When portraying mental illness and psychotherapy, the media tends to get it wrong — a lot — which has far-reaching results. Inaccurate depictions fuel stigma and may prevent people from seeking help.
“There are people out there who could benefit from therapy but don’t go because they think it’s just for ‘crazy’ people or think all therapists are nuts — because that’s what they see in the media,” said Ryan Howes, Ph.D, a psychologist, writer and professor in Pasadena, California.
When a tragic or violent act happens, the news media tends to exaggerate mental illness and depict it negatively, according to Jeffrey Sumber, MA, LCPC, a Chicago psychotherapist, author and teacher. “In circumstances such as a school shooting or the Giffords shooting, the person’s mental illness is portrayed as something dark and dangerous,” he noted.
Therapists don’t fare any better. “The mental health field is often portrayed as incompetent in these situations, as if a competent therapist has the ability to cure a personality or thought disorder or as if a therapist can tell the future and know which client will commit violent acts,” Sumber said. The reality is that many people reveal dark thoughts, dreams and fantasies in therapy. Doing so helps clients to heal and grow, Sumber said. If therapists reacted fearfully every time, it would squelch these opportunities.
Famous therapists like Dr. Phil and Dr. Drew also perpetuate the many misconceptions surrounding mental illness and how therapy actually works. For instance, they tend to make sweeping statements about everyone struggling with a specific mental illness, Sumber said. Dr. Phil also has created the expectation for quick fixes and short answers to complicated problems, he said.
Shows & Films That Got It Wrong
Most therapists are portrayed as having more problems than their patients, said Howes, who also writes the blog In Therapy. Therapists in shows like “Frasier,” Lisa Kudrow’s “Web Therapy” and “What About Bob?” are depicted as “highly neurotic, scatterbrained and self-congratulatory.”
Yes, therapists have their own issues, but often what we see are warped depictions. “Therapists are real people with as many quirks and hangups as everyone else, but these are distorted caricatures that don’t represent the profession as a whole,” he said.
Both Sumber and Howes also called out Betty Draper’s therapist on “Mad Men.” Without her knowledge, Draper’s therapist tells her husband everything they talk about in therapy.
Shows & Films That Got It Right
While authentic portrayals of mental illness and psychotherapy are slim pickings, they do occur, even if we just get bits and pieces. Sumber likes the depiction of schizophrenia in “Julien Donkey Boy.” “The film was intensely unsettling, disturbing and at times utterly absurd, and yet there are few films that have done the illness as much justice, as well as the dysfunctional family that surrounds the main character,” he said.
Howes believes that Paul Giamatti in “Sideways” and Zach Braff in “Garden State” provide a good look at depression. Reality shows such as “Obsessed” and “Hoarders” give viewers accurate snippets of cognitive-behavioral therapy, he said. Still, he’d like to see other therapies explored. “It may be easier to find sound bites for CBT, but many people in dynamic therapy experience profound, lasting change, and that might make for interesting viewing.”
While it’s overly dramatic, HBO’s “In Treatment” is the best portrayal of therapy, according to both Sumber and Howes. “I love the way the show brings us into the intimate process between client and counselor and how we get the opportunity to follow the ups and downs, shifts and stuck places over a number of sessions,” Sumber said.
Judd Hirsch in “Ordinary People,” Robin Williams in “Good Will Hunting” and Lorraine Bracco in “The Sopranos” offer some truthful elements, according to Howes. Sumber also likes Williams’s portrayal “because it showed how deeply he became connected to the process of his client and the struggle to remain neutral.”
His favorite portrayal is Bruce Willis in “The Sixth Sense.” “Willis did a great job demonstrating the methodical, note-taking, conscientious side of the therapist behind the door.”
“I even think some of what we saw in the comedic roles from Bob Newhart (‘The Bob Newhart Show’), Allan Arbus (Dr. Sidney Freedman on ‘M*A*S*H’) and Jonathan Katz (‘Dr. Katz, Professional Therapist’) occasionally show up in the room,” Howes added.
Taking the Media with a Grain of Salt
The media’s job is entertainment, not education, Howes said. “What we see on TV or in the movies is therefore several times more dramatic, dangerous, condensed, frightening and/or bizarre than reality,” he said.
A screenwriter’s job, he noted, is to create larger-than-life stories that capture viewers, are artistic representations and drive ticket sales. “It’s not up to them to provide us with a balanced and nuanced education.” (On the other hand, it is the news media’s job to provide accurate information.)
Just compare an episode of Law & Order or a John Grisham film to your jury duty experience, Howes said. “That’s about the same distance you’ll find between TV therapy and actual therapy.”
Also, keep in mind that even when you do get an accurate portrayal, it’s just one character’s struggle and life. “The reality is that no two people are alike and that mental health exists on a multi-axis spectrum where many different factors intersect to paint a unique picture of each situation and each individual,” Sumber said.
Whatever the portrayal, the key is to take the media with a grain of salt, Sumber said. And get your facts from reputable resources.