Red flags in therapy: when to walk away

Therapy involves an unusual power asymmetry: one person discloses everything, the other very little. That asymmetry is necessary, and it is exactly why professional boundaries matter so much.

Leave immediately

These are not matters of style or fit. They are breaches.

• —Any romantic or sexual approach. Never acceptable, at any point, including after therapy ends. This is the most serious breach there is.
• —Breaching your confidentiality outside the limits explained to you at the start.
• —Discrimination or contempt regarding your gender, caste, religion, sexuality, disability or background.
• —Pressure into a personal or financial arrangement — lending money, business involvement, recruitment into anything.
• —Practising under the influence.
• —Refusing to let you stop, or making leaving feel dangerous or disloyal.

If any of these occur, end the work. You do not owe an explanation or a final session.

Serious concerns worth raising, then acting on

• —Consistently late, distracted, or clearly unprepared.
• —Talking about themselves at length. Occasional, relevant self-disclosure can be useful; a therapist processing their own life in your hour is not.
• —Telling you what to do with your life, repeatedly, rather than helping you work it out.
• —Dismissing your concerns about the therapy by reframing them as your pathology. Raising a doubt should be met with curiosity.
• —Vagueness about qualifications when asked directly.
• —Diagnosing confidently outside their competence, or discouraging you from seeing a doctor or psychiatrist.
• —Guarantees. Nobody can promise to cure you in a set number of sessions.

Things that look like red flags and are not

Worth naming, because people leave good therapy for these reasons.

• —Feeling worse early on. Common, and often a sign the work has started.
• —Being challenged. A therapist who only agrees with you is not doing much.
• —Silence. Deliberate, and frequently where the thinking happens.
• —Not receiving advice. Most therapy is not advice-giving, and being told what to do rarely produces lasting change.
• —A charged cancellation. Standard practice; the slot was held for you.

Trust the physical signal

People frequently describe knowing something was wrong long before they acted. Dread before sessions, relief when one was cancelled, an instinct to minimise it when a friend asked.

If you notice yourself constructing elaborate explanations for a practitioner’s behaviour, that is worth attending to. You are allowed to leave on discomfort alone. You do not need proof.

If something serious has happened

Where a practitioner is registered with a professional body or the RCI, complaints can be raised with that body. Serious misconduct, particularly of a sexual nature, may also be a criminal matter and can be reported to the police.

India’s patchy regulation — see what RCI registration means — makes redress harder than it should be when a practitioner belongs to no body at all. That is a real gap, and it is another argument for checking credentials at the start.