Feb 23

Bad Therapy Boundaries and Beyond On TV and Film

Looks as though How I Met Your Mother has finally found a way to get rid of Kevin, he of bad therapy boundaries, he who never should have been dating his former client Robin.

Let me make this brief: Before knowing that she can never have kids, Kevin proposes. Robin discloses. He again proposes. She accepts. She discloses she doesn’t want kids either. He’s unfazed. She insists he really thinks this through. He un-proposes. Done.

So, this has gone the way of all of those inappropriate shrink/client relationships we’ve seen on TV or in movies that eventually crumble because in the end the client realizes he or she’s been exploited or because of other negative effects on the client’s well-being or…

Whoa. Wait a minute. Wait a darn minute. That actually never happened on HIMYM, and…well, has it ever happened anywhere on TV? In the movies?

Back around 1993, a study regarding therapy boundaries in U.S. movies showed that there were 22 that featured female therapists having sexual relationships with male clients; eight had male therapists getting involved with female clients. (In real life, by the way, more male therapists take advantage of female clients than the other way around.)

The psychiatrist behind this film research, Glen O. Gabbard, states: “Dr. Hannibal Lecter in the movie The Silence of the Lambs was probably more ethical than most screen psychiatrists–he only ate his patients.” (For more info, see the second edition—1999— of Gabbard’s book Psychiatry and the Cinema, cowritten with his brother Krin, a literature professor.)

As stated by Dr. Ofer Zur, Ph.D., author of Boundaries in Psychotherapy: Ethical and Clinical Explorations (2007) on his website:

Sexual relationships between therapists and current or recently terminated clients are always unethical and often illegal.

Whereas in real life, most clients who’ve become lovers of their therapists are significantly harmed emotionally, most of the celluloid clients and shrinks seem to suffer no such thing. Many of these films, in fact, have even been billed as exciting “romances” by their producers. And, Zur adds:

What is interesting about some of these movies is that they depict the sexual relationships as effective in promoting health and healing.

Fortunately, more and more of the public is aware that it’s wrong for therapists to develop romantic or sexual relationships with clients and/or clients’ family members. One way that I see this every day, in fact, is in the disproportionately large number of hits to this blog by people searching for info about whether or not the therapist in the movie 50/50 and Kevin on HIMYM have been unethical. It’s as though these searchers already know the answer but need some validation.

I don’t remember if the following scene from The First Wives Club (1996) happens before or after Annie (Diane Keaton) finds out that her therapist (Marcia Gay Harden) has become involved with her husband—probably before—but, in either case, it may serve as some small comfort to those who’ve felt betrayed by their shrinks:

Oct 14

“50 50”: Problems With the Therapist/Patient Boundaries

There’s a new movie in theaters called 50 50 about a young man, Adam, who is diagnosed with cancer. Joseph Gordon-Levitt is the lead actor.

I saw the trailer while at another movie, found it interesting–a mix of humor and seriousness—and proceeded to my next usual step, reading a synopsis.

What I learn is that Adam sees a therapist post-diagnosis. Cool. And that she happens to be young and inexperienced in her career. Okaaay—tell me more. He falls for her. Yeah, that can happen, of course. It might be that she falls back for him. Aaarghh!!! Not another therapist-crossing-boundaries film!!!

I look up Roger Ebert‘s review. He’s had cancer himself. He hated The Bucket List, about two men dying of cancer, because it wasn’t realistic. I listened to him and therefore haven’t seen this popular movie.

Well…ta da! Ebert likes it! But what’s he say about the therapist thing?

Anna Kendrick plays Katherine, Adam’s therapist, who gets just as involved as his oncologist is aloof. I know therapists are supposed to observe a certain distance, but in a case like this, I don’t see how one can. I would make a terrible therapist.

Okay, I won’t become a movie critic if you won’t become a shrink. But what about this over-involvement thing? I need to know more.

I turn next to Rex Reed. Wow. Even snarkier than usual. He really does not like this movie:

When Adam undergoes his first chemo treatment, his duplicitous girlfriend (badly overacted by Bryce Dallas Howard) waits four hours in the car because she can’t stand the interiors of hospitals. His stressed-out mother (and what, you may well ask, is Anjelica Huston doing in this blunder?) acts like a cross between Lady Macbeth and Zasu Pitts. Eventually Adam gives up and falls for his psychiatrist (Anna Kendrick) in a sex game that is pure cardboard.

A what!? A ‘sex game’??? Oh crap—I had really wanted to like this movie. Ebert liked this movie. But more importantly, another bad depiction of a therapist?! Clearly something we don’t need in this world.

I search for a female critic. I need one who’ll actually take the trouble to explain this 50/50 therapist/patient relationship to me.

So many many reviews I sift through. Over and over again, it’s the therapist is “inexperienced”—really?! That’s all you’ve got?

I keep skimming. Finally, whoa…bingo! Carrie Rickey calls out the young shrink as “unprofessional”…But, just how unprofessional?

Update: Well, now I can tell you from actually seeing it myself.

Adam’s unexpected breakup with his girlfriend, who has cheated on him, and Katherine’s own admission that she’s pining for her recent ex are factors involved in each of them starting to notice the other as fuller individuals, that is, as not just therapist and client. We can see that Katherine knows she shouldn’t reciprocate Adam’s interest, but we don’t see her consulting a supervisor, for example, or showing her internal conflict in a significant enough way. This stuff can happen when someone’s as inexperienced as she—but that doesn’t make it okay.

By the time Adam is told his cancer isn’t shrinking and that he needs a major and highly risky surgery, Katherine’s presence in the waiting area with his family and best friend seems much more personal than professional. At his bedside, this is even clearer.

Before 50/50 ends, Katherine meets Adam at his home to start their first date. His best friend, who has hated all of Adam’s previous girlfriends, approves of her. The implication is that Adam, a nice guy, has finally found his match. Isn’t that sweet.

I should note that the onus of maintaining appropriate boundaries, which are there to keep therapy safe for the client, is solely on the therapist no matter how a client feels or what he expresses to her.

If Katherine and Adam were in the non-movie world, I would like to see Katherine managing her own attraction somehow and continuing to support him in her professional capacity. Then, when Adam no longer needs to be in a medical setting on a frequent basis, he could be referred to another therapist who’s competent enough to help him.

Although it’s made to look in 50/50 as though nothing bad could come of such nice young people finding each other, that’s not what many clients-who’ve-become-lovers-with-their-shrinks in the real world will tell you. Issues of betrayal of trust and/or exploitation of trust, for instance, commonly arise in the dynamics of romantic relationships that started out as therapeutic ones.