In the movie "The Prince of Tides," a psychiatrist (played by Barbra Streisand) is working with a woman so troubled by traumatic childhood events that she has attempted suicide several times. The woman's concerned brother (played by Nick Nolte) tries to help by working with the psychiatrist to recall his family's buried memories. By the end of the film, the childhood memories are clear, the sister is recovering and the psychiatrist and the brother—who is married—have fallen in love.
Although the 1991 movie was a box-office hit and nominated for seven Academy Awards, psychologists like James C. Kaufman, PhD, who chairs the Div. 46 (Society for Media Psychology and Technology) Media Watch Committee, can't ignore the unethical portrayal of therapy in movies like this one.
"The therapist was overstepping her boundaries by allowing personal feelings to interfere," says Kaufman, a professor in the Neag School of Education at the University of Connecticut. "The film also perpetuates the myth that therapy is miraculous as long as you remember some type of bad thing from the past. In reality, it's usually an ongoing process with small and meaningful insights that lead to progress."
Although these depictions may make for a good story, research suggests that media portrayals have a significant influence on the public's perceptions of mental health professionals. In a study by Julia Maier, PhD, published in Psychology of Popular Media Culture in 2014, participants answered questions about movie characters portraying therapists, people with mental illness and people seeking mental health services. The more likely participants were to indicate a willingness to seek help from a character (if such were possible), the more positive was their impression of psychologists in general. This favorable association was correlated with a decreased sense of stigma about seeking psychological help in their own lives. The researchers also found that participants who had a negative perception of characters with mental illness experienced an increased sense of stigma about seeking help for mental health issues.
"Our findings suggest that movie characters can influence thoughts about ourselves and our willingness to seek help," says Maier, an assistant professor in the psychology department at Waldorf University. "It's important to increase positive portrayals of therapists and decrease the negative portrayals of the mentally ill."
Fortunately, the depictions of psychologists in television and movies has gradually become more favorable and realistic over time, Kaufman says. "As a society, we have slowly progressed toward more understanding and less stigma associated with mental illness and therapy, and media is a mirror of that change."
The evolution of therapy on screen
Psychologists have been represented in film for decades, though the early characters were often a form of comic relief, says Ryan Niemiec, PsyD, co-author of "Movies and Mental Illness: Using Films to Understand Psychopathology." In the 1977 slapstick comedy "High Anxiety," for example, Mel Brooks plays a psychologist who suffers from a crippling condition called "high anxiety." Other times, the characters are sinister, such as Hannibal Lector in "Silence of the Lambs," the psychiatrist played by Anthony Hopkins who is also a cannibalistic serial killer.
More recent films such as "A Beautiful Mind" (2001) portrayed mental illness in a positive light, but the treatment facility was stigmatized in the story, says Danny Wedding, PhD, MPH, Niemiec's co-author of "Movies and Mental Illness" and professor and chair of behavioral science and neuroscience at American University of Antigua.
"The character of John Nash, a brilliant man who suffers from schizophrenia, comes out of a mental health hospital unable to do the math that used to come easily," Wedding says. "Psychiatric hospitals in this movie are portrayed as places that block creativity and intelligence."
In more recent years, however, movies like "Antwon Fisher" (2003) have started featuring mental health professionals as characters who are inspiring, well-intentioned and intelligent, says Niemiec, who works as the education director at the VIA Institute on Character, a global nonprofit focused on advancing research and best practice tools related to building character strengths.
"Denzel Washington plays a clinician who is helping a very troubled Air Force cadet struggling with abuse issues, isolation and anger," he says. "Denzel is clever and doesn't force Antwon to talk until he is ready."
Television has also increasingly started to represent psychologists accurately in shows, Kaufman says. This year, the APA Div. 46 (Society for Media Psychology & Technology) Media Watch Committee awarded actor Bill Brochtrup the Golden Psi Award for his role as Dr. Joe Bowman on the TNT television series "Major Crimes." The award is given for the most accurate and responsible portrayal of mental health professionals in film, television, theater, video games or other media. In the show, Dr. Joe works with a college-aged character named Rusty who is dealing with issues from his past.
"Dr. Joe helps the teen recognize inconsistencies in his thinking and helps him to change his thought patterns," Kaufman says. "He is not a magician and not telling the teen what to do."
Brochtrup says this accurate portrayal was no accident. "It was very important to the executive producer to make the relationship between Rusty and Dr. Joe believable," Brochtrup says. "He did not want the therapist to be a savior, but instead show growth in Rusty over time."
In the show, now in its fifth season, Rusty sees Dr. Joe once a week. Rusty has learned how to accept the mother who adopted him, relate to his biological mother (a drug addict in prison) and come to terms with his troubled past as an abandoned boy who turned to prostitution to survive.
The HBO series "The Sopranos" featured another well-known psychiatrist character. In the series, which ran from 1999 to 2007, Mafia boss Tony Soprano regularly sees Dr. Jennifer Melfi for therapy. "I thought the therapy portrayed in the show was very realistic," says Jennie Singer, PhD, a clinical psychologist in Sacramento, California, who has worked with many types of offenders, including those with Mafia experience. "The show even delved into Dr. Melfi's own issues with countertransference with Tony Soprano. I think ‘The Sopranos' helped to normalize the act of going to therapy, and said to the world that it's OK to be introspective, even if you are a powerful man."
Teaching on TV
Psychologists are also starting to appear on reality TV shows, such as "Big Brother" in the United Kingdom. The series follows a group of contestants who are housemates living in a home under constant surveillance. Each week, the participants vote someone out of the house. Tomas Chamorro-Premuzic, PhD, a psychologist with expertise in personality assessment, was featured on the show weekly from 2006 to 2012 to comment on the dynamics among the contestants and educate viewers about a variety of psychological topics. During one episode, for example, he assessed all the houseguests' emotional intelligence, and explained why it matters and how it can be developed. In another show, he explained the meaning of impression management—the degree to which individuals are truly themselves or just constructing a fictional character for the show.
"The producers trusted my expertise and judgment and never scripted me," says Chamorro-Premuzic, a professor of business psychology at University College London. "I think academics shy away from the media spotlight, but ultimately I think we have a responsibility to educate the general public. The most valuable thing from this experience was learning how to explain technical concepts to a mass audience."
Offering expertise to film producers is another way mental health professionals can influence how psychology is portrayed on film. Stephen Sands, PsyD, a pediatric neuropsychologist at Memorial Sloan Kettering Cancer Center in New York, was a technical adviser for "Analyze That," starring Billy Crystal as a psychiatrist and Robert De Niro as a mobster. Sands reviewed different versions of the script and was on the set for the majority of the film to ensure that mental illness and therapy were depicted accurately. When Crystal, for example, was naming De Niro's feelings in one scene, Sands coached the actor to take more time to let De Niro uncover his feelings himself. De Niro was so eager to accurately portray mental illness that he visited a psychiatric hospital where Sands worked and participated in a group therapy meeting.
Overall, movies can be a powerful tool in helping patients achieve well-being, says Niemiec, noting how character strengths such as love, teamwork and gratitude are displayed.
"When people watch any movie with an eye toward a particular character strength, they train themselves to become familiar with these virtues," he says. "Psychologists can use those strengths in their own lives and help clients recognize and deploy their strengths."
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