There Is No Such Thing as Adverse Idealising Transference (AIT): A Continuation

By Maja Farrell

This article is a continuation of my earlier piece, Psychotherapy Abuse: When Is It the Client’s Fault?, in which I responded to Dawn Devereux’s 2016 article "Transference, Love and Harm" in Therapy Today. In that first article, I expressed concern about how Devereux—and the broader framework of the Clinic for Boundaries Studies (CfBS)—frames the client’s longing and idealisation as inherently dangerous.

Here, I want to take the critique further. The term “adverse idealising transference” (AIT) has been used to describe what is, in fact, a natural and meaningful part of the therapeutic process: the client’s experience of love, trust, and hope placed in the therapist. What Devereux calls a "harmful side effect," I see as a combination of two therapist vulnerabilities: an inability to tolerate being loved and an even more disturbing inability to tolerate not being loved.

In other words, the client’s love becomes a threat not just when it is intense, but when it fails to sufficiently mirror the therapist’s own narcissistic need to be special, adored, admired. When that need is not fed—when the love feels too dependent, too vulnerable, too unflattering—the therapist may retaliate. They may reject the client, punish them with silence, escalate control, or terminate the work altogether. It is not that the client’s love is dangerous—it is that it does not feed the therapist’s ego.

This distinction lies at the heart of the difference between true love and carnal love, a theme I explored in a previous article. True love in therapy is self-sacrificial—it bears the weight of another’s longing without needing to be flattered or worshipped. It does not depend on reciprocity or admiration. Carnal love, by contrast, demands gratification, admiration, control. When a therapist cannot distinguish between the two, they begin to confuse their unmet personal longings with the ethical demands of the therapeutic relationship.

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PSYOP: Psychological Operations and the Manipulation of Narrative

The term PSYOP, short for psychological operations, refers to the use of information to manipulate emotions, reasoning, and behaviour. In this light, Devereux’s article can be seen as a psyop-level intervention, subtly reshaping how therapists and clients view the transference dynamic. The result? Clients are primed to believe they are inherently dangerous when they feel too much.

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The Central Premise: AIT as a "Harmful Side Effect"

Devereux’s opening statement casts AIT as a "harmful side effect" of therapy. But side effects only occur when something else is working. If transference is harmful, what then is the therapy? The implication is that the moment a client deeply attaches, their feelings become suspect. But what if the "harm" only arises when the therapist cannot tolerate being loved—or worse, not being loved enough?

This is not a side effect of therapy. It is a side effect of the therapist’s inability to love in a self-sacrificial way, and a symptom of the therapist’s narcissistic wound when the client’s love is not sufficiently gratifying.

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Pathologising the Client: A Dangerous Trend

Devereux lays out a taxonomy of client pathology. She writes of AIT as emerging from within the client alone, with no contribution from the therapist. This creates a diagnostic loop that protects the therapist while further marginalising the client:

• The client is predisposed.

• The therapist is innocent.

• The love is delusional.

• The boundary breach was prompted.

This logic echoes the worst of victim-blaming narratives. Devereux even proposes that the therapeutic setting itself—calm lighting, sustained attention, eye contact—might trigger AIT in fragile clients. That is: love and care become dangerous stimuli.

What is the inevitable conclusion? That some clients are simply too broken to be helped.

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A Glorified Defence of Therapist Helplessness

Devereux categorises therapists into types: the Lover, the Opportunist, the Weak One, the Perfect One. But even the so-called "Perfect" therapist can fall victim to a client who develops a regressive or malignant transference. The solution? Reject, contain, or terminate. There is no reflection on the therapist’s countertransference, no invitation to examine their own longing, avoidance, or fear.

She notes that the CfBS receives "several hundred" reports of harm each year—and then pivots to suggest that the real cause is not unethical therapists, but clients suffering from AIT.

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The False Myth of Therapist Neutrality

We are told that some clients suffer from a transference so intense and autonomous that it acts independently of any therapeutic conditions. This myth of therapist neutrality is dangerous. All transference has a hook. It is evoked, not conjured from nothing.

In reality, transference—including idealisation—is not evidence of madness. It is evidence of pain. Idealisation arises because the client must see the therapist as good in order to feel safe. Beneath the "adverse idealisation" is a split-off terror that the therapist will be like everyone else: rejecting, abandoning, unsafe. The client is not manipulating; they are surviving.

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The Real Danger: Therapist Countertransference and Fear of Not Being Admired

The true risk in therapy is not AIT. It is the therapist’s inability to hold and metabolise the client’s unconscious longing without retreating into control, blame, or diagnostic superiority. It is also the therapist’s inability to face their own unmet needs for affirmation, worship, uniqueness. When the therapist’s narcissistic needs go unmet—when the client does not idealise them in the right way—the therapist may reject or punish the client.

When Devereux calls AIT a risk that can be managed by "informing clients," "not making them feel special," and "maintaining strict professional boundaries," she outlines not safety but emotional starvation. It is a blueprint for relational retreat—a preemptive strike against love, dependency, and relational vulnerability.

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When Institutions Pathologise Love

That Devereux now works in a leadership position at an organisation that handles complaints makes this framework especially concerning. When love is misread as pathology, the client is seen as the problem. When power colludes with fear, complaints are dismissed not on ethical grounds, but on diagnostic ones.

Clients are not losing faith in therapy because they are fragile or delusional. They are losing faith because the profession gaslights them with theories like AIT that locate harm in their love, rather than in the therapist's failure to respond to it ethically—or in the therapist's narcissistic need to be idealised in more flattering, manageable ways.

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What Is to Be Done?

Therapists must do the painful inner work of tolerating transference without acting it out, fleeing, or pathologising. Transference is not a threat. It is an invitation. An ethical therapist welcomes it, holds it, and bears the pain of not needing to be adored, not needing to be special, not needing to be the hero.

We need less discussion about how to avoid being loved by clients, and more discussion about how to love them responsibly—and how to face the pain of not always being the object of their adoration.

The client who idealises is not a threat. The therapist who cannot receive love without fearing it—or resents the kind of love they receive—is the one who poses danger.

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Final Words

The therapeutic frame exists not to shield the therapist from love, but to provide a container in which love can be understood. When that container becomes a fortress or a pedestal, the client is left alone with their pain once more.

Let us stop writing about how love is dangerous, and begin again to write about how it can be held safely—with humility, responsibility, and grace.

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The harm is not in the transference. The harm is in how we fail to meet it—and in how some therapists resent the form it takes when it doesn’t serve their ego.

Love in the Therapy Room: Between Desire and Sacrifice

“Love does no harm to a neighbor. Therefore love is the fulfillment of the law.”

—Romans 13:10

The therapy room is a place of profound intimacy—a space where unconscious desires, unmet needs, and infantile longings re-emerge in raw and potent form. Love often becomes a central transference theme, not only as an object of longing but also as a site of confusion, distortion, and potential healing. But what kind of love are we speaking about?

In both life and therapy, love is not one thing. There is the worldly love that arises from the carnal mind—self-serving, grasping, seductive. This form of love, often confused with affection or passion, is rooted in the flesh, the ego, and the drive for gratification. It seeks to possess and be possessed. It operates through fantasy and projection. In therapy, it is the kind of love that fuels erotic or idealizing transference, drawing therapist and client alike into powerful enactments if not held consciously.

But there is another love—one written on the heart, not born of desire but of conscience. This love is aligned with what is “right” in the deepest sense: a love that does no harm. It is, paradoxically, a love that sacrifices the self in order to uphold the integrity of the other. In the therapy room, this love often looks quiet, even cold. It refrains. It withstands. It does not indulge. Yet it is precisely this restraint that constitutes its ethical and transformative power.

Transference, Temptation, and the Possibility of Harm

Clients do not arrive in therapy as blank slates. They bring with them the full weight of their internal object world—yearning, rage, need, and a lifetime of unmet attachment. Within this frame, love is often expressed as a desperate plea: See me. Touch me. Want me.

In intense therapeutic relationships, especially those influenced by AIT (Attachment-Informed Transference), clients may unconsciously test or provoke their therapist’s boundaries. These enactments are not manipulations in the conventional sense but efforts to recreate early relational dynamics in the hope of a different outcome.

But the risk is high. Erotic or idealizing transferences can awaken countertransferential responses that feel like love, even destiny. When therapists act on these impulses—even subtly—they enact betrayal. Abuse in therapy is rarely overt at first. It can begin as a compliment, a prolonged hug, an email sent after hours. Eventually, lines blur, and when the collapse comes, the client is often blamed for “pushing” too far.

Such actions are not love. They are exploitation masked as intimacy—fleshly love posing as care.

Love That Does No Harm: A Sacrificial Stance

What, then, does real love look like in the therapy room?

The psychoanalyst Erich Fromm reminds us that “love is the active concern for the life and the growth of that which we love.” True love, in this sense, is never self-seeking. It is attuned to what the other needs, not what we want to give. It does not use the other to gratify our own unmet needs. It requires the sacrifice of ego.

This aligns closely with Paul’s injunction in Romans—to love as the fulfillment of the law, meaning to act in a way that causes no harm. But "no harm" does not mean passive neutrality. It often requires active suffering by the therapist: to hold erotic, hostile, or dependent projections without retaliation or indulgence.

A profound dilemma arises here: the therapist must love the client without being loved in return. At least, not yet. Many therapists unconsciously seek to be loved by their clients, to be seen as good or special. But if a client could love—truly love, meaning to recognize the therapist as a separate other and be at peace with that separateness—they likely would not need therapy in the first place. The capacity to love maturely is, in many ways, the outcome of successful therapy, not the starting point.

Boundaries as Love, Not Rejection

This is where boundaries come in—not as cold limits, but as acts of love. A child who becomes the “perfect child,” as Winnicott describes, is often one who never had clear, loving containment. They adapted to survive, suppressing their aggression and need for fear it would be too much for the parent to bear.

So too in therapy: clients will inevitably test the therapist's boundaries—not to destroy, but to find out whether the therapist can survive them.

“The patient needs to be able to do the worst thing and find that they are still loved… Only then can true change happen.”

—Donald Winnicott

It is not love to accept all behaviors without consequence. It is not love to endure boundary violations in silence. Love is not permissiveness—it is clarity. Boundaries are the expression of the therapist's ethical position and care. They say, I will not let either of us be harmed. I will not use you, and I will not let you use me.

Consequences are love. Structure is love. And yet, love is also forgiveness. When a client acts out—crosses a boundary, lashes out, withdraws—what then? The question becomes: Can the therapist forgive when the client returns? Can the door of the room, and the door of the heart, remain open for the one who asks to come back in?

This is where many therapeutic relationships collapse. Boundary-pushing is to be expected—it is not the failure of the therapy. The failure often lies in the therapist’s inability to forgive, to re-open the container, to metabolize rupture into healing. It is not weakness to forgive; it is the therapist’s highest form of love.

Holding the Tension: Eros and Agape

Psychoanalysis has long wrestled with the place of love in treatment. Freud famously warned against acting on erotic transference, yet he also acknowledged that analysis without love would fail. Ferenczi, in contrast, explored the therapeutic potential of tenderness, even mutuality, while later analysts like Heinz Kohut emphasized empathic mirroring as a healing force. But none of these bypass the essential ethical dilemma: love heals only when it remains conscious, boundaried, and sacrificial.

The love that heals in therapy is not eros but agape—a self-emptying concern for the other’s growth. It is the therapist’s capacity to become the container of the client’s unintegrated parts without requiring anything in return. This love does not seek gratification. It does not need to be seen or thanked. It simply remains, unwavering, in the storm.

Final Reflections

When a client enters therapy, they are not yet capable of mature love. The therapist must carry the burden of loving first—without being loved in return, without being seen, and without being understood. That is the crucible of therapeutic love.

To love in the therapy room is not to indulge, idealize, or correct. It is to stand firm in the face of unrelenting testing, to draw clear lines not as punishment, but as protection. And when the client inevitably crosses those lines—as they must—the question becomes: Will you still be here when I come back?

Love in the therapy room is not about feelings. It is about moral action, the restraint of desire, and the willingness to suffer for the sake of the other’s becoming. It is costly. And it is holy.

References:

Winnicott, D.W. (1965). The Maturational Processes and the Facilitating Environment. London: Hogarth Press.

Fromm, E. (1956). The Art of Loving. Harper & Row.

Freud, S. (1915). Observations on Transference-Love. Standard Edition, Vol. 12.

Ferenczi, S. (1931). Confusion of Tongues Between the Adult and the Child. Final Contributions to the Problems and Methods of Psycho-Analysis.

Kohut, H. (1971). The Analysis of the Self. International Universities Press.

Romans 13:10, Holy Bible, NIV.

Splitting, Shame, and Supervision: A Psychoanalytic Reflection on Narcissistic Abuse in Counsellor Training

The name "Sandra" is a pseudonym used to protect privacy.

Introduction

Supervision is meant to be a space of reflection, learning, and ethical containment. However, when it is co-opted by unresolved narcissistic dynamics in the supervisor, it can become a site of subtle and overt psychological abuse. This paper explores a personal experience of narcissistic supervision during counsellor training, framed within psychoanalytic theory. It examines the phenomena of splitting, idealisation and devaluation, projective identification, and the weaponisation of shame, situating the experience within the wider challenges of professional power dynamics and developmental vulnerability. The intention is to offer a professional account that may support and guide other trainees who find themselves in similar dynamics, and to contribute to a growing body of literature examining supervision abuse.

Initial Idealisation and Early Signs of Narcissistic Dynamics

When I entered my first supervision group, we were a small cohort of four, overseen by a supervisor—Sandra—who was often late and emotionally distant. Her attitude toward clients raised early concerns. On one occasion, when I described a session in which a client was weeping with visible snot running down her face, Sandra commented coldly that the client “had no decorum.” This lack of empathy stood out but did not yet raise alarm. At that point, I was still, in her eyes, a valuable supervisee—engaged, competent, and reflective.

However, I would later come to understand this initial period as one of idealisation. As Kernberg (1975) observed, narcissistically organised individuals tend to split others into “all good” or “all bad” depending on whether they serve their self-esteem regulation. At this early stage, I was still “good.” My interest in psychoanalytic ideas and my ability to articulate clinical material made me useful—what Kohut (1971) would later call a “mirror object” that helped sustain Sandra’s fragile self-image as a competent, powerful supervisor.

The Breakdown of Idealisation and the Rise of Hostility

Subtle signs of enmeshment and control emerged over time. While Sandra was seemingly indifferent when other trainees missed sessions, I was told by a colleague that she anxiously asked about my whereabouts whenever I was absent. My responses in supervision were often met with contradiction: if I said A, she said B; if I said B, she said A. This unpredictable opposition became a constant undercurrent—what Freud (1914) described as repetition compulsion, a re-enactment of unresolved relational trauma, possibly Sandra’s own.

The turning point came when I sent an email to my personal and professional contacts (including Sandra), sharing that my son was running a cancer fundraiser. It included a light-hearted remark along the lines of “God sees if you don’t donate.” When I returned to supervision, Sandra used this as an opportunity to publicly shame me. In front of the group, she declared that I had crossed boundaries by sending her the email. Though I calmly apologised and said it wouldn’t happen again, she refused to move on—her eyes growing wider, her tone increasingly fixated.

Her inability to accept my non-defensive response led to prolonged humiliation. The group fell silent. Some looked at the floor. No one intervened. When I eventually said, more firmly, “I hear you, and I’ve apologised—can we move on?” Sandra accused me of “always switching things around.” The accusation was both vague and loaded—classic projective identification (Bion, 1962), in which her own confusion or instability was located in me.

Power, Dependency, and the Collapse of the False Self

Sandra had institutional power: she was one of the professionals who would decide whether I passed my training. This structural imbalance—common in counselling education—left little room to challenge her behaviour. During this time, I was also experiencing a breakdown in my personal therapy, which I will explore in a future paper. My husband was working abroad for three years, leaving me to face not only the present distress, but also reawakened feelings of childhood shame and abandonment. Despite this complex emotional terrain, I remained professionally functional, holding clients, attending training, and working reflectively.

Looking back, I see that I was caught in a coercive relational bind: if I submitted, I was rewarded with praise and favour; if I asserted myself, I was devalued and attacked. Sandra’s dynamic fits closely with the narcissistic pattern described by Masterson (1981), in which the caregiver (or supervisor, in this case) creates an emotional environment where the other must continually regulate the narcissist’s sense of self.

When the first half of the training ended and new supervision groups were being allocated, Sandra informed our group—with a visible grin—that everyone would move to a new supervisor except me. “You’re going to be my favourite child now,” she said, half-joking, half-serious. I responded, “I don’t want to be anyone’s favourite child.” Her laughter was unnerving. I felt trapped.

Shame as a Weapon of Control

Ferenczi (1931) wrote poignantly about how shame can be used as a weapon in therapeutic relationships. He argued that pathogenic shame—induced rather than uncovered—serves to control the other through humiliation and confusion. Sandra's use of shame was not revelatory but silencing. Her “feedback” turned into character assassination. A formal report was written, portraying me as emotionally unstable and psychologically unwell—despite previous praise for my clinical insight and theoretical competence.

Alongside this, she wrote a separate, three-page document describing me in degrading terms, which I was never supposed to see. In a rare act of transparency, the training organisation shared it with me, so I could respond. This moment was pivotal: for the first time, I was believed. I suspect I was not the only supervisee who had raised concerns.

At a meeting with the organisation's leadership, Sandra, and my husband present, I was informed that I would no longer be in her supervision group. At that moment, Sandra stood up and shoved her chair back. Her body language betrayed her inner collapse—rage, loss, and perhaps panic. The narcissistic supply had been severed. I was no longer available to stabilise her false self. As Kohut (1977) described, narcissistic rage arises when the self-object fails to mirror or admire, triggering a collapse of the narcissist’s cohesion.

The Power of Documentation and Pedagogical Transparency

I still possess the reports Sandra wrote about me. Though painful, they now serve a new purpose. I have chosen to share them—selectively and privately—with my supervisees via a closed Patreon platform. My aim is pedagogical: to help trainees recognise the signs of supervisory misuse of power, the tactics of institutional gaslighting, and the emotional toll such experiences can take. These documents are not shared to shame, but to teach.

In supervision, we often speak about ethics, boundaries, and emotional safety. But we must also speak about power—the power to shape narratives, the power to destroy reputations, the power to determine who is "well enough" to practice. When that power is misused, especially in environments where trainees are already vulnerable, the damage can be profound.

Conclusion

This paper is offered to the field as both a personal testimony and a theoretical reflection on narcissistic dynamics in supervision. It is a reminder that clinical training does not occur in a vacuum; it takes place within human relationships, fraught with projection, transference, and unspoken power. Narcissistic supervisors, like Sandra, often operate within systems that fail to hold them accountable. But when we name the dynamics—splitting, idealisation, shame, rage—we begin to take back the power they seek to steal.

For trainees currently navigating confusing or disturbing supervisory relationships, may this paper offer both insight and solidarity. You are not alone. Your intuition matters. And you can survive it with your integrity intact.

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References

• Bion, W. R. (1962). Learning from Experience. Heinemann.

• Ferenczi, S. (1931). Confusion of Tongues Between the Adults and the Child. In Final Contributions to the Problems and Methods of Psycho-analysis. Karnac, 1980.

• Freud, S. (1914). Remembering, Repeating and Working-Through. In The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 12.

• Kernberg, O. (1975). Borderline Conditions and Pathological Narcissism. Jason Aronson.

• Kohut, H. (1971). The Analysis of the Self. International Universities Press.

• Kohut, H. (1977). The Restoration of the Self. International Universities Press.

• Masterson, J. F. (1981). The Narcissistic and Borderline Disorders: An Integrated Developmental Approach. Brunner/Mazel.

All Is Vanity”: Hopelessness, Therapy, and the Search for Something Greater

 “Vanity of vanities, saith the Preacher, vanity of vanities; all is vanity.” — Ecclesiastes 1:2

The Void Beneath the Surface

There is a quiet despair that can live within even the most functional, successful, and outwardly fulfilled lives. This despair is rarely shouted—it is sighed, shrugged, hidden beneath routines, progress, or even purpose. In the therapy room, it can settle like fog. Not always dramatic, but unmistakably present.

All is vanity...

It is the despair that Ecclesiastes knew well: a spiritual exhaustion, a futility that makes even the most celebrated human achievements seem hollow. “I made me great works,” writes the Preacher. “I built me houses; I planted me vineyards... Then I looked on all the works that my hands had wrought... and, behold, all was vanity and vexation of spirit, and there was no profit under the sun.” (Ecclesiastes 2:4, 2:11)

The question arises quietly but dangerously: What is the point of all this? 

The Dangerous Question and the Therapist’s Own Vanity

The question of purpose is often deferred in life—replaced with plans, ambition, children, relationships, or therapy itself. But eventually, for some, the scaffolding collapses. Clients may arrive at therapy when that collapse has begun or when it is already complete. The drive that once fueled their life—career success, family roles, intellectual mastery—suddenly feels meaningless. And therapy, if idealized as a path to healing or growth, can become yet another expression of vanity.

As therapists, we may unconsciously enter into this same fantasy. We hope to help, to repair, to facilitate meaning. But the despair lives in us too. We are not immune to the questions that torment our clients. As Wilfred Bion warned, the analyst must surrender the desire to “know” or “understand” too quickly. He advocated for “faith in the analytic process,” which includes tolerating not-knowing—sitting with the utter absence of meaning when it arises.

This is not a position of helplessness, but of depth. As Bion writes, “The analyst must suspend memory, desire, and understanding,” and that includes our desire for hope, direction, or outcome. Therapy becomes not a cure, but a shared witness to the void. Which really, may only be possible when there is a strong sense of hope internalised. 

Transference, Countertransference, and the Fantasy of Meaning

In therapy, unconscious hopelessness is often enacted through transference. The client may feel the therapist holds the key to a life of meaning, expecting them to reawaken a purpose that feels lost. But this projection—this fantasy of the therapist as redeemer—can be quietly destructive.

For the therapist, the corresponding countertransference may take the form of pressure: the need to “restore” the client, to inject meaning into an otherwise barren psychic landscape. Here, Donald Winnicott’s idea of holding becomes vital. Holding does not mean comforting, nor does it mean offering answers. It means staying. Remaining. Facing what feels unfaceable without fleeing into technique or cheerfulness.

When both therapist and client are able to endure this hopelessness without disavowal, something changes.

Ecclesiastes and the Therapeutic Collapse of Illusion

Ecclesiastes names what most of us dread: the futility not just of failure, but of success. It is not that we don’t achieve—it is that achievement itself cannot ultimately satisfy. "There is no remembrance of former things,” the Preacher laments, “neither shall there be any remembrance of things that are to come with those that shall come after.” (1:11)

This is a chilling truth, and one that therapy must occasionally confront. Psychoanalyst Thomas Ogden has written about the “analytic third”—the space created by therapist and client together, where new understanding emerges. But before this emergence, there is often collapse: the collapse of self-image, of illusions of control, of the fantasy that therapy or life itself will deliver us to lasting peace.

And in that collapse lies a strange hope.

Despair as a Portal to the Sacred

The deepest therapeutic work may involve not change, but surrender. Not triumph, but humility. As analyst Marion Milner observed, the psyche’s longing is not for answers, but for a capacity to stay with inner experience—however painful. To stop avoiding what feels meaningless and to discover, paradoxically, that it is in that confrontation where something meaningful can begin.

Despair, when faced and not bypassed, becomes a threshold. Ecclesiastes never resolves into optimism, but it does conclude with reverence: “Fear God, and keep his commandments: for this is the whole duty of man.” (12:13)

Whether one reads this literally or metaphorically, it suggests that meaning cannot be self-generated indefinitely. The ego must collapse. Purpose must be relinquished before it is transformed.

In clinical language, this is not far from what Jung meant when he described the necessity of encountering the “shadow,” or what Bion evoked with the idea of O—ultimate truth, unknowable yet real, which can only be approached through surrender, not mastery.

Conclusion: Facing the Void Together

There is something sacred in the moment when therapist and client face the void together. When neither clings to false hope. When both are willing to admit that sometimes life does not make sense, and that therapy may not rescue us.

But it is also in this shared space—of hopelessness survived—that a deeper form of hope begins to stir. Not the hope of progress, but the hope of presence. Not the hope of outcome, but the hope of truth.

And sometimes, through the cracks of despair, something greater shines through. Whether one calls it God, a Higher Power or the Soul, or simply Being—it arrives not because we chased it, but because we stopped running.

"To everything there is a season, and a time to every purpose under the heaven.” (Ecclesiastes 3:1)

Perhaps therapy at its most honest is not a search for meaning, but a willingness to sit with its absence—and to discover, in time, that we are not destroyed by it but reconnected to our true purpose.

© Maja Farrell

When Therapy Hurts: Navigating Attachment and the Risk of Re-traumatization in a New Therapeutic Relationship

"It is a joy to be hidden, and a disaster not to be found.” – D. W. Winnicott

Therapy, at its best, is a sanctuary—a place where the psyche can soften, reorganize, and begin to heal. But not all therapeutic relationships are healing. Some become subtly (or overtly) exploitative, mirroring the very dynamics of neglect, intrusion, or manipulation that a client came to escape. In such cases, the rupture of the therapy relationship can itself be traumatic. And when a client, still caught in the web of unfulfilled attachment needs, moves into a new therapy without careful reflection or support, they may unknowingly repeat the past—sometimes with devastating consequences.

This article is not about blaming therapists. It is about taking seriously the complexity of human vulnerability—on both sides of the therapeutic relationship—and naming how easily the dynamics of early trauma can be replicated even in supposedly “safe” spaces. Especially when those spaces are misunderstood or misused by the therapist.

The Unmet Attachment Need

A client who has experienced a harmful therapy relationship (and ending) often leaves not only hurt but confused—still psychologically entangled with the former therapist, which will be most likely a repeat of earlier more significant attachment bonds. Attachment bonds, once formed, are not easily seen as such or "undone". Even when the relationship was deeply problematic, the longing to be understood, soothed, and seen persists. This is the child’s need that never got met. And now, in the absence of safety, it becomes even more urgent.

In this state, the client seeks another attachment figure. Another opportunity. A rescuer. A better “good object.” This desire is raw and primal, and a sensitive therapist will feel its weight in the countrr-transference—the grief, the rage, the helplessness, and the hopelessness.

But not all therapists can hold it.

Some become frightened by it. Some mistake it for pathology. Others—consciously or unconsciously—begin to exploit it. The client, vulnerable, angry yet eager to attach, may become a source of professional gratification: a case study, a loyal follower, an income stream, or a means to confirm the therapist’s self-image as a healer.

Becoming aware of this may cause the well meaning therapist to withdraw! 

It is important to recognize: not all re-traumatizations are intentional. Some therapists truly mean well, but act out their own unresolved dynamics through the therapeutic relationship. Others are more predatory. In either case, the result is the same: the client becomes trapped in a new dynamic that may be just as violating as the one they escaped.

How to Protect Yourself After a Harmful Therapy Experience

If you have experienced a harmful or disturbing therapy relationship, your longing for help is real—and valid. But so is your need for protection.

Here are some ways to guard your psychological integrity while seeking a new therapist:

1. Pause Before You Attach

If possible, give yourself time to reflect on what happened in the previous therapy. Write about it. Talk to trusted friends. If you can afford it, work with a clinical supervisor, therapist-consultant, or trauma-informed practitioner whose role is explicitly to help you make sense of what happened—without requiring you to form a deep attachment right away.

2. Interview Your Next Therapist Carefully

Before committing, ask difficult but essential questions:

Have you worked with clients who’ve had traumatic experiences in previous therapies?

How do you handle strong attachment dynamics in therapy?

Are you open to discussing power, authority, and rupture in the therapeutic relationship?

What’s your stance on clients reading or accessing their notes?

Have you had your own therapy or supervision around enactments and countertransference?

A good therapist will welcome these questions. A defensive or dismissive response is a red flag.

3. Look for Evidence of Accountability

Ask if the therapist participates in regular supervision, consultation, or peer review. Are they open about their own learning process? Do they acknowledge the possibility of mistakes—not just theoretically, but in practice?

4. Trust the Small Signals

Pay attention to how you feel during early sessions—not just what’s said, but what’s implied. Do you feel pressured to commit quickly? Are your questions answered with openness or with evasion? Do you feel that the therapist is attuned to your pace—or trying to fit you into theirs?

5. Name the Wound

If you feel able, tell the new therapist what went wrong before. Share your fears. The way they respond will tell you more than any credentials or training ever could.

A Final Word

Winnicott taught us that the therapist’s task is not to be the perfect parent, but to survive the client’s need for one—to hold space for the unmanageable without collapsing or retaliating. This is a sacred responsibility, and one that too often gets lost in the competitive, performative culture of modern psychotherapy.

No one can ever fully prevent harm, but we can increase awareness. We can speak the truth, even when it’s uncomfortable. And we can remind ourselves—and our clients—that even when the first (or second) attempt at healing fails, the possibility of a more real, more honest connection is still alive.

There is hope in a hopeless place.

The therapeutic relationship can hurt. But it can also heal. And the difference lies in whether the therapist can truly see the person before them—not as a project, not as a product, but as a human being whose utterly hopeless.

I believe it is this hopelessness, the confrontation of that bottomless abyss, that we are all so afraid of, even if it is mostly unconscious -- because it is so terrifying.

Stare into the abyss, and the fear is, the abyss will 
stare back into you....

© Maja Farrell

When Therapists Harm: The Dangers of Narcissistic Wounding in Counselling

The Disruption in Supervision

As I sat in group supervision another counsellor knocks at the door. A colleague within the group immediately looks at our supervisor who pulls a face but says nothing. The door opens and another colleague enters the door. Without apology she announced "Someone parked their car in the driveway and I cant get out, does it belong to any of you?" After she was told that the car didn't belong to us, she shut the door.

Emotional Reactions and Sudden Indignation

Two group members seemed to bristle with anger

informing the rest of the group that this "had never happened before in all our time we have been in supervision!" Intense indignation filled the room within seconds of the door shutting when suddenly another door in the hallway was opened. Faint voices and the door was shut again.

The colleague had entered another room, asking the counsellor, who saw a client at the time, if it was her car and if she could move it.

When Therapists Harm

Lack of Empathy Among Therapists

How was it possible that my colleagues expressed no compassion for the counsellor who had entered our supervision group but felt so slighted by her action? It seemed as if they took the disturbance very personal, unable to put themselves into the other's situation. Yet when they sat with clients they reported feeling very empathic and concerned.

The "intruder" too seemed to have difficulty putting herself into the client's (and counsellor's) shoes when she disturbed their session demanding the counsellor move her car. Yet these are the people who see clients...

The Withholding Counsellor

What happens when such narcissistically wounded practitioners work with clients?

They become sadistic and unconsciously desire to hurt, torture and annihilate the client. A bit extreme? Not at all.

Anyone who has ever been on the receiving end of narcissistic rage or anyone emotionally intelligent enough to recognise their own narcissistic wounding and need to hurt the other, will know that the rage of the hurt baby/child, re-experienced within the adult, can be boundless, ruthless and annihilating.

A therapist who has not worked through such early emotional childhood trauma (and who did not get his needs met by his own therapist), who is unaware of the unconscious urge to re-create traumatic past situations within relationships, will use the client to re-play past experiences. But this time, the then helpless child is in control. No longer does it have to be the victim. Now, it is powerful, now it can hit back.

When Therapy Becomes a Weapon

Psychodynamic/psychoanalytic counselling is used by many narcissistic practitioners to do just that - hit back. The client, seen through the counsellor's lens, is either experienced as a victim or a persecutor and (mis) treated accordingly.

This is not to say that a "caring" counsellor cannot be extremely narcissistic and dangerous, but that is food for another post.

The Angry Client

After working with a client for some months she became attached to the counsellor and despaired whenever she felt separated from him (counsellor). Vulnerable and exposed (as is a child) she asked if he could get her a glass of water (she couldn't stop coughing - asthma). The counsellor said "No". The client explodes with anger, acts out, hurts herself and withdraws. Left to deal with the sudden tidal wave of rage she leaves therapy never to return again.

Supervised Sadism

In supervision this counsellor reports that he withheld the water on purpose.

When asked why, he replied "She is a very angry person but was unable to feel or express it. Me not giving her what she wanted got her in touch with her rage."

This is absolute non-sense yet there are many psychoanalytic schools who integrate such abusive behaviour into their training. Supported by "theories" those narcissistic practitioners, unable to get in touch with their own self (as there is a lack of Self/Narcissism) mostly depend on a fanatic obsession with Freud/tutor/supervisor/personal therapist and what s/he did and didn't do or say, rather than to feel their way into the clients' world, meeting their needs (vs wants). Sadistic urges stemming from childhood are openly played out withholding words and actions in order to evoke/provoke suppressed anger. Whose anger? Perhaps the counsellor's own suppressed rage against those who humiliated him as a baby/child.

Whose Rage Is It, Really?

The goal of therapy is not to provoke suppressed rage. Rage will come naturally and can be worked through, over time, if trust is built, and especially if the counsellor is genuinely accepting and containing (see Melanie Klein and Primitive Envy).

It is the narcissistic counsellor who forces the client to become angry because the narcissistic counsellor does not see the client or hear the client instead is caught up in the past when s/he herself was a victim of terrible emotional abuse at the hands of superior adults who should have treated her/him with respect and dignity not humiliation and ridicule.

The Mask Falls Off

Going back to my colleagues, it is my guess that all three felt personally attacked by the "intruder". Re-experiencing painful feelings from the past when their own meeting of needs was denied, they were left "starved" and therefore incapable to empathise with and give to the other; quickly enraged the counsellor mask flew off and a raging, venom spewing harpy showed her pain distorted face.

The Psychological Dilemma that causes tension

A Final Reflection

Psychodynamic counselling can be very helpful but also extremely dangerous if the therapist is unaware of her narcissistic wounds. If you are unsure whether you are in an abusive "therapeutic" relationship please reach out to others. Not everything is transference and every transference needs a hook - more on this in a later post.

© Maja Farrell

The Retaliatory Practitioner - Returning the Unbearable

by Maja Farrell

I would like to encourage other therapists to think about possible unconscious forces that may arise in a very short space of time; e.g. within/after a phone call or e-mail from a client enquiring about therapy, the first session or a first presentation of a client in supervision and the damage that can be caused to the client within this very short period of time in which therapist can become deeply affected by the client's internal world and unable to think and act, re-acts and rejects, leaving the client in even greater distress.

Being a therapist myself, I have found the very first contact with a client (be it face to face or via e-mail or telephone) creates an energetic space in which our minds meet and communicate in a powerful way. I believe it is the task of the psych-dynamic practitioner to tune into this communication and help create some meaning, for and with the client together, of his internal world. Even if contact is very brief, the practitioner has a responsibility to "first do no (psychological) harm" meaning, he needs to stay aware of his anxieties towards the potential client, acting in her best psychological interest.

What, however, happens if the client's unconscious communications reach the mind of the practitioner in such a powerful way that he cannot, does not want to, is unable to hold and contain them and act empathically?

Wilfred Bion thought about those dangerous pitfalls with help of the infant-mother relationship in which baby, unable to think about the frightening world around him, needs mother to help make sense of what he is experiencing. Bion suggested because baby has no words to communicate his distress, he uses the unconscious vessel of projective identification to put into mother his anxieties, who in a state of reverie, picks up on her baby's fears and, able to think about them, returns them to him in a more digestible form, thereby offering him an experience of both, himself and mother, surviving the unbearable.

The mother's response is to acknowledge the anxiety and do whatever is necessary to relieve the infant's distress. The infant's perception is that he has projected something intolerable into his object, but the object was capable of containing it and dealing with it. He can then reintroject not only his original anxiety but an anxiety modified by having been contained. He also introjects an object capable of containing and dealing with anxiety (Segal 1975, pages 134-5).

On the other hand, should mother fail to provide such a mental container (capacity) to receive, take in and think about her baby's anxieties, his, as well as his mother's anxieties, may be returned to him in their raw, terrifying form. Unable to make sense of what is being returned to him, he is left with an experience of his mind, feelings and thoughts being too intolerable to be thought about.

 "If the projection is not accepted by the mother the infant feels that its feeling that it is dying is stripped of such meaning that it has. It therefore reintrojects, not a fear of dying made tolerable, but a nameless dread" (Bion, 1962, p. 183).

If a client, especially after having experienced previous abuse, enters counselling sessions s/he may hold a lot of conscious or unconscious hopelessness, anguish and murderous rage.
Unable to direct those feelings towards the Object (person) and not having any Object available that seems strong enough to hold and contain this rage, make sense of it and resolve it, the mind of the client projects it outwards; away from him/her; it is too unbearable to feel, to be aware of. S/He is left with the "nameless dread" of something horrific - a fear of the unknown known.

We as therapists need to remember that even the first phone or e-mail contact from a client is not only highly significant but also utterly important - we must strive to keep the client's pain in mind at all times while reflecting on our responses so we do not add to the client’s already fragile sense of self.

If we as therapists are unable to hold this tension and the anxiety (ours and that of the client) we may be likely to Re-act rather than Act empathically and therapeutically (after having been able to think and link - Bion). If the client is extremely anxious, the (intuitive and involved) therapist will pick on it (un/consciously), but if he is not mentally strong enough will return the unbearable to the client in a traumatic and further damaging manner.  

References:

Bion, W.R. 1959 Attacks on linking. International Journal of Psycho-Analysis 40: 308-315.

Bion, W.R. 1962. A Theory of Thinking. In E. Bott Spillius (ed.) Melanie Klein Today: Developments in theory and practice. Volume 1: Mainly Theory. 1988. London: Routledge.

Segal, Hanna 1975 A psychoanalytic approach to the treatment of schizophrenia. In Malcolm Lader (ed) Studies of Schizophrenia. Ashford: Headley

© Maja Farrell

Poisonous Psychotherapy

by Maja Farrell

I found Alice Miller's term "Poisonous Pedagogy" when I was looking for reasons why so many therapies and analyses feel so abusive to clients and eventually break down altogether. I could not understand, reading forums full of patients/clients who were able to apparently "thrive" and "love" their therapist although reporting experiences that, to me, seemed inhibiting at best and abusive at worst. Looking back, I myself had stayed in such 'therapeutic' relationships, and the constant struggle I was experiencing within those relationships was intensified by the internal war against my intuition and gut instinct; the innate knowledge that I was not treated the way I needed to be treated in order to flourish and find my Self. As the years passed and the "unintentional" oppression by therapists/analyst of my needs and Self continued,

I became curious as to why therapists fought so hard against me having my needs (vs wants) met. It felt like the more I expressed my needs the greater was the withdrawal by the therapists mentally and emotionally until they finally left physically. How could a relationship created to promote Self growth and maybe even healing feel so repressing, punitive and sadistic? In psychoanalytic training myself at the time, I read paper after book and opened up online discussions with other practitioners, but instead of finding answers to my questions or other curious professionals, I found practitioners who either ignored or attacked me, perhaps terrified of something I had unconsciously reminded them of? I could not understand how people in the helping profession, those who were supposed to be open minded, curious, empathic and analytic, could suddenly close down, become extremely defensive and in some cases even bullying. It seemed I had become a mirror that reflected something horrific...something needed to be protected from this monster, a reflection of their own inner turmoil. At the time I took it on board as something abhorrent within me, something that was abnormal and ill. Supported by my analytic training, the breakdown of my analysis and the Freudian notion of the innate Death drive, I experienced my Self increasingly evil and unable or unwilling to be "tamed" as one therapist called it. My belief to be evil and dangerous was intensified by the therapist's need to stay away from her own repressed rage and guilt towards the adults of her early childhood. I have paid a very high price, mentally and financially, to find the answer to my questions as after many broken down, traumatic and deeply tragic 'therapeutic' encounters I became very bitter, angry, resentful and suicidal; equally profound, however, was my move into consciousness which brought with it a deep sense of empathy and acceptance of my Self and therefore the Other. I have now realised that the reason my therapies had ended so abruptly and unethically was not because I was mentally ill, evil or dangerous but because I had unconsciously been kept from raging against my parents, as the therapist herself was still stuck in childish guilt and shame of having "betrayed" her parents with her own rage and hatred for what had been done to her - in the name of care and "for your own good". I fought against this oppression, my parents' oppression, her parents' oppression which had now become her oppression. I wanted to become me, why was I not allowed? The following chapter out of Thou Shalt Not Be Aware: Society's Betrayal of the Child By Alice Miller which, I feel, illustrates beautifully the painful dilemma of the growing child and patient alike, might shed some light onto this question:

  The reports of all three analysands gave me the impression that all four analysts devoted themselves to their patients, tried to understand them, and place their entire professional knowledge at the patients disposal. Why are the results so different? Can it be explained simply by calling an analysand incurable if the analysis was a four-year-long misunderstanding?

Formulations such as "negative therapeutic reaction" or "resentful patients" remind me of the "wicked" (because "willful") child of "poisonous pedagogy," according to which children are always guilty if their parents don't understand them. Yet patients are just as little to blame for our lack of understanding as children for the blows administered by their parents. We owe this incomprehension to our professional training, which can be just as misleading as those "tried and true" principles of our upbringing we have taken over from our parents. In my opinion, the difference between Cardinal's successful analysis on the one hand and Moser's and Drigalski's tragedies on the other is that in the first case the seriously ill patient, whose life was in danger, found out in analysis what her parents had done to her and was able to relive her tragic childhood. Her description is so vivid that the empathic reader goes through the process with her. The boundless rage and deep sorrow she felt at what she had been forced to endure as a child led to relief from the dangerous and chronic haemorrhaging that had preciously been unsuccessfully treated by surgery.

The result of her sorrow was the full blossoming of her creativity. It is obvious to the professionally trained reader that Cardinal's case psychoanalysis - not family therapy or transactional analysis, for instance - was used, for the connections can be traced between her tragic emotional discovery about her childhood and what happened in the transference. The other therapists also used a psychoanalytic approach, but we can sense in them an attempt to interpret whatever the patient says and does from the perspective of the drive theory. If it is an axiom of psychoanalytic training that everything that happened to the patient in childhood was the result of his drive conflicts, then sooner or later the patient must be taught to regard himself as wicked, destructive, megalomaniac, or homosexual without understanding the reasons for his particular behaviour.

For those narcissistic traumas - humiliation, rejection, mistreatment - inflicted on the child and traditionally considered a normal part of child-rearing are not touched upon and thus cannot be experienced by the patient. Yet it is only by addressing these concrete situations that we can help the patient acknowledge his feelings of rage, hatred, indignation, and eventually, grief. There are unquestionably many analysands who "successfully" survive the pedagogical approach inherent in their therapy because they are completely unaware of it. As a result of "poisonous pedagogy" they are so accustomed to not being understood and frequently even blamed for their fate that they are unable to detect the same situation when it occurs in analysis and will adapt themselves to their new mentor. They will leave analysis having substituted one superego for another. It should not surprise us that Tilmann Moser and Doerte von Drigalski, both creative people, are reduced to despair as a result. In Moser's case, it is true, the despair is still concealed behind idealisation of the analyst, but his next book, Gottesvergiftung (God Poisoning), shows that he was not able to experience his aggression toward his parents in analysis because obviously the analyst as well as the parents had to be spared. In Drigalski's case, her disappointment with both analyses leads to a rejection of the psychoanalysis per se, which is understandable although regrettable, for the case of Cardinal for one demonstrates that psychoanalysis can contribute positively to a person's creative growth.

In Drigalski's report, the tragic traces of "poisonous pedagogy" are particularly striking. They can be seen not only in the approaches of the psychoanalytic training institutes, which often appear to have a veritable horror of originality, but, most tragically, in the years of wasted effort on the part of the patient and both analysts, all of whom were prevented from gaining access to the narcissistic traumas of early childhood because they were inhibited by the unspoken commandment to spare the parents and blame the child. For this reason, what the other reports about her childhood, her parents, and her brothers remains sketchy and devoid of strong feelings, as in the case of Moser, but very unlike that of Cardinal. Now all Drigalski's outrage is directed against psychoanalysis and her second analyst, who did not understand her.Would this woman have been able to struggle against her feelings for four years and bear such torment if she had not been brought up to ignore  her inner Voice and keep a stiff upper lip? The adults who figured in her early childhood are spared her rage, however.

This is the rule for the more or less conscious gaol of adult in rearing infants is to make sure they will never find out later in life that they were trained not to become aware of how they were manipulated. Without "poisonous pedagogy" there would be no "poisonous psychoanalysis," for patients would react negatively from the very beginning if they were misunderstood, ignored, not listened to, or belittled in order to be forced into a Procrustean bed of theories.

There is a good deal else that would not exist without "poisonous pedagogy." It would be inconceivable, for example, for politicians mouthing empty clichés to attain the highest positions of power by democratic means. But since voters, who as children would normally have been capable of seeing through these clichés with aid of their feelings, were specifically forbidden to do so in their early years, they lose this ability as adults. The capacity to experience the strong feelings of childhood and puberty (which are so often stifled by child-rearing methods, beatings, or even drugs) could provide the individual with important means of orientation with which he or she could easily determine whether politicians are speaking from genuine experience or are merely parroting time-worn platitudes for sake of manipulating voters.

Our whole system of raising and education children provides the power-hungry with a ready-made railway network they can use to reach the destination of their choice. They need only push the buttons that parents and educators have already installed. [...] I looked into the background of Sophie and Hans Scholl, two university students in Hitler's Germany who became famous as a result of their activities in the resistance movement, "The White Rose," and were both executed by the Nazis in 1944. I discovered that the tolerant and open atmosphere of their childhood had enabled them to see through Hitler's platitudes at the Nuremberg Rally, when the brother and sister were members of the Nazi youth organisations. Nearly all their peers were completely won over by the Fuehrer, whereas Hans and Sophie had other, higher expectations of human, not shared by their comrades, against which they could measure Hitler. Because such standards are rare, it s also very difficult for patients in therapy to see through the manipulative methods they are subjected to; the patient doesn't even notice such methods because the are inherent in a system he takes completely for granted.

[...] It is essential for us to perceive the unintentional persecution of children by their parents, sanctioned by the society and called child-rearing, if our patients are to be freed from the feeling imposed on them from an early age that they are to blame for their parents' suffering. In order for this to happen, the analyst has to be free from guilt feelings toward his won parents and be sensitise to the narcissistic wounds that can be inflicted in early childhood. If he lacks this sensitivity, he will minimize the extent of persecution. He will not be able to empathise with a child's humiliation, since his own childhood humiliation is still repressed. If, in keeping with the saying "You'll be the death of me yet," he has learned to accept all the guilt in order to spare his parents, he will try to allay his patient's aggression, which he cannot understand, by repeatedly empathising the parents' good sides; this method is referred to as "the establishment of good objects" in the patient.

If the mother sees her infant as wicked and destructive, then she will have to bring him under control and train him. But if she recognises his rage and hatred as reactions to painful experiences, whose significance may still escape her, she will not try to train the child but will permit him to experience his feelings. The same is true of the psychoanalytic process. The example of Marie Cardinal demonstrates why it is not necessary to "establish a good object in the patient" and keep telling him that his parents also had their positive sides and were concerned for his welfare. He had never questioned that; on the contrary, the child does not need to repress what is positive for the sake of survival (see my book The Drama of the Gifted Child). When anger of early childhood and the ensuing grief have been experienced, affirmative feelings, which are not based on denial or feelings of duty or guilt, can emerge of their own accord, assuming the right preconditions are present. These affirmative, more mature feelings must be clearly distinguished from the small child's unconditional, dependent, all-forgiving, and therefore tragic love for his or her parents.

© Maja Farrell

Psychotherapy Abuse: When Is It The Client's Fault?

by Maja Farrell

After having read the PSYOP Transference Love and Harm by Dawn Devereux, published in the Sep 2016 BACP magazine Therapy Today, I felt the need to respond and address the many subtle yet dangerous suggestions dropped by Ms Devereux, in agreement with the Clinic of Boundary Studies.

PSYOP
Psychological operations (PSYOP) are planned operations to convey selected information and indicators to audiences to influence their emotions, motives, and objective reasoning, and ultimately the behaviour of governments, organizations, groups, and individuals.

AIT
Adverse Idealising Transference

Adverse = adjective: adverse, preventing success or development; harmful; unfavourable.

It is the Client's Fault!

No rape victim is ever at fault of being raped, neither is a client ever at fault of being abused or taken advantage of by a health professional. Yet the Clinic of Boundary Studies (CfBS) and perhaps the BACP too, would like us to believe differently. In the eyes of the CfBS a client is not only predisposed to developing a state of mind that creates and encourages abuse by the therapist but the therapist's behaviour is not even abuse, in most cases, it is either love that the client cannot tolerate "If the client is predisposed to developing AIT, they are likely to find it difficult to tolerate the constraints of a time-limited love relationship."
or an development of "intense, delusional ideas about the therapist’s actions in the therapy [...] just as a successful therapeutic alliance is forming..."


Let us start at the very first paragraph  which was clearly written to set the stage of an actively searching, dare I say aggressive patient who is ruthlessly trying to still his already existing, not-in-reality-grounded-longings which are brought to life by a rather passive therapist whose only mistake it is that he is either loving or successful in creating a therapeutic setting (see above).

Are we encouraged to believe that any abuse at the hands of a therapist is really the client's fault due to his unfavourable transference which is a "potentially harmful side effect" that can rear its ugly head if he is predisposed to AIT.

Within this adverse idealising transference "side -effect" the abuse of the client is not seen for what it is - an acting out from the unethical and often narcissistic therapist - but excused as a reaction from a therapist who has been enticed by a client's wish to cause harm and prevent success.

 

The Therapeutic Relationship is an Illusion!

If there should be any hope left in the client for the governing body to take his complaint seriously - based on the theory that it takes two to tango meaning anything within the room is co-created by therapist and client - Devereux makes sure she bursts this therapy myth explaining "that there is a type of AIT that develops independent of the therapist, and quickly becomes very negative. This is known variously as malign, malignant, regressive or psychotic transference," (see 1)

The client stands no chance, even if he decides to state in a complaint that his behaviour was a result of the therapist's abuse, with help of the CfBS' explanation of an unfavourable and malignant transference reaction the well-meaning, loving therapist has now proof that the client is mentally ill and a dangerous fantasist.

The defense of abusive therapists continues by emphasizing that clients' realities are really just based on feelings and beliefs that are not grounded in the present therefore are clearly affecting the person’s judgement and are definitely not connected to the therapist.
The client is not just someone who creates an unfavorable and harmful transference but he is also mad.

Transference is Masking the Real Problem!

To confuse the client, as well as the therapist even more, Devereux suggests that this transference is actually "masking the problems that brought the person into therapy and so masquerades as a cure."

Yes, away with the pillar on which psycho-analyis rests, transference is no longer the way into a person's internal world but it is indeed a hindrance - only if the therapist feels out of his depth, of course.
On a more serious note, how can transference, no matter how "unfavorable", be masking problems when it yet has to be explored what the unconscious problems of the client are. Sure, the client might have entered therapy because of bereavement but how do we know this loss is not triggering other painful, repressed feelings that were split off?
We do not know! Hence everything about a client's transference is a gift, which, unafraid of her own pain, the therapist can use to get closer to the pain of the client.

Indeed it is true that many clients "spend thousands of pounds on therapy, only to discover that their presenting problems have not been addressed" but this is not due to the transference but rather the therapist's inability to address the transference appropriately so the client can become aware of and understand any resistance to moving forward.

  Your Characteristics may let You fall Victim to a Client!

"From our discussions with clients seeking our help, we have noted particular therapist characteristics that appear to be associated with AIT"

Not associate with abusive tendencies, no! Accosiciated with AIT!

Although the author finally begins to mention the therapist, his abuse only happens in conjunction with the client's Adverse Idealising Transference, an unfavourable, harmful and success preventing state of mind.

The Psychopaths
Not surprising then that Devereux puts therapists' characteristics on a continuum that highlights different therapeutic pit falls associated with someone afflicted with AIT; Oh, except of course, for the psychopath, who by default is a planning and conniving manipulator,the only one whose actions really count as abuse - unless the client can't proof he is not suffering from AIT, naturally.

The Lover
But not to worry, those psychopaths can't be many and we would surely recognise them; in any event, they can't possibly be white, middle class, older ladies who offer a "love relationship" and who only overstep boundaries because the client demands it.

"Some therapists in this category do not set out to oˆffer love but respond to the client’s demand that they prove that they care and find themselves breaching boundaries if the client’s demands then escalate and cannot be satisfied."

The Weak One
This therapist cannot resist the harmful lure of the client and just has to take advantage of him/her.
"Then there are the opportunist therapists, who may not set out to exploit the transference but cannot resist doing so when it emerges."

To give us a good picture of the therapist's helplessness when working with such a predisposed-to-madness person the author uses the example of a client holding a piece of glass to her own throat because she had seen another client leave the office. Devereux works hard to show such clients in a light of absolute irrational, dangerous and nonsensical behaviour that exists in a vacuum and has no connection to the therapist's previous behaviour.

The Perfect One
And then we have the therapist who does everything right and because he does everything right, his client becomes delusional and hands in a complaint.

"Therapists who act appropriately but find that the client is predisposed to developing a regressive transference. This is likely to become apparent just when the therapist feels the therapy is going well, and it frequently involves delusional ideas about the therapist’s actions and intentions. It may be impossible for the therapist to resolve the situation because the client’s beliefs are so tenacious. Therapists in this group may find themselves the subject of a complaint, because the client truly believes they have acted inappropriately."

I wonder if all complaints dismissed by counselling organisations rest on this terribly grandiose statement and narcissistic illusion.

Love, Nurture and Nature creates a Mad and Bad Client!

"Clearly there will also be factors that contribute to AIT but are outside the therapist’s control."

Devereux's article so far has been about convincing the reader that the helpless therapist is in a no win situation when working with someone predisposed to AIT; everything seems to be outside of the therapist's control. So rather than finally exploring the therapist's role in this unconscious dynamic called AIT, the author lists even more reasons why therapy abuse is definitely down to the client.

Again, the client suffers from an unfavourable and success preventing transference, which demands the therapist to act out of love. Yet even such ethically sound behaviour by the therapist can contribute to the client becoming more harmful and psychotic. Here is the list of triggers that can contribute to the client being taken advantage of, mistreated, rejected, abandoned or abused:


•    client’s early developmental experience
•    genetic makeup
•    neurobiology of the brain
•    the therapeutic setting: low lighting, a calm comfortable room, prolonged eye contact
•    finding themselves the focus of another’s intense interest may be a unique experience for the client and may be unconsciously associated with a promise of love and nurture.


As it stands, not only is a potential therapy breakdown and abuse woven into the client's innate being but he is also told that therapy cannot help him. Yes, he is indeed so damaged that everything normal like low lighting, a calm comfortable room, prolonged eye contact, finding himself the focus of another’s interest - yes even love - turns him into a harmful, dangerous, psychotic, malignant beast.

We are lead to believe that love will cause hurt to such a client and ultimately end in tragic destruction of everyone around him. I wonder what would reduce the risk of this destruction; perhaps we as therapists need to become colder, more aloof and indifferent before we finally decide to get rid of the client?

Reduce the Risk of AIT  - Reduce the Risk of Abuse

The author continues to ask "what can reduce the risk of AIT" therefore still trying to convince the reader that reducing AIT will reduce the possibility of being mistreated or abused by the therapist. What is missing of course is the question "What could reduce the risk of a needful client being abused by a therapist"

Further reading shows what is really meant by a "reduction of risk of AIT'.
If the therapist finds, in her assessment of the client, that he has a history of feeling strongly about other people, especially health professionals it may suggest he is not really wanting to heal but is really just "primarily seeking care,  not insight into his problems" which in turn means he "holds unrealistic views about what therapy can provide" which brings us back to the client not being anchored in reality.

Perhaps an article about "How to be a good therapy candidate" would be more appropriate, so clients can mold themselves to the needs of the therapist before "therapy" even starts.


Right near the end the author mentions that "the risk of AIT can also be reduced by responding appropriately when clients bring up transference concerns, as AIT is much more likely to occur if the first indications are ignored."

Acknowledging the abused client's blamelessness by mentioning an appropriate response by the therapist is only a smoke screen for the underlying message that this can only reduce the risk of the client becoming unfavourable, harmful, malignant and dangerous.

What is missing yet again is the acknowledgement of the risk of potential abuse by a therapist who is confronted with a regressed client who has become needful and frightened in the transference.

Not all is lost though! What follows next is a list, written by Devereux and approved by the CfBS, of therapist behaviours that can keep the therapist save and therefore reduce the risk of the client's AIT breaking out!

(Just a reminder, those points about to follow are actually boundaries that are part of the therapeutic and ethical framework; boundaries the therapist should practice at all times, not just with clients prone to become mad and bad.

How to reduce the risk of AIT

1.    Inform clients
2.    Carry out regular reviews
3.    Maintain consistent professional boundaries 
4.    refrain from personal disclosures
5.    Refrain from making the client feel special.
6.    Be clear that the relationship can only ever be professional.
7.    discuss with client in order to work out the best way forward
8.    Take it to supervision
9.    seek external consultation
10.   Take responsibility for any actions
11.   Refrain from acting defensively by blame, rejection and sudden rigid boundaries, or terminating the therapy without the agreed notice period. 

What really is Transference?

Now that I have dissected and untangled the information within this PSYOP, let us examine what transference really is.

Projection
Although the author rightly points out that transference feelings are rooted within (past) relationships to significant others, transference is not a projection as Ms Devereux would like us to believe in her example:

'When a client falls in love with a therapist it is likely to be ‘transference’: the predisposition we all have to transfer onto people in the present experiences and related emotions and unmet longings associated with people from  our past. In the initial stages of therapy, such transferences are usually idealising, because clients tend to project onto  their therapists the qualities they  longed for from their early carers,  and so experience them in a particularly positive way."

This is really an example of splitting and projection in which a (very young/early) part of the client splits the needed person (therapist/mother) into good and bad.  That way he can experience the therapist/mother as good and doesn't have to become overwhelmed and psychologically stunted by any anxiety that could be evoked by this significant person's "badness" (which is incapable of meeting the baby's needs.)

So, if the client did experience unmet needs in childhood, as suggested by the author, the feelings would not have been positive even though they may have presented as positive to the conscious mind but unconsciously the baby would have experienced anxiety created by the split off and suppressed anxiety of having to trust a caregiver who was potentially dangerous to the baby's psychic or physical life.


Transference
In the transference the same process will be repeated:
Unable to deal with anxiety towards the needed therapist, the client splits this internalised relationship into good and bad. He may now project either goodness or badness onto/into the therapist.
If goodness is projected on the therapist, the badness will remain elsewhere.

What we may see as therapists is a client who seems to idealise us, what is not visible, however, is the split of, unbearable pain.

Hence this "adverse, idealising" behaviour is therefore not based on the client's wanting to have a mother/father/therapist who takes care of him but it is based on his need for safety triggered by the unconscious, transferred fear, an anxiety of the therapist being exactly like the significant other from the past - rejecting, abandoning or abusive. And that is the transference.


Hopefully,  seeing transference in this way enables therapists to become aware and hold on to the client's pain (the reason for coming to counselling in the first place!) and keep him in mind as a vulnerable person rather than a manipulating, fearless pursuer who is not only out to prevent a successful therapy but also to cause harm.
Portraying him in such a light and calling this state of anxiety a "honeymoon period", not only fails to acknowledge the enormous amount of fear and terror underneath the client's idealisation but hints that:

a.this is a phase that will naturally come to an end
b. the therapist cannot and does not in any way cause or influence it.

both assumptions are of course wrong and play a huge part in therapy abuse and breakdown.


Transference is not a phase that miraculously appears and then fades away
Yes, we all transfer feelings from the past onto present relationships, but not chaotically and without reason.
For a transference to find a receptor, the therapist must possess a hook, a trigger. This may be the therapist's voice which reminds the client of his father, or a giving and taking away of privileges (such as contact between sessions) which may remind him of his intrusive yet equally withholding mother.
Both examples may trigger feelings from the past which create a lens through which the therapist will be carefully watched.

It is this hook, this trigger that we therapists look for and need to explore with the client. As painful as transference can be for both parties, it is also a gift of the client's unconscious that invites and allows us entry into his internal world.

When Therapists are Unable to Work with Transferential Feelings

Transference will always exist between therapist and client and if it is not made conscious and understood it will have no other choice but hide and lay dormant behind strengthened psychological defenses; because just as the child had to adapt to a parent who was unable to contain his anxieties, so does the client now adapt to an in-the-transference-perceived-as-uncontaining therapist. If we were to look at the client now through the lens of AIT, we would make his biggest fear (and projection) come true - that his feelings are dangerous, harmful and too frightening to be hel[pe]d. We would identify with his projections and ultimately act them out by either abusing or rejecting him.

The client would have no other choice but to either leave and take with him his own as well as the therapist's anxiety or stay and become compliant/idealising; a process Alice Miller highlights in Thou Shalt not be Aware: Society's Betrayal of the Child:

Formulations such as "negative therapeutic reaction" or "resentful patients" remind me of the "wicked" (because "willful") child of "poisonous pedagogy," according to which children are always guilty if their parents don't understand them. Yet patients are just as little to blame for our lack of understanding as children for the blows administered by their parents. We owe this incomprehension to our professional training, which can be just as misleading as those "tried and true" principles of our upbringing we have taken over from our parents. [...]

As a result of "poisonous pedagogy" they [clients] are so accustomed to not being understood and frequently even blamed for their fate that they are unable to detect the same situation when it occurs in analysis and will adapt themselves to their new mentor. They will leave analysis having substituted one superego for another.

The Client Needs to Become the Abuser

There is a huge amount of anxiety behind the therapist's need to reject or abuse the client. This anxiety is clearly reflected in the author's need to dismiss the client's transference feelings as either a honeymoon period or AIT - both extremes that are not favourable and need to "fade away".

To deal with her anxiety, Devereux minimises such painful realities to a "small number" of people.

"However, for a small but significant number of people, the experience is very different: the idealisation intensifies rather than fades, and the client becomes increasingly consumed with and dependent on thoughts about the therapist."

The therapist becomes the victim while the client has now shifted from a love-struck, harmless because idealising client to a suddenly frightening client "consumed with and dependant on thoughts about the therapist". A client who has now become "adverse" because this independent thing in him, that has no connection to the therapeutic relationship whatsoever, is making it difficult for him to act autonomously. Worse even, this mental defect is now making him dangerous and harmful to his family as he has also lost the ability to think rationally! The client has now turned into an unpredictable abuser!


Is that what CfBS, BACP and other organisations see when such a labelled client hands in his complaint?

"Several hundred people contact the CfBS each year, and a substantial number report lasting harm as a result of AIT. The phenomenon is often discussed within the discourse on erotic transference."

"This accords with the experience of people who contact the CfBS, who usually describe experiences of inadequate parenting, rather than overt abuse."

The author has changed yet again something that started to acknowledge the abuse of the client to something that really is quite dismissive by interpreting it as an "experience of inadequate parenting rather than overt abuse".

Perhaps we should ask ourselves whether clients who feel they have been abused by their therapist (and/or who want to make a complaint) really go through their childhood history with the CfBS and if so, who are these people within the CfBS who "have worked successfully with clients who have a history of dependent/ idealised relationships" ?
Are these the same people who judge whether a client's experience was indeed abuse or just a delusional acting out?
If so, how are these people connected to individual counselling governing bodies that review complaints.

Conclusion

No, hundreds of people are not harmed as a result of AIT; hundreds of people are harmed because a therapist abused his/her power and did not uphold his/her ethical boundaries. The abuse or mistreatment may have been a response to the client's projections or behaviour but it was acted out by the therapist.
The client was not abused because he suffered from an 'adverse transference' but because the therapist was unable to deal with her counter-transference appropriately.

Perhaps it would have been more helpful and hopeful for Devereux to explore the therapist's perception and underlying fear of being harmed rather than spending all this time, energy and magazine space trying to formulate a text to convince clients and the public that there should be doubt about who is at fault in a psychotherapy abuse case.


Yet fault is very rarely appointed to the therapist (compare number of therapists called to a hearing to "the several hundred people contacting the CfBS each year"), especially psychoanalytic therapists have many theories that provide cover from possible awareness of client abuse. This ignorance can cause deep trauma to the abused client, especially when governing organisations refuse to take his complaint serious. 
Thanks to this article we now know why many, many complaints don't even make it to a hearing -
because the client is at fault! He has created his maltreatment with his transference!  


Please stop writing articles about why therapy abuse is the fault of the client and instead offer us therapists and trainees more possibilities to examine our need, desire and longing to abuse, reject and abandon certain clients. This profession needs a non judgmental and truly private setting that is not permeated by the incestuous and intrusive world of (psychoanalytic) counselling and training in the UK.

1
"Although the literature greatly underplays the role of the therapist in AIT, it is important to state that there is a type of AIT that develops independent of the therapist, and quickly becomes very negative. This is known variously as malign, malignant, regressive or psychotic transference,"

The reader expects to read
Although the literature greatly underplays the role of the therapist in
AIT, it is important to state that therapists do play a role in it

Instead we read

Although the literature greatly underplays the role of the therapist in
AIT, it is important to state that therapists do not play a role in it.

                                                                               
                                                                         © Maja Farrell