I am therapist, but not like the ones on TV

Reading Dr. Paul H. Ting’s blog post about the differences between Anesthesiologists in reality and the ones portrayed on television, made me think about the similar problems that this creates for therapists. In my practice, when I see adolescents for teen therapy or couples for couples counseling, I have to explain that therapy isn’t like how it is dramatized on TV. I  am repeatedly confronted with patients in pain looking for solutions to their problems, who I must unfortunately tell there are no quick solutions. I feel TV has done a disservice to my patients. Popular culture paints psychotherapy in a somewhat Oracle of Delphi light where clinicians mysteriously offer solutions and advice. Patient come in expecting to be told to do something simple to solve their issues. Anyone who has seen a Dr. Phil episode can attest to this. The appeal of this type of sage-like advice-giving is clear. It is a powerful idea to think that with very little effort one can consult with a psychotherapist, be given some piece of vital missing  information about how to live one’s life, and be ‘cured’. Now, I think TV isn’t solely to blame here: psychology as a profession must take some responsibility too. The recent article by the New York Times about the branding problem of psychotherapy points out how out of desperation to make a living as a therapist many counselors are marketing themselves as coaches. Along with this rebranding comes promises of ‘quick fixes’. Statements like “overcome anxiety in three sessions” or “beat the blues guaranteed” are indeed alluring, but misleading. These coaches do not provide therapy, they provide advice. The problem is advice is easy to come by. Anyone with friends or family knows this. People are eager to offer solutions to the problems of others. So why pay a professional for advice if one can get it anywhere? Advice doesn’t reduce the suffering people feel, but the thought is that the advice from a professional would be superior. This is partially true. Psychologists spend many years learning how to help others. They have expert knowledge about the most effective ways to improve one’s life, and can cite empirical evidence for this. However this is not the thing that make psychotherapy curative. As Jared DeFife, Ph.D puts it “[what makes therapy effective is] …two people sitting down and working together to explore and find effective ways of coping with mental anguish, troubled lives, broken relationships, and physical effects of emotional ailments.” In other words, it is the therapy relationship that is the curative element. Just as any relationship needs time to develop so does the clinical one. Evidence has shown that the therapy relationship is the number one predictor of favorable treatment outcomes. This means reduced symptoms that are sustained over time. I am a therapist, but not like the ones on TV. I take the time to build real relationships with my patients, and work with them to develop long-term solutions to their problems.
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