Category Archives: Therapists

Sep 13

“Tiny Beautiful Things”: The Couples Therapy (Spoilers)

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Tiny Beautiful Things on Hulu is a fictional adaptation of advice columnist Cheryl Strayed‘s 2012 book Tiny Beautiful Things: Advice on Love and Life from Dear Sugar. (For additional background, see this previous post about the film Wild based on Strayed’s solo hike of the Pacific Coast Trail.)

As the series Tiny Beautiful Things begins, Clare (Kathryn Hahn) has not yet fulfilled her writing ambitions; also, she has not yet become “Dear Sugar.” She carries tremendous grief about her mom who died from advanced cancer, can’t connect with her teenage daughter, and is separated from her husband Danny (Quentin Plair) but pursuing couples therapy with him.

In Episode One we see that Clare “doesn’t trust their therapist, Mel, who wonders aloud whether Clare’s instability is due to latent anxieties about her decaying beauty as she approaches 50” (TV Line). While this statement seems out of left field and representative of a biased attitude toward Clare that gets repeated down the line, the style of this therapist (Tijuana Ricks) with Danny seems different, possibly even flirtatious. The latter has actually been acknowledged by both Hahn and Plair (Decider).

Beyond this, however, there’s a lot we don’t get to understand about the couples therapy dynamics.

For example, although it’s briefly mentioned early on that Danny has met with Mel separately, we don’t know in what context or how many times. Did Clare choose not to attend a session or more? Was Danny in individual therapy with Mel before it became couples therapy? Or maybe he still has separate sessions? Whatever the case, perhaps there were appropriate reasons for separate sessions, just as there may have been inappropriate ones.

A Google search reveals that many viewers are confused about what is happening between Danny and the couples therapist. Many wonder if Mel is a bad therapist, period. Question categories include:

  • Why is Danny seen (by Clare) chatting with Mel in her office after their session has ended? (A major stressor for Clare, by the way, who only witnessed this inadvertently.)
  • Does Mel pick on Clare unnecessarily? Is Danny Mel’s “favorite”?
  • Why did Mel single Danny out by sending him that column (that led to his realization that he needs to end his marriage)?
  • Is it appropriate that Mel then gave him a special after-hours individual session? He clearly requested it, but is this the right course of action?
  • Is Danny “Johnny,” the married sender of the letter to Sugar about falling in love with someone—and is that someone Mel?

It’s left for viewers to draw their own conclusions. As a viewer myself who’s also been a couples therapist, I do have a few thoughts.

  • The dynamics in the couples sessions do seem out of whack and biased towards Danny. (But you didn’t need me to tell you that.)
  • The dynamics outside of couples sessions do seem inappropriate. If couples therapy is going to proceed fairly, each party should be informed if separate talks are occurring with the therapist.
  • Mel did show a clear bias or favoritism by sending the column to Danny only. Why not share it with both of them, if at all?
  • It follows that the “emergency” session with Danny didn’t have to happen if he hadn’t received this special treatment from Mel. Moreover, I think it’s implied that Clare is not aware of this happening.
  • If Danny has fallen for Mel, she likely has contributed to this.  And if something more intimate is happening between them, it’s highly inappropriate and unethical on Mel’s part as a therapist.
Jul 26

“You Hurt My Feelings”: Lesson in Truth and Support

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In the new indie film You Hurt My Feelings by Nicole Holofcener, one of the main characters is Don  (Tobias Menzies), a therapist who offers his various clients listening and support but not enough honest feedback and/or advice. He’s married to Beth (Julia Louis-Dreyfus), a writer and teacher who regularly provides well-meaning—but not necessarily earned—support to her adult students and loved ones. As a couple they’re seemingly close; they’re also enmeshed.

Think, if you will, about how Don’s and Beth’s styles might have affected each other as well as their son over the years. Actually, just see the film.

Jake Coyle, Associated Press: “Do any of us really want straightforward feedback or do we just want emotional support? That’s the rich vein that Holofcener, a master of nagging neuroses, mines so expertly in You Hurt My Feelings — a film that I very much adored. I swear.”

Have you ever felt that your therapist is giving you space to talk but little else? Does your spouse or friend or anyone else you care about boost your ego when you’re feeling insecure—without ever telling you some of the hard truths?

It is possible, by the way, to be both honest and supportive at the same time—even if you won’t want to practice this 100 percent of the time. After all, little white lies exist for a reason. “Deciding what is an ‘okay’ lie and what is a ‘dangerous lie’ requires consideration of your motivation and the potential fall-out if the truth were found out,” states Suzanne Degges-White, PhD, Psychology Today.

Generally speaking, honesty is truly the best policy. And, as Dr. Jonice Webb advises on her website, “Truth with compassion is a way to express your truth while reducing its hurtfulness as much as possible.” The following are three steps she recommends in order to achieve this:

1. Clarify your message within yourself before saying anything to the other person

2. Think about the personality and nature of your recipient. How emotionally fragile is he? How will he best hear this message?

3. Identify the best time, place, and words to communicate your message

Interestingly, Webb is the author of Running On Empty, about childhood emotional neglect. One of the long-term effects of such neglect, as with abuse, can be a damaged ability to establish healthy emotional intimacy. Beth, for instance, in You Hurt My Feelings was the victim of verbal abuse by her father. Her mother gives her backhanded compliments that sting.

Although we are not similarly aware of Don’s background, in his foreground we know he has chosen a profession in which it’s important to have a strong understanding of healthy intimacy. This film shows us that—like all therapists—he has some continued learning to do.

May 30

Therapy Quotes (Humor)

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The following therapy quotes find the humor in what clients and therapists experience.

My therapist says our sessions are a safe space, a judgement-free zone, but I think she only told me that to see how I’d react. Avery Edison

My therapist gets so upset when she walks into her waiting room and finds me treating her other clients. Jenny Mollen

Do you ever feel like your therapist is the priest from the Exorcist who catches your demons and then jumps out a window? Trevor S

Dear creators of every new fall sitcom: I am sorry your parents were so noisy and shitty, but can’t you punish a therapist instead? Dave Holmes

I go to therapy just so someone will talk to me without looking at their phone. Patrick Walsh

Next time I try therapy I’ll bring up how I’ve never been more than once since my need to please makes me feign recovery after 1 session. Erin Whitehead

Can anyone recommend a bad therapist? (I need a good scapegoat). Josh Comers

˝Gonna talk about you in therapy today˝ -21st century romance. Jake Weisman

Therapists are the atheist’s confessional. So long as you tell your therapist about it, you can keep doing it with a guilt-free conscience. Erin Whitehead

Therapy hasn’t really made me feel any better, it just made me understand why I feel bad. Corey Pandolph

i go to therapy to deal with people who don’t go to therapy. Lauren Ashley Bishop

I like to call therapy baggage claim. Aparna Nancherla

my therapist gave me homework to do before our next session so now I can never go back to therapy maura quint

Among other therapy quotes I’ve found is this one from Laura Munson‘s memoir, This Is Not the Story You Think It Is…:A Season of Unlikely Happiness:

Probably the wisest words that were ever uttered to me came from a therapist. I was sitting in her office, crying my eyes out. . . and she said, “So let me get this straight. You base your personal happiness on things entirely out of your control.”

Also, from Sofiya Alexandra‘s Tumblr:

“Ten Things My Therapist Says That Make Me Angry,” Sofiya Alexandra

  1. “Exercise does wonders for depression!”
  2. “You’re of course aware that alcohol is a depressant?”
  3. “Maybe we should consider medication.”
  4. “It seems like your boyfriend had a point.”
  5. “Maybe we shouldn’t consider medication and just stick to exercise.”
  6. “It’s warm in here, isn’t it, I’m going to turn up the air.”
  7. “You’re of course aware that marijuana can be a depressant?”
  8. “You seem angry.”
  9. “This is going to require a lot of patience and hard work.”
  10. “I no longer take Blue Shield.”
Feb 07

“Shrinking” Series: Dysfunctional Radical Honesty

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The Apple TV comedy Shrinking boasts a lot of big names in its cast, including Harrison Ford, Jason Segel, and Jessica Williams, all of whom play therapists. The series shares some of its creators with Ted Lasso. It has a big heart and a lot of jokes, even if you absolutely, definitely would not want your therapist to take any cues from it. NPR regarding Shrinking

The new series Shrinking as described on IMDB: “A grieving therapist starts to tell his clients exactly what he thinks. Ignoring his training and ethics, he finds himself making huge changes to people’s lives — including his own.”

Kristen Baldwin, ew.com, calls this series “a funny, brainy grief-com about the power — and dangers — of radical honesty.” (See “Radical Honesty“).

In a nutshell, Jason Segel plays therapist and single parent Jimmy, whose wife died a year ago. He’s now a mess.

During the day, a fried and hungover Jimmy heads to work at the Cognitive Behavioral Therapy Center, where he struggles to stay engaged as his regular patients recite their regular complaints. Exhausted and pushed to the limits of decorum by a woman (SNL‘s Heidi Gardner) who’s forever making excuses for her emotionally abusive husband, Jimmy erupts. ‘Just f—ing leave him!’ To his surprise, it works. Despite warnings from his methodical boss Paul (Harrison Ford) and newly divorced colleague Gabby (Jessica Williams), Jimmy decides to continue his ‘psychological vigilante’ approach with his newest patient, Sean (Luke Tennie), a military vet who keeps getting into violent altercations with strangers.

But Linda Holmes, NPR, believes the hyped radical honesty isn’t actually a large part of the series. Larger is “that on top of his own struggles, he has to listen to everybody else’s — one of the themes of the show is that even your therapist has stuff.”

It’s Paul’s opinion, in fact, that Jimmy has compassion fatigue; however, this doesn’t excuse his behavior. (See this previous post about a therapist in therapy and this one on impaired therapists.)

Robert Lloyd, Los Angeles Times: “If he were a responsible [therapist] he’d have taken a sabbatical and sent his clients elsewhere, because if this is how he’s doing after a year, one wonders how he was getting on at three or six or nine months…”

So, what do other reviewers think about how it all goes down in Shrinking?

Nate Richard, Collider: “Shrinking is a series that never laughs at its characters’ misfortunes or faults; it’s not a mean-spirited show by any definition, but it is sincere. Mental health hasn’t always been portrayed in the best way across the media landscape, and despite it becoming much more accepted in today’s climate, there are certain areas that are still two large steps behind in accurately portraying it in a meaningful way. Shrinking, to its benefit, seems like a major step forward…”

But Nick Schager, The Daily Beast, isn’t having it. Jimmy is “a jerk, an idiot, and a lousy doctor all at once, and the show’s attempt to make that cute and okay—because, you see, it’s a byproduct of the inner pain he can’t face—is its prime, if far from only, failing.”

Back to Linda Holmes (NPR), who remarks, on the other hand, that in addition to its great ensemble cast (which also includes Michael Urie, Christa Miller, and Ted McGinley, to name a few), the series “is a bright spot in a very crowded landscape that isn’t always this good at taking pain and decency — and comedy — and giving them all room to breathe.”

I will probably pass, by the way. Why? I’m just generally tired of bad therapy boundaries and ethics on TV and in movies. But if you have decided to watch it, please feel free to let me know what you think! I can be open!

Nov 11

Sexual Abuse of Boys and Men: Recovery

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1in6, an organization whose mission is “to help men who have had unwanted or abusive sexual experiences live healthier, happier lives,” lists on their site eight facts that counter common myths about the sexual abuse of boys and men:

  • Boys and men can be sexually used or abused, and it has nothing to do with how masculine they are.
  • If a boy liked the attention he was getting, or got sexually aroused during abuse, or even sometimes wanted the attention or sexual contact, this does not mean he wanted or liked being manipulated or abused, or that any part of what happened, in any way, was his responsibility or fault.
  • Sexual abuse harms boys and girls in ways that are similar and different, but equally harmful.
  • Boys can be sexually abused by both straight men and gay men. It’s about taking advantage of a child’s vulnerability, not the sexual orientation of the abusive person.
  • Whether he is gay, straight or bisexual, a boy’s sexual orientation is neither the cause or the result of sexual abuse.
  • Girls and women can sexually abuse boys.
  • Most boys who are sexually abused will not go on to sexually abuse others.
  • Not understanding these facts is understandable, but harmful, and needs to be overcome.

The following pertinent quotes are from therapists/writers who are experts on the effects of the sexual abuse of boys and men.

Jim Hopper, PhD:

Many men fear their masculinity has been robbed or destroyed, that they’ll be exposed as a ‘fake’ – even if no one has a clue about what happened or thinks twice about their masculinity.

...(L)earning to experience and express vulnerable emotions (at times and places of your own choosing), means becoming more masculine in many positive ways. 

         Richard Gartner, PhD, Psychology Today (author of Beyond Betrayal: Taking Charge of Your Life           After Boyhood Sexual Abuse):

Boys who grow up without coming to terms with their childhood abuse often struggle as men with addictions, anxiety, depression, and thoughts of suicide as well as the inability to develop or maintain relationships.

Confusing affection with abuse, desire with tenderness, sexually abused boys often become men who have difficulty distinguishing among sex, love, nurturance, affection, and abuse. They may experience friendly interpersonal approaches as seductive and manipulative. On the other hand, they may not notice when exploitative demands are made on them – they’ve learned to see these as normal and acceptable.

        Mike Lew, M.Ed., Victims No Longer: Men Recovering from Incest and Other Sexual Child Abuse:

Another question I am frequently asked is, “What do you mean by recovery?” It has taken me a while to answer that one. I had been depending on other people’s definitions of recovery until I developed one that worked for me (just as you must come to one that makes sense for you.) Mine is simple. For me, it is about freedom.
Recovery is the freedom to make choices in your life that aren’t determined by the abuse.
The specific choices will be different for each of you; the freedom to choose is your birthright.  

Lists of various resources are available to male survivors at 1in6 as well as on the websites of Jim Hopper and Next Step Counseling (co-directed by therapists Mike Lew and Thom Harrigan), and Dr. Kelli Palfy (author of Men Too: Unspoken Truths About Male Sexual Abuse), among others.