Patrick Carnes, Ph.D., author of The Betrayal Bond; Breaking Free of Exploitative Relationships and founder of the International Institute for Trauma and Addiction Professionals (IITAP) says, “Exploitive relationships create trauma bonds. They occur when a victim bonds with someone destructive to them.” Essentially, trauma bonding occurs when unhealthy attachments form between victims and someone who is harming them—emotionally, sexually, psychologically, or physically. Now let’s imagine that the relationship in question is between an abusive therapist and an unsuspecting client. Clients who experience trauma bonds in abusive therapy find themselves in a horrifying and baffling reality—a reality in which they know they are being harmed, yet they feel unable to walk away.
Imagine being abused by the very person, the very professional, you turned to for help. The person you believed had the training, the experience, and the emotional maturity to help you overcome past abuses in your life. A person whom, over time, you would grow to love and trust so much so that you would share everything with them.
Never in my wildest dreams did I imagine being hurt by a therapist, someone who gets paid to help people. That is, until I was groomed and abused by my psychiatrist in 2014. Don’t those people possess an extra dose of empathy and compassion? As it turns out, I’m afraid many go into the helping profession because they enjoy manipulating and abusing others, and clients in therapy, often hurting, vulnerable, and unsuspecting, provide the perfect victim pool.
The abuse is not easy to detect, however. If it were easily detected, we wouldn’t have clients being harmed at such an alarming rate. (Therapy Exploitation Link Line hears from approximately 40-50,000 therapist and clergy abuse survivors every year.) No, the abuse process is extremely subtle, almost benign. For that reason, most clients never see it coming until it is too late.
Stages of Abuse in Therapeutic Settings
- Love bombing: This is the honeymoon period where the abuser (therapist or pastor) will convince victims that they are special, worthy, and desirable. During this phase, abusers will uncover the person’s voids and attempt to fill them, resulting in a sense of euphoria in the victims.
- Trust and dependency: The clients become attached to this newfound sense of wholeness and optimism as the therapist or pastor continues to satisfy these (often unconscious) childhood longings.
- Criticism: Cracks in the perpetrator’s shiny veneer will begin to show at this point, but only sporadically, and the clients are willing to overlook these flaws or momentary “slips” to keep this newfound sense of hope and fulfillment.
- Gaslighting: Abusers try to distort victims’ sense of reality and break down their sense of self. Therapists may do this by convincing their clients that they are mentally ill and that they imagined the abuse. They will also plant seeds of doubt about any significant relationships in the patients’ lives to weaken those bonds and isolate them further.
- Resignation: The victims eventually accept that they need this relationship despite its flaws and must do whatever it takes to keep it. Like being given a taste of a drug, abuse in therapeutic settings causes clients to do whatever is necessary, even if it means abandoning their own consciences, to keep the abuser happy and maintain the connection they believed they experienced in the beginning.
- Loss of self: The victims feel self-hatred and shame for staying in an unhealthy relationship and for participating in acts they would otherwise never participate in, allowing behavior they would otherwise never allow. They feel hopeless and trapped—hurt if they stay and hurt if they leave.
- Emotional addiction: Victims stay knowing they are being harmed in the hopes that the good parts of the abuser will return, while on some level suspecting that those good parts were never real to begin with. Accepting that reality is simply too painful, so they hold on to the lie.
Trauma Bonds in Abusive Therapy
Experts describe many reasons why people develop trauma bonds in abusive therapy. Here are some of them:
Childhood Abuse
When we have experienced abuse as children, we tend to gravitate towards abusive people as adults. We do this for several reasons. First, the dynamic feels familiar. Dr. Lenore E. Walker states, “The abused child learns that love and harm can coexist, and this confusion can shape adult relationships in dangerous ways.” Meaning we may tolerate an abusive therapist because our original caregivers taught us that cruelty, when it is interspersed with kindness and care, is normal.
Second, Bessel van der Kolk explains: “Trauma survivors often unconsciously seek out situations that replicate the original trauma in an effort to gain mastery over it.” In other words, we stick with abusers with the hope that this time around, we can right the wrong or convince the abuser to change and provide us with the love we need. As children, we could not convince our mom or dad to love us and stop hurting us, so it makes sense that as adults, we would gravitate toward a therapist who replicates our abusive caregiver, hoping that this time things can be different.
Childhood abuse is very common among survivors of therapist and clergy abuse. Victims may seek counsel/help from a therapist or a pastor due in part to the abuse they suffered as children at their parents’ hands. Perpetrators use this to their advantage by playing the role of savior, perhaps becoming an adoring, loving mother or father figure for the victims. As a result, the clients feel soothed, elated even, as this childhood void is met for the first time. Duly attached, predators begin to up the ante.
Obligation
Mo Therese Hannah, Ph.D., chair and co-founder of the Battered Mothers Custody Conference, and professor of psychology at Siena College, says, “trauma bonding can also occur when the victim feels a sense of obligation to the abuser. ‘Certainly not all, but especially in instances where a female survivor became bonded to her abuser in her youth … she feels dutiful and obligated to him and, in most cases, at least for a while, he has treated her well,’ says Hannah.” My predatory therapist breached boundaries, such as providing longer sessions and free sessions. He implemented this strategy to create a sense of indebtedness in me. And I can tell you it worked because feeling like I owed him made it harder for me to leave when his offenses grew more nefarious down the road.
Survival Technique
“Hannah says trauma bonding has similar traits to Stockholm syndrome, a term originally created to describe how victims of kidnapping can begin to feel a connection to their captors over time.” Survival is the goal here. By aligning with the perpetrator, victims feel less threatened and more protected by the abuser as if they are on the same side. In addition, they will convince themselves that they are at least partially to blame for the assaults, thus leveling the playing field even more.
Most therapist and clergy victims I have spoken with tell me they stay with the abuser not because of fear for their life, as many domestic violence survivors can attest, but rather because they no longer trust that they can survive without the abuser. The lines have become so blurred that they cannot see where the abuser ends and they begin. The perpetrator who is harming them has also become their lifeline. That was certainly the case for me. I needed my abuser to comfort me for the abuse and pain he was inflicting. Talk about baffling.
Often, victims need help to get away, and most outsiders will not understand abuse in therapeutic settings or the psychological hold the abuser has over them. So, instead of walking into a lion’s den of judgment and ridicule, clients stay with the abusive therapist. At least, the abusive therapists grasp what is happening. Without them, victims are utterly alone. As a matter of survival, they will stay with the abuser until they find somewhere safe to go. And until the issue of therapy harm is more widely understood, those safe places are limited.
Negative Reinforcement
Trauma bonds in abusive therapy can resemble an addiction. This is due to a pattern of repeated positive and negative reinforcement, but the negative reinforcement is what keeps the clients stuck. When abusers love bomb victims, feel-good chemicals flood their brains. When those loving acts end or are removed—maybe the session ends—the victim goes into a negative emotional state which mimics heroin withdrawal.
As the positive reinforcements continue over time—longer sessions, personal sharing, physical nurturing, gifts—just like repeated hits of a drug, the highs diminish in intensity, while the lows deepen. As a result, victims are thrust into a state of perpetual agony as they struggle to return to baseline. They long for that initial high that no longer carries the emotional intensity it did in the beginning, while suffering from increasingly darker lows. Like an addict, they are desperate to escape this state of despair. And who has the power to remove them from this miserable state? The abusive therapist. To learn more about how negative reinforcement entraps victims, see this brief video from neuroscientist, Dr. Hermina Nedelescu.
Intermittent Reinforcement
Intermittent reinforcement is a powerful form of reinforcement and is a hallmark of any abusive relationship. In this form of reinforcement, the rewards come randomly, intermittently, so the people in its grip are constantly waiting, continually hoping for the next win, the next dopamine rush. This type of reinforcement is exactly what makes gambling so addictive.
Not knowing when to expect the next win or the next emotional high traps victims in a state of perpetual craving. Abusers create this insatiable hunger by love-bombing their victims—showering them with kindness, attention, and affection, but these acts come sporadically and without warning.
Later, these positives will become interspersed with negatives or abusive behavior, but once addicted to the abusive therapist, the clients will hold on, convinced good times are just around the corner. As my abusive therapist’s cruelty intensified, I knew I should walk away, but I was too attached to the father figure I thought he was in the beginning. I would wait for that person to come back. Surely, when he realizes he is hurting me, he will return to the nurturing and safe parental figure I thought he was in the beginning.
The only problem with that plan was that I couldn’t see the pattern of manipulation. The parts of the relationship that I deemed positive were merely grooming tactics employed to gain my trust and attachment. So, in reality, there was nothing good to return to.
Cognitive Dissonance
“The reason why trauma bonding can occur, adds Dr. Tholen, may also have to do with the theory of cognitive dissonance—which is when a person has one or more conflicting beliefs or behaviors that lead them to strive to alter one of the beliefs or behaviors to reduce the discomfort they’re feeling.”
Once I was attached to my abusive therapist, I couldn’t make sense of the negative behaviors I was seeing. How could this kind and gentle soul be both loving and abusive? Good and evil? Humans cannot tolerate such conflicting thoughts or emotions about one person, so they are forced to pick a side to lessen the psychological distress. I chose the persona I wanted to believe in most, the good and nurturing therapist, and I dismissed or minimized any evidence to the contrary.
Signs of Trauma Bonds in Abusive Therapy
This article was written for victims of domestic violence, but I believe this list also describes the dynamics between an abusive therapist and client. (Kippert, 2026)
- You feel stuck and powerless in the relationship but want to make the best of it.
- You don’t know if you trust the other person, but you can’t leave.
- You would describe your relationship as intense and complex.
- There are promises of things getting better in the future.
- You focus on the good parts of the relationship despite behaviors you know are abusive.
- You think you can change your abusive partner (therapist).
- Your significant others have advised you to leave the relationship, but you stay.
- You find yourself defending the relationship when others criticize it.
- The abusive partner (therapist) frequently lets you down, but you still give them the benefit of the doubt.
How to Break Trauma Bonds in Abusive Therapy
Walking away from an abuser is challenging. Just as a person would not begin a long journey without first sorting out all the details, a victim needs a plan before they make a break from an abuser.
Breaking the Initial Tie
Before victims can leave an abuser, they must free themselves from the proverbial chains that enslave them. I was unable to do that on my own. It required reaching out for help, but I was ashamed. What will people think of me when they find out what I had done, what I had allowed, what a fool I was for falling for this abuser’s tricks? As a result, fear held me hostage until I garnered the strength to tell.
It is important to note here that we must tell…until. In other words, we must reach out for help until someone believes us. The first person I shared my abuse with sided with the abuser, which forced me back into his clutches. However, the second person believed me and helped me to escape. Abuse of power and abuse of adults by therapists is largely misunderstood. Because of this, we have to tell and keep telling until someone hears us and believes us.
Staying the Course
Second, victims must stay the course, avoiding the abuser as he attempts to lure them back in. Survivors must cut off all contact. These abusers are master manipulators! They will say whatever is needed to regain control. My abuser guilted me, telling me it would kill him if I ever left. He suggested that I could not survive without him. He also told one of his victims that no one will believe a patient in therapy over a trained professional.
My last therapy session was at 9 am on a Monday. Instead of going, I drove to my pastor’s house, and he and his wife sat with me while I cried and cried, and the abuser called and called. He left nine voicemails, and they became increasingly desperate. I could hear the sadness in his voice. Had I not had the immediate support, I believe I would have caved and answered his call.
Escaping abuse in therapeutic settings is no easy task. Therefore, a support team is vital during those initial days, weeks, and months. Survivors need people to remind them that the abuser harmed them because trauma bonds create such confusing and contradictory emotions. Victims hate the abusers for hurting them while simultaneously grieving the loss of the man or woman they thought was trying to save them. That is too much for someone to process alone.
Healing Trauma Bonds in Abusive Therapy
Trauma bonds in abusive therapy create a baffling set of issues for the victims. They may feel both hatred and longing towards their abusers for months, even years to come. They may vacillate between knowing they were harmed and believing they caused the abuse. As victims continue to heal, these conflicting feelings will shift, and the reality of the situation will become more apparent.
It is painful to admit that we were duped and used by someone we thought we could trust, by someone we possibly came to love, but it is a vital step in healing from therapy harm. Accepting the truth about the relationship opens the door to healing. Trauma bonds are not love. They are what they say—a bond based on trauma, cruelty, interspersed with the illusion of love and kindness. Shattering that illusion is the first step in moving forward.
For more on grooming tactics abusers use to manipulate their victims, click here.
