Therapist in Cinema

According to the filmography in Psychiatry and the Cinema, over 450 films depict some form of psychotherapy experience (Gabbard & Gabbard, 1999). And yet, as Faberman (1997) found, the public has very little understanding of the qualifications and credentials of psychologists and cannot tell one mental health provider from another. In a research paper by Jorm (2000), conceptualization of psychotherapy and its uses is formulated through the often stereotypic portrayals of psychologists in TV programs or films. Beliefs regarding appropriate mental health care treatments are vastly incongruent with the accepted and effective treatments recommended by mental health care practitioners. Negative portrayals of psychotherapists are even more damaging to the discipline of professional psychology than are the negative depictions of other professional disciplines, since most people would not be likely to get the chance to dis-confirm their belief with direct exposure to therapy (Schultz, 2005).

In the book by Gabbard and Gabbard (1999), psychology was thought to arrive from Europe at the same time as the movie industry. Filmmakers often use psychology to quickly provide the viewer with access into the hidden motives of their characters. It was suggested that the link between both disciplines may have to do with their respective concern with the intricacies of human emotions, thoughts, motivations, and experiences (Schneider, 1999).

In 2006, Orchowski, Spickard, and McNamara broke down the various types of therapists depicted into five different categories: the Oracle (especially in crimes and detective movies), the Societal Agent, the Eccentric, the Romantic Therapist, and the Wounded Healer.

Most films often would depict psychologists in a stereotypical psychoanalytic role: interpreting dream sequences and talking about the role of early childhood experiences. While psychoanalysis is still a big pie in Europe, in North America, it has been pushed aside for newer approaches, in particular Cognitive Behavioural Therapy.

Another great source of misinformation has to do with medication. It is usually unclear where pharmacological interventions come from, who prescribes the medication, and how medication is used in combination with therapy (Gabbard & Gabbard, 1999). There is also a great confusion over the distinction between psychiatry and psychology. Whereas the former is a medical doctor and can prescribe medicine, the latter relies more on talk therapy, though that has begun to change with implementations to allow psychologists to prescribe medication for their clients as well. That would surely add to the confusion within the field, never mind with the public.

As for whom therapy often serves, there is a great stigma as well as misunderstanding of the type of clients coming in for therapy. More often that not, homicidal maniacs (Hyler et al., 1991) are depicted to be the ones perusing the service. Wedding and Niemiec (2003)'s paper also discussed other depictions of clients. They found that harmless eccentricity was frequently labeled as mental illness and inappropriately treated. There was often the presumption of traumatic etiology in the client's profile. While that would give the films convenient dramatic art, it skewed the representation of those coming into therapy. Love alone was many times depicted to be all one needed to heal psychological distress. And finally, the researchers found that schizophrenia and dissociative identity disorder were depicted as equivalent forms of psychological illness.

The Symposiums and publications from Division 46 of the American Psychological Association, the Division of Media Psychology, has initiated discussion and research into trends within cinematic portrayals of psychotherapy. There's even a little known Golden Psi Media Award for TV and movie producers showing excellence in the responsible portrayal of mental health professionals.

The inaccuracy of therapists in cinema may have an adverse effects on therapists (and future therapists), as well as clients' expectation of therapy and their role and identity in therapy. However, cinema can also be a great source to mine for therapy. For example, prescribing films to clients as part of therapy can help clients identify internal strengths and values, or demonstrate alternative perspectives on psychological distress that is similar to the client's. Of course, since films carry so many different messages, it would be very challenging to pick the more appropriate and strategic films for clients. The efficacy of cinema therapy deserves more attention than it currently gets within the field.

So next time you see a therapist depicted in a film, be cautious of the portrayal, as it is more often than not a service to the film and not so much for the field of therapy or the public.

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Film(s) to watch: There are not many films that depict therapists fairly; in fact, I can't think of any at this moment. However, to get an idea of what is actually portrayed in film, the following films are at least interesting to watch, even though their portrayal of therapists are far from accurate (although for older films, the portrayal may have been perhaps accurate in their time).

Robert Redford's Ordinary People (1980), Martin Scorsese's The Departed (2006), Robert Wiene's The Cabinet of Dr. Caligari (1920), Ingmar Bergman's Scenes from a Marriage (1973).

References:

Farberman, R. K. (1997). Public attitudes about psychologists and mental health care: Research to guide the American Psychological Association public education campaign. Professional Psychology: Research and Practice, 28, 128 –136.

Gabbard, G. O., & Gabbard, K. (1999). Psychiatry and the cinema (2nd ed.). Washington, DC: American Psychiatric Press.

Hyler, S. E., Gabbard, G. O., & Schneider, I. (1991). Homicidal maniacs and narcissistic parasites: Stigmatization of mentally ill persons in the movies. Hospital and Community Psychiatry, 42, 1044 –1048.

Jorm, A. F. (2000). Mental health literacy: Public knowledge and beliefs about mental disorders. British Journal of Psychiatry, 177, 396 – 401.

Orchowski, L. M., Spickard, B. A., & McNamara, J. R. (2006). Cinema and the valuing of psychotherapy: Implications for clinical practice. Professional Psychology: Research and Practice, 37(5), 506 –514.

Schneider, I. (1999). Foreword. In G. O. Gabbard & K. Gabbard, Psychiatry and the cinema (2nd ed., pp. xv–xvi). Washington, DC: American Psychiatric Press.

Schultz, H. T. (2005, Winter). Good and bad movie therapy with good and bad outcomes. The Amplifier, p. 19.

Wedding, D., & Niemiec, R. M. (2003). The clinical use of films in psychotherapy. Journal of Clinical Psychology, 59, 207–215.

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