Therapists Talk About the Patients That Actually Frightened Them

Let’s get creepy, shall we?

I’ve always wondered what it would be like to be a therapist who had a scary patient and I guess now I’m gonna find out.

Because we’re about to read responses from therapists who’ve had patients that they were genuinely afraid of.

Check out these responses from AskReddit users.

1. Scary.

“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.”

2. She meant it.

“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.”

3. Rage.

“I have a student who is 6’4” with emotional behavioral issues.

Reading his social history made me cry because of all the sh*t 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. “

4. Freaky.

“I was pretty nervous when the drunk partner of a client backed me into a corner, and pretty goddamn sweaty when a violent s*x 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.”

5. That’s bad.

“In my first semester as a therapist I had a client bring a large hunting knife to session one day, he had it in his waist band in the back.

He revealed it halfway through our session He had been referred to our practice for anger issues.

When in doubt, REPORT.”

6. Had enough.

“Enough to quit my job.

Had 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.”

7. WHOA.

“They were very delusional and a heavy addict.

They decided our therapeutic engagement was a love story unfolding. Ended with the swat team showing up at the office when they showed up with a weapon and lost their sh*t 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 s*x offender. I moved as soon as I could.”

8. Like a horror movie.

“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 gf, 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.”

9. Takes a strong person.

“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. 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, rapists, 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.”

10. Two incidents.

“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.”

11. A charmer.

“Worked residential for 20 years. Had only 2 kids scare me

. One put his baby sister in the freezer. She was found quickly and was ok. He was charming, a good looking kid and quite clever. Also no history of trauma or abuse. Serious serial killer vibes.

One was horribly abused and somehow figured out I was pregnant. I wasn’t showing at all since I was fat. He would just stare at my stomach. I asked to be moved to a different group. First kid was or still may be a case study for students at the local big university.”

12. The door is blocked.

“The only time I’ve ever been scared is when my physical safety is threatened such as a patient blocking the door, hinting they know where I live, or implying they’d like to hurt or r*pe me.

I have a stellar poker face and once these really tough patients realize that I’m unfazed they usually drop it. My strength in therapy is mostly just broad acceptance and tolerance of whatever they bring to the table.

I let them know when I have to break confidentiality from the get go and that’s that.”

Have you ever had a patient, a co-worker, a friend, or a family member who you were legitimately afraid of?

If so, tell us all about it in the comments.