Category Archives: Therapy

Nov 02

Clown Phobia: Getting Exposed to One’s Intense Fears

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Today’s theme: clowns. The fear of clowns, that is. Clown phobia.

First, a little comic relief about clown phobia: Dr. Frasier Crane (played by Kelsey Grammer from TV’s Frasier) tries to help a client overcome her fear of clowns by using exposure therapy.

Fear of clowns can lead to a variety of symptoms associated with phobias. From Fearof.net: “…(I)ndividuals report feeling ‘shaken and traumatized’ at the sight or even the mere thought of clowns. A study conducted by a Hospital in UK showed that decorating a children’s ward with images of clowns actually backfired when more than 250 children (in the age groups of 4 to 16) reported disliking the images.”

Having some degree of this fear, sometimes known as coulrophobia, is apparently pretty common. A few of those who have admitted to this publicly include Carol Burnett, Sean Combs, and Daniel Radcliffe.

And Johnny Depp explained his fear of clowns to the Courier Mail: “I guess I am afraid of them because it’s impossible — thanks to their painted-on smiles, to distinguish if they are happy or if they’re about to bite your face off.”

Update, 2019: As with other types of phobias, though, not everyone who suffers from this knows why, and it’s not usually necessary to figure out the causes in order to treat it successfully. Treatment is often done with behavioral techniques via cognitive behavioral therapy, exposure therapy, and relaxation therapy (BetterHelp.com).

At least in part, then, because causation has not been firmly established, emphasis is on changing one’s response to clowns. Lisa Fritscher, VeryWellMind.com: “Until more research is performed, the causes of clown phobia will remain firmly in the realm of speculation. Fortunately, it is possible for mental health professionals to treat clown phobia, as any other phobia, without learning the precise reasons for its development.”

Oct 25

“Sybil Exposed”: Not An Argument Against Multiplicity Itself

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A newly released book by journalist Debbie Nathan, Sybil Exposed: The ExtraordinaryStory Behind the Famous Multiple Personality Case, is currently getting a lot of attention in the press, as well it should if it is accurate in its depiction of highly fraudulent practices on the part of three individuals—the therapist, the author of the original book about Sybil (1973), and the patient herself—who allegedly conspired to make this woman’s condition and treatment into something that it wasn’t, turning her into “Sybil Inc.,” an immensely popular and lucrative enterprise.

On the positive side of this mess, the products generated by Sybil Inc. have served to popularize multiple personality disorder, now known as dissociative identity disorder (DID), and have given many people hope that their complex conditions could become better understood and treated.

On the negative side, the doubters—including some mental health professionals who don’t believe the condition actually exists in anyone—may now seize the chance to use Sybil Exposed to add fuel to that particular fire. See? Dissociative identity disorder is a crock, some are likely (illogically) to maintain.

I have neither read Nathan’s book nor can I weigh in on whether our Sybil of yore does represent one big fat lie, but I have witnessed and do strongly believe that there are those who do live with DID and that they represent one major truth: it is possible, it is indeed highly creative, when faced with severe childhood trauma, for one’s personality to become divided in order to withstand the torturous pain.

Do an online search for DID and you’ll find many up-to-date books that can serve to offset any indications, however shocking and upsetting, that this one particular patient/therapist/writer team may have fabricated multiplicity. (Clarification/ update, 6/10/12: In other words, there are still many experts who cite other case examples and histories; there are still many who believe that DID exists.) Two highly recommended books are The Dissociative Identity Disorder Sourcebook by Deborah Haddock and Multiple Personality Disorder From the Inside Out, edited by Cohen, Giller, and Lynn W.

With so many written and oral testimonies by those who’ve experienced DID firsthand, I confess that it’s beyond my ability to comprehend how anyone in my field could be a disbeliever. I contend that the therapists who disbelieve are either uninformed or unexposed or that they are so closed off to the possibility that they are unable or unwilling to see or accept it in their clients.

Moreover, clients may be unable or unwilling to reveal themselves fully in therapy if they sense any of the above characteristics in their shrinks.

For anyone who counters with, If they can hide it, it must not be so, consider your own personality. Do you routinely, for various reasons, keep parts of yourself in check? Please don’t say no. Because if you don’t, the rest of society may ask you to get some help learning how.

Oct 21

Therapist Boundaries (Violence): Two Movies

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Do a Google search about therapist boundaries, specifically therapists and violence, and you’ll find plenty about clients attending therapy for being violent.

But can you find any reliable info about therapists being violent? Against their clients? No? Do we have to (misguidedly) look to the movies for such things?

I. Good Will Hunting

Will (Matt Damon) in the movie Good Will Hunting (1997) is one character who has to attend therapy after an episode of violence. Finding the right shrink for Will, who trusts no one who tries to help him, turns out to be no easy feat. Well, maybe the less traditional, more directive kind of therapist we eventually find in Sean Maguire (Robin Williams) will fill the bill.

But before Will gets anywhere close to the meaningful catharsis the film wants him to have, he has to put Maguire through the usual hoops, in one instance meanly and provocatively maligning Maguire’s dead wife. What follows is this disturbing scene involving terrible therapist boundaries:

Lesson #1 (You Wouldn’t Pick Up From The Movies): It’s never okay to choke a client. (Or harm a client in any way.) (Unless, of course, in self-defense.) Even if the client then backs off and actually moves on to have one particular wowie-zowie life-changing therapy session.

JC Schildbach, LMHC, RespecttheBlankie.com: “Despite what the filmmakers would have us believe, this is not a valid technique for establishing rapport or ensuring appropriate transference with clients who have suffered abuse–even when therapist and client are both from south Boston and the client just shit-talked the therapist’s dead wife.”

II. What About Bob?

Next up, there’s actually worse things a shrink can do. In the film What About Bob? (1991), the psychiatrist played by Richard Dreyfuss goes nuts himself dealing with Bob (Bill Murray), his dependent client who follows him, uninvited of course, on vacation.

Lesson #2 (You Might Not Pick Up From the Movies): Even unsuccessful attempts at killing one’s (annoying) clients are not allowed.

Well, at least Leo Marvin’s “death therapy” doesn’t work, and while there’s an unhappy ending in store for him—catatonia and psychiatric hospitalization—there’s a happy ending for Bob, who marries Lily,  becoming Leo’s brother-in-law. And there’s more: We find out in the Epilogue that Bob goes on to get his psychology degree and to write the bestselling Death Therapy.

Sep 28

Is Your Therapist For Real? Practicing Without Credentials

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Is your therapist for real? As in practicing with appropriate licenses and/or credentials? I mean, there can actually be “therapists” out there who lack the necessary education and credentials and/or licensure to practice.

When I worked in various agencies before entering private practice, it was never required of me to prove to my clients that I was indeed a therapist for real—I worked there, so obviously I was. Or was I?

Yes. I was. Looking back, though, I wonder how many of my employers even actually verified all of my credentials.

When I began my own practice, every now and then a client did ask about my education or experience. Whereas I freely shared this info, for the longest time I didn’t think it was necessary to display my diploma and other certificates in my office. Wouldn’t that be kinda showy?

Actually, no. Simply put, clients have the right to know that you’re for real. So now, all the framed evidence of the “letters after my name” hangs in my waiting room. Ha, joke’s on you—they’re fake! Anyone with access to the internet can…

Kidding.

In the 1999 film Mumford a man relocates to a small community—named Mumford—where he pretends to be a psychologist named, oddly enough, Mumford. It seems that in his previous life, Mumford—the man, not the town—had learned something about relationships even in the midst of some serious drug problems:

For some reason, probably because I was too stoned to talk, everywhere I went people would talk to me. Tell me everything. Their problems, their inner most thoughts. Sometimes they needed advice, but most of the people just wanted someone to listen.

Rehab then taught the man not yet named Mumford even more about how help is given and how help is received.

When he moves on to become a fake shrink in Mumford the town and Mumford the movie, Mumford the man is remarkably successful—and greatly appreciated for his shrink-like capabilities. As you may have already guessed, no one has bothered to check out the credentials of this likable newcomer.

Eventually, though, in Mumford the movie and in Mumford the man and in Mumford the town, things do fall apart—as they should, given the deceptive circumstances.

Sep 26

President In Therapy: Fictional “West Wing” One, That Is

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I’m feeling bad for President Obama these days. So much stress—and possibly no therapy. How does someone in his position manage it all? Has there ever been a president in therapy?

At a professional forum in 1999, Kitty Dukakis, social worker and wife of former Massachusetts Governor Michael Dukakis, reportedly stated, “If you’re running for public office and expect to be elected, forget about letting it be known that you’ve been in therapy. It’s a tragedy that it’s come to this.” Moreover, she was grateful her husband didn’t get to become the president, as it enabled her—as the wife of a politician—to seek treatment for her addictions.

Has much changed since then? Has anything? Has any politician at a higher level ever admitted to being in therapy while in office?

My own internet research came up almost empty. The exception? It turns out there was a U.S. president who consulted a psychiatrist during office—he was fictional, however.

On the TV series The West Wing that aired from 1999-2006, Martin Sheen as President Josiah Bartlet saw Dr. Stanley Keyworth, played by Adam Arkin. At least once, possibly more.

In the story represented in the clip below, Bartlet has experienced a serious bout of insomnia following a conversation he’d had with staffer Toby about his abusive father, who’s deceased. Toby had suggested that Bartlet had never felt his father’s approval and thus still might be seeking it via winning votes.

I think it’s an interesting take on what it could be like to be a U.S. president in therapy: