When I say therapeutic harm, most people think of sex, money, or someone crossing a physical line. That stuff is real and serious, and at least it’s easy to spot.

What nobody talks about is the quieter kind. The kind that happens when boundaries are inconsistent, the relationship isn’t managed well, and a therapist and client slowly become enmeshed.

That’s what happened to me.

I don’t think it started with anyone intending to cause harm. I don’t think every warm gesture or bent boundary was wrong, either. But good intentions don’t protect a client when attachment and boundaries aren’t properly managed. Whatever the intention, the impact on me was real.

I’ve spent a lot of my life in therapy. Most people with a severe and enduring eating disorder have. I’ve also copped a shit tonne of iatrogenic harm through eating-disorder treatment: loss of autonomy, paternalism, coercion, pathologising, and a lot of oversimplifying about why someone might need an eating disorder to survive. It left me with significant healthcare trauma.

In hospital, being reduced to obs, bloods and risk ratings is almost expected. I never expected to feel reduced to a list of symptoms by a therapist who’d claimed to see the whole of me.

But in the end, that’s how it felt. My distress got explained away as attachment. My attempts to understand what had happened became evidence that I was dependent. The relationship I’d developed those responses in seemed to vanish from the formulation. In the account that was eventually written, I was the sole contributor to the dynamic.

We’d built what I thought was a close bond. Other people noticed it. I didn’t see a problem. The research is pretty clear that the therapeutic relationship is one of the best predictors of whether therapy works.

Big tick.

Except something in my body never quite settled.

I put the unease down to trauma. My nervous system just hadn’t caught up with what I knew in my head: this person was safe; this person could be trusted. If I sometimes didn’t know where I stood, that was because I was anxious or too attached. It couldn’t be because the frame itself kept shifting.

I got attached. Strongly, anxiously attached. I trusted their read on me over my own. I could justify nearly anything they did, including the things that hurt. I put them on a pedestal.

I bought gifts and made gifts. I wrote endless reflections and formulations to prove I was insightful, accountable and worth the effort. I was performing the perfect client: self-aware enough to understand everything, grateful enough not to push, compliant enough to stay the ‘good client’.

Nobody ever explored what that performance meant. Why did I feel responsible for holding the relationship together? Why did I think I had to explain myself perfectly to be understood? Why did normal limits feel like proof I’d done something wrong? Why was I working so hard to stay special, safe and acceptable?

When I raised this stuff, it was rarely explored in any depth, and I can’t recall the therapist ever raising it first. Noticing the pattern, naming it and trying to repair it was mostly left to me, even though I was the more vulnerable person in the room. And when I did bring it up, it was suggested I was covering old ground, and I was asked why I didn’t trust them.

There was no single moment that should have set off alarm bells. It was a pile of small things over a long time. Each one on its own could be explained away. Together, they made a relationship that felt more and more important and harder for me to regulate.

Then there was my ‘excessive’ emailing.

I wasn’t emailing into a void. I got replies, so I kept writing. A boundary would go in. I’d email anyway. Sometimes I’d get a reminder that it needed to wait for session. Other times the content got a proper response. Tighten, soften, tighten again.

Anyone who’s tried to hold a boundary with kids knows how this goes. A limit you only enforce some of the time doesn’t get clearer. It gets more compelling. If the behaviour works sometimes, you keep trying. For someone with my history, that was potent.

So email became the problem and also the place the cycle kept getting fed. I was told my emailing reflected attachment, dysregulation, difficulty tolerating separation. Maybe it did. But the replies I got shaped what happened next too. I wasn’t doing it on my own.

Looking back, I was stuck in a cycle we’d built together. Uncertainty in the relationship made me distressed, and the only thing that reliably settled it was more contact with that same relationship. I was meant to regulate my attachment on my own while still getting mixed signals from the person I was attached to. I started calling it the Cycle of Attachment Fuckery.

My attachment got treated as if it had come fully formed out of my pathology and latched onto an otherwise neutral relationship. Attachment doesn’t grow in a vacuum.

Therapists don’t cause every feeling a client has about them. Clients bring their histories, their vulnerabilities, their unmet needs. I brought all of that in spades. I’m not denying my part, and I’m not saying my therapist was responsible for everything I felt. But my vulnerability doesn’t cancel out the therapist’s responsibility to notice when what they’re doing is feeding it. Managing the frame is their job.

That’s why this kind of harm is so hard to name. There’s rarely one indefensible act. It’s the push-pull: warm, then distant. Flexible, then rigid. Close, then clinical. And boundaries that only firm up once the inconsistency has already built the dependence.

I was left holding both ends of it. I was told the relationship was safe. I was encouraged to trust. I was shown I mattered. And when I did the obvious thing and got attached, my attachment became the problem to manage.

Eventually I couldn’t tell where my old wounds ended and the ones from therapy started. I knew I was distressed, but I’d learned not to trust my own read on why. Any discomfort had to be my trauma, my anorexia, my autism, my attachment, my inability to cope with boundaries. The problem was me.

The idea that the relationship itself might be hurting me was close to unthinkable. I trusted the therapist more than I trusted myself.

Being hurt by someone with professional power is one thing. Being taught to read the pain they helped cause as more proof that something’s wrong with you is worse.