How Are Therapists Portrayed On TV?

Dec 19, 2018

We're seeing more therapists on our screens with shows like Wanderlust, Women on the Verge and Hang Ups
Therapy client Anna Quadri looks at accurately these TV therapists are portrayed

Over the last few months, there have been a number of programmes on British TV whose protagonist either IS a therapist or is seeing a therapist. While therapy on TV is nothing new - think The Sopranos, or Frasier - I was struck by the appearance of several high profile shows at the same time.

The first of the three programmes is Women on the Verge. Based on the memoirs of journalist Lorna Martin, it was written by Martin and Sharon Horgan, is set in Dublin and portrays the trials and singleton tribulations of three thirty-something friends, Katie, Allison and Laura. The second, Hang Ups, is very much set in London, although its origins lie in an American series Web Therapy, starring Lisa Kudrow. Written by Stephen Mangan, he also stars as therapist Richard, who starts offering short online therapy sessions to an eclectic range of clients when his previous, more conventional business fails. Finally, there is Wanderlust. Toni Collette stars as therapist Joy who, with her husband Alan, decides that extra-marital sex is the best way to save their own sex life and therefore their marriage.

The three series are all very different in tone and in their treatment of therapy, but very much place it in the foreground and crucially, unlike the experience of a client in a therapeutic relationship, the viewer gets to see the therapist in his or her daily life. Of course, the portrayal of each therapist is governed to a significant extent by the dramatic and / or comedic priorities of each show’s writers. Nonetheless, as is the case with any portrayal of an individual who fulfils a particular professional role, there is a significant grain of truth in each of the characters. As each programme has come to the small screen, it has also been interesting to read about the writers’ and actors’ own experiences of therapy, how it has helped them, and what of the role of therapist they wanted to bring to a wider audience.

How are therapists portrayed on TV?

The latter is particularly relevant since the (often unflattering) depictions of members of the profession in many popular TV shows and films might lead us to view therapists as a group of unworthy professionals whose behaviour can frequently border on the unethical or even illegal. If a TV therapist isn’t breaking professional boundaries, making mistakes or sharing his or her clients’ secrets inappropriately, another common trope is the therapist who will solve all of the clients’ problems. In fact, the role of a therapist is to help clients find their own answers. In film and television representations however, the eureka moments of therapeutic interventions are often overdramatised for effect. The reality is that while therapy can be a truly transformative experience, there are no shortcuts to personal change and it comes at a cost, in terms of time, emotional effort and also money.

Therapists on screen also often participate in the daily life of their clients. In reality, boundaries are a key feature of any successful therapeutic relationship and in general, interactions between therapist and client are limited to the 50 minute sessions that take place each week, whether once, twice or even more frequently. Some therapists may allow for contact in between sessions but this is something for the individual therapist to decide and to discuss with his or her clients. As a general principle however, the relation between therapist and client remains within the confines of the time spent in the consulting room. Other than in situations in which there is a real risk of harm to self or others, therapists are not generally supposed to disclose their relationship with a client, or even to greet a client in public.

Hang Ups

Stephen Mangan’s therapist Richard does a good job of breaching much of the professional code of conduct that governs the behaviour of any qualified therapist within the first few episodes of Hang Ups. In principle, his new business offering online video therapy could be a sound venture: clients don’t have to travel, his short, sharp sessions are cheaper than conventional therapy, and even the therapist doesn’t need to leave the comfort of his own couch. However our confidence in Richard’s ability to offer any kind of sound therapeutic guidance is quickly undermined by the way in which his personal and professional lives are intertwined and are both completely chaotic. His extremely efficient wife is frequently travelling for business, leaving Richard to manage the family home, which is full of their teenage children and an assortment of friends and extended family members. For some of these characters, their primary interaction with each other and with Richard is through a phone or computer screen, reflecting how much of our lives now take place online and how this digital existence can lead to the hang ups of the show’s title, which provide ready psychological material for Richard’s online therapy service.

The insights into Richard’s online therapy sessions are the comedic highlight of the series. Richard’s clients include an American teen who may or may not be his long lost son, a teacher who appears to be having an affair with Richard’s teenage daughter and a woman who remains resolutely positive despite a range of personal tragedies. Despite the extreme nature of the issues that have led them to seek therapy, and despite the way in which Richard’s professional and personal life gradually bleed into one, the improvised interactions between client and therapist can at times feel familiar and authentic. Richard’s own therapeutic relationships as client or supervisee also provide insight into the working life of the therapist, albeit from a comedic angle. All trainee therapists must undergo regular supervision and many continue with this throughout their professional career.

The show’s sense of authenticity reflects the experiences of its writer and director, both of whom have personal experience of therapy. In writing the series, Stephen Mangan also spent time discussing each of Richard’s clients with a therapist, who gave him strategies for dealing with their therapy. He has also said that he was determined to create a good therapist. Both Stephen Mangan and his director Robert Delamere have expressed the belief that there has been a real shift in attitudes towards therapy in this country in recent years, towards a greater understanding that it can be an incredibly helpful tool in our efforts to manage our mental wellbeing.

Women on the Verge

Unable to extricate herself from a destructive relationship with her married boss, feeling sidelined by her parents’ all-consuming love for her new nephew and overlooked for promotion at work, the protagonist of Women on the Verge, Laura, decides to take her friend Katie’s advice and gets in touch with therapist Dr Fitzgerald, played by the show’s co-creator, Sharon Horgan. When Laura eventually plucks up the courage to phone to arrange her first appointment, she drunkenly tries to reassure the therapist that she is not nuts, just struggling. This struggle immediately plays out as Laura rushes to the bathroom to be sick, leaving the dregs of her bottle of wine to empty themselves all over her laptop.

Sharon Horgan has said that Lorna Martin’s original book, Women on the Verge of a Nervous Breakdown, struck a chord in part due to her own experience of therapy in earlier life. Martin wrote a column in Grazia magazine and then her book while attending psychotherapy sessions three times a week over the course of a year. While Martin is very much the protagonist of her memoir, the series expands its focus to depict three friends, all struggling to contend with single life in their thirties. It focuses less on the therapy that is at the heart of the book and more on the day-to-day lives of the central characters. It also takes an honest look at the nature of female friendship and how it can be affected when individuals within a friendship group are floundering and struggling to make sense of their own lives and identities. Martin’s characters keep good news from each other for fear of the response from their friends, who often see others’ achievements as a reflection on their own comparative lack of professional or personal success.

When Laura seeks help, we get a glimpse into the therapist’s consulting room and into the relationship between therapist and client. Laura is played by Irish actress Kerry Condon and both she and her co-stars have talked about their own experiences of therapy and how important they feel it is to challenge the taboos that still remain around admitting that you need help. While Laura is finally able to take that first step, it takes her a lot longer to be entirely honest with her therapist and therefore to begin to unravel the emotional mess she has tried to manage through a combination of alcohol, frantic activity, illicit sex and self-denial. As we watch Laura explain quite how well she is coping from Dr F’s couch, we are also privy to her therapist’s responses. Although she says very little, it is clear that Dr F can see through Laura’s defences and is waiting patiently - and then not so patiently - for Laura to see through them herself. On one level, these therapy sessions are played for comic effect, but on another, they reflect just how difficult women find it to articulate complex emotions that are still deemed unfeminine, such as anger or jealousy, instead turning them in on themselves. While the show and the delusions of its protagonist are undeniably entertaining, the value of the show also lies in its no-holds-barred depiction of the emotional and practical complexities of life as a thirty-something woman, and also in its positing of therapy as a possible way to address those complexities and to dedicate valuable time to finding and caring for your authentic self.

Wanderlust

The last of the three shows is Wanderlust, in which therapy plays a far more central role. The main narrative thread concerns the challenges in the relationship between Joy and her husband Alan, but it is interwoven with insights into her professional life as a therapist.

In the first episode, we see Joy in her initial session with a couple who have come to her for help with their marriage. Joy clearly sets out how the sessions work on a practical level, what the couple’s expectations should be about the kind of support she can provide, and explains that the first session is primarily aimed at helping them see if they feel they could work together. In later episodes, the viewer sees parts of sessions with a more long-term client, a young man who has lost his partner and who is struggling to deal with his grief and his emotions. Susie Orbach, the renowned British psychotherapist and author, was a consultant on the series and it is therefore not surprising that these scenes give viewers a very accurate sense of how a session with a psychodynamic therapist might be: Joy reflects many of her client’s statements back to him, encouraging him to elaborate further; she focuses in on particular expressions he uses and probes them, asking him to help her understand what he means; she is not afraid of silence, creating space for him to think and eventually to be more open. Joy’s interaction with this client also gives us an insight into her sense of responsibility as a therapist. Her client, Jason, is at times reluctant to talk directly about his relationship with his girlfriend, but despite his resistance and at times even anger, Joy draws him back to it, telling him that she would not be doing her job if she allowed him to avoid the topics he finds most difficult.

The narrative arc of the series creates challenges in Joy’s professional life. While more extreme than might ordinarily be the case, these challenges do highlight the fact that a therapist has a personal life beyond the consulting room and also reflect the assumptions we may make about the way a therapist conducts his or her life outside of that role. At the beginning of the first episode, we see Joy and Alan’s aborted attempt to resurrect their sex life which has been on hold since Joy was injured in a serious cycling accident. It quickly becomes clear that there are emotional as well as physical obstacles to the renewal of their physical relationship, and at Joy’s instigation they come to the decision to take an open approach to their marriage and to initiate sexual relationships with other people. Joy’s first extramarital affair begins with a sexual encounter in her consulting room, which reflects the way that her personal decisions subsequently come to affect her professional status. Her and her husband’s choices eventually become public knowledge, and the husband in the couple we met in the first episode returns alone to tell Joy that his wife no longer has faith her ability to help them, given that to her mind Joy is clearly incapable of resolving her own marital problems.

Other incidents in the series further serve to highlight the need for the therapist to preserve clear boundaries between the personal and the professional. When Joy discovers that one of her clients has begun a relationship with her eldest daughter, she is very clear that she can no longer continue seeing him, despite his protestations. However, the series also clearly shows how these distinctions can at times be extremely difficult to maintain, not least because therapists have their own personal sensibilities that can be affected by their relationships with their clients. This is one reason why supervision and personal therapy can be so important to a therapist. Through Joy’s own sessions, we gradually come to understand that she has been deeply affected by the suicide of one of her clients. His death has also forced her to examine her feelings about another significant loss in her life, that of her mother. Joy’s sessions with her own therapist give us a real insight into the strategies that psychotherapists use to help their clients untangle complex emotions and emotional responses. They also lay bare the ways in which we - like Joy - might aim to manage those emotions rather than to deal with them, perhaps by internalising them, or by engaging in behaviours that distract us from how we are really feeling. By the end of the final episode of Wanderlust, Joy’s difficulties are far from being definitively resolved. Nonetheless the series offers a clear example of the ways in which therapy can provide emotional and practical support.

While the representation of therapy and therapists in each of the three series is necessarily determined in part by the wider intentions of its writers, they nonetheless appear to share a genuine commitment to present aspects of both in an authentic and positive light, and thus to make the concept of therapy a more understandable one to viewers who have had no personal experience of it. For this, and for the contribution they have therefore made to the dismantling of taboos around the idea of seeking the support of a therapist, I believe all three are to be commended.