Therapists are supposed to be impartial, but sometimes a patient crosses a line. These therapists share the moments where they realized just how messed up their patients really were and when they realized they might be in danger. Stories slightly edited for clarity.
"There was only one time I think I was in real danger.
Before I was a therapist, I worked for a brief time at a residential facility for youth with severe neurodevelopmental disabilities (eg, autism, intellectual disability) and behavioral problems. All of our youth had a history of violence, most had experienced trauma, and 2/3 were in state custody. Also, this was a for-profit institution that was horribly managed and woefully understaffed.
I was on the older boys' wing trying to get my group ready to transition to the next activity. Now, one of the boys in my group, let's call him Jay, was pretty high functioning but had significant attachment issues. When new staff (like myself) would come in, he would quickly develop a favorite (unsurprisingly, it tended to be one of the few who would actually treat the residents as fellow humans worthy of respect). Jay was funny and likable and would generally do what you asked, with only a lil bit of sass, which honestly just added to his charming rapscallion persona. However, he'd gradually start to push boundaries, INSISTING that he be in that staff's group (groups changed each shift for this exact reason), constantly demanding attention, acting out to try to get a reaction (one time he told me I would never get a boyfriend because I had a mustache ????), etc. If he didn't get his way, he'd get incredibly angry and upset. And then the next time you saw him, he'd be sweet as pie. Oh, and he'd also stabbed a previous 'favorite' staff member in the face with a pencil.
So anyway, I'm trying to get my group ready to go, and Jay has been continuously saying my name for like 5 minutes. In order to reinforce boundaries and NOT reinforce his tantrumming, I told him that I would be happy to talk when we were all ready to go and then started ignoring him.
I go into the room of a resident with more significant needs (eg, largely nonverbal, intellectually disabled), to get his shoes on, and I close the bedroom door so Jay's yelling would be less upsetting to the resident. All of a sudden, Jay LAUNCHES himself at the door. He's spitting mad and he's trying to get into the room with me. I don't know what he had planned, but I knew it wasn't a calm heart-to-heart conversation. So I put my whole weight on the door, fighting to keep it closed. Unfortunately, at 15, Jay is much bigger than larger than I am (which isn't saying much as I'm 5'0"), and none of the doors have locks on them. It is not going my way. He's able to get the door open a crack, and I can see he's smiling, like this has turned into a game to him. But he's not less threatening or any more in control of his rage. I am freaking out and yelling for backup, but I can't reach my walkie without letting go of the door.
Suddenly, out of nowhere, Jay gets full-body tackled and hits the ground with a thud. I take advantage of the opportunity to SLAM the door closed and send out a frantic emergency call on the walkie.
When I finally walk shaking out of the room, I see Jay, still spitting mad, is being physically restrained by staff members and sporting a brand new bloody lip. To my surprise, staff members are restraining another resident, Tom, who is sitting there calmly just waiting to be released.
Apparently, Tom had a history of witnessing domestic violence, and seeing someone try to hurt women was a huge trigger for him. So he had sprinted from his room, tackled Jay, and put him in a hold. (Tom's parents thought that karate would help their oppositional, angry son more than therapy, so he knew what he was doing.) Tom had to face the standard consequences for violence (eg, physical restraint until no longer a threat, loss of privileges for that day), but I made sure to thank him. I really don't know what would've happened if Tom hadn't intervened.
Most of the other times I was scared while working there involved potential minor injuries (eg, scratching, hair pulling) or exposure to poop. I came out of my 2 months' employment with so many poop stories."
"The only one I have felt a little scared of was one who threatened to kill me. I knew she meant it. She had already assaulted a number of other staff. She got sent to a higher security ward and I heard she had broke staff’s fingers first day she was there. She held staff and other patients hostage in one of our rooms threatening them but circling the table as if playing with them first. I see violence and aggression regularly and it doesn’t phase me but she did. I would purposely avoid eye contact and look straight ahead avoiding her and pretend I wasn’t intimidated, as that’s what she wanted."
"This was early on in training but a mandated client had dropped acid before the session and it started coming on while we were talking - he didn't want to be there as it was and was much larger than me (5'0"). Once he got to threatening me for being the reason everything was wrong with the world I ended up needing to get up and leave my own office to get a supervisor. I definitely thought he would hit and/or strangle me if I stayed."
"I used to be a therapist at a behavioral health hospital. I had some patients who genuinely scared me in theory, but nothing ever happened with them. I was significantly attacked twice at work. Both patients were young women. Neither of them 'scared' me beforehand. Both were incredibly quiet, withdrawn, and unassuming. One strangled me with my keys- my lanyard was a breakaway for that very reason, but she had tried to steal them several times that shift in attempt to escape the building and run into traffic, so I stupidly knotted off the breakaway portion. We carried panic buttons on the lanyards and I was able to press it while being strangled with it.
The other attack occurred when I was fairly new and on a low-security unit, in view of other staff. I was walking away from the patient and she grabbed me by my hair, pulled me to the ground, and dragged me for several feet down the hallway where she began kicking me in the chest and stomach. She was sent to a higher security unit as a result. I guess I was afraid of her after that, but she wasn’t there long. There was law enforcement intervention after she assaulted a pregnant nurse, pulled her to the ground as well, and stomped on her stomach."
"I'm technically a person on the other side.
I went to my university's psych hospital due to suicidal ideation. I was 18 at the time. I was lobbed in with the under 22 group, and there's this fireman in his 20s, who I'd learned through the grapevine (other nosey patients) was bipolar.
No biggie, we all got something wrong in there, right?
He was VERY quiet, decently attractive and kept to himself even in group sessions. He would always give me this penetrative, unblinking stare all day long.
I'm very shy and hadn't spoken two words to the guy. Maybe smiled in passing if I made eye contact (which I avoided due to the staring).
In the main room (like a living room i guess for a psych ward) we'd all be hanging out and he'd sit across from me with a sketchbook. Honestly just thought he was passing time. Once you're committed you can't leave unless the doctor says so.
Anyways, my mom comes to the hospital to visit me and she noticed the guy staring at me.
She walks behind him while he's with his sketchbook and her entire body froze. Like completely locked up as if you're watching a video and press pause.
He had drawn a VERY detailed picture of me.
Hanging from the ceiling in the psych ward.
She calmly tells the nurse and the guy is removed from the room. Never saw him again.
A couple of days later I overheard some nurses saying that the guy had filled the ENTIRE SKETCHBOOK with different drawings of me.....dead...in different scenarios.
Honestly, it was scariest thing I've ever been through.
I could write a book about everything that happened the 8 days I was there."
"Not a therapist but a school counselor (small young female). I have a student who is 6’4” with emotional behavioral issues. Reading his social history made me cry because of all the stuff he’s been through. So, of course, I have a soft spot for him. But his anger gets out of control and it can be very scary. He punched a pole right in front of me once and narrowly missed my face. I looked at him in the eyes and sternly said do you realize you almost just punched me in the face? He snapped out of his rage and apologized profusely. I wanted to hug him and tell him everything was going to be alright."
"I was pretty nervous when the inebriated partner of a client backed me into a corner, and pretty understandably sweaty when a violent convicted offender with a good 80 pounds on me blocked my exit and told me he was going to kill me and my family.
The one that really got me long-term was a 15-year-old girl in a residential program I worked at. She had substance use issues, which is why she was there, but it was clear from the jump that she had deep, DEEP mental health stuff stemming from her child. She had been adopted out of a Russian orphanage where she and a younger sibling has been left in a crib alone for god knows how long, covered in lice and shaved bald. She had a lot of (expected) attachment issues but talking to her was like talking to a black pit full of hatred. She hated everyone and everything and had no conception of consequences or what self preservation was. She'd do stuff that would spin your head around in terms of how unsafe it was...and she just had no reaction. There was no getting through to her, as she needed the interventions when she was a very small child to be able to move forward successfully. She was discharged when it was found out that she was hiding knives under her mattress. I would not be surprised if she was in jail at this point."
"I taught a little boy last year with serious attachment issues. He was only 4 and was typical of a child with trauma - incredibly risky behaviors and a lot of uncontrollable rage that would flare up over nothing (e.g. he decided he was bad and had to go on time out, I said that he wasn't bad but he could sit in the time out spot if he wanted, he screamed that he wanted a time out and trashed the class room). Unfortunately the issues stemmed from his home life - his mom was severely neglectful at best, but there were also significant signs of physical and other abuse. We reported everything and he went into emergency foster care twice during the year, but social services always sent him back to his mom. As a result, all the stuff we were doing at school was undermined as soon as he went home - he used to ask me if he could come home with me, thinking about that child breaks my heart every day."
"In my first semester as a practicum therapist I had a gentleman client bring a large hunting knife to session one day (he had it in his waistband in the back). He revealed it halfway through our session. He had been referred to our practice for anger issues.
Another client, this ENORMOUS dude, confessed to punching a sleeping infant in the face and head repeatedly because he had become jealous of it. Then one day he comes into session. He seems more calm than usual, and as we discuss the previous week’s session he tells me about how much he hates his wife, and he had incidentally bought a loaded weapon to go deer hunting (We are in SoCal). That was the last session we had before he stopped coming. I still think about that guy a lot. I hope that baby’s okay.
When in doubt, REPORT."
"I am a woman and a therapist working with people with severe issues. I had a client come in for an initial visit whose file read like that of a serial killer. Animal abuse, torture of other children when he was a child, homicidal attempts. I had an initial moment of intense feelings of 'ahhhhh!!!' And then shifted to 'what happened to this guy'. Turns out it what he went through As a child was more horrible than I could have imagined. We did a lot of great therapy work together and last I heard he was doing really well in his life. As a therapist, I don’t give up on people just because they have done and are capable of some pretty horrible stuff."
"Yes, I was so scared- scared enough to quit my job. I had a high case load of suicidal teens. Most were medicated and low risk, but had two kiddos who had several suicide attempts prior to me, and while under my watch. I was getting physically ill, not sleeping well, constantly worried. I tried to transfer them to a higher level of care but our company was greedy and didn’t want to transfer them and lose those funds.
I ended up quitting on the spot for these kids to be given a trauma-focused therapist and get the help they needed.
Best decision for both myself and those kids."
"Yes, I was scared and still am scared of them.
They were very delusional and a heavy addict. They decided our therapeutic engagement was a love story unfolding. It all ended with the SWAT team showing up at the office when they showed up with a weapon and lost their minds when I wasn’t there. They disappeared for a couple years. They appeared behind me on a bus one day and said, 'I saw you with your daughter at your house she’s really pretty.' Then gave me my address. They are a known convicted offender. I moved as soon as I could"
"Worked with a patient that complained of reoccurring night terrors about lobsters being boiled alive.
He couldn't figure out what was causing them.
The fact he killed his girlfriend, chopped her up and boiled her head didn't seem come to him as a reason he might be having these dreams.
My only fear is the system will have to release him one day as they could never get him sane enough to stand trial."
"I have been scared a handful of times. It’s not the people who have done the worst stuff—it has a lot more to do with the way the dynamic feels.
I remember when I was working on an adult acute unit, there was a guy who had come to be there through some kind of bizarre circumstances. He was a pretty important person in the rural area he was from, and he was pretty charismatic. He had a huge family that all showed up for the family session despite having to drive several hours to get there.
The unit had windows that were translucent from ceiling to floor so that light could get in but no one could see into or out of the unit for privacy.
I met with each patient individually as well as in groups, and my office door locked automatically (as is typical for acute units). No one but myself and the custodian had a key. For this reason, I usually tried to meet with folks individually in the group room when it was empty, so we had privacy but I could also get help if needed.
This guy came to my office door and knocked. When I opened it, he came in without an invitation and sat in one of the 2 chairs on the door side of my desk. I sat in the other. He was going on about how much he appreciated my work and how much I’d helped him (which felt disingenuous—he frequently indicated he didn’t feel he needed to be there).
I became gradually aware that he was between me and the door, which was not usually a problem (you actually want to make sure folks have easy access to an exit. Contrary to popular belief, you don’t want to be between a patient and the door. I did home-based work after I left inpatient work, and in that context, you most definitely do need to be closest to the door). I was also uncomfortably aware of how close he was to me. He could easily touch me if he decided to. I was aware of the fact that I don’t usually feel uncomfortable with proximity, as long as I generally feel safe, so alarm bells started going off.
Then he suddenly said, 'how do you like driving that little silver [make and model of my exact car]?' As I said, the windows of this building were all frosted, so there was no way for him to see me getting into or out of my car. All the hairs on my body stood on end.
I had the mental image of being in a room with a tiger. Maybe I’d be fine. Maybe the tiger wasn’t hungry or mad. Or maybe he was. I was only going to get out of that room safely if he decided to let me, which is exactly the experience he wanted me to have, and I could see that he was enjoying it. That was scary, even though I didn’t have any reason to think he was interested in hurting me physically.
Thank god I have a degree in theatre. I’m sure his predatory instincts told him that I’d received his message loud and clear, but I gave no outward indication of my feelings. I got him out by saying I had to meet with the psychiatrist, and he left the unit soon after.
That was very early in my career, and one of the first of a handful of instances. I’ve done meaningful work with murderers, men who abused women in bed, animal and child abusers, and just ordinary bullies, and like I said, it’s not about what someone has done. The folks who have frightened me were (with one notable exception) just ordinary people without scary rap sheets."
"My sister is a therapist and I am currently in school to be one. This thing happened to her and it actually caused her to contemplate other career choices.
Like most therapists working for the public, she was treating a court-order client who had a personality disorder and a history of antisocial and predatory behavior.
Long story short he developed an obsession with her, and told her in session that he could, and would, find out where she lived and visit her sometime. She tried to redirect the conversation but he remained fixated on it.
Needless to say this bothered her, but it really came to a head when, a couple of weeks later, her husband noticed a particular car drive past the house a few times one day while he was working out in the garage. They found out soon after that this car belonged to the client that was fixated on her.
My sister was terrified to the point of not being able to sleep and needing her own anxiety counseling. It was very traumatic for her and I don't think she ever found out exactly how the client got her address. Needless to say his case was dropped from her and she never had to work with him again, and I believe she got a restraining order. Fortunately she also lives next to a Sheriff so that helps.
That was a scary situation and this is why I'm convinced that in order to be a Mental Health Therapist, you need to be just as tough as you are compassionate, at least if you work on the public/community level. Especially in this day and age where someone can always find your dox if they look hard enough.
As for my own work on the field, I've worked with a number of dangerous clients, but i sort of thrive on stressful work, even with trauma in different situations. You've gotta know yourself and which situations you're getting into."
"I’m not a therapist, but I know someone who once worked at a behavioral hospital. Scariest thing they told me was when a client admitted themselves after blacking out on Ambien. They woke up one morning, covered in blood, and could not find the source. They went to the bathroom only to find that their poodle was disemboweled, demonic words were written in blood on the walls, and there was a recording of them doing everything on their own. They swear they had no recollection. Nothing. The clinician called the family to gain further history and background. Evidently, that wasn’t the persons first time mutilating animals and this was a pattern. The family said that they reviewed the video and it was a massacre."
"When I worked with family court there was this super smart, super troubled kid who was in hot water for beating up a random guy on the street with a baseball bat. Open and shut, surveillance camera caught everything. Apparently he didn’t know his victim, just a random act.
Anyways, he was being tried as an adult (he REALLY beat this dude up) and was being held in adult jail pre-trial. He was assigned a therapist and had a few sessions per week. Long story short, one session the kid gets mad, grabs the chair he was sitting on, and beats his therapist within an inch of his life. I think the poor guy was on a ventilator for like a week.
Yeah, the kid had some issues."