By Imagine a paranoid schizophrenic. He believes that everyone is out to get him. The world is conspiring to kill him. They are at every corner, at the bus stop, in the parking lot and watching his house at night. He seeks out a psychotherapist. He is surprised but delighted when the therapist agrees with all his delusions. The therapist says, “Yes, people are out to get you, they are at the bus stop and parking lot and they are watching your house.” The patient and therapist collude on how to deal with this “problem” and in so doing dig the patient deeper and deeper into a delusional world that is ruining his life and the lives of the patient’s family. The family has been trying to help the gentleman realize that this is a part of his psychosis, and he needs to take his meds, but they have been far from successful. Nothing they can say has made any difference. Now the patient has a professional ally who agrees with his delusions and that person is also an authority. The family is sunk. They try to get a court ordered commitment to a mental health facility but the therapist testifies that the man is fine and his thoughts are not in error. The judge listens to the therapist and decides against the commitment. Things go downhill quickly. It was bad enough for the family to deal with the man’s pathology on their own but now they are outgunned and easily defeated by the authority, the therapist, speaking out and contradicting their reality. It is simple to see the devastating impact of such collusion and the irresponsibility of the therapist. This is clearly malpractice.
But could this happen in real life? I’m afraid so.
But could this happen in real life? I’m afraid so.

