Mar 07

Couples In Therapy: The Challenges For the Therapist

In a March 2nd article about couples in therapy (New York Times) writer Elizabeth Weil states, “The fact that couples therapy stresses out therapists has long been an open secret.” She adds that a recent issue of The Psychotherapy Networker, whose readers are mostly mental health professionals, asks “Who’s Afraid of Couples Therapy?” A key article inside the issue is “Why We Avoid Doing Couples Therapy.”

Weil interviewed various therapists about this topic. The following are some of the factors cited as contributing to making couples therapy feel more challenging as a modality than individual therapy:

  • dealing with more anger and volatility
  • dealing with secrets between partners
  • one partner might think you’re bonding more with him/her
  • one partner might think you’re effective; one might not
  • increased need to be on top of things in the moment
  • interactions need to be more actively structured
  • couples often present too late to be helped adequately
  • more triggering of therapist’s own couples/family issues
  • lack of consensus in the field about what works

Entering couples therapy as clients is similarly daunting for many. Many partners, in fact, stick to addressing relationship issues separately, as in individual therapy. And often that’s okay. Maybe even preferable sometimes.

Even though the following video clip is very brief, it says a ton about what can occur when a couple does go this (separate) route, however. The topic in the scene is sex, but it could be any other relationship issue and still make a certain point.

It’s from the classic film Annie Hall (1977), starring Woody Allen and Diane Keaton.

In case you missed it, here’s the transcript:

Alvy Singer’s Therapist: How often do you sleep together?

Annie Hall’s Therapist: Do you have sex often?

Alvy Singer: [lamenting] Hardly ever. Maybe three times a week.

Annie Hall: [annoyed] Constantly. I’d say three times a week.

If you’d like to see trailer for the whole film, please click here.

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: