Dear Dr. Brian

Brian, I was wondering if I could suggest a topic for a blog post. I’d really love to hear what you think about the new Bravo series:

Admirer in Atlanta

Dear Admirer in Atlanta,

I have mixed feelings about this new series. It’ll be one of a very few reality shows to premiere in recent memory wherein the entertainment proposition for viewers isn’t solely downward social comparison to trash (e.g. trash polluting the Jersey Shore, trash “showing” its offspring like a piglet on the county fair circuit, trash masquerading as socialite housewives, etc., etc., etc.). For a refreshing change of pace, this show will offer viewers an opportunity for downward social comparison to people with psychological issues (perhaps including the show’s therapists).

I’m not too worried about the privacy angle – if competent adult patients (I know, I’m assuming) want to waive their privacy in exchange for free therapy, chances to be on television, etc., that’s okay by me. I’ve even thought about making a reality show about divorce/child-custody mediation on which viewers could watch those dramas play out and maybe even learn something about settling those issues out of court. Given the nature and brevity of the mediation process, I believe that I could still be an effective mediator with a national audience observing, but I’m skeptical about the efficacy of the psychotherapy to be chronicled in this new series.

A few years ago, there was a reality show (I don’t recall the name or network) on which a therapist helped patients get over various types of phobias. That show didn’t last long (probably because the therapy – graduated exposure or “systematic desensitization” – looked pretty much the same whether the phobia was of spiders, mice, heights, flying, etc.), but in that circumscribed context, I imagine that the patients probably benefited about as much as they could’ve benefitted in the therapist’s office while the audience learned something (possibly) about overcoming fears. When it comes to other kinds of psychological problems, though – for example, mood disorders like depression or relationship problems – I have doubts.

And my doubts aren’t just about the patients’ willingness to fully disclose their thoughts, feelings, and actions in front of a national audience. I also have doubts about the quality of the therapy that we’ll see, if in fact it’s entertaining and/or interesting enough, even in edited form, to hold a national audience’s attention. I’ve given advice to callers on the radio and on television, but that wasn’t therapy – for the viewing/listening audience, it was entertainment (hopefully educational), and for the callers it was simply a few minutes of directional perspective (hopefully helpful) on how they might want to think differently about their issues and what actions might help them start moving toward resolutions of those issues (getting into therapy, getting legal advice, etc.).

Real therapy, though, is inherently boring to watch, even for supervising psychologists and therapist trainees, let alone for the general public. It takes many patients a long time to make “breakthroughs,” even longer to be “cured” (when a “cure” is even possible), and much of that time is filled with relatively mundane chronology of past and current events in the patients’ lives. Maybe this show will feature enough patients that the audience will only see brief snippets of each patient’s progress in each episode, with the main focus then being on the therapists (their perspectives, professional and personal lives, etc.), but it’s tough for me to imagine the general public really wanting to spend many hours following individual patients’ struggles with, for example, depression symptoms, in a genuine, “by-the-book,” cognitive-behavioral psychotherapeutic process.

If the therapy itself is particularly entertaining or interesting in this show, my guess is that it’ll have to involve some degree of misrepresentation of the normal therapeutic process. In that case – and especially to the extent that therapists’ lives and pathologies are dramatized simultaneously – I imagine that some viewers may be less inclined to consider therapy either as a mental-health treatment or as a life-improvement tool. At the same time, I also imagine that some viewers may be more inclined to get themselves into therapy, albeit perhaps for the wrong reasons (e.g. misguided self-identification with the patients on the show).

So, while I’m really not alarmed by the potential of this new show to significantly damage the psychology profession, my prediction is that it’ll be typical of reality television, i.e. trash.

Dr. Brian

(“Dear Dr. Brian” is published for public-interest and entertainment purposes only – it does not establish doctor-patient or attorney-client relationships, and it should not be used as a substitute for psychological, legal, or financial advice from a licensed professional in your area.)

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