Bathed in the warm glow of Monterey sunshine, the office of Dr. Amanda Reisman (Robin Weigert) is a safe space for the women of Big Little Lies to discuss their marital issues. Her delicate cashmere sweaters and non-threatening necklaces suggest she's there to be a supportive ally (and she is), but she also does the tough work of guiding her patients to examine and confront the negative patterns in their lives. Real-life therapists praised her portrayal during Season 1, as this profession is often misrepresented on television. However, her methods in recent sessions with Celeste (Nicole Kidman) and in Madeline (Reese Witherspoon) and Ed's couples therapy have not been met with the same approval. Instead, Dr. Reisman now joins a long list of TV therapists who step outside professional boundaries while failing to offer any practical solutions.
Dramatic license seems to go hand-in-hand with a license to practice therapy on television, dating back to Bob Newhart on The Bob Newhart Show in the 1970s. Before Frasier (Kelsey Grammer) and Niles Crane (David Hyde Pierce) became TV's most famous psychiatrists, Dr. Jason Seaver (Alan Thicke) turned his home into his workplace in Growing Pains. The way we talk about mental health has come a long way since these sitcoms first aired, but the role of therapists on TV hasn't quite kept up the pace.
The narrative function of therapy sessions can vary greatly show to show, but it often serves as a way to share the inner-most thoughts of a character on shows that don't employ the use of voiceover or narration. Felicity Porter (Keri Russell) sent tapes to her French tutor Sally, which allowed J.J. Abrams and Matt Reeves to put a unique spin on the narrator format. But even they got bored by this, and Season 2 of Felicity introduced a new counselor who listened to classical music and smoked in her office. Dr. Pavone (Amy Aquino) was the prototypical no BS mentor that's so popular in a college setting (see also Robin Williams in Good Will Hunting and Dead Poet’s Society). In Grey’s Anatomy, Meredith’s voiceover shifted to comments from her sessions with Katharine Wyatt (Amy Madigan), again opting for a twist in revealing the lead character’s state of mind.
Beginning in the late 1990s, the guest star therapist became a thing, introduced for special episodes that require more introspection from their characters. They are a version of the get-a-grip-friend, but with qualifications and so-called impartiality to back up whatever advice they might dish out. No one is more of a fan of this than Aaron Sorkin, using this archetype to draw out the feelings of the typically stoic (male) characters that inhabit his shows. Most notably, Adam Arkin as trauma specialist Dr. Stanley Keyworth on The West Wing. He was initially called in when Josh (Bradley Whitford) is experiencing symptoms of PTSD and later returned to work with President Bartlet (Martin Sheen).
In this same era, therapists who are in therapy themselves became a pretty standard storyline with In Treatment using this format as an anchor. Likewise, Dr. Jennier Melfi (Lorainne Bracco) didn’t exist as a character to only service and provoke Tony Soprano’s (James Gandolfini) storyline, she too had her own inner-world — albeit one that featured a lot of thoughts about Tony — which was shared in her own sessions with Dr. Elliot Kupferberg (Peter Bogdanovich). Clearly television’s love affair with psychiatrists and psychologists didn’t start with Dr. Melfi, but there is no denying that this depiction had a profound impact on how the profession has since been utilized and relied upon.
Peak TV runs the gamut in the way it depicts therapy sessions. The mind-bending Netflix miniseries Maniac explores a number of conditions and practices via a mix of dreamscapes and real-life scenarios as a method for banishing pain. In Homecoming, the cost of erasing negative feelings mixes a Hitchcockian-style mystery with a dollop of ‘70s conspiracy thrillers. In both cases, therapy sessions invite the viewer to acknowledge that without fear and pain, there is no joy. Both have a science-fiction element, but Maniac leans further into the absurd with a retro-futuristic aesthetic, so questions of professionalism don’t really come into play. However, because Homecoming's setting is more grounded in reality, Julia Roberts' depiction of Heidi Bergman is more dubious in terms of the lines she crosses. In a more straightforward portrayal, taking the title of Most Unprofessional goes to Dr. Nicky (John Stamos) in You who (Spoiler Alert) sleeps with his patient and then gets framed for her murder. Awkward.
Occasionally when professional lines are crossed, the impact is a positive one. The relationship between Nadia (Natasha Lyonne) and Ruth (Elizabeth Ashley) in Russian Doll offers up some of the most poignant recent therapy-adjacent scenes when Ruth talks about the notion of dealing with two incompatible thoughts at the same time and how accepting both of them is “the best of being human.” We are the sum of all our parts -- past, present, and future. Ruth is Nadia’s godmother, but a therapist by profession. In Episode 6, she succinctly tells Alan (Charlie Barnett) why therapists are vital as “without them, we are very unreliable narrators of our own stories.” This also explains why this kind of character is so attractive.
Rachel Bloom’s depiction of Rebecca Bunch in Crazy Ex-Girlfriend was one of television's most profound and nuanced depictions of mental illness. Dr. Noelle Akopian’s (Michael Hyatt) therapeutic approach initially meets a lot of resistance from Rebecca, but progress is made, particularly in the final season. The song “Anti-Depressants Are So Not a Big Deal” is a prime example of how Crazy Ex-Girlfriend worked to normalize aspects of mental illness that remain stigmatized to this day. Bloom expertly breaks down stereotypes — including the “crazy” of the title — and, Rebecca's sessions shatter clichés. Therapy is far from simply a storytelling shortcut for Rebecca.
TV's depiction of doctors, lawyers, and cops range from realistic to fantastic depending on the show (queue requisite Cop Rock reference), so it's no shock that the same would be true of therapists. That said, it is somewhat surpising to see Big Little Lies, a show that was once applauded for its true-to-life depiection of therapy shift in the other direction. But then again, everything is heightened this season, from Laura Dern's meme-baiting Renata moments to Ed’s petulance. Should it really surprise that much like everything else in this town, these once-soothing sessions are now a place of unease and judgment?
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Emma Fraser has wanted to write about TV since she first watched My So-Called Life in the mid-90s, finally getting her wish over a decade later. Follow her on Twitter at @frazbelina.