Is there substantial evidence that psychotherapists sometimes harm, as well as benefit, their clients? I think that there definitely is and that this has been fairly well demonstrated.[[13]]
[[13]] Albert Ellis, "Must Most Psychotherapists Remain as Incompetent as They Now Are?," in J. Hariman, ed., Does Psychotherapy Really Help People?, p. 240.
Even love can harm, and psychotherapy is no exception. Ellis identifies some of the main ways psychotherapists can make clients worse:[[14]]
[[14]] Ibid., pp. 24-36.
* Therapists may encourage clients to be dependent on them. Directly or indirectly a therapist can convey to a client, "You cannot get along without me," "You will probably need to spend at least two more years in therapy," etc.
* Therapists may overemphasize the significance of the client's past experience to the point that they persuade the client to feel unjustifiably weighed down and controlled by past events and circumstances.
* Therapists may become so hooked on the importance of modeling positive personal qualities (warmth, positive regard, congruence, empathy) for a client that they will not provide any active-directive leadership during a time when the client is floundering and needs strong recommendations.
* Therapists may place too much importance on the role of insight. The search for insight can be never-ending. It is useful only to some clients; for others, insight is irrelevant to helping them change.
* Many therapists feel that therapy gives clients a chance to vent their feelings. But catharsis by itself is not enough to replace destructive patterns of behavior and thinking with constructive ones.
* Therapists may rely excessively on distracting the client from issues that trouble him; e.g., relaxation training, meditation, or therapeutic exercise can help clients break out of a cycle of self-preoccupation. Self-absorption perpetuates emotional suffering; distractions can therefore be invaluable. But if a client's underlying self-defeating attitudes are not confronted, distraction alone will not be enough to bring about lasting change.