In this post I’ll write about realistic depictions of psychotherapy in movies. Not many get it right. Barbra Streisand’s portrayal of a psychiatrist in The Prince of Tides comes to mind. Her approach to therapy relies on the inaccurate cliché that when the client recovers the repressed memory of his trauma, he will be cured. More often than not movies about psychotherapy (i.e. Analyze This and Anger Management) treat it as a joke – probably because the idea of being in therapy makes a lot of people nervous. Therapists routinely hear nervous jokes about their profession when they’re introduced to people as a psychotherapist. I can’t tell you how many times I’ve heard comments along the lines of, “I’d better watch what I say around you.” or “My wife really needs to talk to you.”
One of the most realistic depictions of psychotherapy I’ve ever seen in a movie was Ordinary People (1980), the first movie directed by Robert Redford. It depicts the dissolution of a family after the elder son of a loving couple dies in a boating accident. Timothy Hutton won an Oscar for his portrayal of the younger son, who feels guilty for surviving, when his brother died. Mary Tyler Moore distinguished herself as a dramatic actor in her role as the devastated mother, Donald Sutherland was totally convincing as the grieving father, and Judd Hirsch was perfect as a skilled and caring therapist who has to win the trust of his grieving, suicidal client. It’s a sad, beautiful movie, for which Robert Redford won an Oscar.
Good Will Hunting (1997) is another movie that portrays psychotherapy realistically. Matt Damon plays Will, an alienated, self-taught mathematical genius, orphaned and raised in foster homes. He’s grown a hard shell, to keep people out, and trusts nobody other than – to some degree – his best friend, played by Ben Affleck. Robin Williams portrays the therapist, who is willing to try to connect with this tormented genius. Will has to go to therapy in order to stay out of jail, but that’s his only motivation. He does everything he can to provoke and alienate his therapist, and to sabotage therapy. Robin Williams convincingly portrays a therapist who immediately sets boundaries when Will disparages his deceased wife. He’s briefly unprofessional, physically accosting and threatening Will; but this scene reveals that psychotherapists are also flawed human beings.
He clearly sees the sarcasm and hostility that he encounters as weapons that Will uses to push people away. He knows not to take the attacks personally, and works with patience and good humor to win Will’s trust, and to “disarm” him. I’ve dealt with well-defended clients like Will, working to get to the place where they were ready to hear something like this: “Look, we both know that your armor works. It makes you feel safe. The thing is, the only way you can learn that it’s safe – at least sometimes – to go out into the world without your armor is to take it off and venture out into the world.” The final therapy session in Good Will Hunting is riveting, and rings true to me as a therapeutic breakthrough.
Although it takes place in a “mental institution,” there’s not much psychotherapy in Girl, Interrupted (1999). Winona Ryder plays a young woman diagnosed with Borderline Personality Disorder and Angelina Jolie plays an antisocial manipulator. Parts of the movie are melodramatic and implausible, but the acting is good. One thing that the primary therapist in the movie – played by Vanessa Redgrave – says has stayed in my memory, because it’s point I’ve made in therapy about the meaning of the word ambivalence. Ambivalence doesn’t just mean, “Oh, I really don’t know if I want to do this or do that.” or “I don’t care if it goes this way or that way,” serving to deflect or minimize an issue. It can also mean being deeply conflicted regarding two opposing courses of action. An addict can both really want to quit using, but also really want to get high. Suicidal people can be ambivalent about living. Part of them wants to live, but another part wants to die.
The most realistic portrayal I’ve seen of therapy on TV was HBO’s series, In Treatment, with Gabriel Byrne as a therapist with, let us say, an extremely challenging caseload. He’s an excellent therapist, but his own life is something of a mess. One thing I liked about the series was that it not only depicted therapy sessions with a variety of clients and issues realistically, but it also showed us the therapist’s weekly sessions with his own therapist and clinical supervisor, played by Diane Wiest. Healers often need healing, themselves.
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