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Abuse
 My Experience of Group Psychotherapy
by Terry Johnsen
How do we respond to stories of therapist abuse? Do we defend ourselves? Or can we listen beyond the words to the feelings being related? This account by Terry Johnsen may challenge both our consciences and our illusions.
I am a man 42 years of age, have been married for 13 years, and do not have children. I am university educated and have worked in my profession for 20 years. Since adolescence I have had several bouts of depression. These have been either ignored or treated by short periods of counselling and medication. However, several years ago after a viral illness I began to experience severe anxiety and depression. I realised that my poor sense of self worth had contributed to my being easily stressed and susceptible to illness. I needed to improve my mental health to regain my physical health. After some enquiries I obtained the name of a `reputable' psychiatrist. I met Dr X in February 1997.
Individual Psychotherapy
I had only ever seen one psychiatrist before Dr X, and his interaction with me was only to ascertain my symptoms and prescribe drug therapy. Dr X was different. She did not actually prescribe drugs (I had to see another psychiatrist for this), but her therapy was more intense. I saw her weekly for a one hour session. She was most interested in my family, and she drew parallels between these interactions and how I was currently viewing the world. Because I was depressed and found life and work very difficult, it was a great relief to be able to tell someone about my pain and insecurity. Talking about my family was difficult and emotionally draining but it was a relief that someone wanted to know. I was full of hope that she would be able to help me.
Toward the end of the fourth session Dr X pointed to a couch in the room that, although positioned alongside a wall with a window, faced the wall. She said that it would be best if I sat on it during our sessions and she instructed me to do so automatically at the start of the next session. In subsequent sessions she assumed a position behind my left ear where I could not see her. At the end of each session she avoided eye contact with me and promptly showed me the door. Psychotherapy proper had begun.
After about four months Dr X suggested I do some group work in addition to the individual therapy. This would involve her working with a male colleague, Mr Y; they would both facilitate the group. I agreed to this as it seemed like an advancement to the next level towards being `cured'. I asked Dr X how long I would need to attend therapy and she told me at least twelve months, but possibly forever. I expressed amazement at this statement and she quickly back-pedalled, explaining that some people find that they sink back into depression if they stop attending, and she quickly explained this may not necessarily apply to me. Soon I was assessed by Mr Y and was deemed suitable for group therapy. In July 1997, after about twenty individual sessions, I commenced group therapy. My weekly individual psychotherapy sessions with Dr X were, at her request, continued. Overall, my experience of psychotherapy up to this time was positive; it helped me to gain greater awareness of myself and to change some of my thinking. In retrospect, this would have been an ideal time to terminate.
Group Psychotherapy
The group met twice weekly from 7.30am to 8.45am. Both therapists attended the sessions. There was no set agenda for discussion. Group members tended to speak about their daily activities, life experiences, or whatever they wished. When time was up the discussion ended and everyone left promptly. There was never any summing up or reflection on issues raised prior to the end of a group session, and rarely were topics carried over to future sessions.
Initially there were four other group members in addition to myself: one man and three women. All were around mid-life age and were tertiary educated. One woman left the group after about a month, saying that she found group therapy depressing and it made her unhappy. The other male left about six months later after saying that he felt left out, unsupported and that he was very angry with the therapists. Another woman then joined the group, and two months later another woman left the group unannounced. She had said that she was very fearful of men, and when she left she was in conflict with Mr Y. This left three of us - two women and myself.
Empathy?
The first man to leave said that he felt disadvantaged in the group as he had a different individual therapist to other group members, and that he found it difficult to attend so early in the morning and in the heat of summer. I and the other clients told him we wanted him to stay, and whilst we accepted his reasons and difficulties, we wanted him to realise that we all had issues and difficulties with group attendance. I told him that I valued his company as the only other male client in the group, but I respected his decision to go, if indeed he felt he must.
Dr X however concentrated on this man's anger, drawing it out and highlighting how it was exclusively towards the therapists. She suggested he wanted to leave for other reasons, but did not suggest what these might be. Mr Y commented on how sensitive he thought the man was, and how trivial his stated reasons were. This made the man even angrier, and he left after that session.
About two months later, a woman left the group unannounced; she just never returned and no explanation was provided to the remaining group members by Dr X or Mr Y. This woman said she had problems relating with men, and she had often been in conflict with Mr Y over her irregular attendance. Mr Y occasionally took the group by himself, usually during Dr X's holidays or other professional commitments. When this happened the woman stayed away, and hence Mr Y missed out on a full fee. When she again attended the group in Dr X's presence, Mr Y would confront her about the reason(s) for her absence, expressing displeasure and disbelief at whatever reason she gave.
Direct payment to Mr Y for group therapy also caused problems between him and another woman. She was a sole parent and she was financially stretched. Payment to Mr Y was not subsidised by Medicare. On several occasions Mr Y raised, within the group setting, that she was behind on her payments. He became visibly irritated about this. On one occasion when a group member commented that he obviously did not do this work for love, he replied with a raised voice `You are bloody well right I don't!'
This same woman was rebuked by Mr Y on a regular basis. When she spoke about feeling cheated by her alcoholic ex-husband, who had been very abusive toward her but since re-marrying was being very generous with his time and money with his new wife, Mr Y presented the husband's side, saying `this new woman was this man's wife' and `he (the husband) had a right to spend his money with her how he pleased'. This woman's problems over child sharing arrangements caused ongoing stress for her, but Mr Y never seemed to be supportive, comforting or helpful for her.
I had been attending a relaxation course at a TAFE college one night per week. One evening, as I entered the college carpark I had a minor altercation with a pedestrian that left me quite shaken. I told the class and the teacher what had happened and received many understanding and supportive comments. When, at group therapy the following day, I mentioned this experience, Mr Y immediately challenged me, shaking his head and saying in what seemed to me to be an aggressive manner, `Sensitive aren't you Terry. Really don't like a surprise do you'.
I subsequently had a (very) minor traffic accident with a truckie who apologised without reservation for being careless. The event came to nothing but when I told this story to the group it was Dr X's turn to do the head shaking. She said `Terry, you should have been very angry with that truck driver. You let him off the hook too easily. I think you do that far too much'. Mr Y concurred and posed the question that perhaps I was afraid of conflict, afraid of just how angry I might become.
Unusual Therapeutic Practice
When the first man left, Dr X had said within the group that she thought it was for reasons other than what he stated. I knew what she meant - she had commented during my individual therapy that she thought this man had difficulties regarding his sexuality and was afraid this was going to be raised in group. Dr X actually had said to me `Why don't you ask him about his sex life?' I did not comply with this request.
On another occasion during individual therapy Dr X said to me something like `you can't go on being nice to them (i.e. the group members) all the time you know, tell them what you really think'. So, during the next group session, I told a group member what I thought of them. They became angry and upset. Neither therapist made any attempt to help or console the group member who bore the brunt of my criticism, nor did they take the opportunity to initiate any group discussion from my actions. I felt very poorly about what I had done, but during my next individual therapy session Dr X said to me `Now, I don't want to get into an argument about what you said in the group' and the matter was not discussed further.
Mr Y regularly expressed his view within the group that I had trouble letting go of issues. Whenever he thought I demonstrated this he would call me `Terry-the-Terrier'. He first coined this nick name when he said `tenacious aren't you Terry; Terry-the-Terrier, that suits you.' I had not been called by a nick name since high school; such names are usually used to denigrate people. Surely the use of uncomplimentary nick names as a therapeutic tool with clients who have low self esteem and who feel unaccepted by people, must be questionable. Mr Y's use of this nick name further widened the gap between the group members and the therapists because we had been instructed to always call them `Dr X' and `Mr Y', but they always called us by our first names.
The Psychoanalytic Model
To believe that peoples' behaviour is totally influenced by their subconscious drives, as these psychoanalytic purists did, is the sporting equivalent of playing the man not the ball. Dr X and Mr Y held the view that nothing the client experiences and processes with the conscious mind, is in fact the true reason for their behaviour; and that the only true reason was the unconscious one, as suggested by Dr X and Mr Y. For example, if I said I was angry, then they suggested that this was my unconscious mind's defence against emptiness and rejection; if I said I was sad or disappointed, then that was anger; and when I said I was anxious, I was desperately afraid. Further, they indicated that all these unconscious feelings stemmed exclusively from unresolved trauma in early life.
A Series of Crisis Points
Despite my confusion and frustration with the group process, and my feelings that group members were often being attacked or probed in a negative or derogatory way by the therapists, I continued to accept this situation passively without challenging the efficacy of their techniques. However about three months after starting in the group my anxiety and depression increased, and I had to increase my dose of anti-depressant medication to the maximum. I discussed my increased reliance on medication with Dr X, and she told me it was quite common to get worse before one got better.
My crisis point came after about eight months of group therapy. Mr Y made a remark to me regarding an incident at work that I had told the group about. My work-place is often busy, and during one flat-out day, I was delayed in re-issuing an urgent report because a colleague was writing a personal letter to a Building Society at the workstation I needed to use. I was rather annoyed and unsure what to do, subsequently I made a note about it in my diary; writing down a problem that I would otherwise waste time ruminating over was a technique I learnt from a self help book.
I mentioned this event in the next group session. Then I told the group that I was going on a beach holiday for several weeks, and would be fishing while my wife collected shells. When one group member asked if my wife would be bored I replied that she wouldn't as she was a passionate collector of shells. Immediately Mr Y interrupted and said `And you are a passionate collector of Building Society letters!' He then made remarks about me having an extreme reaction to things that were of no concern of mine, and that I was not able to let them go.
After my holidays my participation in group therapy lessened. One Saturday morning about four weeks later I broke down at home and wept profusely for hours. My wife had never seen me in such a state and called Dr X's emergency after-hours number. Dr X was not available. I told my wife of my feelings of being rubbished in the group by Mr Y, and of some of the things he had said to me and his manner toward me. She was surprised and confused.
At my next individual therapy session I told Dr X what had happened on the previous Saturday. Other than apologising for her answering service, she said that I would need to talk to Mr Y about how I was feeling as a result of his comments and manner. But Mr Y seemed so omnipotent, and having to confront him was very difficult and frightening for me. He once said that he could easily handle angry people, and that if he chose to try to hurt someone with words he could be `positively murderous' compared to any of the group members. I believed this.
By the time of the next group therapy session I was feeling very anxious. Towards the final part of that session my heart was pounding, and I brought up the topic of Mr Y's comments about my being a `passionate collector of Building Society letters'. I told Mr Y that I felt hurt and upset that he always chose to interpret my actions in the most negative way, and how in this example it was cruel of him to turn my words about my wife against me. Mr Y looked smug, and with his usual vacant gaze, looking towards but not at me, simply said `I'm sorry that you were hurt, but the comments stand'.
At a minimum I wanted Mr Y to acknowledge he had gone too far and that his comments were insensitive and inappropriate. I interpreted Mr Y's smug thoughtless reply as saying `No, I'm right, you are wrong, so pull your head in'. My fear turned to rage and words deserted me; I wanted a piece of him. The group session lasted another two minutes before time up was called. I waited as the other group members filed out the door hoping that Mr Y would take me aside and make some acknowledgement of his mistake and apologise. However, all I got as he held the door open for me was a smug little grin. It seemed that physical confrontation was the only way to make this man respond and acknowledge me and what I was experiencing.
I punched Mr Y in the stomach, about as hard as I might slap someone on the back. I then swung my arm towards him, which brushed his face, before slipping it over his head and putting him in a sturdy headlock. We went to the ground with me still grasping his head. I said `You can't always handle angry people'. After a few seconds I let go of his head and we both got up. Dr X appeared and said `Terry, go'. I walked out the door. As I approached my car, what I had done sunk in, and I was filled with a most terrible remorse. My violence against Mr Y was wrong and I was very sorry that I had done it.
Therapeutic Results?
When I arrived at work after group that morning, I went straight to my supervisor and told him `This morning I assaulted someone'. He was shocked but I reassured him that the person was unmarked, and seemed not to be injured. I then explained to him the circumstances, including what had led up to it and why I had done it. He was even more amazed and asked `Why would you put up with shit like that?'
I then went to my desk and telephoned Mr Y at his office. Mr Y answered his phone immediately and through my sobbing I apologised to him with utmost sincerity. I asked him if I could see him at his office to try and resolve the problem I had with him. Mr Y said that my attack on him was `unreasonable, unprovoked and unwarranted', that he would not see me, and that I was out of the group and that Dr X would be phoning me to inform me of this.
About twenty minutes later Dr X telephoned me at work. She said, `Terry, this was a group of words, not actions. You are out of the group, and I will not see you any more. Would you see someone who helps people like you?'. I said that I would and took the phone number and name from her. Dr Y then said `Terry, you are now a criminal. And this is the type of person Dr Z sees. He is a forensic psychiatrist'. I asked `Can't you see why I might have responded like that? Didn't you have any idea that this might have happened?' She said `No, we did not. You did not have a history of violence'. Stricken with grief I apologised to her.
I felt absolutely devastated that Dr X had labelled me a criminal. My sense of self worth was shattered, and my feelings of remorse, guilt and fear were overwhelming. I hoped the complete lack of understanding and support shown by Mr Y and Dr X would be transitory, and that they would reconsider their attitude towards me. This was not to be.
I saw Dr Z almost every week for the following six months. When he asked why I had hit Mr Y, I explained it was because of the built up frustration I had experienced resulting from the style of therapy I had participated in. I wrote letters of apology to Dr X and Mr Y in which I thanked them for their therapy, and made some suggestions on how I thought what had happened may have been avoided. I told Mr Y, that I was in the process of trying to forgive myself for my actions toward him, and that I hoped in time he would forgive me. I received a prompt written reply from Dr X thanking me for my letter and saying how pleased she was that I was seeing Dr Z. Mr Y never replied.
In the months that followed I experienced debilitating anxiety and extreme remorse. I felt devastated by my perceived failure in group therapy, and the lack of understanding and rejection shown to me by the therapists. I was very stressed but could function at work; however away from work I would regularly think about what had happened, and what I had become. I was frequently ill.
Dr Z asked if there was anything he could do to ease my anguish. I told him I wanted him to approach Dr X and Mr Y to find out if they had lodged a complaint about me with the Police. As my employment was in a position of public trust in a government agency, any charge or complaint against me could result in the loss of my job. Within a few weeks Dr Z told me he had seen Dr X, who had told him that only a telephone complaint had been made to the Police.
The months slipped past and I continued weekly individual therapy with Dr Z. He introduced me to cognitive behavioural therapy (CBT) to try to abate my anxiety and poor feelings about myself. The process involved writing down episodes of anxiety and my feelings associated with them. I then had to re-evaluate these feelings and give myself before and after scores for how I was feeling. I considered it ironic that I had been referred to this type of therapy by therapists who had chastised me of writing things down and being a collector of events that had upset me. Yet the same process was now deemed therapeutic! However it did not help me.
Finding the Truth
About four months after the incident Dr Z commented that in his experience it was very unlikely that the Police would follow up a telephone complaint after such a long period of time. One week later a detective rang me to arrange an interview. The process of my prosecution for assault was proceeding. I was eventually told I was to be charged with common assault. My solicitor informed me that to defend this charge she would have to prove it was a result of provocation and/or an act of self-defence. The cost of such a defence is typically about $30,000, and can take years, with the details usually making the press. Given my feelings about what had happened, my wife and I decided I would plead guilty to the charge.
I then learned that Mr Y had provided the Police with a large amount of personal information about myself - why I had been seeing him and details of my employment. Because of the nature of my government position, and with Mr Y's agreement, the Police referred the matter to the Criminal Justice Commission (CJC), a public service watchdog body. Soon I was being investigated for official misconduct; if found guilty, I stood to be demoted or lose my job.
Through my solicitor, I offered Mr Y monetary compensation in lieu of the prosecution proceeding. He refused this offer. The detective was sympathetic to my situation, but said that Mr Y was keen for the charge of assault and the CJC investigation to proceed. The detective indicated that Mr Y wanted to use the CJC disciplinary process to teach me anger management. The detective thought that this was inappropriate. I asked the detective if there was any way to stop the case going to court. He replied `No way. For this matter to stop now it would require the complainant to sign a `Withdrawal of Complaint' form. He is simply not going to do that.' I was subsequently charged, photographed and finger-printed by the Police.
The Court process turned into a day of personal enlightenment. I discovered that Mr Y and Dr. X had, on the day of the incident, gone down to the Police Station and provided full detailed statements to the Police. Most probably Dr Z knew that all along. Yet curiously I felt set free through this new knowledge and understanding. I could finish with these therapists and find a new pathway to overcome my depression.
In court the magistrate concluded that the incident seemed to be an isolated case of me `losing it'. He found me guilty of common assault, with no conviction to be recorded, and I was fined $400 dollars. My legal fees were another $2200. Seven months later I was informed of the CJC decision that I had no case to answer.
My career options have been damaged; when applying for other jobs in my field I must disclose any criminal history, and the `no conviction recorded' does not apply. Further, as an official complaint was made against me whilst I was a Public Servant, my name is now listed in a complaints register which would be checked if I applied for other Government positions.
Conclusions
The departure of four group members, three of whom left under less than amicable circumstances, indicates how the psychotherapists treated their clients. The first man to leave might have stayed if the therapists had reduced their focus on his allegedly misplaced anger. The second woman may have stayed if she had not been intimidated by Mr Y. My dismissal might have been avoided if Mr Y had acknowledged his debasing attitude and manner toward me.
My painful court case could have been avoided if the therapists had met with me, even in the presence of a mediator. By seeing me, they would have demonstrated their concern for my welfare and respect for me as a person. Instead they proceeded with the prosecution by stealth and I felt rejected and betrayed.
My experience of group therapy was of sadistic treatment from the therapists. Mr Y was a master with facial expression, especially derogatory ones. His head shaking, lip pursing, and scowling were used to express his contempt for group members. Dr X was more passive; she was a voyeur who obtained vicarious pleasure watching Mr Y, or another group member who she may have `primed' during individual therapy, verbally attack and wound other group members.
What is the purpose in playing the devil's advocate with clients? Surely this strategy should never be practised at the expense of denying clients the empathy and support that is required in any therapeutic relationship. Each group member paid the therapists, trusting them to use their expertise to assist them to deal with mental health issues. My interactions with these therapists were the most devastating experiences in my life; more so than my unpleasant childhood experiences. I still have difficulty believing these events actually occurred, and that these therapists were funded by Medicare to carry out what I believe was psychological sadism.
My behaviour towards Mr Y was a spontaneous act of violence that did nothing to improve my relationship with the therapists. I am sorry that I acted in this way.
Terry Johnsen later wrote: `It is my hope that `bad therapy experience' articles such as mine will float in the ocean of psychotherapy literature, and `flash' like a warning beacon to help practitioners `steer' their clients or the clients `steer' themselves towards effective therapy and a happy and fulfilled life.'
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