In the twenty years since I started in the therapy profession, the stigma around counselling and psychotherapy has significantly reduced and over the last few years it has become a routine part of everyday film and drama.
You would think that as a therapist I would welcome this move into mainstream culture but overall, when I reflect on what I’ve seen I am left thinking that all too often therapy remains misunderstood and depictions in mainstream media only serve to perpetuate unhelpful myths and stereotypes.
The confusion of terminology doesn’t help; for example there is counselling, therapy, psychotherapy, psychology, and psychiatry and the words used for someone who goes to therapy. ‘Client’ and ‘patient’ are the two words in common usage and personally I feel uncomfortable with both.
I prefer to trace back the word patient to its Latin origin, when patien was a word used for someone enduring suffering. For me therapy is a conversation between someone currently enduring suffering and someone experienced in how to better understand the suffering; because when we understand the origin of suffering the possibilities for change are revealed.
All too often the therapist is depicted as someone who is able to offer amazingly insightful and life changing analyses, suggesting they know their client / patient better than they know themselves. This is problematic because it suggests that if you are struggling, you give an account of your problem to a therapist who, like a doctor, will be able to give you specialist knowledge.
Image above: DI Steve Arnottt required to see a psychologist to keep his job in BBC’s Line of Duty; photograph BBC
The reality of therapy is borne out by research that shows when therapy finishes both the therapist and client will most often have different views of what the therapy was about and where and when change occurred. Therapists have differing ways of exploring suffering, but it is the insight or change or perspective that comes from the patien themselves which facilitates change.
Another depiction is that therapy is needed when people don’t talk about their feelings. True talking about feelings doesn’t always come easily for many people but ultimately it is our understanding of our feelings such that we are able to think clearly that is most important. Whether feelings are expressed is of far less importance than whether they are understood and acted upon skilfully.
I’m also often fascinated and often dismayed by the way therapists are portrayed, sometimes they turn out to be the villains, completely chaotic, unboundaried, or cold and aloof sitting sternly with a notebook and pen, whilst at other times they are egoistic and decisive advisors, but rarely do I see them portrayed as someone simply engrossed by their patiens suffering with compassion, patience, curiosity and concern.
In writing this reflection I realise that what concerns me most is that unrealistic depictions create expectations that are unhelpful. A felt sense of trusting, relaxed connection enables both patien and therapist as equals to work through the suffering and this cannot easily be achieved with unhelpful expectations.
If you have found this article interesting and would like me to critique specific depictions in film and tv drama, then please let me know.
Psychotherapist, Counsellor, Couples Counsellor and Coach
UKCP registrant, MBACP (accred), UKRCP
PGDip, MA, Adv Dip Ex Psych
Nicholas Rose & Associates
Counselling, psychotherapy and coaching for children, adults, couples and families.
Read more blogs by Nicholas Rose
Read the next in the series here – Mind Matters – Looking after the mental health of children and young people
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