“What do you hope to get from coming to therapy?” I recently asked a new client. She replied that she didn't really know what to expect. “All I know about therapy is what I've seen on TV.”
This got me thinking about how the media portrays therapy, and the Hollywood version of it that we regularly consume. Often when therapy is shown on TV or film I am left frustrated by the therapist's lack of boundaries. For example, Naomi Watts' baffling Netflix show Gypsy in which, among other cardinal sins, the therapist embarks on an affair with her client’s ex-girlfriend and turns up at the house of another client to offer emotional support.
Even when the (fictional) therapist adheres to boundaries I'm left banging my head against the wall as the 'expert' therapist tells their client what to do, completely disempowering them in the process. An example of this presented itself in the otherwise excellent HBO series Big Little Lies (spoilers follow).
In Big Little Lies the therapist explicitly tells their client (Nicole Kidman's character Celeste) what she has to do. Celeste is in a vulnerable position. She is in a domestically abusive relationship with a man who is controlling, manipulative and holding all of the power. Her therapist witnesses this and makes a plan for the client to get out of the relationship, urging her to follow it. The process is not collaborative. The therapist dictates the plan to the client with no attempt to empower her in doing so.
There is no regard shown for the complexities of the situation. Statistically the most dangerous time in a domestically abusive relationship is once the survivor leaves the perpetrator. According to domestic abuse charity Standing Together, 76% of domestic homicides happen after the point of separation. Ordering someone to simply up and leave that relationship is not therapeutic, nor is it necessarily the safest option. Celeste is a privileged woman with the means to secretly rent her own apartment to take herself and her sons to at a moment’s notice. Leaving may be simpler for her than for most women in this situation who face relocating to a completely new area, finding work, childcare, housing, with the ongoing fear of being discovered by the perpetrator overshadowing it all.
I am not arguing that a therapist should sit back and say nothing when a client is in an abusive relationship. But our role is to meet the client where they are, and start from a place of understanding and affirming them. In therapy the client has a space that is theirs alone. In a therapeutic relationship where they are valued, accepted and understood I believe that the client will connect with their strength, resilience and power as the therapist reflects this back to them. We must start from a position of 'you're ok, you're doing your best.' Not 'you are wrong. You should be doing this instead.'
I always stress early on that I am not there to tell a client what to do, or offer my opinions. This can be met with disappointment or frustration. The therapeutic process may be slow and laborious. It certainly would not further the plot of a TV show very efficiently. Real life therapy would probably make for dull viewing. I understand why therapy is glamorised in TV and film, but it's worth remembering that a client's expectations of therapy may be informed by these portrayals, and taking a moment to be clear about what real-life therapy might look like. It might not be pretty, it will not be glamorous, but ideally it will be a nurturing space in which the client will grow and achieve something meaningful and substantial.