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Page Contents: How a psychotherapist obstructed treatment for BPD.                    


I have been receiving help within the mental health system for much of my life in [location deleted for confidentiality]. I have been diagnosed as having Borderline Personality Disorder. I have anxiety that grips me . . . despite a lifetime of looking for spiritual or other answers to my mental an emotional suffering. I had a psychotherapist for 15 years; he [recently] retired . . . . He was very cruel in the last year, I don’t understand why; he said things such as “You will probably take your serious condition to the grave,” “You should have made more progress in 15 years,” “There are patients worse than you.” Why he said these things I am not clear even now....All this has left me unable to integrate or move on. Feel very hurt, angry, stuck. . . . And my pain from therapist relationship ending (though I may have contact in future after 6 month+ break, he has said—though I have to admit I did badger him about contact....) and being so hurtful/cruel....leaves me feeling I need closure, a talk with him NOW, but I have to wait he says. . . .

I didn’t realise how much I was actually “in love” with him until most recently (last session was August 27th) and it seems he flirted with me for most of 15 years with a cup of tea ready at the outset of each session—no other patient had that....he said I was “special”...and seems like he never really cared about me and it seems I have fallen in love with him. Yet he seems to have just dumped me at the end of the therapy. At least he ignored in the last year all the e-mails I sent (we had e-mail contact between sessions) all the excruciating pain of in the erotic transference. . . . I could not when I was in the therapy room with him, express anger at him or get him to help me deal with all the feelings, and suffered mostly the anger and pain between sessions in the last year, and cannot now work it through because he no longer does psychotherapy. . . .

I feel so let down by the mental health system. . . . it feels it was sado-masochistic. . . . and he often said he felt that sado-masochism would be an approach I should look towards. I wonder now about his own intentions towards me as it has felt like this is what he has been doing to me, and I have not enjoyed it at all. . . . and I feel so damaged by him. How can this be? I paid so much money, and I can barely survive on my benefits? And even struggle to survive? . . . he kept talking about Nietzsche and how everything moves towards disintegration and therefore self-destruction is not a bad thing, but when I said I felt suicidal because of the way he was speaking to me he said that would make him angry. . . . He talked a fair bit about his atheism, and this itself has disturbed me, and been unhelpful. He has criticised my spiritual . . . inclinations….but more to the point, any spiritual understanding of life—which has always been very important to me.

He said lots of hurtful things to me like “You would have been better dealt with by the criminal justice system.” When I said how hurt this phrase (and others I mentioned earlier) made me feel and how destructive his approach was being (in the last year), he just didn’t deal with it, or help me deal with my feelings; my emails expressing hurt and pain and anger about his attitude, he just ignored 90% of the time. And in sessions I was so besotted with him and felt so happy to be there in his room, I found it hard to challenge him or express anger. When I did on the phone for example, he was just angry and nasty back.

Yet I was clearly suffering so much and so distressed. I think, now, we had “just a cup of a tea and a chat” and no “real therapy” for 15 years—it seemed like more of a “real” relationship, and yet when I asked for contact after termination he said it has all been “just illusion”. I trusted he knew what he was doing. I believe now he realised I was actually in love with him, but he seems clueless about the impact he has had on me. . . . I really don’t know what to do—have had suicidal thoughts for some time about this matter regarding my psychotherapist.....and trying to find a way out of this mess. I don’t believe people in the mental health system here . . . have much insight or care for those they are paid to help. . . . I cannot decide what to do, just know I am not coping well, and have been ill, mentally, emotionally and physically because of this situation. He would blame me, angrily, and say I am doing it to myself. (I see the point of this judgment to some extent, but still, surely I have been in therapy to deal with this problem?) 15 years is a long time to have wasted and that is how it feels. I don’t feel he has helped me, and I feel so angry, and often feel like I cannot go on. Can you suggest how I might get help with this and go forward in a life that was already very, very difficult before I started seeing him 15 years ago, and now feels intolerable?

As I say on the web page about Borderline Personality Disorder (BPD), the core of the BPD dynamic is unresolved rage from the emotional traumas of childhood. Accordingly, the psychotherapeutic treatment for BPD involves a psychological resolution of rage. This resolution is accomplished by bringing to conscious expression the emotions underlying the rage; in essence, this process discovers the unconscious meaning of the rage itself and thereby contains the raw experiences. It’s a bit like taming a wild animal.

Now, in the psychotherapeutic process, it is inevitable that the client’s anger will be brought out into the open from time to time. The psychologist, therefore, has the task of tolerating the client’s anger without reacting to it with the natural response of revenge. The psychologist must always seek the meaning of the client’s behavior—and bring that meaning out into the open so that the client can recognize it and learn from it. There is no room in this for retaliation.

In this regard, the psychotherapeutic process can be obstructed by two things.


The psychologist could attempt to appease the client. This usually happens because the psychologist has an unconscious fear of the client and wants to escape an emotionally difficult experience. In clinical practice this appeasement manifests in the psychologist violating professional boundaries so as to make the client feel special.



The psychologist could react to the client’s anger with his or her own anger. This reaction contains an unconscious—or, sadly, even a conscious—desire to harm the client. Quite often this reaction takes the form of saying something that demeans or belittles the client, and it’s all based in an abuse of power that allows the psychologist to recover from a feeling of helplessness when confronted with an angry client.


With this introduction, we can understand how your experience with your psychotherapist went wrong. His making tea for you at the beginning of sessions was an appeasement. The proof of this is in his own words: you were “special.” And the cruel things he said to you throughout the treatment, in addition to his ignoring your e-mails and “dumping” you, illustrate his desire to harm you in retaliation for your anger.

These psychotherapeutic mistakes had clear consequences for you.

First, they gave you hope that, in being special, you might not lose his approval.


Second, they pushed you into thoughts that, through a sado-masochistic relationship, you might win his approval.


In the end, then, you didn’t really fall in love with him, you became enamored of the hope that you might, through your own efforts, overcome his anger at you. This isn’t being uplifted to the level of love, it’s being reduced to the level of your own childhood trauma.

By that last statement I mean that, because of his own unrecognized counter-transference issues, your psychotherapist did not provide psychotherapy to you; instead, he merely recreated the original trauma of your childhood: a parent who both abused you and appeased you but failed to understand your true emotional needs.

Now, as you yourself have remarked, the prospects of your finding help in the mental health system are bleak. Nevertheless, even though you lack the funds to pay for competent private care, you still have one option. You could use your desire for spiritual healing to lead you into a discovery of true love. Through personal study and meditation you could find that place where, rather than constantly feeling frustrated by the failures of the world around you, and trying impossibly to satisfy your need for approval from others, you can learn to acknowledge openly your emotional hurt. Then, rather than react with rage and retaliation, you might give to others your expression of profound emotional qualities such as patience, forbearance, compassion, understanding, and forgiveness. In this way, you will find what you have been seeking all your life: real love.


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