By Marlyse Bergstra, MSW RSW
I’m guessing most people cringe when they see their job portrayed on TV. Nurses and servers especially come to mind as two professions that seem incredibly fun and simple until you actually set foot in a hospital or sit in a crowded restaurant! When I watch therapist characters, I typically experience an urge to write a strongly worded letter to the writers and producers. In an effort to channel this into something more useful, here is my take on the fiction versus reality based on a few therapists from recent film and TV history.
The Sopranos
“Is everything about everybody really about their mothers?’ – Tony Soprano (played by James Gandolfini)
Dr. Jennifer Melfi in the Sopranos often depicts an old-school, psychoanalytic approach to therapy. Tony is her client, but it’s his mother who is constantly brought up in sessions. There are lots of loooong silences that make you want to scream at Dr. Melfi, “SAY SOMETHING, PLEASE”.
Newer psychotherapy models favour more structure and therapist guidance. Silence is necessary at times, but no longer an indication of deep-seated issues. Childhood relationships are seen as an important part of life, but talking for years about the source of someone’s current pain is now considered to be less helpful than strategizing on how to manage it.
Some things don’t totally change. Dr. Melfi says in one episode, “Look, ordinarily, a patient is helped to make his own breakthroughs,” meaning that the therapist’s role is to guide one towards self-discovery, not instruct or analyze. Modern psychotherapy still encourages clients to come to their own insights. If you aren’t part of the process, it won’t work.
Good Will Hunting
“If a patient doesn’t feel safe enough to trust you, then they won’t be honest with you. Then there’s really no point in them being in therapy.” – Dr. Sean Maguire (played by Robin Williams)
In Good Will Hunting, Robin Williams plays Dr. Sean Maguire, an unorthodox college professor offered as a last resort. However, using persistence, unconditional affection, and good humour, he is the only therapist able to crack Will Hunting’s (Matt Damon) tough apathy, culminating in a heart-wrenching display of emotion from Will in the iconic “it’s not your fault” scene.
Newer psychotherapy models value the therapy relationship but strive for more. It is no longer seen as enough to have someone open up about something they have never talked about before. We want to do that, plus introduce strategies and techniques that create real change. Amazingly, that can happen! There really are methods that people can use to change their mood, process their emotions, or work through their trauma.
That being said, change cannot happen without a strong relationship: the most powerful “tool” that any therapist possesses. In many ways, Dr. Maguire gets it right. The positive impact of a trusting and unconditional connection can endure far beyond the physical relationship. To be clear, I’ve personally never repeated the same thing over and over again until my client cried and hugged me. Call me boring, but I tend to lean towards less dramatic and more conventional methods.
The Joker
“You don’t listen, do you? I don’t think you ever really hear me. You just ask the same questions every week. How’s your job? Are you having any negative thoughts? All I have are negative thoughts, but you don’t listen anyway.” –Arthur Fleck (played by Joaquin Phoenix)
I’ll admit to having sympathy for the therapist who makes a brief appearance in the Joker. She is perceived as uncaring by Arthur, but I see her as trying to focus him into making real-life changes and worried about his safety. She sets homework (journaling) and follows up on it. Current practices in the field of therapy suggest that regularly implementing therapeutic exercises into your daily life may be more effective than limiting your therapy exposure to one of the 168 hours in the week (who knew!). She seems to get this. I see her as doing her best within a healthcare system that is insufficient to meet Arthur’s complex needs.
My biggest qualm with this portrayal may actually be the therapist’s office. It is hard to imagine anyone leaving such a dingy, messy, dark, dungeon-like space feeling less depressed. It’s kind of how I picture the inside of the old Don Jail at Bridgepoint. Most therapists that I have known try their best to make the inside of their office welcoming, safe, and comfortable.
To sum up, I would encourage you to take anything outside of your own experience on the topic of therapy with a grain of salt. And I promise to enjoy shows about doctors, lawyers, writers, servers, and police officers with the same level of skepticism.
Eberly, T. (2017). Photograph. Unsplash. https://unsplash.com/photos/dTLlhgeEJWg