Chances are most of what you think you know about therapy is misrepresented in the media. Why? Because pop culture’s idea of what goes on in the therapy room is largely based on fictional therapists. In short, good TV and movies depict bad therapy. The dramas—made famous by fictional therapists—that interest viewers portray the qualities that would be harmful to real-life people in therapy (and most likely would get those therapists in legal trouble).
Below are the top five lies that you may have learned about therapists on television and in movies, followed by a more realistic view of therapy:
Lie No. 1: Therapists can’t be trusted to keep your secrets or respect your privacy. Television and movie therapists are often portrayed as devious or self-serving. On Mad Men, Don Draper’s wife was seeing psychiatrist Dr. Arnold Wayne, who then reported the details of their sessions to Draper (this one tops the list).
The reality: Therapists are ethically bound to maintain confidentiality. What is said in a therapy session will never be shared with anyone else without your permission. The exception to this rule is when someone is in danger, as in the case of child abuse, for example. Legitimate therapists will explain the limitations of confidentiality at your first session.
The reality: Therapists are highly educated, normal people. In general, therapists hold either a doctorate or a master’s degree in psychology or a subspecialty (such as marriage and family therapy), and they are required to take continuing education courses on a regular basis to keep their skills and licenses current—a license is required in most states. Therapists are bound by the ethical standards of their profession as well as by local and federal laws. While perfection might be desired by a person in therapy, therapists are human just like everyone else.
Lie No. 3: Your therapist will fix your problems. Fictional therapists on TV and in movies tell people in therapy what to do, taking for granted they “have the answer.” Even Dr. Phil (who is not fictional) primarily lectures and offers advice on his show.
The reality: A good therapist will assist you in finding your own answers. Your therapist might occasionally offer a suggestion about changing a behavior, or give you “homework” to try out between sessions (this isn’t advice, but a directive). It is much more likely that if you ask your therapist for advice, he or she will help you explore your own inner knowledge about what is best for you in a given situation. Each therapist has his or her own style. And there are different therapies that prescribe a more direct vs. indirect approach.
Lie No. 4: Your therapist will become very involved in your life as your on-call crisis manager. Many TV therapists are portrayed as being intimately involved in the day-to-day dramas of people’s lives, taking endless phone calls to help the client resolve a sticky situation. In the comedies Analyze This and What About Bob? this concept is taken to an extreme, as the therapists become overly involved and react defensively to people’s needy behaviors.
The reality: Therapists maintain therapeutic boundaries in order for therapy to be effective. The therapist will explain his/her policies at your first visit. Most likely, your interaction with your therapist will be limited to scheduled visits, which are typically just once a week, but short five- or 10-minute calls between sessions are usually not prohibited (this is an individual therapist courtesy). Therapists often do respond to crisis calls when deemed appropriate to do so. It is good practice to ask your therapist how he or she handles these issues if you are uncertain.
Lie No. 5: Your therapist might become romantically or sexually involved with you. It’s easy to think, from the examples we see on TV and in the movies, that most therapists end up in romantic entanglements with people in treatment. As an example, in the blockbuster romance The Prince of Tides, the psychiatrist played by Barbra Streisand begins therapy with her client’s brother and eventually has a sexual fling with him.
The reality: Therapists are ethically bound to avoid dual relationships or sexual contact with people in therapy. A dual relationship refers to a situation in which the therapist interacts with a person in therapy in a way that may be harmful to the person. In general, this is highly frowned upon by therapeutic ethics. No therapist should engage in a romantic or sexual relationship with you while you are in treatment with him/her.
“My therapist told me the way to achieve true inner peace is to finish what I start. So far today, I have finished two bags of M&M’s and a chocolate cake. I feel better already.”
So, how are you supposed to feel safe and keep pace with all these potential issues? First of all, it’s your therapist’s responsibility to handle sticky situations correctly and within the laws that govern them. Mental health professionals are required, ethically and legally, to explain these issues to you before the process of therapy begins. Typically, you will be asked to read and sign a detailed document (usually called an “informed consent” or “disclosure”) that describes the therapist’s way of practicing and his/her ethical and legal obligations. If you have questions, you can also contact your state licensing board, as it is set up to protect your rights.
Squiddo (2013), Retrieved May 5, 2013, http://www.squidoo.com/psyquotes by Jaktraks.
© Copyright 2013 GoodTherapy.org. All rights reserved. Permission to publish granted by Douglas Mitchell, MFTI, therapist in San Francisco, California
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