The Evolution Of Therapy In Media: Global Media And The Shifting Perspective

Consider the classic scenes from movies or TV shows that feature a therapist's office. You might envision a dimly lit room, a patient reclining on a leather couch, and a stoic therapist jotting notes in a notepad. While such portrayals were common, the depiction of therapy in the media has evolved significantly. From harmful stereotypes to more nuanced and empathetic representations, the way therapy is presented on screen and in the media reflects a gradual shift in our society’s understanding of mental health.

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Therapy before the screen: A brief historical context

Long before therapy became a common plot device in movies or sitcoms, mental health treatment existed in various forms. Early 20th-century psychoanalysis, with its emphasis on talk therapy, can be said to have laid the groundwork for the kinds of therapeutic conversations we often see portrayed on screen. However, these treatments were often difficult to reach due to cost or limited to institutionalized settings, often creating a disconnect from everyday experiences.

Shifts in the mid-nineteenth century, like the move to outpatient therapy and new treatment methods, made mental healthcare more widely available. However, societal stigma and inaccurate media portrayals of mental healthcare kept many people from openly seeking therapy. It wasn't until later in the twentieth century that popular culture began to reflect therapy in the media.

Early portrayals in TV and film: The age of stereotypes

For decades, popular media tended to paint therapists and mental health treatment in an unflattering light. Therapists were frequently portrayed as cold and detached, their methods mysterious and sometimes even comical. Psychiatric disorders were often sensationalized, with mentally ill characters labeled as "crazy" or "dangerous." These harmful stereotypes often perpetuated stigma and contributed to a negative perception of mental health conditions.

A prime example may lie in the iconic 1975 film One Flew Over the Cuckoo's Nest. While groundbreaking in some ways, the film may have reinforced harmful stereotypes about psychiatric institutions and the people within them. Similarly, thrillers often used the trope of the "deranged killer" with unresolved childhood trauma, linking mental illness with violent crime.

A shift in perspective

As society's understanding of mental health deepened, media representations began to change. Characters like Dr. Frasier Crane, the titular psychiatrist in the sitcom Frasier (1993-2004), may have signaled a shift away from harmful stereotypes. While the show often played on Frasier's own neuroses for comedic effect, it also portrayed therapy in a positive, normalized light. The presence of a therapist as a main character likely helped destigmatize the idea of seeking professional help. 

Later shows would build on this, offering even more nuanced explorations of therapy for a variety of challenges like grief, anxiety, or relationship issues. Shows like HBO's In Treatment (2008-2010) offered intimate glimpses into the therapeutic process, showcasing a variety of therapy styles with both challenges and breakthroughs.

This shift wasn't limited to scripted content. Reality TV frequently embraced portrayals of individuals and families navigating therapy. While some shows faced criticism for potential sensationalism, others sparked open conversations about mental health challenges and the path to healing.

Social media and the democratization of mental health

In many cases, celebrities also began to open up about their mental health journeys in the public sphere. By talking about their own lives and experiences with therapy, they normalized seeking help and challenged the idea that mental health challenges are something to be ashamed of.

Today, portrayals of therapy and mental health in the media may be more diverse and nuanced than ever before. Shows like Crazy Ex-Girlfriend (2015-2019) tackle themes of mental illness with a mix of humor and poignancy. The character of Rebecca undergoes a complex journey involving therapy and medication, potentially providing a more authentic representation of managing challenges like borderline personality disorder (BPD).

Therapy also tends to be increasingly normalized across genres. Characters in teen dramas, superhero flicks, and workplace comedies might casually mention therapy or cope with issues of anxiety and depression in relatable ways. This everyday integration of mental health themes may chip away at lingering stigma. Additionally, some modern shows explore themes of suicidal ideation with greater sensitivity than past media. Instead of sensationalizing it, they may focus on a character's journey toward seeking help and the support systems that make a difference.

If you or a loved one are experiencing thoughts of suicide, please know that help is available. You can call the National Suicide Prevention Lifeline anytime, 24/7, at 988.

The importance of accurate portrayals

The evolution of media representation often has a real-world impact. Studies by organizations like the American Psychological Association suggest a link between positive media portrayals of mental health and the public's perception. When people see characters with whom they relate facing their struggles and seeking help, they may be more likely to consider therapy for themselves.

Accurate portrayals of mental health and mental healthcare may particularly benefit young adults. Growing up in a world where therapy is spoken of more openly and shown in a positive light could encourage them to prioritize their mental well-being, reducing the hesitation sometimes associated with reaching out for support.

While significant progress has been made, there may still be room for improvement. Some portrayals of mental health in the media continue to rely on outdated tropes or center therapy narratives around privileged individuals. This inaccuracy can create a disconnect for viewers who may not have similar resources. Increased representation of diverse therapists and a wider spectrum of mental health experiences can bolster inclusivity.

Media creators may have an opportunity to shape how audiences understand mental health. With this opportunity can come responsibility. Consulting with mental health professionals can ensure that portrayals are grounded in reality and avoid harmful stereotypes. Additionally, showing therapy alongside other coping mechanisms, like support networks or healthy lifestyle changes, can underscore that it's one vital part of a broader wellness toolkit.

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Therapy and the ongoing conversation

Therapy on screen often focuses on individual sessions, but the impact of mental health challenges can ripple outward. Portraying family therapy or couples counseling can highlight how mental health issues affect relationships and showcase the support therapy can offer within those systems. This kind of representation could increase understanding for loved ones of those living with mental illness, promoting empathy and stronger support networks.

As technology evolves, so may the potential for new pathways in mental health care and its portrayal in media. Shows or films might explore how virtual reality therapies can help with specific phobias or how new technologies may offer alternative support. Media depictions may have the power to spark conversations about these innovations, potentially increasing awareness of new treatment options.

Additionally, global media can offer the chance to explore therapy through diverse cultural lenses. Portrayals of therapeutic practices rooted in different cultural traditions could broaden viewers' understanding of mental well-being and highlight that there's no single "right" way to seek support.

The evolution of therapy's portrayal in media can be considered a dynamic and ongoing process. It may reflect changes in public perception and advances within the mental health field. As creators continue to push for more realistic, nuanced depictions of mental health and therapy, media can become a helpful tool. It can break down stigma, raise awareness, and ultimately encourage those who need it to seek the support that can change their lives. 

As therapy becomes more normalized in film and television, so too may the idea of seeking help through online platforms. The convenience and affordability of online therapy can be particularly appealing to a generation that grew up seeing therapy discussed more openly on screen, making it a practical next step in prioritizing their mental health.

Online therapy's adaptability may align with a generation accustomed to personalized, on-demand experiences. Studies suggest that online therapy can be as effective as in-person therapy for a wide range of mental health conditions. A systematic review of 12 randomized controlled trials shows that there seems to be no difference between the effectiveness of in-person therapy and telehealth therapy for less common mental health conditions, like substance use disorder and eating disorders. These results may parallel the way forward-thinking media portrayals embrace therapy as a relevant tool for navigating modern complexities.