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The authors discuss four kinds of intervention by psychotherapists deemed to make treatment not only ineffective but harmful. These interventions are derogation, invalidation of the patient's experience, opaqueness of the therapist and putting the patient in an untenable position. The latter arises when the therapist leaves
the patient in the dark about what is likely to happen, makes impossible or conflicting demands on the patient, gives him conflicting messages or sets up a persecutory spiral. That spiral comes about if the therapist himself feels persecuted by the patient and ‘responds by overt and covert attack’.
The authors derive the evidence for what they consider harmful therapy from their own and their colleagues’ therapeutic experience and from the published diaries of A. Nin . Nin writes about her experience with René Allendy (founder of the French Psychoanalytic Society), Otto Rank and Martha Jaeger (Jungian analyst).
Nobody will deny that therapists occasionally make mistakes. However, Mears and Hobson do not mention that a patient's account may be distorted by unresolved transference elements, and that the mistakes enumerated by them could be manifestations of a complementary countertransference (Racker) in which the analyst temporarily identifies with an internal object in the patient. If this occurs and is recognised it can be put to valuable therapeutic use. Furthermore, as Jung says, ‘a sufferer can transmit his disease to a healthy person whose powers then subdue the demon’. During this process mistakes may happen yet, in the long run, can be in the service of healing.