From “Sopranos” to “Ted Lasso,” 3 Real-Life Therapists Rate the Best and Worst of TV Therapy

Hulu / Netflix / Apple TV+

Image Source: Hulu / Netflix / Apple TV+

“Never Have I Ever,” “You,” “Ginny & Georgia,” “Insecure,” “Ted Lasso,” “Sex Education” – streamers have created an ongoing watchlist of shows normalizing conversations around mental health and therapy onscreen. In “Ted Lasso,” an entire men’s soccer team is introduced to the benefits of psychotherapy, also known as talk therapy, thanks to a sports psychologist named Dr. Sharon (Sarah Niles). In “Insecure,” we see Molly (Yvonne Orji) confront questions of ambition with the help of a Black woman therapist – played by Denise Yvonne Dowse – who helps her re-examine her desires. And in “Tiny Beautiful Things,” starring Kathryn Hahn, we learn that therapists aren’t just people who help us through our struggles; their lives are equally complex on the other side of the notepad.

Speaking with POPSUGAR, Maria Sosa, LMFT, Lia Mancao, LCSW, and Mariel Buqué, PhD, a licensed trauma psychologist and author of “Break the Cycle,” dismantled some of the most common therapy tropes on TV. Sosa, Mancao, and Buqué also examined the influence these onscreen portrayals have on real-life conversations about mental health.

Is Therapy on TV Accurate?

“What we see on TV isn’t always an accurate representation,” Mancao says. Early portrayals of onscreen therapy often fit a clear-cut mold: a patient monologuing about their problems from the comfort of a chaise lounge, as a therapist – usually an older white man in glasses – scribbles notes on a pad of paper.

In the early 2000s, shows like “The Sopranos” and “Law & Order: SVU” laid a more fleshed-out model of what therapy is actually. But these onscreen sessions were either brief or showed characters coping with unrealistic situations, given that they were bookended by dark glimpses into violent criminal underworlds. This kind of sensationalized TV can be entertaining, but it also muddles the lines between reality and fiction.

“One thing that I think is really positive about a lot of these shows is the fact that they aren’t reflective of like severe mental illness.”

As viewers, we watch TV to be transported. In the same way surgical scenes on “Grey’s Anatomy” diverge from real-life medical practices, TV therapy is sensationalized for the sake of spectacle and advancing the story. As anyone who’s been to therapy knows, a play-by-play of a real-life therapy session would rarely qualify as “entertaining” by media industry standards. So show writers lean on dramatic moments of excitement – confessions of murder, psychological breakdowns, etc. – to keep viewers hooked.

While this habit might seem fairly innocuous, it could have an unintended consequence of perpetuating a false idea that all therapy patients must be grappling with debilitating symptoms of mental illness, or a catastrophic life event, in order to participate in therapy. Many of us recognize when a show or character is being over the top for a laugh or to advance the plot. Still, it can be difficult to separate our subconscious thoughts about what we see on TV from our personal opinions about therapy, especially for those who have never tried it themselves.

Image Source: Netflix

Another area where depictions of therapy on TV still falter is in the portrayal of the therapist-client relationship. On screen, many therapists make a habit of crossing ethical boundaries. For instance, in “You,” Beck (Elizabeth Lail) enters a romantic and sexual relationship with her therapist, Dr. Nicky (John Stamos). We see the same pattern reflected between Annie (Mae Whitman) and Dr. Cohen (Rob Heaps) on “Good Girls,” and between Michelle (Andrea Anders) and Dr. Jacob (Mike O’Gorman) on “Ted Lasso.”

“They allow their countertransference to enter the room unchecked and they have a very inappropriate relationship with the client,” Mancao says of the onscreen therapists.

For people seeking therapy, this could be a major deterrent. “That can send a message to the general public that the relationship with the therapist can look different than what it actually would be,” Dr. Buqué says. It could also misrepresent this kind of improper relationship as being “normal” or common, and make a client who’s feeling uncomfortable less likely to speak up.

“Our role as therapists is not to tell our clients what to do with their lives.”

Relationships between patients and therapists are major red flags, especially because the patient-therapist relationship relies so heavily on the therapist remaining unbiased toward their client. The reality of the therapeutic alliance, as exemplified in Jonah Hill’s candid psychiatry documentary, “Stutz,” is that therapists and their patients have to be prepared to be “incredibly vulnerable and incredibly trusting,” Mancao says. She adds that therapy, as a rule, has systems of checks and balances in place to ensure that no lines are crossed.

“In Treatment” demonstrates this well, when a therapist seeks counsel from a supervisor to check her bias. These personal biases are referred to as transference and the aforementioned countertransference, and occur when a patient or therapist – consciously or unconsciously – projects their emotions about someone else onto the other. “Most of us have other people that we talk to to make sure that our own stuff, our own experiences aren’t getting in the way of our treatment,” Mancao says. “We don’t want people just projecting all over the place.”

Another significant ethical boundary that often gets crossed onscreen occurs when the therapist tells the patient what to do. In “Shrinking,” we see Jimmy Laird (Jason Segel) allow his personal grievances to interfere with the way he treats his patients. For example, Jimmy orders one patient to leave her husband with the threat of dropping her as a client.

“That’s not therapy; that’s essentially telling your client what to do,” Sosa says. “Our role as therapists is not to tell our clients what to do with their lives. I think our role is to ask questions, it’s to frame a way of thinking that allows our clients to make those decisions for themselves so that they feel empowered to do that.”

When Does Therapy on TV Get It Right?

While TV depictions of therapy still have a ways to go, some recent shows like “Never Have I Ever” are injecting a much-needed dose of reality into storylines involving the practice. “One thing that I think is really positive about a lot of these shows is the fact that they aren’t reflective of like severe mental illness; instead they’re reflective of day-to-day issues that people have,” Dr. Buqué says. In “Never Have I Ever,” we see this exemplified through Devi.

For Devi, therapy begins as a way to help her process the latent grief she’s experiencing after her father’s death and the somatic expression of that pain. As her story progresses, her grief becomes secondary to everyday problems: relationship struggles, conflicts with friends, and wavering self-confidence.

Still, Devi keeps her regular therapy schedule with Dr. Ryan, making time to talk through intricate moments of confusion and self-doubt as she navigates high school. Through Devi, we see that it’s OK to continue attending therapy even after you’ve processed the major life event that sparked the initial appointment.

The show also opens up a conversation about who goes to therapy. As a young Indian-American woman, Devi counters the narrative that therapy is an exclusive experience simply by sitting across from Dr. Ryan. Overworked CEOs and couples running on resentment are no longer the norm when it comes to therapy patients on TV. Young, old, striving or thriving – therapy is for everyone.

One could argue that even the some kinds of fictionalized misrepresentations of therapy can be useful, when thought of as a teaching moment, according to Dr. Buqué. Claire’s storyline in “Tiny Beautiful Things,” for example, showcases that a therapist’s personal struggles shouldn’t impact the quality of their work. When viewed under a positive framework, it’s possible that seeing this type of situation play out on TV could help make clients and therapists alike better able to recognize this type of red flag. “I believe that it can be helpful for both therapists and clients to see the ethical pitfalls that can happen inside of therapy, so that they can aim to not go that route,” she says.

TV portrayals of therapy also have the ability to humanize therapists, which is important. Through Jimmy in “Shrinking,” for instance, we see that therapists harbor their own complexities and struggle with their own issues. In real life, it’s crucial to keep these external problems from influencing a session with a patient. Onscreen, though, the therapist’s point of view can be more fully explored, and this can be a useful way to remind everyone that while therapists are typically meant to be impartial, they’re also fallible humans.

“There is a way in which therapists can be seen as people that hold their own stories and their own lives.”

On “Never Have I Ever,” Dr. Ryan’s ability to casually treat Devi while getting ready for a party reminds us that therapists are not trapped in the confines of their offices. What starts out between Devi and Dr. Ryan as a set relationship with rigid boundaries softens into something we as viewers are more easily able to digest. This makes it easier to understand that each therapist is a fully fleshed individual with their own set of troubles, and their humanity should be taken into consideration at all times.

“There is a way in which therapists can be seen as people that hold their own stories and their own lives,” Dr. Buqué says. “Very often, people believe that they can just trauma dump on therapists because they see the therapist as being able to hold their story [by default], even when there hasn’t been an explicit client-therapist relationship [defined].” She adds, “The fair way of approaching it is for there to be an established therapeutic relationship and for them to then have a space where they can talk about their dilemmas.”

By developing these characters onscreen, TV reimagines therapists as human beings, rather than just a job title.

The Future of Therapy on TV

The caricature of therapy and therapists on TV can cement harmful tropes that have the potential to dissuade viewers from seeking treatment. On the other hand, TV is challenging old clichés about mental health and setting new expectations for a generation of viewers who may find – or already have found – themselves sitting across from a therapist.

In terms of destigmatizing the conversation around therapy, there’s still work to be done: crafting a deeper appreciation for the humanity of the therapist, emphasizing patient-client confidentiality, solidifying boundaries, and increasing the representation of marginalized voices, to name a few. Mancao, personally, hopes that allowing others to see themselves represented onscreen plants the seed for people from marginalized communities – where discussions around mental health are often stigmatized – to seek therapy.

Finding a therapist that’s a good fit is an intimate experience. This can involve months of searching, especially for many who are seeking a therapist that can speak to their specific lived experiences. “Everybody is shaped by their culture and everybody was shaped by their upbringing, and sometimes that doesn’t fit into the Western mold of how therapy was created,” Mancao says. “And I think it’s very important for therapists to recognize the different cultural and systemic issues, that impact their clients.” Recently, we’ve seen this cultural competency reflected in the casting and screenwriting for shows like “Insecure,” “Never Have I Ever,” “UnPrisoned,” and more.

TV alone can’t reshape society’s perception of mental health or therapy, but the influence of pop culture is powerful. Sosa points out that memes have even played a role in changing the perception of therapy. Therapy – what was once seen as something scary or serious – has transformed into something that can also be funny and help people uncover the joy in life.

Above all else, Sosa, Mancao, and Dr. Buqué encourage anyone doubtful about therapy – as a result of TV or otherwise – to try it for themselves. Dr. Buqué adds, “I think there’s still a long way to go to reflect the full landscape of what therapy can actually look like, but for a five-year span of like all these shows popping up, I think we’re already in a really good place.”

Related: Is In-Person Therapy “Better” Than Virtual Sessions? Therapists Weigh In

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