Potential Benefits and Risks of the Therapy Harm Community
(And, to some extent, survivor communities more generally)
Why am I writing this?
The therapy harm community has been a valuable resource for many individuals who experienced harm or abuse in therapy, and certainly has been a resource that I am grateful to have found personally. It can help one identify and describe their experience with therapy harm, offer validation and connection after what can often be an incredibly isolating experience, and potentially provide information or resources that lead to more healing.
However, as with any community, there are limitations and potential risks or ways that principles may be counterproductive in specific circumstances. Most of these risks are not unique to the therapy harm community (in particular, most could apply to other survivor communities or communities based on a particular shared experience), nor is this article meant to diminish the valuable work the community does. Rather, it reflects the reality that no single community or approach can fully meet all needs, and that most approaches carry both risks and benefits simultaneously.
In summary, the goal of this document is to be of use for people who are considering engaging more in the therapy harm community or therapy harm-related resources. At the end, there are also some potential guiding questions that might help determine what type of involvement (if any) would be most beneficial for each individual, though these questions are certainly not meant to be prescriptive. As a key disclaimer– the examples included are by no means exhaustive, there are likely many benefits and risks that are not included here.
Note #1: This is very much a draft in progress, and any feedback is welcome!
Note #2: All ideas are my own, though I did use ChatGPT to help condense some thoughts (given my naturally incredibly long-winded writing tendencies!), and then lightly revised afterwards
Some strengths of therapy harm communities
Many people find that the therapy harm community and related resources help them:
recognize unhealthy therapeutic relationships or dynamics, and in doing so potentially alleviate confusion or self-blame;
develop language to describe their experiences;
reduce isolation/help connect with people who understand experiences that are often misunderstood elsewhere;
find alternatives to healing if they choose not to return to therapy (and/or potential supplemental tools if they do choose to return to therapy);
find resources, research, information about complaint processes, advocacy organizations, and other practical information;
potentially find more confidence, self-understanding, or some healing after a painful experience in therapy
feel a reduction of shame and/or an ability to access or express emotions that may have previously been penalized or suppressed (e.g. understandable anger or frustration towards their therapist)
Unfortunately, many people who experience harm in therapy also experience some element of blame, whether explicit or implicit. For example, from reading many accounts of severe harm in therapy, it is sadly not uncommon to see patients being labelled by the therapist as “difficult” or otherwise being told by the therapist that they are responsible for the situation. In some other cases, therapy harm may not involve overt blame, but may involve a certain amount of defensiveness or minimisation of harm, or therapists may struggle to fully acknowledge the impact on the patient. Perhaps as a result, therapy harm communities often place particular emphasis on listening carefully to patients’ accounts, taking reports of harm seriously, and avoiding the minimization of abusive or unethical behaviour. For many people, this shift is deeply validating and an essential part of recovery.
Some possible challenges
Your experience and/or identities may not be widely represented
Although the therapy harm community generally welcomes many different experiences, available resources often focus on therapy abuse, exploitation, boundary violations, or professional misconduct. These experiences certainly can leave a profound impact and deserve attention.
However, if your experience primarily involves other circumstances—such as a therapist’s illness, personal crises, or death, institutional or systemic failures, harm from a specific modality of therapy, harm related to exclusion from therapy, being mandated to attend therapy against one’s will, or other less frequently discussed situations—you may find fewer people with similar stories or fewer resources that directly address your experience. This does not mean your experience is less real or less deserving of support.
Similarly, some experiences may be underrepresented in literature and resources on therapy harm. While there is a growing body of research on therapy harm, much of it has focused on particular forms of abuse or misconduct and has been conducted in Western countries with predominantly white participants (and predominantly women participants), often in outpatient settings. As a result, the available research – and online community more broadly– does not fully reflect the diversity of therapy harms, clinical settings, or identities/cultures. There is also a risk that participation in the therapy harm community can compound stress for some, especially for highly marginalized individuals: for example, if someone experienced identity-based harm in therapy, only to find that the therapy harm community itself also has relatively little knowledge or representation on the relevant topic (and may have stigma or microaggressions), that could be isolating or challenging.
Support and validation can be complicated
Many people come to these communities hoping to feel their experience will finally be understood and supported.
While that absolutely can happen to varying degrees, there is also a risk that it may not happen (or may only happen for parts of your experience) which can bring a unique isolation. You might experience:
Far more or fewer responses/connections than anticipated
Responses or feedback that interprets your experience differently than you do (in some cases, potentially people trying to share what was helpful for them in a way that may or may not map well onto your own experience)
Stress from the inherent limitations of any (largely virtual) community– i.e. realizing that the community generally aims to be supportive, but isn’t able to provide ongoing peer support (outside of dedicated peer support resources)
One thing I personally noticed was that– as someone who had a very complicated experience in therapy, where the therapist was also facing extreme external stressors/traumas– there were often several helpful existing resources for the ways that my experience involved harm, but (understandably) relatively few resources for the broader context of the situation or for processing more positive moments or moments of care within the broader, complicated experience. Of course, this is just one example, and each person will likely have different needs for support and resources.
Community perspectives may shape how you think (and whether you return to therapy and/or seek alternatives)
Participating in any community often changes how we understand our own experiences.
Many people find being involved in advocacy to be meaningful or even empowering, and in some cases may be a part of post-traumatic growth. Others may notice that spending significant time reading about therapy harm keeps the experience emotionally active in their mind (or, in my case, at times risked re-fueling painful rumination on the topic). Similarly, reading other’s experiences repeatedly may cause some vicarious stress. And, in many cases, someone might experience a combination of impacts and emotions that are both helpful and stressful.
It may be helpful to notice how participation is affecting you over time.
Likewise, community discussions often include people who have experienced repeated or devastating harms and who understandably have strong reasons for avoiding therapy. Their experiences are important and highlight very real complexities and risks of therapy for therapy harm survivors, but they may not predict what every person’s future relationship with therapy will look like.
Similarly, alternatives to therapy that are effective for many in the community may not be helpful for all.
Generally good principles related to therapy harm may backfire in unique circumstances
To give a personal example here: many therapy harm communities encourage people to trust their own experiences. For many people, this is an important corrective– especially if their experience with therapy harm involved repeatedly being faced with skepticism, doubt, etc.
At the same time, I think there are edge cases where this approach may amplify risks. In my own case, I went through a period of attenuated psychosis following my therapy experience, during which I was increasingly anxious that my former therapist secretly wished me harm. In hindsight, some materials on therapy harm that I was reading likely exacerbated those symptoms with the emphasis on trusting one’s perspective/patient’s abilities to intuit their clinician’s intentions– not because the materials were inherently wrong, but because they were risky for my particular situation at the time. In short, I view this experience as a reminder that the same resource can affect different people in different ways.
Volunteer-led communities often have practical limitations.
Many therapy harm organisations, projects, etc. are composed of volunteers, most of whom are themselves navigating the effects of therapy harm and/or other significant life challenges. As a result, in some cases projects may pause unexpectedly, responses to emails or submissions may take time, resources may be updated less frequently, etc. While this is generally a reflection of limited bandwidth rather than a lack of care, it can also understandably feel disappointing or anxiety inducing.
If you are considering sharing a particularly vulnerable experience with an organisation or project (or more generally hoping to be involved in an initiative), it may be worth first considering whether you are comfortable reaching out even if there may be a significant delay in response. If the idea of a potential delay sounds uncomfortable or anxiety-inducing, you could potentially ask whether the organization or initiative has information about the expected timeline of involvement before proceeding.
Online therapy harm communities have the same challenges as other online spaces
Social media platforms themselves may encourage repetitive engagement, comparison, emotional overwhelm, or difficulty taking breaks. Likewise, while social media in many ways can be a wonderful tool for coming across a variety of perspectives, some people may find sifting through the volume of content (and/or potential critical comments) overwhelming.
Personally, I find Substack to be an especially helpful avenue as it lends itself to slightly longer-form content, which allows me to better understand the context of someone’s perspective. However, for others, long-form content can bring its own stressors and alternative platforms with short-form content may be more appealing or accessible.
Privacy Considerations
If you are sharing your experiences online, it is possible that people in the rest of your life may come across your material (or, unfortunately, that people who are less understanding of or receptive to the concept of therapy harm may come across your material.)
Likewise, it is possible that (depending on the algorithm) you might have a sudden increase of exposure which in some cases can be overwhelming and happen very quickly. Making an account private can help mitigate some of these risks or, if you would like to share an experience or story anonymously, finding some of the available resources which allow for anonymous submission of stories can be helpful alternatives.
Potential check-in prompts:
Overall, do I feel more supported/helped or discouraged/confused by my involvement with the community?
Are there specific types of engagement that seem to be especially meaningful/helpful or, alternatively, especially challenging/stressful (example types of engagement could include reading articles, participating in peer support initiatives, volunteering, communicating on social media, other)?
Would I feel less restricted by being more public with my story (or more secure/less anxious by scaling back what I share or changing the privacy of my accounts/avenues of involvement?)
Am I finding language that helps me understand my experience?
Are there parts of my experience that I am able to understand better now or feel less isolated with?
Are there parts of my experience that I feel more confused about or am more isolated in?
Is participating helping me move toward the kind of life I want, or am I finding myself becoming increasingly stuck?
Am I increasingly spending more time in the therapy harm community?
How do I usually feel after engaging with the therapy harm community and/or reading resources related to therapy harm? (Or, if identifying specific emotions is challenging, what types of thoughts do I tend to have?)
Am I participating out of obligation (for example, feeling that I need to use advocacy to turn my experience into something meaningful, or feeling that it would be impolite to step back after being involved)?
Would taking a break (or, alternatively, becoming more involved) be helpful right now?
Are there other forms of support that I would like alongside this community?
