What’s Wrong with Therapy (And What Isn’t): A Former Therapist’s Perspective
- Dr. Patty Gently
- Jun 24
- 8 min read
Updated: Jul 1
By Dr. Patty Gently on June 24, 2025
Bright Insight Support Network founder and president Dr. Patricia Gently supports gifted and twice-exceptional adults in their own autopsychotherapy through identity exploration, structured reflection, and alignment with inner values. A writer, educator, and 2e adult, Dr. Patty centers depth, integrity, and complexity in all aspects of her work.
What’s Wrong with Therapy (And What Isn’t): A Former Therapist’s Perspective
“You need a companion, not a guide.”
When I first entered the field of psychotherapy, I did so with a reverence for what I believed to be a relatively altruistic profession. The guiding myth was that therapy is about helping others, that it is a sacred relationship of healing and care. For many practitioners, that story is compelling enough to endure for decades. And yet, over time, I found myself confronting an uncomfortable truth: therapy, as it is widely practiced, often centers the needs of the therapist in addition to, and maybe more than, those of the client.
This is not an indictment of character, but an observation rooted in developmental awareness. Most therapists enter the field with unconscious motivations. Perhaps they want to feel useful, find meaning, or to resolve inner conflicts through the seemingly kind guise of healing others. These impulses can be powerful sources of empathy. However, when left unexamined, they may subtly shape the therapeutic dynamic, sometimes undermining the client’s autonomy or clarity.
Therapy as a Developmental Mismatch
Imagine sitting across from a therapist who nods politely as you speak about the dissonance felt when navigating giftedness in a world that demands conformity. You use metaphor, layered language, and ask rhetorical questions that aren’t meant to be answered, only witnessed. Imagine, also, that the therapist then responds with a CBT handout on “distorted thinking” and a suggestion to track your automatic thoughts. I wouldn’t return. And it wouldn’t be because of hostility, it would be from compression.
So often, even after just one session, we realized we've already outgrown the room and the therapeutic support offered. And this may not be because the therapist is wrong. We are not wrong either, though. Just mismatched in dimensionality.
For many individuals, especially those in early stages of psychological development or in acute distress, therapy can provide necessary structure and support. It offers safety, scaffolding, and language for experience. Yet for others, particularly gifted, twice-exceptional, and neurodivergent individuals who have already developed complex internal frameworks, therapy often feels insufficient or misaligned. These individuals do not need interpretation or behavioral correction. They do not require step-by-step education about coping skills. What they need is a relationship that honors their inherent capacity for self-examination and a companion who does not presume to know better. They require something that therapists are not trained to provide: space for autopsychotherapy.
At first glance, the idea of a therapist supporting autopsychotherapy may seem paradoxical. After all, the prefix 'auto' implies self-direction. And yet, the presence of another, when held with precision and reverence, can be exactly what makes self-direction possible.
The Medicalization of Human Experience
In graduate school, we question professors about the validity of diagnosing grief with a timeline.
We ask: “At what point does mourning a lost child become pathological?”
They reply, “Twelve months, according to the DSM.”
We feel it too, the sinking in our chests. The constriction of empathy. A sadness we then override in an attempt to “get it right," the diagnosis process, I mean. It feels good after all to say you are a trained diagnostician.
It is also then that we began to understand how diagnostic structures, while useful for administrative clarity, often fail to hold the sacred or the nonlinear. The human soul does not reorganize itself to meet billing cycles. Sometimes “what just is" resides in liminal spaces.
At its core, therapy remains entangled with the medical model. This is evidenced not just by its insurance coding or diagnostic requirements, but by its underlying philosophy. According to Merriam-Webster, a therapist is “an individual specializing in the therapeutic medical treatment of impairment, injury, disease, or disorder." And this framing is unfortunately antithetical to the view that human struggle is meaningful. The person entering therapy is presumed to be disordered. The therapist is presumed to be trained to diagnose and treat.
Yet, what if the best wisdom for attending to this disorder comes from within the client?
What if the core need is not treatment?
What if it is validation, understanding, or witnessing that truly heals us?
Such a model cannot hold the existential territory that many gifted neurodivergent or other marginalized individuals occupy. These individuals are not looking for a fix; they are looking for resonance. They need someone to accompany them and share alongside, not to guide ahead of or push from behind. Answers may help, yet the most authentic ones arise not from the professional but from the client’s inner knowing.
And questions that match the gravity of an inquiry, well, those are invaluable.
The Role of Autopsychotherapy
Kazimierz Dąbrowski used the term “autopsychotherapy" to describe the self-directed process of inner development that emerges during positive disintegration. This is not self-help in the contemporary sense. It is a serious, often painful, examination of one's own internal contradictions and value hierarchies. It is a reconstructive act that cannot be outsourced. Others may support it. They cannot initiate or direct it.
I do not position myself as an expert, and I do not offer solutions. I walk beside. I reflect. I scaffold. I trust the process of the individual before me, and I attune to their rhythm rather than imposing one. In doing so, I have discovered that what many clients long for is not therapy as it is conventionally offered. They are seeking something quieter and more radical: the affirmation that they are not broken, and the presence of someone who can help them remember how to listen to themselves.
The Ethical Limits of the Expert Model
The therapist-as-expert model is ethically fraught. It places one person in the position of knowing, diagnosing, and interpreting, and by doing so, subtly displaces the client's own epistemology. This becomes especially problematic when the therapist lacks insight into their own hard-won biases, values, or even developmental limitations.
Even well-meaning therapists can pathologize what they do not understand. A gifted client questioning the moral foundations of society may be labeled oppositional. A twice-exceptional client with supposedly asynchronous development may be seen as resistant. A person in existential despair may be assessed for depression or an attachment injury without recognizing the philosophical nature of their suffering.
These misinterpretations are not neutral. They can interrupt or derail the client’s self-understanding. And worse, they can lead to self-doubt in individuals who already possess profound inner clarity and a healthy dose of critical thinking turned criticism.
What I Look for in a Professional Doing This Work
So if we are not seeking typical practitioners and acknowledge the limits of the therapist-as-expert model, what are the rare qualities we should look for in those doing this work as therapists, coaches, or otherwise? Personally, I look for individuals who are:
Deeply self-reflective, able to track their own motives and projections in real time
Grounded in humility, willing to unlearn and question their frameworks
Comfortable with ambiguity and silence, not rushing to closure
Attuned to existential and developmental nuance
Willing to name power differentials without reinforcing them
Unafraid of their clients' overexcitability, intellect, complexity, or spiritual depth
Disinterested in being perceived as experts, and uninterested in maintaining a hierarchical role
Oriented toward co-creation rather than behavior modification or insight delivery
Transparent about their own humanity and not overly identified with their professional identity
Aware and avoidant of logical fallacies
Willing to make immediate repair due to impact rather than intent (or both)
Creators of safety within the therapeutic relationship
Adherent users of bias-reduction work in word and deed
Lifelong learners who seek professional consultation and education
NO GURUS ON A HILL (Sleiman, 2024) **I will attend to this in a future blog post, though for now, know it means your professional supporter should not think they know better than anyone else and should be willing to seek professional education and support**
And these are not merely preferences. For the kind of transformational work I believe in, these are essentials. They are also difficult to find in traditional therapy settings, though not impossible. The individuals who carry these qualities often work at the edges of institutional norms; liminal, principled, and quietly radical. Their presence is a form of grace. They do not offer answers. They offer a mirror, a question, a pause, and the courage to stay present in the unknown.
And to be clear, I am not suggesting therapy is inherently flawed. Therapy is a form, and like all forms, it carries limits. The key is the alignment between the form and the person engaging with it. For some, it provides necessary scaffolding. For others, particularly those with high developmental capacity, the form must evolve to meet the complexity of the inner terrain. What we need is not a new diagnostic category or another toolkit. We need a shift in stance from intervention to accompaniment, from expertise to presence, from treating disorder to revering development.
To accompany another person in their autopsychotherapy is to honor the sacred unknown, to sit without solving, and to trust in their capacity to become. If we can do that with humility, clarity, and care, then perhaps we are not abandoning therapy at all. Perhaps we are finally allowing it to become what it was always meant to be.
Final Reflections: What It Means to Accompany
When I transitioned from therapist to mentor, one of my clients looked at me and said, “You’ve always been this way. You just didn’t call it that.” What they meant was that I had never tried to fix them. I didn’t push interpretations or redirect them when their process progressed in non-linear ways. My general response to such stream-of-consciousness zig-zagging: “Yeah, we do non-linear here."
I ask questions that have no pedagogical function, only existential gravity. That moment clarified for me what I had suspected for years: I had been practicing something else entirely. Something unnamed. Something sacred. And some therapists already do this work, whether they call it therapy or not.
They sit with complexity.
They relinquish control.
They do not fear silence.
They do not rush to assign meaning.
They meet the other person with reverence, not intervention.
Such practitioners may not fit neatly into institutional roles. Their work may be misunderstood or undervalued by systems that prioritize (and monetize) measurable outcomes. Yet they are doing the work that matters by protecting a sacred, liminal space where truth can emerge on its own terms.
I no longer call myself a therapist in the conventional sense, though I remain deeply committed to supporting human growth. My role now is to serve as a companion in autopsychotherapy. I offer reflection, structure, and presence, with a dash (or bigger helping as needed) of psychoeducation.
I do not assume expertise.
I do not advise.
I do not fix.
What I offer is less immediately definable and less easily commodified. Yet it is deeply aligned with what many people, especially those operating at high levels of depth and complexity, are truly seeking.
If therapy has failed to meet you where you are, it is not damned to be your fault. It may be that you have outgrown the frame. It may be that the only authority you need now is the one within you.
And if you are a practitioner who senses this dissonance, who feels constrained by the protocols of the field, you are not alone. There is another way to do this work.
You are not here to fix. You are here to remember. And to accompany others in doing the same.
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