11/26/2025
"Clinical Harm: An IPNB Perspective on the Therapist’s Agenda"
When a therapist repeatedly interrupts, dismisses a client’s distressing experiences, or imposes their own agenda, it can have significant negative effects on the client’s nervous system, often triggering a state of dysregulation. Here’s what happens from an Interpersonal Neurobiology (IPNB) perspective:
Activates the Fight/Flight/Freeze Response
Interrupting the Client: Each interruption can signal to the client’s nervous system that they are not being heard or understood. This activates the brain’s threat detection system (amygdala), potentially triggering a fight (anger, frustration), flight (withdrawal, avoidance), or freeze (shutting down) response. The client may become hyperaroused (anxious, agitated) or hypoaroused (numb, disconnected), depending on how their nervous system responds to the perceived lack of safety.
Triggers Shame and Self-Doubt
Dismissing Distress: When a therapist dismisses or minimizes the client’s experiences, it can signal that their emotions or perceptions are not valid. This can activate deep feelings of shame, inadequacy, or confusion, as the client might feel that something is wrong with them for having these feelings. Shame and self-doubt further dysregulate the nervous system, making it harder for the client to engage in the therapeutic process.
Impedes Nervous System Regulation
Lack of Attunement: Attunement is a process where the therapist resonates with the client’s emotional state, providing co-regulation that helps the client’s nervous system find balance. When a therapist turns the focus to their own agenda instead of attuning to the client, it disrupts this co-regulation process. The client’s nervous system may stay in a state of heightened stress or overwhelm, unable to reach a state of calm or safety, which is essential for healing.
Destroys Relational Trust
Betrayal of Safety Cues: Therapy should be a safe space where the client feels heard, validated, and supported. Interruptions and dismissals send contradictory signals, telling the client’s nervous system that the relational safety they need is not present. This erodes trust, making the client’s nervous system more hypervigilant in future sessions, anticipating further invalidation or judgment. Without trust, the therapeutic relationship breaks down, and the client may become resistant, anxious, or disengaged.
Reinforces Trauma Patterns
Re-traumatization: For clients who have experienced trauma, being interrupted or dismissed in therapy can mirror past experiences of being silenced, ignored, or disempowered. This can re-traumatize the client, reinforcing patterns of helplessness, hopelessness, or mistrust. The nervous system may revert to protective strategies (e.g., dissociation, emotional shutdown) that were adaptive in previous traumatic contexts but are now barriers to healing.
When a therapist interrupts, dismisses, or imposes their agenda, the client’s nervous system is pushed into a state of dysregulation. Instead of creating a space where the brain can heal and integrate, it reinforces threat responses, shame, and disconnection, all of which are detrimental to the therapeutic process. The foundation of IPNB–attunement, empathy, and co-regulation–must be prioritized to support nervous system health and healing. But few in the mental illness industry have even a clue.
