Malpractice in psychodynamic psychotherapy—A retrospective case study

This article describes a case of psychotherapeutic malpractice in Finland in the early 1990s. A patient in their early twenties who had previously been hospitalized for a suicide attempt and extreme abandonment anxiety attended psychodynamic psychotherapy sessions given by a female senior psychoanalyst for nine months. The therapist repeatedly threatened the patient with abandonment, i.e. discontinuation of the sessions if the patient did not 'obey' the therapist's demands. She repeatedly claimed that the patient had said something that the patient did not remember saying. Her conclusions, based on the claimed statements, did not appear legitimate to the patient. Due to the resulting uncertainty, the patient began to lose grounding in reality. In order to be able to ascertain what was real, the patient eventually resorted to secretly recording the sessions and reviewing the recordings afterwards. After six months, the patient concluded that the derealization was due to the therapist. The patient was afraid to confront the therapist and announced the discontinuation of the therapy by sending a postcard. Official complaints by the patient led to only a written warning being issued to the psychoanalyst by her professional association. There was no compensation for the patient. The therapist continued psychotherapy practice for at least a decade. The details of the case were acquired from written documents and audio recordings.