Therapy has long been a source of fascination, with all sorts of scenes depicting it in film and TV.

But is therapy really like in the movies or on TV? If not, how is real therapy different?

1. You don't generally lie on a couch.

This is still a beloved cliche of films, and it comes from Freud and the type of therapy he created, 'psychoanalysis'. Psychoanalysis is still popular in places like France and Argentina, if far less so in places like the UK where Freud’s theories have long been challenged, if not disproven.

In general, you'll be seated in a chair or upright on couch. As will your therapist. They don't hide behind a giant desk, fiddling with things. They face you at a comfortable distance and focus on you.

2. You don't endlessly sit in silence.

Again, this is more a hangover from psychoanalysis.

Sure, there will be moments of quiet, and time to think. Perhaps even long silences. But then your therapist might ask you about the silence. Or about what has changed for you since your last session.

Other forms of therapy don't involve long pauses as they are not about looking to the past but are are structured and active. Cognitive behavioural therapy (CBT), for example, sees you working through current problems. You'll be going through exercises with your therapist, even writing out things with a paper and pen.

3. Your therapist doesn't tell you what to do.

This is a literary device of screenwriters. We see the therapist tell the client how to deal with a relationship or problem, so that the audience has more information, or so that the plot of the film can move along.

A therapist doesn't tell you what to do. That's not their job. They are there to listen and reflect back, then ask just the right questions that you find the answers you want for yourself. You do the searching and the deciding.

4. They aren't mean or a bully and they don't treat you like a child.

For some reason a lot of TV and film therapists are mean. They are sighing and looking at the client like he or she is stupid, ignoring the client. Looking bored or staring at their notepad (many therapists don't even take notes), or talking to the client like they are a child.

A real therapist is on your side. They practise what person-centred therapy calls 'unconditional positive regard' (UPR). This means believing in the resources of a client and that are a worthy person.

5. But on the other hand, your therapist isn't your friend.

Some films and TV programs can make the relationship between a therapist and client seem very close. You even see the therapist talking about their own life or other clients. Nope. A therapist very rarely brings their own life into sessions, the focus is on you the client. And talking about other clients breaks the code of ethics a registered therapist is obliged to follow.

As for being a friend, therapy is a professional relationship. Your therapist will see the best in you, like you, and respect you. But they aren't a friend.

6. They would never also work with your recently divorced spouse, your boss, mother, etc, etc.

Big no on the 'you won't believe who I ran into in my therapist's waiting room' scenes. Therapists respect conflict of interest issues. They aren't going to know someone is your attacker, or recent ex, or manipulative boss, and also take them on as a client.

7. And they will not talk about you with other clients.

In real life, if a client did that? Divulged any of your secrets to another client? Or even their partner or friend? They could lose their license. The only person a client would discuss you with would be their supervisor, who is also obligated to protect your privacy.

The only time a therapist crosses this boundary of confidentiality is if they feel your wellbeing or that of another is at risk, if you might hurt yourself or someone else. Or if you have broken the law, in which case they are obligated to report you. The exception here is if you confess to personal drug use, they would not report this. Or something petty long in the past, like shoplifting as a teen.

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