder/coordinator of Stop Abuse by Counselors, a client/advocate organization that was based in Seattle, WA, and author of What To Do When Psychotherapy Goes Wrong.

This article first appeared in Cult Observer, Volume 9, Number 3, 1992.