Post-Traumatic Growth: Finding a Silver Lining After Therapy Harm

This is a personal reflection on post-traumatic growth after a difficult experience in therapy. I’ve chosen to share it in case it resonates with anyone who is navigating a similar situation (or supporting someone who is.)

Introduction: When Therapy Hurts Instead of Heals

I had an extremely stressful experience with therapy that came to a close a little over a year ago.

It had a surprisingly difficult impact on my life, and there was a great deal of confusion and isolation that came with it. I think part of what added to the confusion is that therapy is typically hailed as a healing process or a safe environment that people go to in order to get better, and so there can be a level of self-doubt when therapy ends up not only not helping but actually making things significantly worse.

However, in time, I was able to find some positives from the situation and (hopefully) grow a bit as a person as a result of it. Part of the reason I wanted to write this article is because a year ago it would have been a huge relief and source of hope to know that something positive would eventually come out of the stress. I realize that each person’s situation and trajectory will be unique, and I also don’t at all mean to imply that anyone is obligated to “see the positive” in a harmful or traumatic situation.

But I wanted to share this in case it is helpful for anyone who has experienced therapy harm or who is supporting someone who has.

1. Direct/Immediate Positives

In my case, the therapist I worked with was a very kind and insightful person. Obviously, there’s a lot that I wish she had done differently, but even during the most stressful time period I could have easily pointed to several things I learned from her – most of these things were not specifically related to mental health, but rather more to do with her overall philosophy or the way she would approach some of my more existential questions.

I did also view her as a significant mentor in my life at the time, and even though it ended in a difficult way, there is a lot that I am grateful for.

2. A Better Understanding – and Compassion – for Human Fallibility

When I was in high school, I discovered the Lord of the Rings trilogy and became absolutely enamored with the sense of vastness in this fictional world. One of the characters I was most drawn to was Frodo, and I think part of the reason for that is because he was the single most qualified being on Middle Earth to carry the ring, persevered through all sorts of internal and external difficulties, gained insight along the way, and still ultimately failed to be able to cast aside the ring– but his failure was a relatively technical one, in the way that any living being would “fail” under such circumstances (if not earlier).

I felt the trilogy dissolved the sort of binary outcomes of what “success vs. failure” look like and replaced it with something much more multidimensional, vast, and compassionate — and even restorative, as Frodo was ultimately able to leave Middle Earth to heal and find peace.

I’m not trying to compare my previous therapist to Frodo– she is of course her own person, and she obviously isn’t a hobbit. Rather, I feel like the lesson I learned from her was somehow parallel (or a specific extension) of the one I learned as a high schooler. In particular, it:

• Challenged the Dichotomy of “Good” vs. “Bad” Therapists

It broke down the dichotomy that there are “basically good” therapists who won’t cause harm to their patients versus a small handful of “bad” therapists who might engage in more predatory or harmful practices. I’ve realized that harm and “blurred boundaries” – like many things in life – exist in a sort of vector space where there are several different dimensions of harm that can occur, and each dimension can occur to different degrees. Likewise, I’ve thought a lot more about how generally well-intentioned therapists who generally help their patients heal still come with a risk of causing significant harm (particularly if they end up working outside of their scope, are facing extenuating circumstances, or haven’t taken enough time for self-reflection).

On the flipside, just because someone has caused harm (even very significantly so) doesn’t mean that this fully characterizes them as a person or that they are destined to repeat this harm in every circumstance. And so, as much as the gap between intentions and impact can lead to harm (and may also at times be fueled by people not fully acknowledging their more subconscious intentions), I think it also offers hope for restoration and ongoing growth.

• Cautious Trust Without Cynicism

More generally, it led to a bit more cautiousness in trusting people – and not always in a bad way. I always had some degree of awareness that good people can cause harm (e.g. “generally kind people can still occasionally say unkind things or be uncharacteristically dismissive/impatient/etc.”), even if it was more of a surface-level awareness initially.

But I think I had an oversized amount of trust in therapists, and my previous therapist in particular. I had assumed that her combination of mental health knowledge and good intentions meant that she would be able to more or less “fix” any problem that came up – or that if harm happened, she would know how to repair it. This led to a relatively absolute trust which, in hindsight, was probably too much to place on one person.

3. A Stronger Desire for Personal Responsibility/Accountability

As an extension of the above, I’ve thought a lot about interpersonal harm, accountability, growth, etc., more generally and have tried to apply these concepts to my own life (even as a non-clinician).

There are times where I think I’ve taken better accountability in my own life as a result of my experience with therapy harm. In particular, my perspective on apologies and accountability has shifted somewhat. I know that during my experience with therapy harm, a genuine apology would have meant a great deal – not because I wanted my previous therapist to feel bad or “feel sorry,” but because it would have shown some amount of care or acknowledgment and would have reduced confusion.

As such, my own perspective on apologizing in my own life has shifted from “how can I show that I’m really sorry?” to “what type of accountability is most likely to be helpful to the other person?” Of course, there’s likely to be some overlap between these questions at times, and I don’t at all claim to carry out this process perfectly! But I find the shift in mindset to be beneficial overall.

The experience has also made me much more careful with boundaries in general. At times, I have been able to channel this caution and the amount of thought I’ve put into this topic into something useful – e.g., identifying a need for proactively collecting feedback, supporting organizations I work with in developing a concern reporting protocol, and so on. It’s definitely an area of ongoing learning for me as well.

4. A Better Understanding of People-Pleasing and Internal “Warning Lights”

In my case, I had quite a bit of stress and internal “warning signs” (e.g. panic attacks before every time I would meet my previous therapist) toward the end of my interactions with her. For a while, I had also sort of overextended myself in trying to make the situation work without bothering her too much. However, at the time, I was so used to just dealing with stress (relatively) internally or coping with anxiety in general that this didn’t stand out as much as it should have.

The result is that I didn’t fully realize how unhealthy the situation had become until it had reached a significant level of stress.

Unfortunately, I can’t time travel and approach that particular situation differently. But I have used this as a learning experience going forward. For example, if there is a situation where I can be (hopefully!) supportive to someone, I still care – but in a more sustainable way rather than using a more people-pleasing approach that tends to lead to burnout, which ultimately allows for more genuine care over time, as it isn’t mixed with anxiety or obligation to the same degree. Likewise, instead of trying to make every moment “productive” or filling it with responsibility (whether caring for my wonderful child or work), I’ve started taking more seriously the need to find a balanced or sustainable approach to life.

I think I’ve also gotten better at giving gentle feedback earlier rather than being completely conflict-averse, which has resulted in stronger and closer connections with people, and prevented stress from accumulating.

5. A Better Understanding of Clinical Harm in General

Finally, my experience led me to become curious about clinical harm and the impacts of it more generally. I’m especially fascinated by how different restorative justice approaches (and particularly mediation) may be helpful in allowing patients to heal after therapy harm and allowing clinicians to self-reflect or grow. I’ve also become interested in what supports may help clinicians who are experiencing burnout, and ways to mitigate the fact that the current system probably pushes clinicians to continue working beyond their capacity (e.g. due to financial reasons/employer requirements, feelings of obligation to be there for their current patients, etc.).