01/07/2013 04:57 pm ET Updated Mar 09, 2013

Notes From the Couch: Movie Shrinks Make Me Crazy

Years ago, a young client of mine told me that she had no idea what her father did for a living. When she asked about his work, and she did ask repeatedly, his answers were always mysterious. He would say something like, "I work for the government" and give her a look that told her, "Leave it alone."

In her adolescent mind, my client imagined her father as an undercover agent, living a seemingly-normal life in the suburbs, but always under great danger, protecting the nation. She was afraid for him, and chronically afraid that international terrorists might shoot up their home. He was unrelenting, though, in not revealing his true identity. Until he was dying. No kidding, this was a deathbed confession. What was his true occupation, that which had to be hidden, until his very end? He was an auditor for the Internal Revenue Service! My client's fears and imaginings of a dramatic, covert life of espionage were dashed. And why? Because the father knew that everyone hated tax auditors. They're seen as boring, pencil-pushing snitches. He couldn't deal with the risk of losing his precious daughter's admiration.

Well, I went to the movies recently, and I'm beginning to feel like that guy. Or maybe an honest used car salesman. My husband insisted that we see Silver Linings Playbook because the reviews touted its accurate and gritty depiction of mental health issues. Since I'm in the mental health biz, I figured I should see it. Inevitably, one of my clients would want to know if I saw it, what did I think, and are they as crazy as those characters.

So, I have to see a lot of television and film that depict shrinks. And as a college faculty member, I teach a lot of students who want to become ethical and effective psychotherapists. Often, they are delighted to see movies that show the therapeutic process so they can apply what they've learned, critiquing or emulating skills. And the truth is, I almost always have to give the assignment with the caveat that there will be more to critique than praise. (Someone out there, please let me know if you've seen a good therapist in a film other than Judd Hirsch in Ordinary People or maybe Robin Williams in Good Will Hunting.)

The psychiatrist/therapist guy in Silver Linings Playbook is introduced after he deliberately triggers a violent, psychotic break in a patient (the film's main character) by piping a traumatic memory-inducing song into his packed office waiting room. The patient had just been released from a psych hospital, so it would make sense to put a whole room full of people's safety at risk, right? Or maybe just confirm to him that he was irrevocably insane and unable to live independently? What was that little ditty from Hippocrates? Oh yeah, right... "Do no harm."

In my movie seat, I was already alarmed before "Dr. Patel" uttered his second sentence. When he finally engaged his patient, the doctor seemed to have only two moves (we call them interventions). First, take your medicine, and then develop a strategy for calming yourself when you're triggered. The doctor is cold and distant.

Later in the movie, the patient runs into his therapist at a football game and is relieved when Dr. Patel reveals he is just a regular guy by calling the other fans and players "cock suckers." Last time I checked, that is not typically seen as a compliment. I kind of think it's bigotry against homosexuals and/or women. The whole therapy thing falls apart after that. The shrink winds up in the home of the main character, participating in the family craziness with no professional boundaries whatsoever. Game over. I can never assign this movie to my students.

Is this what the therapists in Hollywood are like? Boundary-less, sycophants, with no skills whatsoever? If so, that explains a lot. For me, movie portrayals of mental health professionals are generally infuriating, insulting and depressing. Why would anyone reasonable invest the time and money going to see a shrink like the ones they see in films? These depictions of people in my field are embarrassing. Maybe from now on, I'll tell people I'm an auditor for the IRS.

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