What You May Think Therapy Is . . .

According to Wikipedia, Dr Sigmund Frued,  is the “father of modern psychology”  “He was an Austrian neurologist and the founder of psychoanalysis (early 1900’s) which is a clinical method for evaluating and treating pathologies in the psyche through dialogue between a patient and a psychoanalyst.” 

He created a set of techniques that involved “talk therapy” that used strategies such as transference (where someone takes their feelings about one person and “transfers” them onto someone else)   for example, you’re mad at your boss and you come home and yell at your wife instead. Free association (asking a client to just talk freely and openly about things and look for connections among it all)  and dream interpretation (reviewing your dreams and identifying patterns and associations with your waking life).

Take for example the TV series Mad Men. It was a drama that followed an ad man named Don Draper who was sleeping around on his wife, Betty, who is very attractive, always well-dressed, and visits a psychiatrist after she has, what I would call, a generalized anxiety attack that may have caused a car accident.  

When you look at the therapy scenes from the show it’s like your very typical old school analyst, think Dr. Freud with the glasses and suit and his patient lying on a couch.    Apparently back in those days it was pretty common for people to lay down on a couch and talk about their feelings. I don’t know about you but how many different types of offices can you walk into, kick off your shoes and lay down on a couch to have a conversation with somebody else. Granted don’t get me wrong I’ve definitely kicked off my shoes and tucked my feet up underneath me while sitting in my therapist’s office but I’m not sure I’d ever go as far as to lay flat out on their couch. But that’s just me.

Therapy In The Movies

Let’s take two of my favorite movies, “Analyze This “and” Analyze That”. Two movies that show a humorous portrayal of who goes to therapy and why they may need it.   In these movies there’s a mobster named Paul Vitti who is having a meeting with a friend who’s telling him to be careful because his life is in jeopardy. 

And that friend basically gets gunned down right in front of him. Later that day a therapist named Ben rear-ends Vitti, who happens to have a body in his trunk and instead of being able to work out the accident right there, because they are trying to hide the body, Ben gives them him his business card (he’s a psychiatrist) and says ito contact them to take care of the damages. Later on in a meeting, Vitti basically has a “panic attack” and tells his right-hand man that he needs a psychiatrist. Out pops Ben’s business card and this is how we see the beginning of the relationship taking place.  

You start out seeing Vitti show up in Ben’s office talking about needing “a therapist for a friend” which Ben sees through and they quickly begin to discuss what is going on. Vitti is impressed that Ben doesn’t treat him like the scary mobster that he is. He calls him on his stuff. The rest of the movie is obviously about the comedy of errors surrounding mobsters and therapists and all the ways this relationship works and yet has blurred lines and boundary crossings.  It’s funny but also very enlightening as to the relationship between therapist and client. 

“The Sopranos” TV series is probably the first serious show on television to take a dive into the world of therapy. Yes,  Tony Soprano’s therapist didn’t do it all the “right” way in her methods. The way she portrays  the therapy relationship is pretty darn accurate. And while Tony Soprano’s psychiatrist, Dr. Jennifer Melfi, wasn’t always above board in her approach to treating notorious mobster Tony Soprano, experts have long agreed the portrayal is pretty accurate.

Okay fine, how many people do we know who are mobsters who see somebody get shot in front of them on the street and then start having panic attacks and realize they need to see a therapist?  Yes It’s a bit far-fetched but it does show the significant importance people place upon seeing a therapist and the different situations that lead up to somebody deciding that they need to get help. It also delves into the importance of the relationship between the therapist and patient.

For therapy to work there needs to be a compatible relationship.  If you don’t “vibe” with your therapist it can be challenging to work together. Communication, listening and trust are all necessary for the relationship to grow.  Let’s check back in with some very famous shows for some insight into who and why we go to therapy. I tell all of my patients that you really need to give it at least three sessions in order to determine if the relationship is going to work or not. I tell this to students who are looking for a therapist. I tell this to adults who are looking for a therapist. I basically tell this to everybody.

What we see here is that teens are very reluctant to talk to adults about the issues they are struggling with.  They would rather meet someone in an abandoned bathroom facility to get peer to peer help than have that uncomfortable moment with an adult.

We all know it can be intimidating to ask for help with your mental health . . .

Noting our own faults, worries or deficits in one thing, but admitting it out loud to others is even more intimidating.  When our parents or friends confront us that we have an issue it’s difficult and to have to agree is a whole nother level of hard. There are certain things that one should be looking for that would be a sign that it’s time to get help.  This site outlines the following issues: 

Possible signs you need to see a therapist

1.  Overwhelmed. You might feel like you have too many things on your plate and you can’t’ get a break. Or there are too many issues to cope with. You might feel like you can’t rest or even get a breath. Stress and being overwhelmed can lead to serious physical health concerns.

2.  Fatigue. This physical reaction your body is having can be caused by mental health issues. It can indicate depression. Fatigue can cause you to sleep more than usual or have trouble getting out of bed in the morning.

3.  Everyone feels anger at times. Even the occasional rage moment isn’t necessarily harmful. But if they linger or are not passing it is a good idea to seek counseling. If things seem too extreme compared to the situation, or if they lead you to take violent or potentially harmful actions you should immediately seek help.

4.  Agoraphobia. People with agoraphobia fear being in places where they might experience panic attacks or become trapped. Some people may become unable to leave their houses.

5.  Anxious or intrusive thoughts. It’s normal to worry about things from time to time, but when worry takes up a significant part of your day or causes physical symptoms, therapy can help you deal with it.

6.  Apathy. Losing interest in usual activities, the world around you, or life in general can indicate mental health issues like depression or anxiety.

7.  Hopelessness. Losing hope or motivation, or feeling as if you have no future, can indicate depression or another mental health condition. Feeling hopeless from time to time, especially after a period of difficulty, isn’t uncommon. But when it persists, it may lead to thoughts of suicide.

8.  Social withdrawal. Many people feel better when they’re able to spend at least some time alone. Introverted people may need even more time alone than others. But if you feel distressed around others or fear being with other people, therapy can help you understand and deal with these feelings.