Are therapists supposed to tell you how to live your love life?
July 19, 2011 7:21 AM   Subscribe

Is it normal or ethical for a therapist to tell their patient to break up with someone?

This happened a few years ago but has bothered me ever since, and I've never really had a sense of what was going on in the situation. Back then I was in a very serious intend-to-get-married relationship with a man who struggled with clinical depression. He saw a variety of therapists and tried a few different medications during the course of our relationship.

One of the therapists that he saw was a very old school psychoanalyst. After about a month of therapy, he told me that she had told him that he should break up with me, and that ending our relationship would be beneficial to his mental health. To be clear -- he didn't say this to break up with me (we stayed together for years afterward) -- he simply told me that his therapist had told him to break up with me.

Some caveats: obviously I have no idea if he was accurately relaying what this therapist said, though I have no reason to suspect he wasn't. I can understand that a therapist might urge a patient to leave a relationship if it's clearly abusive, but ours was not.

So, assuming the above... was what the therapist said weird and manipulative? Or is that a typical piece of advice you might get in therapy?
posted by anonymous to Human Relations (22 answers total) 5 users marked this as a favorite
Highly unusual.
posted by JohnnyGunn at 7:26 AM on July 19, 2011 [2 favorites]

As one data point. I know that several therapists have told, guided, suggested or led my sister to the belief that she should end relationships over the years. The relationships were not abusive they were just toxic to her well being. I don't mean to imply that you are toxic.
posted by saradarlin at 7:27 AM on July 19, 2011 [2 favorites]

Is it possible that the therapist asked questions like "Do you think this is a healthy relationship for you?" that your ex interpreted as "Don't you think you should break up with her"?

There is no way to know if what your ex told you the therapist "told him to do" was in fact what happened in that room.
posted by mauvest at 7:28 AM on July 19, 2011 [9 favorites]

Some caveats: obviously I have no idea if he was accurately relaying what this therapist said, though I have no reason to suspect he wasn't.

You also don't know what he was telling the therapist about you. For all you know, he could have been relating tales of a terribly abusive/manipulative/bad for him relationship to his therapist.
posted by xingcat at 7:29 AM on July 19, 2011 [3 favorites]

My very close friend was once told by his shrink that he should definitely get out of what was really, very clearly a terrible relationship. It wasn't abusive, per se, but it was just godawful and definitely doing a number on his mental health. However, this was about after at least a year of seeing said doctor and there was a relationship developed and so on.
posted by griphus at 7:29 AM on July 19, 2011

On the one hand, it seems quite odd that a therapist would tell someone after only a month to break up with a girlfriend.

On the other hand, you don't know what your boyfriend said to the therapist, or what the therapist actually said to him, so it's really quite hard for us to judge what happened.
posted by insectosaurus at 7:36 AM on July 19, 2011 [1 favorite]

This also sounds very unusual to me. My therapist has told me that part of the point of therapy is that she does NOT tell me exactly what to do - rather, I find she helps me come to conclusions myself by asking the right questions.
posted by guessthis at 7:38 AM on July 19, 2011 [2 favorites]

Maybe he was using his therapy as a shield, consciously or unconsciously, from actually having to say "I want to break up with you." Maybe what the guided discussions led him to decide was to break up with you. Maybe he wanted to break up with you, but he was too confused to think this and put this into action until therapy gave him some strength and structure.

I saw an old-school psychoanalysis some years ago, and while she was very much "not in the advice-giving business," I do remember two or three times saying "maybe I should do x" and she would respond.

I also used to date someone who constantly said "my therapist says this" and "my therapist says that" for all kinds of things. I have no way of truly knowing if the therapist was actually micromanaging her life or if she would put things that way in order to give them more authority or because she was afraid to take responsibility for actions (even minor or positive-to-neutral actions).

You don't know and you have no way of really knowing. Let it go.
posted by Sticherbeast at 7:38 AM on July 19, 2011 [5 favorites]

"very old school psychoanalyst" is not... current? Terribly modern? do I say possibly using a different set of guidelines without making it sound terribly sketchy? They may be great, for all I know. But, if I were a psychologist... I would tell someone to break up immediately if I thought their life was clearly in danger. I would use the oh so subtle evidence such as 'he stabbed you that one time.' if I thought the relationship was toxic, I'd keep asking the patient to examine why they are in it/what they get out of it and how healthy relationships look. Otherwise... it would have to be a long term client, flat out asking me my opinion, and I'd preface it with a lot of 'not telling you what to do, but this is what youve told me, so this is my opinion'. And still feel mildly unprofessional.
posted by Jacen at 7:51 AM on July 19, 2011 [2 favorites]

No, it's not unethical or unprofessional. Psychologists are there to help us be better "us." If your boyfriend was saying at the time that you were abusing him, emotionally or physically (which may or may not have been the case, we will never know) the therapist would have pushed him to leave and seek more help.

I would expect any therapist to do the same today.
posted by TheBones at 7:57 AM on July 19, 2011

People often walk away from therapy appointments feeling that their therapists have "told them" to do certain things, but that's usually not the way it works at all. People explore their issues out loud, the therapist asks questions or makes observations as a way of guiding the conversation, and often people attribute the conclusions they draw to the intent of their therapist when it really isn't so. I have never met a therapist whom I think would TELL someone to end a relationship.

Just because he arrived at a conclusion during therapy doesn't mean his therapist instructed him to do something about it. (Also, sometimes people take the cowardly way out and blame their decisions on other people so that they don't feel quite as responsible for the fallout. IMO, that's what happened here.)
posted by hermitosis at 8:01 AM on July 19, 2011 [14 favorites]

What the therapist was telling your boyfriend may have had nothing to do with you, personally, or your relationship, specifically; the therapist may have believed that your boyfriend should not be in any romantic relationship. Alternatively, your boyfriend may have not told you all the feelings he had about the relationship, but told his therapist -- such as, "I love her and I don't want to hurt her, but I'm unhappy with our relationship most of the time. I think telling her that would destroy her."

None of this requires that you were abusive or specifically unhealthy, just that your boyfriend may have been unhealthy in the relationship in ways he wasn't admitting to you (as part of the unhealthiness.)

All of this is speculation, but I wanted to move away from the idea that the only reason a therapist would support a breakup is because of abuse. And, of course, sometimes a therapist is supportive of a patient's own idea, and the patient turns it around and acts like it was the therapist's idea, especially when the patient doesn't entirely want to "own" the idea.
posted by endless_forms at 8:06 AM on July 19, 2011

(Also, sometimes people take the cowardly way out and blame their decisions on other people so that they don't feel quite as responsible for the fallout. IMO, that's what happened here.)

That's my opinion as well. Also, I hate when people do stuff like this. It's not fair to you as it comes off as 'even third party person thinks we shouldn't be together!' and also paints an unfair and incomplete picture of what therapy is for.
posted by sweetkid at 8:23 AM on July 19, 2011

The therapist worked for your boyfriend not you so I don't see why it wouldn't be ethical for them to tell your boyfriend to break up for you. Some therapists also give more advice than others.

Of course its much more likely to be something like your boyfriend said "i'm so unhappy all the time I can't handle being in a relationship it takes to much energy I think I should break up with her." and the therapist responded with something like "Do you think breaking up would help you?" and he took that as advice. Traditional psychoanalysis, if your using the word in the technical manner, tends not to be an advice driven therapy.
posted by SpaceWarp13 at 8:32 AM on July 19, 2011

I just wanted to highlight your caveats here, and suggest that we don't have nearly enough information to judge this particular therapist. I think it highly likely that this was either a misunderstanding on the part of your boyfriend, a result of your boyfriend telling the therapist things about you that were not factually true, or some combination of those things. Regardless, why in the world would your boyfriend relate this to you? That choice makes me think it more likely, rather than less, that your bf was not operating on the up and up here.

No, it's not unethical or unprofessional.

Now, as to whether or not it's a common practice for therapists. I'd say that it is not, and that it's a bad practice when it happens. Therapists really should help people question their assumptions and framings, rather than give advice. In my experience giving advice almost always backfires. People (patients) tend to experience it as an imposition. That said, it's not really unethical or unprofessional to give advice, it's just not a very good idea. There are certainly some situations, in which the therapist is exercising undue influence on the patient, or is otherwise manipulative, where giving advice would be unethical, but that stems not from the advice but from the otherwise unethical situation. Otherwise patients are free to simply ignore the advice, as the patient in this case did, and so there really isn't an ethical issue.
posted by OmieWise at 8:36 AM on July 19, 2011

he simply told me that his therapist had told him to break up with me.

That's a way of avoiding taking responsibility for his choices. It may not be an accurate representation of what happened in therapy.
posted by justsomebodythatyouusedtoknow at 10:14 AM on July 19, 2011 [1 favorite]

Most therapists would not flat out say something like this, but they would probably strongly hint.

But again, we don't know what the shrink said or what your guy said and especially we don't know how he interpreted the situation.
posted by jenfullmoon at 10:47 AM on July 19, 2011

A while back, I was in therapy due to a horrible break-up. My therapist retired and I went to see one of his suggested replacements. After talking to me for half an hour, she said something along the lines of, that if I wanted to continue with her, I would need to break off all contact with my ex.

I never went back to see her again and I told my next therapist that issuing commands to me was off the table. In retrospect, it wasn't bad advice, but it wasn't at all an approach that meshed with my personality.
posted by Squeak Attack at 11:07 AM on July 19, 2011

I have learned over the years that whatever follows the phrase "My therapist told me..." is almost always completely untrue.
posted by txmon at 11:10 AM on July 19, 2011 [3 favorites]

It's possible that it went down as he said, but I very, very much doubt it. I've seen five therapists over the years, a lot of times about relationship stuff, a lot of times bad relationships, and not one of them has "told" me to do anything. Far from it. They've approached the topic with questions -- "How do you think it would feel to be out of this relationship? Have you talked with him about ending your relationship? What's keeping you in your relationship?" And they've made a lot of suggestions like "This week, try to notice every time you start feeling angry at so and so, and next we'll talk about what those triggering events are." We explored the idea of doing things or not doing things. and how those decisions might affect me. We explored my responses to things I had actually done or not done. But none of them told me to do anything.
posted by Miko at 12:59 PM on July 19, 2011 [1 favorite]

I have a suspicion that the conclusion "to most clearly focus on mental health, one needs to not be in a serious romantic relationship" was articulated as "I should break up with you."
posted by DarlingBri at 1:21 PM on July 19, 2011

I've said, "My therapist didn't want me to date you."

What she actually said, "You've got a pattern of [x-type] relationships. If you're attracted to him, I guarantee he's [x-type]. This is not a great time for you to pursue any relationship."

But that takes a while and invites more conversation around the pattern and the other relationships than I wanted to get into. Lazy? Sure. But there's a clear implication of "don't date that guy" without it being at all about "that guy."
posted by Gucky at 2:57 PM on July 19, 2011

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