Welcome to the Back to School for Writers blog series. Every Wednesday until the end of September, a guest poster will share their knowledge and expertise on a specific topic. Today’s guest is therapist and writer Tami Clayton who dispels 5 myths about the mental therapy profession.
I’ve worked in the field of mental health for the past sixteen years, most of that as a child/family therapist, and in all that time, I have yet to read about or see in a movie or T.V. show a therapist that isn’t portrayed as unethical, devious, deceptive, coercive or in some way inaccurate. It’s no wonder many people see therapists and therapy as suspect. And if you only went off of what you read or saw in those forms of entertainment, then you’d be right.
In preparation for this post, I asked several colleagues about the characterizations of therapists in books, movies, and T.V shows. Before any of them answered my question, every single one of them said if they knew there was a therapist in a movie or T.V. show, they would avoid watching it (or at least the part with the therapist) because of how inaccurately (and terribly) we are portrayed. After I explained why I was asking, all of them were eager to share what the inaccuracies they’ve seen. Here’s what they mentioned:
(Note: I’m using the term ‘therapist’ to also mean ‘counselor’ and consider the two interchangeable for the purposes of this post.)
Myth #1: All therapists subscribe only to Freud’s theories and techniques – you know, the bespectacled, bearded older man psychoanalyzing the client while he or she reclines on the sofa talking about their dreams filled with obvious phallic symbols.
Reality: Psychoanalysis is just one theory among many out there for a therapist to use and claim as their theoretical orientation and in my humble opinion, a good therapist draws from a few different theories in order to best meet their clients’ needs. As for the sofa bit, I’ve always worked in social service (read: underfunded, underpaid and overworked) so many of us have offices that are so tiny there’s no room for one. Also, unless you have sought out a psychoanalyst and want to lie down on a sofa, clients are usually sitting up on the sofa or in a chair.
And for the record, in regards to dream analysis – sometimes a carrot is just a carrot.
Myth #2: Therapists must always be overly solicitous about a person’s feelings and only ask questions like “And how does that make you feel?”
Reality: Yes, therapists do ask about feelings, but in all the years I’ve been a therapist, I can’t think of one time I inquired about it in this manner with a child or an adult. A person’s feelings are just one aspect on which we guide clients to focus their awareness. Current patterns of thinking, coping mechanisms, past trauma, past and present relationships, self-esteem, self-awareness, and many, many more topics can be delved into in therapy depending on what a client is seeking it for at that time.
Myth #3: Therapists become close friends with, date, have sex with or have some kind of an outside-of-the-office relationship with their clients.
Reality: Aside from this going against everything you’re taught in your counseling or psychology program, this kind of thing is considered unethical for therapists to do and it can get you a nice malpractice lawsuit and/or the revocation of your license if the infractions are severe enough. The breaking of boundaries is probably the biggest inaccurate portrayal of therapists in movies, T.V. and books. Unless the therapist in your story is the antagonist and needs to engage in such nefarious activities, please reconsider having him or her be a blatant boundary breaker. It’s giving all of us a bad rap.
Myth #4: A client is “cured” when the big epiphany comes wrapped up the big “Aha!” moment.
Reality: Therapy and the therapeutic process is rarely, if ever, a neat, tidy, linear process in which a client reaches a total resolution and is cured of what was ailing them. Therapy is not like getting over the flu or a cold. It can be filled with many ups and downs, a lot like life itself. While epiphanies can certainly be a part of it, they hardly denote a “cure” or complete absence of the mental health symptoms that previously plagued the client. Resist the urge to have your character reach an easily obtained epiphany that somehow cures them. Therapy is a process with many steps forwards and backwards. (Sadly, this is something the insurance companies completely fail at comprehending, but that’s a rant post for another day.)
Myth #5: Therapists are always “on”, assessing people and passing judgment about others’ mental health every moment of the day. This myth is played out in movies, T.V. shows and books, but is just as prevalent at a cocktail party where the inevitable question of “what do you do?” arises when meeting new people. As soon as the word ‘therapist’ is out of my mouth, people often become wary and think I’m assessing the state of their mental health and passing judgment on them.
Reality: I diagnosed you ten minutes ago.
Well, sort of.
Those of us drawn to this helping profession are obviously interested in human behavior and human nature which is why we’ve chosen to do what we do. Even so, we are not always “on the clock” writing mental health assessments in our heads of everyone we meet. Sure, I may wonder about a person’s underlying motivations for saying or doing certain things and yes, I may have a vague notion of what that person’s thought patterns or coping mechanisms might include. But unless you are going to pay me for my time and effort, I’m not usually going to spend much more time thinking about it beyond that. And as far as passing judgment, unless you are behaving in an utterly deplorable manner, I’m typically not in the habit of casually passing judgment on the state of other people’s mental health. We all have baggage and we’re all on a journey, even us therapists. Personally, I’d rather lend a hand than stand aside passing judgment.
There are also a lot of misconceptions and misunderstandings of the different terminology used in the field of mental health. Here are some terms and their definitions to help in better understanding the field:
A psychologist is someone who has obtained his or her PhD in the field of psychology. They can be refered to as therapists or counselors if they so choose, though most go by the term psychologist.
Therapists and counselors are not psychologists. Therapists and counselors have typically have obtained their Master’s in counseling psychology, psychology, or marriage and family therapy.
Social workers (someone who has completed their Master’s or PhD in social work) can also be considered a counselor or therapist. Quite often, the term social worker is used in movies, T.V. shows, and books as synonymous with someone who works in child welfare. This is not the case. One is a job/career (child welfare caseworker) while the other is what someone who has graduated from a social work program (social worker).
The term “shrink” refers to a psychiatrist, a medically trained doctor who can prescribe psychotropic medications. Psychologists, therapists, and counselors are not psychiatrists and the terms are not interchangeable, though the two types of professions often work in together when treating a client.
I won’t go into detail about different diagnoses here because this post would become far too lengthy. If anyone has questions about a diagnosis for their character or would like further information about symptomology of a particular diagnosis for a character, feel free to contact me and I would be happy to help.
Hopefully this was useful to those who are writing about someone who works in the mental health field or to anyone wanting to learn more about therapists/therapy in general. For an example of an accurately portrayed and well-written therapist, check out This Much I Know is True by Wally Lamb. Aside from being a fantastic book, it has one of the few well-written therapists in it that I’ve ever read.
Tami Clayton is a YA and Middle Grade writer with a passion for travel, all things dark chocolate and coffee, and reading everything she can get her hands on. She is a child and family therapist by day, writer by night, and a dreamer of far off lands she hopes to one day explore in person. Visit her online at Taking Tea in the Kasbah.