How accurately does the media portray mental health and therapy?

There is the old saying that art imitates life, but sometimes art can distort what is real for the sake of entertainment. Therapists and other mental health professionals have been portrayed for years in comic roles (Frasier) and, more recently, in dramas in the valuable role of criminal profilers (The Mentalist, Criminal Minds, and Law and Order: SVU). It has even gone as far as reality television (Dr. Phil, Dr. Drew, Hoarder, and Intervention) where people get help from an expert. Media attention on mental health and psychology should be a positive way to create debates about mental health problems without an associated negative stigma.

However, attitudes about mental health and therapy have been influenced by comedies and dramas that skew the truth about what therapy is really about. People may find it funny to see Lisa Kudrow as a snobbish and dysfunctional web therapist who deals with misfits, but these types of characters can also cause people to avoid getting the help they need. TV and movie therapists often do things that are unethical, like get romantically involved with a client.

Let’s take a closer look at some recent representations on television and film to see how fiction compares to reality.

TV

In treatment: This half-hour HBO show ran between 2008 and 2010 and featured Gabriel Byrne as Dr. Paul Weston, a therapist who helps the patient solve personal problems while seeking his own therapy to fight his own inner demons.

What is good: The show is engaging and plausible in showing how Byrne’s character helps her clients explore their personal lives and recognize things about them that are out of their awareness. Exploring your patient’s relationships and how events in their life led them to therapy is exhilarating.

What is not so good? While having feelings about clients is not uncommon (countertransference), Dr. Weston regularly struggles with attraction to a client in season 1, and is later drawn to a new therapist that he begins seeing for counseling in the season. 3. Weston is neurotic in his struggles with personal relationships and traumatic childhood events that result in his need to save others.

Tell me you Love Me: This HBO series followed 3 couples connected through a sex therapist (Jane Alexander). Couples include middle-aged Katie (Ally Walker) and Dave (Tim DeKay) who haven’t had sex in over a year; Carolyn (Sonya Walger) and Palek (Adam Scott) have a lot of sexual intimacy, but they struggle with both the ability and desire to conceive. There is also a couple in their twenties with a healthy sex life, but trust issues that arise during an engagement.

What is good: The show shows three couples in different stages of their relationships. His visits to the same couples therapist (Jane Alexander) are realistic and show the demeanor and composure of a therapist. It is also realistic in showing how sometimes couples do not always start therapy together, but initially alone when addressing their emotional and physical intimacy issues.

What is not so good? These couples are portrayed negatively as mostly arguing with each other and showing that their relationships are stagnant in some cases of destructive behaviors even though they genuinely love each other.

Films

Hope is: Kay (Meryl Streep) and Arnold (Tommy Lee Jones) are a couple who decide to reconnect and spice up their marriage by seeing the couples specialist, played by Steve Carell. There is a lot of humor in watching the couple lose their complexes and reignite the spark that made them fall in love.

What is good: Steve Carell plays Dr. Feld as calm and compassionate in helping the frustrated couple. Carell portrays Dr. Feld as a non-judgmental therapist and serious about creating a safe environment for the couple to open up about their relationship. In an interview, Carell stated that he spoke with counselors to learn of their approach as a guy who is not there to solve your problems, but to help open lines of communication without judgment.

What is not so good? The movie has the couple through a week of intensive therapy, but realistic marriage counseling isn’t something that can be condensed into the span of a week, making it even more awkward when Dr. Feld asks deeply personal questions about Kay. and Arnold’s Marriage and Sex Life. Long-lasting and effective in-depth partner work takes longer than is shown on the screen.

50/50: Adam (Joseph Gordon-Levitt) is in his twenties who discovers that he has a rare and serious form of cancer. Adam is supported by his best friend and a therapist (Ana Kendrick) who help him cope with the disease in his youth.

What is good: This movie is funny and heartwarming, and there are moments in the movie where Adam and his therapist have a good relationship and address their fear of dying. There is some humor in her being a young and inexperienced, but competent therapist.

What is not so good? This movie is described as based on a true story, but there is not a shred of truth about how the relationship between him and his therapist is described. For starters, his therapist crosses several boundaries including her driving him home, breaking confidentiality by telling his family who he is, and finally being his love interest.

In many TV shows and movies, therapists always seem to cross the line by sleeping with their client, becoming overly involved, or talking about their clients outside of the therapy session. This almost never happens in real life, but entertainment is common.

It seems that most programs do not display the skill, experience, and ethics of being a therapist. Representations of people in therapy can be skewed as deeply flawed and unbalanced, which can lead people to consider anyone seeking therapy to be insane. Therapists are as prone to emotional problems as anyone else, yet ethical codes of conduct and having professional boundaries is what makes entering into a working relationship with your therapist safe. By shedding light on the fact and fiction of what therapy is and is not, we can help create an awareness where people can feel more comfortable and confident about mental health issues, therapists, and counseling.

“I would advise anyone who wants to imitate well, to take a close look at life and manners, and thus learn to express them truthfully.” ~ Horace (Quintus Horatius Flaccus) Ars Poetica (CCCXVII)