Can Therapy Be Harmful? About Retraumatization and Pseudotherapy
- Trainer Misfit
- Jun 29
- 4 min read
For decades, psychotherapy has been regarded as one of the most effective methods for treating mental disorders, supporting emotional health, and facilitating personal growth. Numerous clinical studies and meta-analyses confirm its effectiveness in reducing symptoms of depression, anxiety, PTSD, and personality disorders (Lambert, 2013). However, behind these successes lies a topic rarely addressed openly - situations in which psychotherapy not only fails to help but actually causes harm.
The concept of psychotherapeutic harm includes both side effects of therapy and more severe phenomena such as retraumatization, deterioration of mental health, dependency on the therapist, or mistakes resulting from unethical or incompetent therapeutic practices. In this article, we will explore this issue from the perspective of clinical psychology, psychiatry, and psychotherapy effectiveness research.
Therapy Is Not Always Safe - Where Does the Problem Lie?
In public perception, therapy is seen as a synonym for safety and professional support. For example, a study by Munder et al. (2019), based on a re-analysis of a meta-analysis by Cuijpers and colleagues (2018), confirms the high effectiveness of psychotherapy in treating depression in adults. However, data from studies indicate that some patients may experience a deterioration in their mental health during or after the completion of psychotherapy.
This problem may stem from several causes:
Inappropriately chosen therapeutic method
Lack of therapist competence
Opening traumatic topics too quickly
Boundary violations in the therapeutic relationship
Pseudotherapies and alternative psychological practices
Retraumatization in Psychotherapy
One of the most serious risks is retraumatization - the re-experiencing of trauma as a result of improperly conducted therapy. This occurs when a therapist introduces painful past experiences too quickly or clumsily, without providing a safe, controlled environment and adequate emotional regulation tools (Van der Kolk, 2015).
Not every exploration of difficult topics is harmful - on the contrary, it is a necessary element of well-conducted therapy. The problem arises when:
The client is emotionally unprepared.
The therapist fails to notice signs of emotional overload.
There are no strategies for post-session stabilization.
Techniques triggering dissociation are introduced without prior explanation and discussion.
Research on trauma therapy effectiveness clearly shows that a safe pace of work and building self-regulation skills beforehand significantly reduce the risk of retraumatization (Briere & Scott, 2014).
Pseudotherapy - When Help Turns Dangerous
A separate but equally serious issue involves pseudotherapies - methods lacking scientific validation, often conducted by unqualified individuals. In Europe and the U.S., practices such as regression therapy, Hellinger family constellations, or so-called spiritual therapies have gained popularity.
While some individuals report feeling better after such interventions, case studies and research analyses indicate significant risks:
Inducing false memories (Loftus, 1997)
Emotional dependency on the “therapist”
Intensification of anxiety and dissociative symptoms
Diverting clients from professional psychiatric or psychotherapeutic help
Equally dangerous are situations where alternative methods attempt to replace pharmacological treatment for severe mental disorders such as schizophrenia or major depression.
Psychotherapy Side Effects - What Research Reveals
In 2017, Rozental’s team conducted a meta-analysis of 70 studies on the negative effects of psychotherapy. They found the most frequent adverse outcomes included:
Increased anxiety and depression
Heightened self-criticism
Deterioration in interpersonal relationships
Loss of hope for improvement
These effects most commonly affected individuals with trauma histories or personality disorders, for whom poorly conducted therapy could have destabilizing consequences.
Dysfunctional Therapeutic Relationships
A safe, ethical relationship between therapist and client is the foundation of effective psychotherapy. Unfortunately, this is not always the case. Risks include:
Emotional abuse - when the therapist assumes an absolute authority role, disregarding the client’s feelings and needs.
Boundary violations - for example, introducing personal elements into the relationship.
Creating client dependency on therapy - when the therapist discourages autonomy, causing the client to function solely through therapy for years.
Such situations not only fail to help but can lead to secondary trauma and reinforce unhealthy relational patterns (Gelso & Hayes, 2007).
How to Minimize the Risk of Retraumatization and Therapeutic Harm?
From a contemporary clinical psychology perspective, it is crucial to:
Educate clients about their rights and ethical standards in therapy
Certify and professionally supervise therapists
Identify early signs of emotional overload
Adjust the pace and scope of work to the client’s capacity
Ensure regular supervision of therapeutic work
For trauma survivors, implementing stabilization procedures before addressing painful memories is an essential safety measure (Herman, 1992).
Conclusion
Psychotherapy remains an effective and valuable tool in treating mental health conditions and supporting personal development, but like any intervention affecting the psyche, it carries potential risks. The issues of retraumatization, unethical therapeutic relationships, and pseudotherapy demand greater public awareness, professional accountability, and client education.
Not every psychotherapy is safe. It is essential to view it not as a universal remedy, but as a professional, evidence-based method requiring qualification, ethics, and careful reflection on its risks.
References:
Briere, J., & Scott, C. (2014). Principles of Trauma Therapy: A Guide to Symptoms, Evaluation, and Treatment. SAGE.
Gelso, C. J., & Hayes, J. A. (2007). Countertransference and the Therapist's Inner Experience: Perils and Possibilities. Routledge.
Herman, J. L. (1992). Trauma and Recovery. Basic Books.
Lambert, M. J. (2013). Bergin and Garfield's Handbook of Psychotherapy and Behavior Change. Wiley.
Loftus, E. F. (1997). Creating false memories. Scientific American, 277(3), 70-75.
Rozental, A., et al. (2017). Negative effects of psychological treatments: A meta-analysis of randomized controlled trials. Clinical Psychology Review, 57, 33-44.
Van der Kolk, B. (2015). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking.
