Unethical Therapy Practices: My Experience Dealing with a Diagnosed Narcissist

During my three years of therapy, my therapist never clearly informed me that I was dealing with a narcissist. Now, with this critical oversight, I am forced to question the ethical standards of my therapist, as well as consider whether reporting her is the right course of action.

Grounds for Reporting

On what grounds should you report a therapist who fails or misdiagnoses a client? In the case of my therapist, there are specific scenarios that would warrant such action:

If she diagnosed someone without ever meeting them, this would be a legitimate reason for a client to report her. Such a practice is clearly unethical and a breach of professional standards.

If she shared a diagnosis of another client with me, it would also be grounds for reporting. This information should remain confidential unless explicitly shared by the client or with their consent.

Narcissism and the Ethical Dilemma

Narcissism, like other personality disorders, can only be accurately diagnosed when the patient is directly involved in the therapy process. The ethics of a therapist diagnosing someone based on information reported by a third party raises serious questions. My own experience has reinforced that any therapist who diagnoses another person without meeting them is crossing a moral line.

Initially, in 2002, I got engaged to a woman who had already disclosed to me that she had Bipolar II Disorder. By the end of our engagement, lasting 4.5 years, my therapist mentioned during the last session that he had a hunch she might also have Borderline Personality Disorder (BPD). This was information I had already been aware of based on her previous diagnosis from a psychiatrist. This experience has made me question the ethical boundaries of therapy.

Feedback on Therapeutic Ethical Standards

Feedback from professionals and peers has highlighted that even suggesting a patient may be experiencing abuse or have certain value issues can be deemed unethical. The professional ethical guidelines are meant to protect both the therapist and the client, and diagnosing based on second-hand information can jeopardize these protections.

My dream of becoming a therapist is now tempered with caution. As a therapist, one's primary responsibility is to the clients they directly treat, not to the reputation of themselves or their clients. Diagnosing someone else based on a client's report is not only unprofessional but can be seen as crossing into unethical territory.

Conclusion

While my therapist may not have reported the correct information in our therapy sessions, this did not constitute grounds for reporting. The core issue lies in the ethical and professional standards that my therapist should have adhered to. Any therapist who diagnoses another person based on hearsay is not only unethical but also a significant departure from professional ethical guidelines.

Taking harsh feedback for highlighting the responsibilities of therapists is uncomfortable, but it underscores the importance of maintaining ethical boundaries to protect both patients and professionals. The road ahead for me as a potential therapist is marked by the need to be vigilant and ethical in my practice.