BY DR. JENNIFER SULLIVAN
Prior to attending psychotherapy for the first time, many individuals aren’t sure what to expect. Will I lie on a couch? Will my therapist analyze me? Give me advice? Ask me, “How did that make you feel?”
In the absence of credible information about psychotherapy, many rely on what they have learned from movies and TV. Regrettably, these depictions are rife with inaccuracies.
Psychotherapists have appeared in movies for almost as long as cinema has existed. The first portrayal of a psychiatrist in film was in 1906 with Dr. Dippy’s Sanitarium.
Before 1957, psychotherapists were depicted in a most unfavourable light—mad scientists, ineffectual fools, charlatans, and evil psychopaths. However, a “brief golden age” between 1957 and 1963 followed, in which portrayals of psychotherapists were predominantly positive (e.g., caring and competent).
The years 1963 to 1980 marked a “fall from grace,” when psychotherapist portrayals were once again negative.
Some experts argue that depictions of psychotherapists have become more balanced in recent decades. A study that examined psychotherapist portrayals in movies released between 2000 and 2013 found that therapists were generally depicted as having positive qualities, such as being caring, compassionate, and intelligent. However, despite having positive traits, more than half the psychotherapists were also portrayed as behaving unethically.
Many mental health professionals have serious concerns about the inaccurate portrayals of psychotherapists in the media, warning that these can result in harmful misconceptions about therapy and deter individuals from seeking help. Educating the public about the realities of psychotherapy can help counteract common misconceptions.
Here are four Hollywood-generated misconceptions (stereotypes) about psychotherapists, along with information describing the reality of the situation.
Misconception #1: The All-Knowing, Advice-Giving Therapist. In this common stereotype, the all-knowing, intellectually superior therapist tells the client exactly what they need to do to solve their problem.
REALITY: Therapists do not tell clients what to do to fix their problems. Rather, they help clients find their own answers. Therapists also teach skills and assign homework, which is done in collaboration with the client.
Misconception #2: The Unethical Therapist. In this depiction, the therapist discloses client information without consent, fails to maintain boundaries, or engages in other unethical behaviour.
REALITY: Psychotherapists must pass ethics examinations before practicing psychotherapy and strictly adhere to ethical codes, regulations, and standards.
Misconception #3: The “Instant Cure” Therapist. In this portrayal, the therapist uncovers a repressed traumatic memory, leading to a sudden, intense catharsis that solves the client’s problem and almost magically fixes all their life difficulties.
REALITY: Although clients may have an “Aha!” moment in therapy indicating some new insight, these are rarely the cathartic life-altering experiences depicted in the media. In reality, change takes time. And while therapy doesn’t take years (another inaccurate media depiction), more than a few sessions are typically required to make substantive change.
Misconception #4: The “Psychoanalyst.” In this portrayal, the client lies on a couch (usually black leather), talking about whatever comes to mind, while an eccentric, emotionally detached therapist sits stoically taking notes, occasionally asking, “How did that make you feel?”
REALITY: This depiction is based on psychoanalysis, developed by Sigmund Freud in the 1890s and popularized in the first half of the 20th century. The truth is that therapists are friendly, everyday people.
Most modern-day therapists use cognitive-behavioural therapy (CBT) to guide treatment. In a nutshell, this involves the therapist and client working collaboratively to understand the client’s problem, set goals, and develop skills to overcome their difficulties.
Changing the Conversation is a monthly column by Jennifer Sullivan, Psychologist and CEO of Sullivan + Associates Clinical Psychology, that focuses on normalizing mental health issues through education and public awareness. It appears on the Healthstyle page on the second Tuesday of each month.