Identified patient is a term frequently used in family therapy which is used for one member of a dysfunctional & toxic family who is singled out and chosen to be the bearer of all symptoms of the family’s dysfunction. Basically it’s similar to scapegoat or black sheep, but identified patients are usually labelled as “the mentally ill/crazy one that needs help” when the ENTIRE family needs help. Identified patients also get frequently dragged to therapy by their parents who refuse to admit that they need to work on themselves and that their child is having behavioral/mental health issues because of THEM.

I chose my username since I was the identified patient of my family, and because it’s a play on the fake name I.P. Freely, most notably used in one of Bart Simpson’s prank calls to Moe the bartender; this is part of a running gag in The Simpsons where Bart regularly prank calls Moe, asks for a specific person and gives Moe a funny-sounding name, ensuing that Moe asks the bar’s patrons for the person and embarrasses himself causing the patrons to laugh at him.

I created this blog for identified patients, ex-religious, and therapy harm survivors to resonate to, since identified patients may also have a hard time with therapists who refuse to believe them about their family’s abuse & dysfunction.

Here are the signs that you’re an identified patient:

• You are expected to be the face or cause of the family’s dysfunction & problems in general.

• You’re labelled mentally ill or crazy either for no reason or because you reacted to the family’s abuse/mistreatment or because you saw through the family and held them accountable.

• Your family has a strong history of trauma & mental health issues yet YOU’RE the one expected to seek out professional help, break generational curses and change for the better even though the entire family needs some self-improvement.

• You’re gaslit into believing that your “mental illness” is causing the family’s problems/issues and directly or indirectly made to believe that these issues are damaging the family’s reputation.

• Your mental illness/health issues are a butt of the joke in the family, your family regularly throws your mental health issues back into your face, ESPECIALLY when you’re defending yourself and holding them accountable for their behavior.

• You have been repeatedly dragged into counseling/therapy, usually family therapy, since you were a kid, and of course made out to be the cause of the family’s dysfunction. Therapists either sided with them, or saw right through them and held them accountable just for them to pull you out either completely or rinse and repeat until they find a practitioner who unquestioningly believed them and joined in on them blaming you & critiquing you.

• Your family member(s) may have gone out of your way to make your mental health issues a topic of discussion in hopes to damage your reputation and credibility so that when you speak out about the abuse you endured, nobody believes you because they mistakenly believe that you’re too mentally ill to be a reliable narrator. They also do this to protect their own image and avoid accountability for abusing you.

• When you attempt to bring to light about what goes/went on at home when nobody else was around, you aren’t believed. Especially when you’re talking to a mental health practitioner about how your family affected you.

• If you’re the one taking accountability for your actions, behavior & mental health, willing to go to therapy & working on yourself, yet your other family members aren’t doing much and are still the same, THIS IS A MAJOR INDICATOR. They practically wanted you to accept being labelled as mentally ill and go to therapy while continuing to put up with their dysfunction without them putting in effort to change.

• When you go very low or no contact with your family/abusers and notice things changing for the better or your mental health improving, THIS IS ALSO A MAJOR INDICATOR.

• You heavily resent all the practitioners you saw that didn’t believe you about your family, sided with them, & pressured you to forgive their abuse and continue to maintain relationships with them with NO change on their end, ESPECIALLY after you cut your family off and notice things getting better for you.

• Everyone around you has trauma & mental health issues of their own, but somehow YOURS take the spotlight and you’re labelled as “that mentally ill person.”

• You finally come to terms with the fact that you weren’t as crazy as you were made out to be and gain the courage to tell the truth about what happened to you, and this is met with disgust. People you thought loved you and were cool with you suddenly disappear from your life.

• You feel heavily misunderstood and alone, especially when nobody or barely anyone puts in effort to try to understand you or be there for you.

• You struggle with expressing emotions or communicating, mostly out of fear of being pathologized and having your mental health thrown back in your face.

If you find yourself resonating with what I listed or this entire post in general, remember this:

You are NOT the problem.

You are NOT to blame.

If you decide to pursue therapy, do so for your own sake and for YOURSELF, not out of peer pressure.

If your therapist continues to defend yourself family after what you told them, for the love of Pete, FIRE THEM. You deserve better than a practitioner that gaslights you and would rather prioritize your toxic family over your well-being & safety.

Learn to take care of yourself, prioritize yourself, and learn how to set & maintain strict boundaries. Do NOT let people walk all over you.

If you’re like me and have been gaslit & sabotaged to Hell & back by therapists, it’s ok to do research on CPTSD, dysfunctional & toxic family units, and recovery topics on your own. I learned more about myself and how toxic & dysfunctional families work and how to heal from them more than I did from therapists.

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(This next part is for non-Christians, ex-Christians, & exvangelicals ONLY.)

Idc what anyone says, Christian therapists and therapists who happen to be Christian CANNOT be trusted when it comes to healing from leaving religion & toxic families. A lot of therapists who are Christian or conservative have an unwavering pro-family bias that they refuse to put to the side when it comes to working with patients who want nothing to do with their families or religions of origin, and this ends very badly. It is very, VERY, RARE to find a decent Christian practitioner who understands your situation and respects the fact that distancing yourself from your family is for your own good.

I had to include this part because toxic & dysfunctional families are very common in Christian, evangelical, fundamentalist & nearly all religious households, and abuse is normalized and praised at an alarming rate in these kinds of households. You think barely surviving and escaping from a toxic family who is Christian is bad, now try seeking therapy to heal and work through your issues and encountering a therapist who is Christian that sees nothing wrong with how you were raised and what you went through. Now do it again over and over because Christian practitioners usually don’t identify themselves right away and you don’t realize it until it’s too late.

Never fucking again.

We ended things with our therapist. In a rare turn of events, we decided to end it ourselves, which I’ll admit felt strange, sad, overwhelming, anxiety-provoking. But also, unexpectedly, validating. This is the first time in our entire life that we have ended with a provider and told them why instead of just disappearing. Usually, providers discontinue care with us. This time felt different.

I keep searching for the right words to explain it, but explanation feels like part of the problem. Because it wasn’t one thing. It wasn’t a moment or a mistake or a boundary crossed. It was a feeling that built over months. Our body had been sending distress signals related to therapy. The therapy room didn’t feel the same anymore. We noticed we were spending more time outside of session planning how to protect our therapist’s comfort than actually tending to our own healing.

Safety and trust don’t usually disappear all at once. They erode. Quietly. Politely. In ways that are easy to doubt and even easier to blame on yourself. I think the shift here is that instead of blaming ourselves, we put ourselves first and named where harm was happening.

For a lot of systems, therapy is more than a place you visit once a week. It is a relationship that either helps your nervous system settle, teaches your system new ways to mask, or straight up reenacts old trauma cycles. Dissociation does not respond to good intentions. It responds to repetition. To someone showing up consistently in ways that do not require us to manage their reactions or anticipate their limits in order to stay safe. I say that easily. Finding it is another story.

In our situation, there was good intent. At times there was real care and real attunement. Flexibility that mattered. Moments that felt like relief. I need to say that because erasing it would be dishonest. But something began to shift slowly. The time started to feel off. A little icky. Sessions felt more focused on them than on us. We often left feeling defensive, like we hadn’t explained ourselves the right way, like our values were somehow up for debate. It was difficult to name, which is probably why we stayed longer than was helpful. We truly believed we just weren’t doing the work hard enough.

Things became clearer when our provider offered flexibility with payment while we were out of work. The offer initially felt dangerous. We learned early that generosity often comes with strings attached. With debt. They reassured us, framed it as therapeutic support, and we accepted with cautious hope. We relaxed. We felt seen. That’s when things went from subtle to overt.

Sessions increasingly shifted away from our material. We could feel their anxiety in the room. Appointments became more scarce, with cancellations that weren’t rescheduled for long stretches of time. Life happens. We get that. It wasn’t about the logistics. It was the vibe of rejection. Rejection that landed during a significant period of destabilization for us.

We needed support. We thought it was there. And then we realized that in order to receive even small amounts of it, the primary task had become co-regulating our therapist so she felt comfortable, while we sat there feeling like too much. Not the first time this has happened. Probably not the last. Still deeply gross.

Therapy began to feel like something we owed back. The work stopped being about healing and became about reverting to old survival strategies for system safety. Not exceeding. Not being loud. Not being big. Not being emotional. Not crossing invisible lines. Hypervigilance masquerading as self-awareness. Performing “a good client.” Losing any sense of direction or goal other than staying tolerable.

Mental health care often seems to last only as long as we remain manageable and compliant. “Doing the work” without protest. Without destabilizing the room. Without needing more. What does “doing the work” even mean anyway? It’s such a loaded phrase, tossed around like a moral standard, usually by people with far more privilege and far less trauma.

What unfolded was a slow reenactment of the very patterns we went to therapy to work on. Care that stabilizes at first and later becomes something we are made to feel guilty for needing. Withdrawal that is never named but deeply felt. A nervous system that recognizes the pattern long before the mind is ready to admit it.

Boundaries matter. Of course they do. But boundaries without transparency and attunement turn into confused fuckery wrapped in professional language. How many therapists do you know who actively work to reduce systemic barriers for their clients? Who show up with intention and action to interrupt old relational patterns rather than replicate them?

That is what we are looking for. A therapist who is human and grounded. Boundaries that take into account the level of support we actually need. Not boundaries that feel punitive. Not being reminded we went one minute over session time because payment only covers X amount of care and therefore that is all we are allowed.

I get it. What we are looking for is rare. Clinicians are burned out. Insurance systems are brutal. We live in a hellscape. Systemic oppression is real and alive. Everyone is stretched thin. All of that is true. And still, none of that belongs to us to carry as clients trying to build a meaningful, manageable life.

I get jealous of people who go to therapy for a few months for mild depression and feel better after twelve weeks of meds and journaling. It takes us twelve weeks of talking exclusively about our cats before we can even begin to test whether a provider might be able to tolerate one percent of the stress we carry in an average week.

Plural-informed care is not limitless. It is clear and honest. It does not frame support as a favor that later becomes proof of excess. When we asked for a few weeks of increased session frequency during a mental health crisis, we were not asking for something unreasonable. We were asking for support.

Eventually, we could no longer ignore what had been happening for months. Staying meant disappearing parts of ourselves. Staying meant regulating our therapist’s discomfort in real time. Staying meant pulling ourselves back whenever things felt close to the edge so the space could remain tolerable for them. Staying meant holding our own activation quietly and becoming so hypervigilant that we could predict what was available on any given day. That smells like childhood.

Ending this therapy was not clean. Real support did exist at times. This was not some empowering mic-drop moment. It was anguishing. It involved grief, doubt, and a lot of internal negotiation. We questioned whether we were overreacting, whether we were being unfair, whether this was simply the best we could hope for in a therapist. Walking away from subtle harm is much harder than walking away from something obviously bad.

After sitting with it for a few days, it feels clearer. Sometimes leaving is not regulated. Sometimes it is necessary. And necessity still comes with grief. With anger. With the weight of knowing how hard it will be to try again, if trying again is even possible. It means mourning not only the relationship, but the hope we had invested in it.

It is incredibly hard to find competent, dissociation-informed, plural-affirming care. Truly competent. Not “has read about DID.” Not “is open to parts.” Someone who understands dissociation deeply. Who can engage with headmates in real time. Who does not flinch or freeze or center themselves when intensity shows up. Many systems search for years. Many settle. Many stay far longer than they should because starting over feels unbearable and the bar is already painfully low.

The strange silver lining is that the growth we hoped would come from therapy still happened, just not in the way we imagined. We thought it would happen in a therapy office. Instead, it happened through internal collaboration, through naming what wasn’t working, through choosing not to implode or disappear. We wrote a kind email. We took a day to bed rot. We learned more about what we need next time.

Nobody asked therapists to be perfect. Nobody said that they can’t make mistakes. Nobody said they weren’t human.

We’re asking for therapists to treat clients with kindness, compassion & respect. We’re asking them to take accountability & responsibility if they do make mistakes, apologize and do better. We ALL know that humans are inherently imperfect and bound to make mistakes & errors, but guess what, being human & bound to make mistakes does NOT absolve you of accountability & taking responsibility. Mistakes exist so that they can be learned from. Holding people accountable & asking them to take responsibility for their errors is NOT an attack on them. Criticism of therapy & mental health practitioners exists not just for therapy harm survivors to affirm that what they went through was real and that they’re not perceiving things wrong, it also exists so that people looking into therapy can identify the red flags and know what behavior is acceptable & unacceptable from providers. It also exists for providers to learn from so that they know not to do what those providers who were called out did and so that they can provide better therapy for their clients!

The fact that some therapists & pro-therapy folks immediately resort to “oh they’re only human, they make mistakes, they can’t be perfect” when they read about a bad therapy experience instead of you know, showing basic fucking compassion to the client who was harmed and vowing not to do what the provider who was being called out did, let alone enable that bad behavior in the first place, speaks VOLUMES on how they enable that shitty behavior and would rather coddle that shitty provider instead of acknowledging the harm. It also shows how much they downplay therapy harm if they’re willing to brush off a genuinely harmful experience that most likely re-traumatized a client and made them distrustful of providers to the point where they’re afraid to go back as a “mistake.” THERE IS A STARK DIFFERENCE BETWEEN A MISTAKE AND ACTUAL HARM.

Invalidating a client’s abuse experiences isn’t a mistake.

Disrespecting a client isn’t a mistake.

Gaslighting a client isn’t a mistake.

Weaponizing a client’s diagnoses against them isn’t a mistake.

Blaming a client for lack of progress & insisting that they aren’t trying or wanting to get better instead of admitting that you aren’t equipped enough to handle their case or that the modalities you pushed onto them didn’t work isn’t a mistake.

Refusing to apologize after you did or said something awful and the client confronts you for it isn’t a mistake.

These are only a few examples I can think of off the top of my head atm that people claim are mistakes so that they don’t have to fully acknowledge the severity of these grave errors. These are not “whoopsie daisy I made a mistake please forgive me uwu” mistakes. These are real-life examples of therapy harm that are being downplayed as mistakes so that providers who do these things can attempt to avoid accountability and continue doing the same shit they were before as long as they are NEVER EVER held accountable for it.

CLIENTS FUCKING KNOW THAT THERAPISTS ARE ONLY HUMAN, MAKE MISTAKES AND CAN’T BE PERFECT. STOP SAYING THIS SHIT TO SOMEONE TALKING ABOUT THEIR BAD THERAPY EXPERIENCE.

Better yet, why aren’t clients allowed to be human, make mistakes, and be imperfect? OH RIGHT, IT’S BECAUSE A LOT OF Y’ALL DO NOT VIEW THEM AS HUMAN. If you would NOT tolerate a client doing horrible shit such as gaslighting, being disrespectful to others, refusing to take accountability for their actions, and blaming others instead of taking responsibility, YOU SHOULD NOT TOLERATE THAT SAME BEHAVIOR FROM PROVIDERS AND USING THE SAME REGURGITATED “they’re only human” EXCUSE TO SHIELD THEM FROM ACCOUNTABILITY. Therapists are NEVER going to learn from their mistakes or errors or the mistakes/errors of others as long as we hype up this toxic “pro-therapy” culture that allows them to avoid accountability.

ALL CLIENTS LITERALLY ASKED FOR WAS FOR PROVIDERS TO TREAT THEM WITH BASIC HUMAN DECENCY, ACTUALLY BE KIND, SUPPORTIVE & COMPASSIONATE WHILE ALSO HOLDING THEM ACCOUNTABLE WHEN THEY DO MESS UP, AND Y’ALL ARE ACTING LIKE THEY’RE ASKING FOR TOO MUCH.

I speak out because anyone who seeks out mental health services deserves to be treated with respect, kindness, compassion & love.

I speak out because being treated poorly by mental health practitioners should not be normalized.

I speak out because a large majority of “pro-therapy” folks will scream “everyone needs therapy” from the rooftops but are quiet when it comes to acknowledging bad practitioners & educating people on what good & bad practitioners look like.

I speak out because nobody deserves to be harmed by the people who were supposed to help.

I speak out because therapy harm/abuse isn’t being taken seriously enough and is usually being dismissed as incompatibility issues, which does a disservice to therapy abuse/harm survivors. (Example: a queer person describes being harmed by a homophobic/transphobic therapist and whoever they’re venting to just shrugs their shoulders and says “just a bad fit” instead of fully acknowledging how dangerous that therapist was/is, showing the harmed person compassion & validating the person’s experience)

I speak out because a lot more people than we know or realize have definitely been harmed by a bad practitioner at least once in their life, but don’t talk about it.

I speak out because we as a society need to be holding these bad practitioners accountable instead of putting them up on a pedestal, acting like they can do no wrong & that it’s the clients that they harmed that are actually the problem.

I speak out because clients who were genuinely harmed by bad practitioners deserve to be heard & believed instead of being dismissed & silenced because of the negative belief that people with mental health issues are not credible. (This mindset also harms domestic abuse/violence victims & survivors because whether they actually grapple with mental health issues or were falsely diagnosed, abusers use that as an advantage to discredit the abuse they are speaking out about so that they aren’t believed & helped.)

I speak out because people are not willing to acknowledge how traumatizing it is to be harmed by a bad practitioner and how scary it is to give therapy another shot after being harmed by a bad practitioner or having repeated instances of bad therapy.

I speak out because I’m tired of “just keep going from therapist to therapist until you find the right one” being normalized because it normalizes bad/abusive therapists, it’s dismissive to therapy abuse survivors, and does not acknowledge that not everyone has the privileges, money, energy or resources to do so.

I speak out because minors who are being dragged to therapy and forced to see therapists who are siding with their shitty or abusive parents & working on making them more compliant to abuse need more people willing to defend & advocate for them & speak out against their therapists who are being utilized as accessories to further abuse them.

I speak out because I’m tired of people who are rightfully distrustful of therapists & the mental health system & unwilling to go back to therapy because they don’t want to get hurt again being lumped in with genuinely bad humans who are not willing to work on themselves or change their ways and weaponize their trauma/mental health to justify their bad behavior while simultaneously refusing to go to therapy and change despite having the resources & money to do so.

I speak out because therapy abuse/harm has been normalized to the point where some people are being actively harmed & don’t realize it until it’s too late.

I speak out because it is jarring to seek out help for the abuse & trauma endured just to be re-traumatized AGAIN. Especially during multiple instances.

I speak out because I am tired of survivors being blamed for “picking the wrong therapist” the exact same way domestic abuse victims & survivors are blamed for picking their wrong partner.

I speak out because there is ABSOLUTELY NO excuse for a practitioner to harm their patients & refuse to apologize & take accountability.

I speak out because practitioners actively harming their patients do NOT deserve to have a job or career in a field that is supposed to be all about helping others.

I speak out because I refuse to allow bad practitioners to avoid accountability for all the harm they’ve done & the damage they have done; “they’re only human” is NOT a free pass to avoid accountability.

I speak out because I refuse to be silenced & let anyone else be silenced.

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Therapy Life Pro Tip:

If you’re ever at a therapy/counseling appointment talking about the abuse you endured and your therapist/counselor suggests empathizing with them or seeing things from their point of view, tell your therapist/counselor this:

“While I do empathize with them in a way and do try to see things from their point of view, it does not excuse what they did. It is possible for me to simultaneously have some empathy/compassion for someone and acknowledge that their trauma/issues doesn’t excuse the terrible things they’ve done.”

(You don’t have to say the exact words but the sentence above in quote font is a good prompt to use.)