Note: Please see page on ‘Leaving and Stabilisation’ for further information on why therapy may not be indicated. There are many therapeutic experiences that can occur outside of therapy. However if you have already decided that you wish to explore therapy the below information could be useful.
Difficulties accessing therapy
Most survivors would not be able to afford private therapy and therefore may have very limited options. A referral to Community Mental Health Services may give you access to ‘social prescribing’ (access to activity groups for example), group therapy and sometimes individual therapy if you wish to explore this. Recovery college based workshops and groups are usually available much more widely and quickly than individual therapy. However many of the available options in the opinion of many cult recovery specialists would not be suitable for a person with complex PTSD following leaving. For example, many of these groups will include mindfulness, which may be a trigger for you. Mental health professionals are generally not given sufficient education about cult involvement.
Waiting lists for individual therapy in the UK are also often up to a year long and usually only short term therapy is available unless you are offered a support package through a ‘personality disorder’ team. If you are able to afford private therapy or find an appropriate therapist through health services, recommendations based on research, my clinical judgement and experience are below.
What should good therapy feel like?
In order to minimise the risk of retraumatization, the behaviours of the dysfunctional and coercive system must not be replicated within the system that you turn to for support (Bloom, 2000). The environment and person should be transparent, honest, authentic, boundaried and non judgemental (all qualities that are the opposite of the abusive group). The therapeutic relationship is key, and it’s ok to try several therapists before committing to one that ‘feels’ right. Abusive groups reframe abuse, hostility, and coercion using the ‘pure’ shared language so that the feedback your body is giving you about nonverbal cues is dismissed or you are left confused. As a result of this many leavers report that they quickly entered another abusive environment or met an abusive therapist shortly after leaving. Sadly therapists don’t really have ‘reviews’ although any serious incidents reported do have consequences. My thoughts on the qualities of a ‘good’ therapist for a Buddhist cultic group leaver are below.
Empathic and non-judgemental
‘Buddhist’ groups have no understanding of or empathy for abuse and trauma. Leavers are in need of a great deal of unconditional positive regard and empathy. Therefore an emotionally cold therapist in my opinion is retraumatising.
Not ‘What’s wrong with you?’ but ‘What has happened to you?’
Buddhist groups tend to pathologise the person who is not ‘happy’ with a situation within the group as ‘disgruntled’, spiritually inadequate or ‘deluded’. Therefore, any person or system that you turn to must not pathologise you as broken or bad in any way, or pathologise anger. A trauma and attachment sensitive treatment system would see you as temporarily ‘injured’ (although it may feel long lasting) instead of ‘sick’. If you feel judged, or like there is a strong power imbalance between yourself and the clinician, it may be more therapeutic to leave rather than continue. This presents cult leavers with a dilemma because there are not enough treatment environments that are set up in the way that they need. Sometimes mental health professionals feel safer if they protect themselves from the idea that they too could be as vulnerable to trauma as their clients. This means that they might use language that puts distance between you and them, with them in the ‘well’ position and you in the ‘sick’ position. Nonverbal information can also reveal this dynamic, and not just the words they use.
Boundaries and not encouraging co-dependence
Therapists should not encourage you to become dependent on them, their approach or methods alone. Instead they should support you in taking steps to build a new life with people in it that you feel safe around, if this is what you want. This may be difficult to assess however because your intuition and boundaries may still be affected by your trauma. Trying to practice ‘equanimity’ towards people who actually make you uncomfortable also means that you may be disconnected from your intuition. Cult involvement destroys your boundaries, and so it may be difficult to spot if the therapist crosses them. In addition someone who grew up in a dysfunctional family will often pick inappropriate role models because they don’t know what ‘healthy’ feels like, and can make assumptions without checking them out. They are also ideal candidates for exploitation because they don’t know when to say no.
The dilemma of ‘expert’ versus novice
‘What I found in treatment is that therapists and substance abuse counsellors have no clue how to help ex cult members. How do you explain to them you’ve lived in a fantasy world of visualizations, denying anything inherently exists and worshipping an emaciated, elderly man with crap English as an incarnate Buddha?’
Anonymous NKT survivor (shared with me in private email, quoted with permission)
Jenkinson (2018) argues that cult leavers need specialist therapy which frames their experience within psychoeducation about thought reform. She goes on to argue that the therapist needs to understand the cult pseudo-personality, and how this has developed as a result of the persons involvement, overlaying their pre-cult personality. Sadly, there are not enough therapists who have been adequately trained. Some professionals advertise themselves as ‘exit counsellors’ or cult ‘experts’ who may have specialist knowledge and training of how cults operate. However anyone can describe themselves as a cult ‘expert’ and some people are critical of the idea that specialist therapists are necessary. A strong understanding of coercive control and experience of working with those with complex trauma and dissociation would be important in my opinion. Be very wary of anyone who describes themselves as a deprogrammer. Some people who were ‘deprogrammed’ have reported that it was retraumatising and extortionately expensive.
Choosing a therapist based on their model
The therapeutic relationship remains key however the model is also important to consider. It is my opinion that there is a risk that Cognitive Behavioural Therapy (CBT) could be retraumatising due to the focus on challenging negative automatic thoughts and practicing more ‘positive’ ones. Therapy that is manualised is not suitable for a person who has left an authoritarian and coercive environment. Myself and several other ex-members have reported that Gestalt therapy (an experiential/existential therapy that incorporates the body) assisted them in their recovery.
Jenkinson (2018) argues that cult leavers should not have therapy that focuses on traumatic material until the person has left the group both physically and psychologically. This could take significant time. Therapy could assist you in mobilising your social resources in the meantime however. If in the future you do go on to have trauma therapy such as Eye Movement Desensitisation and Reprocessing (EMDR), ask if the therapist has worked with anyone who complex PTSD and dissociation in the past. Only therapists who have done level 3 training are qualified to work with people suffering from dissociation, depersonalisation or derealisation.
This page will be updated when I have gathered new information or new insights become available.
References
Bloom, S. L. (2000). Creating sanctuary: Healing from systematic abuses of power. Therapeutic Communities: The International Journal for Therapeutic and Supportive Organization, 21 (2): 67-91.
Jenkinson, G. (2018). With cult leavers traditional therapy is not enough. New Psychotherapist, Issue 69, page 54.
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