Tag Archives: cinematherapy

All things connect: The integration of mindfulness, cinema and psychotherapy

By Bronwyn Robertson March 29, 2016

Barely able to breathe, a young man battling a panic attack hesitantly enters the group room and makes his way to an empty chair. He and a dozen others “check in” and are then guided through a simple, calming breathing exercise. The lights are dimmed and the group members are asked to focus their attention on the flickering images and pulsating sounds coming from a screen in front of them. Transfixed by these moving images and sounds, the young man’s anxiety begins fading away. He is no longer in the throes of a panic attack.

Seated next to him is a middle-aged woman who has been struggling with racing thoughts and rumination. She, too, is becoming engrossed in this experience, her thoughts slowing down as she shifts her attention to what is unfolding on the screen before her. She settles into a restful state.

The group sits together, sharing this experience, for 45 minutes. Afterward, they together process what they have just experienced. All report being in better moods, much calmer and more reflective than when they first entered the room. All the group members readily agree to explore their experiences in their journals during the upcoming week and then return to share their reflections with the group.

What these group members share a week later is both unexpected and remarkable. They bring journals filled with prose, poetry and sketches. One group member struggling with an addiction shares that focusing on this homework prevented him from relapsing. A few others note that they were inspired to make major life changes during the past week, letting go of unhealthy relationships and circumstances, and even embarking on new careers. Some report having been freed of creative blocks and now being able to paint, write or compose music for the first time in months — or years. All attribute their enhanced awareness and healthy changes to the experience of sitting together in a room and collectively focusing on the same moving images and sounds.

The group didn’t experience some new, groundbreaking therapeutic technology during those 45 minutes in a darkened room. Members viewed “all things,” an episode of The X-Files television series.

 

The therapeutic power of cinema

From full-length feature films to episodes of TV shows, cinema engages individuals like few other mediums. Leading researchers studying the neuroscience of cinema, via the emerging field of neurocinematics, have found that when groups of people view evocative, “well-directed” cinema together, they become collectively engaged through a phenomenon known as neural synchrony. Neuroimaging studies show that the activation of specific areas of their brains and their brain wave patterns actually become synchronized.

According to neuroscientists, the human brain is wired to connect with and be activated by cinema. The iconic Swedish filmmaker Ingmar Bergman suggested that this connection might be even deeper: “No art passes our conscience the way film does, and goes directly to our feelings, deep down into the dark rooms of our souls.”

Branding-Images_Xfiles

X-Files image copyright of Fox

Cinema can be a powerful, transformative catalyst. As a licensed professional counselor, I have found that the therapeutic use of this catalyst, otherwise known as cinematherapy, can be profoundly effective with even the most troubled or resistant clients. While integrating cinematherapy within an experiential, mindfulness-oriented approach, I have used everything from The Wizard of Oz to The X-Files with more than 1,000 clients in individual and group therapy — with remarkable results.

Simply defined, cinematherapy is an expressive, sensory-based therapy that uses movies, TV show episodes, videos and animation as therapeutic tools for growth and healing. The clinical use of cinema has been found to enhance the therapeutic process on many levels, including strengthening the therapeutic alliance and increasing overall engagement in clients who are “difficult to-reach.” As noted by Joshua Cohen, co-editor of Video and Filmmaking as Psychotherapy: Research and Practice, cinema has been used as a healing tool since its inception “because creating and watching a film often can speak directly to the human soul.” What makes this medium therapeutic, he writes, is its use “with therapeutic intent within the safe environment of therapy with credentialed and trained therapists.” Cinematherapy moves beyond talk therapy “by appealing to clients’ visual, auditory and other senses” and offers “opportunities for self-discovery that are not found through words alone,” according to Cohen.

Neuroscientist Uri Hasson, a pioneer in neurocinematics, similarly notes that the multisensory, multilayered complexity of cinema provides viewers with an experience “that evolves over time, grabbing their attention and triggering a sequence of perceptual, cognitive and emotional processes.”

Evidenced-based therapy

Research spanning more than four decades has shown that cinematherapy is effective with many populations in multiple settings, ranging from outpatient to residential treatment, psychiatric hospitals to nursing homes. Cohen and his co-authors reference numerous studies in their book, including a pilot study dating back to the 1980s which found that the use of videos with 17- to 19-year-olds who had dropped out of high school resulted in enhancing their self-worth and self-esteem. More recently, Michael Powell, Rebecca Newgent and Sang Lee found the use of The Lord of the Rings film trilogy effective in the treatment of depression in adolescents.

Several notable international studies published in 2014 explored the use of cinematherapy within different cultures, settings and age groups. A Korean study by H.G. Kim noted the positive effects of a cinematherapy-based “group reminiscence program” on managing depression in nursing home residents. An Iranian study of “vulnerable women” receiving treatment from nongovernmental social service clinics in Tehran found cinematherapy effective in increasing self-esteem. Research from the University of Bucharest in Romania by Sorina Dumtrache concluded that group cinematherapy is effective in decreasing anxiety in young adults.

Cinema selection: Therapeutic resonance and relevance

Cinema must resonate deeply, on multiple levels, with clients for it to be effective therapeutically. The individual’s age, developmental level and relationship with the cinema selection are all crucial factors. As Cohen has noted, “Movies can help clients achieve insights if the movies are strategically selected for relevance to the client’s interests and needs in treatment.”

To meet the unique needs of my clients, I have to give careful consideration to cinema selection. My clients, ranging in age from 3 to their late 70s, have come from diverse backgrounds and have struggled with varying challenges, including anxiety, addiction, depression, domestic violence, grief, panic disorder, social phobia, body dysmorphia, eating disorders and trauma. The selections I use are based on the specific needs, strengths, challenges and aspirations of each individual.

For instance, I have found the films 28 Days, When a Man Loves a Woman and Flight to be particularly useful in helping adults with substance use disorders break through the denial of their addiction and gain a better awareness of the impact it has had on their lives and the lives of their loved ones. While doing a skills-based group on prevention of sexual exploitation for young women with intellectual disability, I discovered that all of the participants were avid fans of Buffy the Vampire Slayer, so I used an episode of the TV show to help them explore the risks of alcohol and drug use. I have also used the favorite cartoons of children in residential treatment in therapeutic exercises to enhance self-regulation and healthy attachment.

When carefully integrated within the therapeutic process, cinema has powerful healing potential. The iconic film The Wizard of Oz and the fantasy drama What Dreams May Come have long served as powerful catalysts of personal healing for my clients. With the help of these movies, they have explored core concepts of mindfulness such as resilience, compassion, acceptance and being present within oneself. Barnet Bain, the producer of What Dreams May Come, has noted that both cinema and psychotherapy use “the power of stories to heal.” An advocate of integrative body psychotherapy, he believes that we all “take refuge” and find healing in transformational stories. “In my view,” Bain explained during a brief interview with me at the Illuminate Film Festival in 2015, “any story that can lead one home to integration in the embodied present, that is a therapeutic story.”

It is through the integration of mindfulness-oriented practices and cinematherapy that I have seen the most profound changes in my clients. In group therapy, for example, I integrate mindfulness-oriented exercises before and/or after viewing cinematic selections, followed by in-depth processing of the cinematic experience. I also assign homework that includes practicing and applying mindfulness skills, watching “prescribed” cinema, journaling and engaging in other expressive exercises. Follow-up sessions explore cinematic experiences via group discussion and experiential exercises, including role-play and writing or rewriting one’s own script. Countless clients have reported that this integrative approach has helped them make life-changing progress.

Mindfulness, resonance and synchronicity

In my work, the therapeutic power of integrative, mindfulness-oriented cinematherapy was perhaps best exemplified by the impact that “all things” had on my clients. Unlike more typical episodes of the sometimes scary sci-fi show The X-Files, “all things” features no monsters, aliens or government conspiracies. Instead, it examines paths to personal transformation and investigates concepts of the mind-body connection, spirituality and synchronicity.

More than a decade ago, I was challenged with introducing mindfulness and mind-body healing concepts to clients who were court ordered for treatment because of substance use, domestic violence or related convictions. At the time, mindfulness was not yet mainstream, and very few of the people referred to me had any prior exposure to its concepts or practices. They were coming to group therapy to avoid incarceration, loss of their driver’s license or removal of their children from the home. These were individuals most in need of having simple, powerful, mindfulness-based skills and concepts to better manage their lives. I needed a means through which I could introduce these concepts in a nonthreatening, entertaining and effective manner.

Initially, I showed only those segments and sequences of the “all things” episode that best illustrated core concepts of mindfulness and mind-body healing, including slowing down, paying attention, acceptance, self-compassion and the impact of toxic emotions on health and well-being. Clients were so moved by these evocative clips that they routinely requested to view the episode in its entirety.

Coincidentally, the 45-minute episode fit very well within groups that ran 90 minutes to two hours, allowing us time to engage in mindfulness-oriented exercises before or after the viewing and time to process the experience as a group and discuss homework assignments. I have now used “all things” in its entirety with more than 1,000 clients in both individual and group therapy.

Over the years, I have used the episode in dozens of different groups focusing on everything from stress management to trauma recovery. These groups have varied from eight- to 16-week structured, skills-based groups to less structured, ongoing groups for individuals with chronic mental health needs. In nearly every instance, at least one group member has reported experiencing some sort of breakthrough or making some sort of positive life-altering change after viewing “all things.” In some groups, every member reported experiencing a significant impact. Many group members have noted that the episode’s images and themes resonated with them on a deeply personal level. In fact, numerous clients have contacted me months or even years after completing treatment and shared that the experience of viewing this episode, in a therapeutic context, played a significant role in their recovery and personal growth.

Having watched so many clients view “all things,” I have noted what moves and soothes them within this episode. Letting go of shame and guilt, seeking meaning in life experiences and “seeing the reasons why all things happen” are themes within the episode that resonate universally with clients. Grief, loss, shame, abandonment and exploitation are among the more personal themes that have emerged and brought tears to the eyes of many clients after watching “all things.” The episode became the means through which those clients could safely identify and begin to process their painful experiences.

The use of “all things” in group therapy has had yet another surprising effect. I found that clients become much calmer and more reflective immediately after viewing the episode. In dozens of cases, I have observed clients shift out of highly anxious or agitated states while watching the episode. As a result, they were better able to reflect on and process their reactions after viewing it.

The way “all things” was directed and filmed seems to have contributed to this effect. Pulsating chimes, dripping water, ticking clocks and tapping pencils set the rhythm, while slow-motion sequences and extreme close-ups focus viewers’ attention. Shots of a window shade toggle undulating back and forth, circulating fans, spinning wheels, flowing curtains, swinging signs and even the main character swaying back and forth while having a mystical experience in a Buddhist temple serve to grasp and direct the gaze of viewers.

I suspect that these cinematic devices are partly what produce an immediate calming effect on my clients, quite possibly inducing a state of mindfulness. They may even contribute to client “breakthroughs.” As if they were some form of cinematic eye movement desensitization and reprocessing, could the audio and visual techniques used in “all things” produce bilateral stimulation of the brain and subsequently enhance adaptive information processing and alleviation of affective distress?

Synchronicity, neural synchrony and interconnection

Neurocinematic research may well explain some of the therapeutic power of “all things.” The episode’s cinematic and thematic complexity, along with its well-directed and evocative sequences, are what neuroscientists have found to contribute most to interspectator neural synchrony, or the synchronization of brain activation and brain wave patterns across viewers. Intersubject correlation (ISC) measures the collective engagement of a group of viewers via neural synchrony. As researchers Kaisu Lankinen, Jukka Saari and Ritta Hari noted in 2014, emotional film clips enhance ISC. Likewise, “a well-directed movie,” in contrast to one that is loosely structured, strengthens ISC.

According to Hasson, a research scientist and lead author of an article titled “Neurocinematics: The Neuroscience of Film,” the concept of ISC is relatively straightforward and simple. “In cinema,” Hasson and his co-authors write, “some films (or films’ segments) lead most viewers through a similar sequence of perceptual, emotional and cognitive states. Such a tight grip on viewers’ minds will be reflected in the similarity of the brain activity (high ISC) across most viewers. By contrast, other films exert (either intentionally or unintentionally) less control over viewers’ responses during movie watching (e.g., less control of viewers’ emotions or thoughts). Throughout the years filmmakers have developed an arsenal of cinematic devices (e.g., montage, continuity editing, close-up) to direct viewers’ minds during movie watching. These techniques, which constitute the formal structure and aesthetics of any given cinematic text, determine how viewers respond to the film.”

When I inquired whether inducing bilateral brain stimulation and synchronized brain activity in viewers was intentional or intuitive, Gillian Anderson, the writer, director and star of the “all things” episode, indicated that it was the latter. She explained, via personal note, that she “had no idea” that those cinematic techniques could produce such “amazing” effects. As she has noted in previous interviews, the writing and directing of the episode was a “deeply personal” endeavor and an exploration of her own deeply held belief that “we are all connected.”

No stranger to counseling and psychotherapy, Anderson has both professional and personal connections to the field. She is currently penning a self-help book and has recently published the second in a trilogy of novels featuring a child psychiatrist as the main character. Personally, she began therapy at age 14 and credits it with keeping her “sane and alive.” She has been a strong supporter of counseling and psychotherapy ever since.

Anderson believes that cinema, like therapy, has powerful healing potential. “Any film that has a message that teaches people about themselves, that teaches people how to get out of a place where they are stuck and get on with their lives and get on with being a productive human being, is important,” she said. “Films are instruments to teach people, and they can affect people in profound and in life-changing ways.”

 

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Note: My use of all films, television episodes, film segments and videos in group and individual therapy was done via “fair use” with no copyright infringement intended.

 

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Bronwyn Robertson, a licensed professional counselor, has lectured and published internationally on the integration of mindfulness in counseling and psychotherapy. She specializes in the treatment of anxiety, depression and trauma-related disorders. Contact her at Bronwyn@BronwynRobertsonLPC.com.

Letters to the editorct@counseling.org

 

Using “Inside Out” to discuss emotions with children in therapy

By Mercedes Fernández Oromendia March 25, 2016

When Inside Out, the latest Pixar movie, was announced this past summer, I was excited to see how the writers would represent complex human inner experiences in a fun and child-friendly way. As a counseling psychology graduate student, I often find myself trying to explain concepts about emotions to children or their parents and searching for creative ways to make our inner experiences more concrete.

Pixar did not take this task lightly. The computer animation film studio consulted with two of the leading scholars on emotion, Paul Ekman and Dacher Keltner, to ensure that the movie portrayed emotions accurately while also capturing the attention of its young audience.

Ekman and Keltner propose that there are seven distinct emotions experienced by everyone across cultures and ages: anger, joy, disgust, fear, sadness, surprise and contempt. The first five of these were the basis for the main characters of Inside Out. The collaboration between the movie’s writers and these two leading experts on emotions created a wonderful tool that clinicians can use to explain emotions to children and adolescents and their parents. It distills complex concepts from neuroanatomy and personality psychology into accessible and fun characters.

Audience members have the opportunity to imagine what it would be like if each of the five main emotions — joy, anger, disgust, fear and sadness — had their own feelings and how they might interact with each other.

The personified emotions take us on a roller coaster ride as they each do their best to help 11-year-old Riley adjust to moving from Minnesota to San Francisco. At the beginning of the movie, Joy tries to find the silver lining in everything, even when the movers lose the family’s things and Riley’s parents start fighting. Sadness seems to be inexplicably sad at all times, but Joy works hard to prevent Sadness from touching the control panel and making Riley experience sadness. As the story unfolds, several key points arise that can be useful to discuss with clients or with our own children:

1) All emotions are important and helpful at times.

2) We can have more than one feeling about an event.

3) Sadness is important and can foster connection with other people.

4) Feelings about past events can change over time. (So true!)

5) Expecting someone to be happy all the time is impossible. (Amen!)

6) Emotions may look a little different for each person.

These six messages can be communicated differently depending on the age of the child. With younger children or children who have difficulty identifying emotions, Inside Out can be a great tool to talk about what each emotion looks like and feels like. When the child is feeling sad, does he or she feel like Sadness: tired, droopy and wanting to cry? When the child feels angry, does he or she resemble Anger: making fists, yelling and wanting to run or hit? Having these types of conversations InsideOut2can be a crucial first step in teaching emotion regulation.

The film’s message that one event can bring up more than one emotion can be introduced into the therapy room by asking a child to write down or draw how Anger, Sadness, Fear and Joy feel about an event, such as an impending divorce. This activity might help children to recognize and accept that they are afraid of not seeing their father and sad about all the fighting but also excited by the idea of getting two sets of Christmas presents next year.

I used the same activity with an adolescent client who was considering ending a difficult romantic relationship. I had tried several other approaches to help her explore her thoughts and feelings around the relationship but hadn’t made much progress.

One session, she mentioned that she had seen Inside Out that past weekend, so I asked her to draw what each of the five characters from the film was feeling about her partner. Next, I asked her why she thought each character was feeling the way she had described. This activity made room for a wider range of emotions and helped the client increase her self-compassion and begin to accept that it was OK to be sad about ending a relationship, regardless of how problematic it had been.

InsideOutAnother helpful activity is to ask children and adolescents (and parents too) to imagine what the five characters are feeling in another person’s head. Doing so can build empathy and understanding and increase connection.

For instance, a girl may be angry at her father because he does not let her go to the movies alone with her friends. The therapist can ask her to describe or draw what is going on with each of the five emotions in her father’s head.

Through this exercise, the girl may slowly realize that her father might be afraid that something will happen to her, sad that she is growing up and soon will be missing family game nights on Fridays, yet joyful that she has friends. As a way to build parents’ communication and compassion with their children, I have also asked them to describe what they believe the five characters might be feeling in their children’s head.

These are just some of the ways that Inside Out can be incorporated into our daily interactions with children and adolescents to help foster emotional awareness, empathy and compassion. The applications are endless.

Now we just have to wait to see what happens to all those emotions when Riley reaches puberty …

 

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Mercedes Fernández Oromendia is a counseling psychology doctoral candidate at the University of California, Santa Barbara. Contact her at mfernandezoromendia@umail.ucsb.edu.

 

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Related reading

 

Counseling goes to the movies

By Bethany Bray December 5, 2014

Watching a movie — whether at home curled up on the couch or at the theater with a tub of popcorn — is a great way to relax and check out from reality for two hours.

Movies can also be a hit-the-nail-on-the-head portrayal of life, including mental health struggles and Movie Tickets and Popcornrelationship problems that counselors hear about on a daily basis.

We asked counselors to tell us about their favorite movie portrayals of counseling or mental health themes — either movies they simply like to watch themselves or films that they have recommended for clients.

From Silver Linings Playbook to Terms of Endearment, their responses show how art – in this case, film – can truly imitate life.

 

(* Indicates an American Counseling Association member. Responses have been edited for length.)

 

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Antwone Fisher (2002)

Submitted by Feliesha Shelton-Wheeler*, a mental health staff therapist at Gannon University’s Health and Counseling Services in Erie, Pennsylvania, with a Psy.D. in clinical psychology

 

Antwone Fisher is one of my favorite films. The 2002 movie is based on the New York Times best-selling book Finding Fish: A Memoir, by and about the author and namesake of the film, Antwone Quenton Fisher.

The movie, directed by Denzel Washington, one of the stars of the film, tells the true story of an African American man’s journey of resilience and movement toward self-awareness. Viewers get a glimpse of Antwone’s (portrayed by actor Derek Luke) struggle to overcome a turbulent life that we learn began the day he was born in prison and placed in foster care. The movie begins with a recurring dream that foreshadows the movie’s ending. We learn that Antwone is in the Navy and, due to several angry outbursts and physical fights, he is mandated to attend therapy with a psychiatrist, Dr. Davenport (Denzel Washington). In the three limited sessions he has with Dr. Davenport, Antwone reveals the painful hardships he has endured in his life.

The content within the counseling sessions between Dr. Davenport and Antwone contain several real-life counseling/mental health themes, including repressed emotions, sexual abuse, posttraumatic stress disorder (PTSD), neglect and abandonment, issues of self-worth and identity, interpersonal relationships and death/grief and loss.

It is not often as therapists that we have the opportunity to witness the transformation of a client. Through the magic of film, the movie allows us to witness Antwone’s transformation in just a few hours.

The movie is definitely a tearjerker, but there are plenty of moments of humor and hope that counter the sadness.

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What About Bob? (1991)

Submitted by April R. Crable*, a licensed professional counselor (LPC) in Virginia and Florida, and field experience coordinator and core faculty member at Walden University

 

I first watched What About Bob? as a teenager. At that time, the thought of becoming a counselor had never crossed my mind, and I enjoyed the movie for what it was: a comedy. I remember thinking that Bill Murray’s role as Bob Wiley was hilarious and annoying, and I felt sorry for Richard Dreyfuss’ character of Dr. Leo Marvin. As a counselor, I can now appreciate the lessons in this movie. What About Bob? contains several helpful teaching moments for both senior and novice clinicians. As a faculty supervisor, I often show clips of this movie to my students to show them the importance of being mindful of our purpose, that we are humans and that there is no such thing as a perfect counselor.

In the movie, we find Dr. Leo Marvin at a point in his career where he seems to be focused on becoming a “renowned therapist” with a slight ego. His ego is the reason he accepted the referral for Bob in the first place, even though it was right before he was going away on a monthlong vacation and he did not do his due diligence in researching the needs of Bob. Dr. Marvin soon abandons Bob and asks him to read his book Baby Steps while he is away.

Throughout the movie, Bob tries various ways to reach Dr. Marvin during his vacation, such as pretending that he is going to kill himself. Dr. Marvin receives a call that Bob completed suicide. Dr. Marvin shares this with his wife — without a second thought about his own feelings of losing a client or about the client. He says, “Oh well, let’s not let it ruin our vacation.”

The lesson learned is that it is easy to become emotionally numb when we are wrapped up in our own lives or after years of practice. If you have seen the movie, you know that Bob continues to infringe on Dr. Marvin’s vacation and family, and while Dr. Marvin continues to try to get rid of Bob before his interview with Good Morning America, Bob eventually wins over Dr. Marvin’s family members and turns his own family against him.

Dr. Marvin eventually loses it to the point where he is hospitalized and tries to kill Bob with a bomb attached to his body. He convinces Bob that this is “death therapy.” At this point, Dr. Marvin does a little kick of joy because he believes he is finally free of Bob.

Haven’t we all experienced this level of frustration with a client? We may not have thought about using death therapy, but we may find ourselves feeling happy if they miss an appointment or take a little vacation from therapy.

Most of my students gain insight midway through the movie. They see that Dr. Marvin spends most of the movie attempting to get rid of Bob without taking time to consider the reason that he needs his help. We may sometimes forget to listen to a client and get wrapped up in our own agenda. We are often the cause of our own frustration and burnout. At the end of the story, Dr. Marvin is shown in a psychiatric facility in a wheelchair, unable to speak.

This is an awesome reminder that we all need a break sometimes. I no longer feel sorry for Dr. Marvin as I once did as a teenager. From a counselor’s perspective, I can honestly say that I identify and empathize with him. At some point, we have all felt a little stressed, frustrated and off our game. After all, there is no such thing as a perfect counselor.

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Ordinary People (1980)

Submitted by Andrea Rohr*, a certified rehabilitation counselor (CRC) who works at an opioid treatment facility in Jamaica, Queens, New York

 

Ordinary People explores the fragmentation a family experiences after the loss of a teenage son. The surviving teenage son, Conrad, has developed survivor’s guilt and posttraumatic stress as a result of the boating accident that killed his older brother. Conrad has recently returned home from a psychiatric hospital following an attempted suicide. Albeit a reticent participant in therapy, Conrad starts seeing Dr. Berger in the hopes of getting better.

In therapy, progress for Conrad is slow and his family tensions continue to escalate. Buck is revealed to have been his mother’s favored son, and he, rather than Conrad, died in the boating mishap. In the hope of offering some insight into the family, Conrad’s father pays Dr. Berger a visit. Forthcoming in expressing his feelings, Conrad’s dad realizes during his session that he’s really there to explore his own feelings. The family unit remains fractured, however, since Conrad’s remote mother abhors therapy, deflects any discussion of feelings and eventually leaves the family.

During one scene in the movie, Conrad seeks out his friend Karen, whom he knew at the psychiatric hospital. Karen assures Conrad she’s all right and is no longer pursuing therapy. She explains she saw a therapist when released from the hospital but quit after her dad said no one could make her better other than herself. The movie crescendos when Conrad later discovers Karen killed herself. That Dr. Berger agrees to see Conrad – after a desperate call late on a cold winter’s night – is a tribute to the commitment of Conrad’s therapist and a discernment of desperation. It is during this heated late-night session that Conrad experiences the epiphany: He held on. Conrad held on to the boat and survived; Buck could not – and died.

Ordinary People is an intense drama with a settled – if not happy – conclusion for its players. The movie implies therapy works. Those who seek treatment make progress and move forward. Those who avoid treatment have less successful – sometimes even suicidal – outcomes.

 

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Canvas (2006)

Submitted by Dominick Carielli*, a licensed mental health counselor (LMHC) who has worked for the Calandra Institute, Queens College, New York, for the past 30 years

 

A number of films deal with counseling and mental illness, and most people will immediately think of A Beautiful Mind and Good Will Hunting. Less well known, though no less riveting and powerful, is Canvas, a 2006 film that chronicles one woman’s battle with schizophrenia and the impact it has on her husband and young son.

There are many things that I love about Canvas. It is a film about real, ordinary human beings who are struggling with the everyday aspects of life while trying to cope with something profound and potentially devastating and destructive. It is also about family and relationships. In counseling, most of us focus on treating individuals. It can be easy to lose sight of how a mental illness can dramatically impact the lives of those who are close to the client.

Particularly salient is the effect of the mother’s illness on her 10-year-old son. While in the beginning stages of forging his own identity and establishing relationships with peers, he is thrust into a world of chaos. He loves his mother but is at the same time angry with her, ashamed of her and has those frightening moments where he wonders if he might become like her.

The film also closely examines the relationship between father and son as well as the symbolic loss of a person that can occur with diseases like Alzheimer’s or schizophrenia; the individual they once were no longer exists. Canvas stirs us, warms us, challenges us and educates us.

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Silver Linings Playbook (2012)

Submitted by Cristina Ciobanu*, who is studying counseling and development/clinical mental health at Texas Woman’s University in Denton, Texas

 

In the 2012 movie Silver Linings Playbook, a [person with a] mental health condition interacting with another doesn’t always equal disaster. Sometimes, it might just equal healing. Pat (Bradley Cooper) is a recovering bipolar disorder patient who formerly snapped at the sight of his wife cheating on him with a colleague. Tiffany (Oscar-winning actress Jennifer Lawrence) is a widow who engages in a medley of sexual behaviors at work in order to deal with the loss of her husband.

What happens next is a hilarious alloy of confusion, unexpected turns and miraculous discoveries. Tiffany’s blunt but humane sincerity pulls Pat out of his obsession to continue a marriage that doesn’t exist anymore, while Pat gives Tiffany back an old dream by being her partner in a dance competition. The two eventually dance their way into a renewed vision of life.

Despite skepticism of the story’s feasibility, the take-home message is that hope, courage and faith in the process of life can be great pillars in promoting mental health recovery. Beyond that, they can bring more authenticity to our lives and show that the human experience is no easy endeavor, therefore removing the stigma still present in the world of mental health today.

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Terms of Endearment (1983)

Submitted by Feliesha Shelton-Wheeler*, a mental health staff therapist at Gannon University’s Health and Counseling Services in Erie, Pennsylvania, with a Psy.D. in clinical psychology

 

Although this movie is extremely sad, Terms of Endearment is one of my favorite films. (I can actually recite some of the lines from the script because I’ve watched it so many times!) The movie focuses on the enmeshed relationship between a mother, Aurora (played by Shirley MacLaine), and daughter, Emma (played by Debra Winger). In the beginning of the movie, viewers get to witness the humorous yet telling signs of Aurora’s anxious and obsessive behaviors as she climbs into Emma’s crib (when Emma is a baby) and shakes her awake to make sure she has not died of sudden infant death syndrome (SIDS). The film takes us on a journey through Emma’s marital struggles and family choices that Aurora observes with great criticism and disapproval. Despite her constant nitpicking and tiring criticism of Emma’s choices, Aurora quickly wins the hearts of viewers as she painfully has to endure watching Emma struggle with a terminal diagnosis of cancer.

Along with parent-child enmeshment, Terms of Endearment contains other real-life counseling/mental health themes such as empty nest syndrome, grief and loss/death, and terminal illness.

There are several funny parts within the movie that help to balance the film’s overwhelmingly sad events. Viewers will likely enjoy Aurora’s date with her next door neighbor, the astronaut Garrett Breedlove (played by Jack Nicholson) or Aurora’s preference of having her oldest grandchild call her “Mrs. Greenway” instead of “grandmother” because she is not ready to be one.

 

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Free Fall (2013)

Submitted by Michael L. Rockel*, an LMHC in Massachusetts who specializes in solution-focused brief therapy; he is also a national certified counselor (NCC) and certified clinical mental health counselor (CCMHC)

 

Truth as defined by Webster’s is simply “the real facts about something.”

Hearing, understanding or telling the truth can be exhilarating, painful and full of angst as well. Those of us in the GLBT (gay, lesbian, bisexual and transgender) community can attest to the power of truth and the pain that truth often carries with it.

Coming out can bring a wide range of experiences and emotions. Realizing and telling the truth about oneself can be life affirming and profound, but it can, and often does, bring the overwhelming sadness that comes when one dares to tell the “real facts” about one’s self.

As therapists and counselors, we are often called upon to help a patient or client tell their story in a frank and truthful manner. The telling of the story is where the therapy lies; we [the counselor] can only sit on the sidelines and listen to the pain and the juxtaposed happiness that being truthful about one’s sexuality brings.

I recently saw a movie titled Free Fall, produced by Stephan Lacant and staring Hanno Koffler and Max Riemelt. It is a story about two German police officers who fall in love and have an affair. However, unlike many movies in the same genre, it is told simply, dramatically and powerfully. The movie instantly became one of my favorite movies.

I would recommend this movie to any of my clients who might be in the process of telling their own coming out story. The acting in the movie is actually not bad, and the story has been told many times in many different movies. There is sex, but not gratuitous, drama without being pathos, and a developing love story that is mature and to the point.

I would not only recommend this movie to therapists, but I would use it as a discussion base for therapy with a client. It is comprised of the “real facts” — the truth if you will. My clients deserve nothing less.

 

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Hope Springs (2012)

Submitted by Maureen C. Kenny*, a professor of counselor education at Florida International University in Miami

 

A movie that I believe represents counselors in an ethical and professional manner is Hope Springs. Steve Carell portrays a counselor (Dr. Feld) who works with a couple that has lost intimacy over the years. They have been married for 30 years, sleep in separate rooms and don’t have sex. The wife (played by Meryl Streep) reads a book by Dr. Feld and convinces her reluctant husband (Tommy Lee Jones) to attend a weeklong couples treatment.

An impressive strength of the film is that the difficulties of the couple are realistically portrayed. The husband struggles with talking about sex with the counselor, while the wife is more open but also apprehensive. Watching them open up in sessions is almost painful. There are silences, there are unstated emotions, and all the while, the counselor is present and working. Dr. Feld is thoughtful, attentive and empathic to the couple’s problems.

The film also shows the struggles people often have committing to treatment (e.g., wanting to keep the status quo, complaints of financial cost, difficulty with self-disclosure and embarrassment).

Most remarkable is that while many movies and television shows portray the counselor breaking boundaries (e.g., becoming friends, overly self-disclosing and, most egregious, engaging in sex with the client), Dr. Feld is represented as a competent and empathic counselor. His depiction is of particular importance in this film because the couple is dealing with sexual and intimacy issues, which in another film might lead to counselor boundary crossing. Dr. Feld does not traverse boundaries, break confidentiality [or] make sexual advances to the wife. Instead, he “stays the course” with the couple. He assigns appropriate homework assignments and maintains a fair and nonjudgmental stance in the sessions. He is able to talk about sexual topics with the couple with ease, proving to be a role model for their increased communication. He normalizes the struggles they have and helps them find ways to address their deepest hurts in the relationship.

The film models a few things for counseling students: couples treatment, working with clients with sexual disorders and working with an older client population and the developmental issues that arise with aging. The counseling scenes in particular make for an excellent training tool.

 

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Raising Cain (1992)

Submitted by Sandy Range*, an LMHC in Stoughton, Massachusetts

 

Raising Cain is one of my all-time favorites! A professor in grad school (in 1997) had my class watch this film directed by Brian De Palma. I ended up purchasing it for my collection. Before entering grad school, I had a client I was a case manager for who had three distinct personalities caused by multiple childhood and adolescent traumas. Once I saw this film in grad school, I knew that trauma would be my specialty.

Raising Cain is a psychological thriller about one man and his four very different personalities (all played by John Lithgow, including the role of his sadistic, psychiatrist father).

Carter is a psychologist, husband and overly caring, helicopter dad. However, he is fearful and unable to take action or take control of his life. Cain is Carter’s twin brother who is psychotic and vicious, yet he gets things done on Carter’s behalf no matter who it hurts or kills. Josh, the little preadolescent boy, is always the victim; Margo, the shero (female hero), only presents herself when absolutely needed to protect Carter and the children from Carter’s father.

I own an outpatient mental health clinic in Stoughton, Massachusetts. Being a trauma specialist, I enjoyed this film (from a clinical perspective) because it shows how Carter’s psychiatrist father experimented on him as a child. Through torture, imprisonment and neglect, he intentionally split Carter’s psyche to see how many personalities would emerge. The others all play a part in doing and undoing the father’s horrific experiments on more children.

This film provided me a visual understanding of how the personalities work together and also against each other toward a goal. The personalities always serve a purpose and have a goal. This film helped me, as a mental health professional, to help my patients understand the goal of each personality and how they can work together, heal and eventually merge.

After viewing this film, I attained a differing insight and perspective into dissociative identities, schizophrenia and psychosis. Makes one wonder about the mind of (the film’s director) Brian De Palma though!

 

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The Squid and the Whale (2005)

Submitted by Daniel Jay Wiggins*, a master’s student (clinical mental health counseling) at Troy University in Alabama who is interested in student affairs counseling

 

The Squid and the Whale was written and directed by Noah Baumbach in 2005. This high-conflict, low-resolution indie film revolves around a fragile family system and is flavored with and characterized by the continuous shattering of the familial dynamic. The film is a great depiction of familial struggles, showcasing the relation between a parent’s weakened behavioral, emotional and interpersonal spheres of existence and the developmental immobility in children.

The two characters that caught my focus in the film were the sons of Bernard and Joan Berkman: 16-year-old Walt and 12-year-old Frank. The film focuses on the journey through divorce between Bernard and Joan and its effect on the children individually and collectively, as well as the divorce’s effect on the overall family dynamic.

Viewing this film through a developmental lens allows the viewer to fully see its multifaceted nature. The beauty of this film is [the portrayal of] the deep psychological and developmental aspects of each character, as well as the use of nontraditional familial conflicts between the protagonists. The characters each have severely damaged interpersonal relationship skills rather than simple, traditional character roles with expected or anticipated familial conflicts.

Through a more in-depth analysis of the film, clinicians should strive to a) identify the characters in struggle; b) understand the comparison/contrast between where each of them should be developmentally according to [Erik] Erikson’s stages of psychosocial development and where they actually are; and c) understand which technique(s) would best be used to help the clients from a wellness perspective.

The Squid and the Whale makes for a great beacon of reassurance for doubtful mothers and fathers everywhere. From an analytical clinician’s perspective, Frank is identifiably stuck in the fourth stage of Erikson’s psychosocial development (industry vs. inferiority), which will undoubtedly create problems for his movement through the fifth stage of development (identity vs. role confusion). Walt has adopted his father’s personality as his own, which is observably incongruent with his authentic self. In Eriksonian terms, he is stuck in the fifth stage of psychosocial development. Both boys have several abnormal behaviors that reinforce the hypothesis of their mental and/or cognitive instability. Frank and Walt show great potential for improvement and developmental resolution. However, the developmental crises must be resolved or else they will continue to negatively affect each boy’s personality and identity until resolution occurs.

I think The Squid and the Whale did a great job of representing modern familial struggles through an overall fragile familial system without going over the top.

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Batman Begins (2005)

Submitted by Michael Brant*, a graduate student in the professional counseling program at Liberty University. He lives in Pennsylvania, near the border of Maryland and plans to practice in Maryland.

 

I especially like Batman Begins because of its origin story. The character of Bruce Wayne/Batman has been around for over 75 years. I believe a lot of the character’s success is that unlike most superhero characters, such as Superman or Spiderman, Batman is a mere human. His humanness makes him easy to identify with.

There are many mental health concepts within Batman Begins. Grief is a key element to the young Bruce Wayne that he carries with him after the death of his parents. Bruce holds on to the past and will not let go of it. It seems as though he has a major depressive disorder that was triggered by his parents’ death. This comes out in how he has an alter ego, Batman, yet still passes himself off as the rich Bruce Wayne. This is how some [people] who have milder conditions take great strides to hide their condition. Additionally, due to his alter ego, the idea of a personality disorder is also an issue.

One of the other areas that deal with mental illness is the Arkham Asylum. Dr. Crane (the film’s villain, also known as the Scarecrow) says, “Yes, but this is a mental asylum for the criminally insane. The unusual is usual here.” One of the questions raised by the film is what causes criminals to be criminals — is it an area within or without their control? Later on in the conversation, Dr. Crane continues, “We’re not talking about a few easily manufactured eccentricities.” This is referencing the idea of how someone might fake a mental illness as a defense for committing a crime. Dr. Crane also leads in a discussion about his advocacy for psychopharmacology and the belief in the mind’s ability to effect change in the body.

There are many areas in which questions are brought up that deal with ethics when it comes to Dr. Crane and the Arkham Asylum. I work with adults with developmental and intellectual disabilities, and often when I see depictions of places like Arkham Asylum on film, I think of places like Willowbrook State School (in New York City) where those with various conditions were sent and abused.

There are many more areas that I could continue to discuss. However, I think that this is a good taste without spoiling the whole movie. Think on these things while watching it either for the first time or the next time.

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Call Me Crazy (2013)

Submitted by Catherine Mukes*, an LPC in Texas who works at a mental health agency and plans to move to private practice

 

The movie I am recommending is titled Call Me Crazy. I ran across this film on Netflix and later realized that it was a Lifetime (channel) movie. The movie is a compilation of five interconnected stories about people with mental illness as well as those with family members who are mentally ill. The film addresses life with schizophrenia, bipolar disorder, major depression and PTSD.

What I love about this movie is that it brings an honest and real look at how mental illness can impact lives — and also be overcome. It takes into account the real struggles that the individual and those around them deal with while trying to cope with the illness, including shame, denial and guilt. The film does not berate or belittle those with mental illness but depicts them as simply human.

It a warm, inspiring and well-crafted film that I think professionals, professionals-in-training, the community at large and clients could really glean from.

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Life as a House (2001)

Submitted by Everett Painter*, a counselor at Walters State Community College in Tennessee and a doctoral student in the counselor education and supervision program at the University of Tennessee–Knoxville; he is also an adjunct instructor in the psychology department at Tusculum College in Tennessee

 

Life as a House offers several scenarios from which to evaluate crises. This is a story of a family in turmoil. The main character, George, is divorced, unhappy and lives in a dilapidated house that is the blight of the neighborhood. His ex-wife, Robin, is remarried but also remains unhappy. Significant friction and conflict exists between them. They have a rebellious 16 year-old son, Sam, who is tormented and angry. Sam actively tries to avoid them and experiments with a variety of drugs.

George is unexpectedly let go from a job he has held for 20 years. Soon after, he learns he has terminal cancer and only four months to live.

Over the course of the film, George is forced to consider issues related to intimacy, work, parenting, substance abuse, communication and mortality. While we never see him seek formal treatment, the process of therapeutic change is depicted in a natural way as people rally around and reconnect with him. The power of social support and unexpected pathways to resilience is revealed.

Life as a House progresses at a rapid pace and is inconsistent with more realistic timelines and the crooked pathways typical of crises or personal transformations of this nature. Nonetheless it is a dramatic illustration of the opportunities embedded in traumatic experiences. This story represents a specialized case featuring compounded losses. It reminds us that in such instances, counselors must have a broad set of skills in order to manage the complex range of emotions and psychoeducation necessary for client care and ethical practice.

In the end, the renovation of George’s house that takes place throughout the film is a metaphor for rebuilding a shattered life. The process that unfolds is analogous to crisis counseling, as elements of empowerment, support, resiliency, growth and meaning are all addressed. George, as well as the rest of his family, is transformed by the experience that embodies the ultimate goal of moving a client from a maladaptive, lowered level of functioning to that of survivor, where strength and growth replace distress.

As George says in the film, “Sometimes things happen for a reason … something bad to force something good.”

 

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Iron Man 3 (2013)

Submitted by Daniil Marchenko, a recent master’s graduate in counseling psychology and a lover of all things “nerd” who is currently pursuing his counseling licensure in Texas

 

Even superheroes have mental health problems.

I liked two things about Iron Man 3. The first is that Tony Stark’s (Iron Man’s) mental health issues were not central to the plot. Unlike more typical mental health movies, Iron Man 3 was not about his mental health issues. It was about Iron Man doing his Iron Man stuff and dealing with his mental issues as they showed up. It presents a truer picture of a typical mental illness than some other movies that are centered specifically on the issue.

The second thing I liked is the popularity of the movie. Identifying with Tony Stark is more socially acceptable than identifying with characters from Good Will Hunting (the 1997 film that also deals with mental illness). Imagine a teen presenting with anxiety in your office. You show him or her a clip of Tony Stark having a panic attack. Panic attacks suddenly become more manageable and less stigmatized. Because now your client can be like Iron Man. And we all want to be a little like the superheroes that we love.

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A Beautiful Mind (2001)

Submitted by Amy Valentine, an NCC in Los Angeles who works in workforce development and uses her counseling background for team-building exercises and training for businesses

 

I love the movie A Beautiful Mind, as it demonstrates what it is like to experience schizophrenia from a first-person perspective. The audience gains a wider perspective and appreciation for this mental illness.

The film is based on the life of John Nash, a brilliant mathematician who suffered from schizophrenia. It makes you really think about what it is like to experience this illness on a daily basis. From a personal standpoint, I found myself empathizing with the wife of the main character.

From a family systems perspective, this gives the clinician and counselor great insights to utilize as a framework for diagnosis and treatment. The director did a great job from a perception point of view. The emotions one experiences while watching this movie will transport you into another’s point of view, allowing you to experience schizophrenia firsthand. I enjoy movies like this.

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What Dreams May Come (1998)

Submitted by Harland C. Wable*, a co-occurring specialist in the field of chemical dependency and licensed mental health counselor associate in Spokane, Washington

 

Within What Dreams May Come there are the all-important factors of relationship building, raising a family and parent-child dynamics. It seems like parents are [too] busy to raise their children and choosing their careers over children.

It raises questions about the different aspects of children wanting the approval and affection of their parents and children becoming distant. The film also deals with the loss of children, depression, suicide and suicide attempts, frustrations, anxiety, loss and despair.

And not lost in all of this is the all-important aspect of love. There is a love that runs deeper than anyone can imagine. During the first part of the movie, one has to look for it, as it is hidden in different aspects of life. During the later parts of the movie, it is not difficult to see the love that is so strong that one would do anything to find [his or her] soul mate.

Of course there is a lot more to this movie than meets the eye.

As a chemical dependency counselor, there are no major chemical dependency issues [in the film]. But from a mental health viewpoint, [there are many such issues].

Love this movie.

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Another Year (2010)

Submitted by Heather Zeng*, an LPC in San Francisco and core faculty member at Capella University

 

Another Year is a portrayal of a well-adjusted British family over the course of a year and their constellation of friends who have challenges coping with life. It’s a favorite to share with counseling students because it’s a distinct portrayal of individuals who forge healthy relationships and those who don’t, with the ensuing aftermath and implication of these impasses to themselves and others around them. The language of the lead character, Gerri, a therapist, is helpful to observe as she models many positive counseling skills, from listening to gentle confrontation in her work and life relationships.

Gerri and her husband, Tom, are gardeners, and you might say they cultivate empathy and compassion in their lives. In one part of the movie when explaining his work to his family and friends at dinner, Tom states in so many words, “I dig holes in the ground to see if things can be held up under our feet.” Essentially, another way of describing his wife’s role as a therapist — digging deep into individual’s selves to find structure in their lives to rebuild.

Tom and Gerri’s life is contented. They tend to their garden of life, and this is how it grows.

However, their friends are another story. Gerri’s friend Mary from work is fragile and frazzled, gliding into everyone’s life with restlessness. Nothing has stuck for her except her work. All problems are perceivably solved by the next great relationship. She’s assured a car will be the answer to her frustrations in life, [but] it only makes things worse. In one scene, she doesn’t want to drop off Joe, Tom and Gerri’s son, as she feels she will get lost and not find her way home. It’s analogous to how lost she is in life. Mary assuredly states several times in the film, “If you have the need to share anything, I’m here for you,” assuming others have the weighty trials she has.

Gerri is compassionate to Mary as a friend, forgiving of all her failings and foibles, until she turns jealous and overtly adversarial to her son Joe upon his good fortune of finding love and happiness in a new relationship.

Equally, Tom’s friend Ken is in the midst of his own struggles, overeating, overdrinking, overworking. At a mutual party, Mary comments about Ken negatively, to which Gerri affirms, “Life isn’t always kind, is it?” The compassion Gerri shows for Ken, Mary cannot offer in turn to him. She is too enmeshed in her own limited view to see that, indeed, in many ways they (she and Ken) are on mutual life tracks. That is, lonely and grieving of nonevents in their lives.

So for your next movie assignment, consider Another Year! Try to have students take a character and transcribe their comments. It can be insightful [concerning] how what is said and what is done can be miles apart. In contrast, it also affirms that perception can be a powerful tool for valuing what is and not what might be. It can also be a great qualitative question for students: How does your garden grow (a metaphor for life and relationships)?

 

 

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Don’t see your favorite movie listed here? Add it in the comments section at the end of this article. Be sure to include why you think it’s a good portrayal of counseling or mental health themes.

 

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Related reading

Check out St. Louis LPC Ryan Thomas Neace’s piece on Good Will Hunting: ct.counseling.org/2014/10/pass-the-popcorn-counseling-in-the-movies

 

Also, see Counseling Today’s 2011 feature article on cinematherapy: ct.counseling.org/2011/10/big-screen-therapy

 

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Bethany Bray is a staff writer for Counseling Today. Contact her at bbray@counseling.org

 

Follow Counseling Today on Twitter @ACA_CTonline and on Facebook: facebook.com/CounselingToday

 

The good in “Good Will Hunting”

Counseling Today October 13, 2014

Every once in awhile, a movie comes along that really seems to “get it,” portraying mental health struggles or the counselor-client relationship in an authentic, meaningful way.

For Ryan Thomas Neace, that movie is Good Will Hunting. The 1997 film portrays the back-and-forth between a therapist, played by Robin Williams, and client, played by Matt Damon, as complicated, imperfect – and real, says Neace, a licensed professional counselor in St. Louis.

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The good in Good Will Hunting

By Ryan Thomas Neace

 

Clients often come into therapy expecting us to be soothsayers or magicians or know-it-alls, but we’re not. Hollywood tends to reinforce these kinds of notions when they depict therapists, as well as humans and human interactions, with the same kind of naïve romance. In the movies, therapists Good Will Huntingusually sit on swanky, leather furniture in offices with ceiling-to-floor windows. Men have six-pack abs and chiseled chins, and women have unrealistically tiny waists and large breasts. People are heroic or villainous, but usually not both. Initially complicated interactions tend to resolve in 120 minutes or less.

But in real life, most of the therapists I know are sweating it out each week to keep costs down and clients coming in — and into offices with wood paneling and florescent lighting no less. Men and women have physical imperfections, and people are capable of all manner of admirable and despicable acts. And much to our chagrin, life doesn’t wrap up neatly and people often remain in some level dysfunction, even after therapy.

I love Good Will Hunting because it portrays all of this, seemingly without trying. The characters possess a tremendous amount of depth and realism. Therapy takes place in the basement office of a community college. Thick Boston accents abound in conversations fueled by fear, sadness and booze, and laced with enough curse words to make you blush. It becomes obvious from the get-go that the therapist, client and supporting characters aren’t going to have everything neatly wrapped up by the end. They remind us that we’re just broken people trying to help one another make sense of a complex world.

Therapist Sean Maguire (portrayed by Robin Williams) is more than capable of executing therapeutic maneuvers, but they aren’t flagrant and obvious, and his emphasis is clearly on relationship over technique. Instead of trying to “be a therapist,” he’s just himself, and in his authenticity, he is therapeutic. That means that when his client makes him mad, he gets mad. When his client weeps, he weeps with him. And when his client challenges him, he has to do some soul searching of his own to keep up his end of the bargain in therapy to be mutually vulnerable. When therapy terminates, his client has made real and substantial progress, but he’s not out of the woods yet.

In short, nothing is perfect. And, thus, neither is the process of therapy perfect.

But Good Will Hunting portrays therapy and, indeed, life as good and worth the while. And good things happen as a result, sometimes in large ways and more frequently in still, small exchanges that we usually overlook.

This is much closer to my actual experience of therapy and life.

 

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Ryan Thomas Neace is a licensed professional counselor in Virginia and Missouri and a national certified clinical mental health counselor. He works extensively with teens, adults and families at his St. Louis private practice, Change Inc. He blogs for the American Counseling Association and The Huffington Post.

 

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Related reading: See “Counseling goes to the movies,” our list of counselor’s favorite movie portrayals of counseling or mental health themes

 

Follow Counseling Today on Twitter @ACA_CTonline and on Facebook: facebook.com/CounselingToday

Big screen therapy

By Lynne Shallcross October 1, 2011

With a Coke and a tub of buttery popcorn in hand, a comfy seat to lean back in and a larger-than-life screen to take you somewhere new, movies provide a great escape from life. But, helping professionals say, movies can also come in handy in counseling by offering clients a window into their own lives.

Bret Hendricks, an associate professor of counselor education at Texas Tech University, points to the 1980 movie Ordinary People as one of his go-to movies for families in counseling. A past president of the International Association of Marriage and Family Counselors, a division of the American Counseling Association, Hendricks says Ordinary People often resonates with families having trouble processing their emotions. “Rather than telling clients they need a ‘feeling language,’ I can let them watch the movie,” Hendricks says. “All of a sudden, they’re seeing things about their own family that they’ve never really looked at before.”

Ordinary People centers around a mother, portrayed by Mary Tyler Moore, closed off to sharing any positive emotions regarding her son. “Her son, who feels responsible for his older brother’s accidental death, desperately needs affirmation from his mother,” Hendricks says. “Instead, she is unapproachable and affectively distant. When her son wants to receive affirmation from her, she responds with an impassive facial expression and cold criticism.”

According to Hendricks, a number of relevant questions emerge from the movie that a counselor could ask clients: What do you think the son needs to hear from his mother? If you were the mother of this son, what would you share with him to encourage him? As you observe this mother, what do you feel? How was your own family similar or different from the family in the movie?

“In order to create a feeling language, a client or family might be given a list of feeling words and describe how these feeling words might be integrated into the movie family’s experience,” Hendricks says. “For example, they could be asked to stop the movie while watching it and describe what the family members are feeling at these points. Then, you could ask them to describe times in their own history when their families experienced similar things and, using the feeling word list, describe the feelings that they felt at these times. Thus, you have helped the individual or family develop a feeling language using the movie as the catalyst.”

Using movies in counseling, also known as cinematherapy, isn’t just for families; movies can be just as helpful with individuals in counseling, says Hendricks, who also works in private practice in Lubbock. “We always want to use interventions that are as close to what people normally use for their own therapeutic interventions,” he says. “Many times, people go to the movies to be entertained and to look at life in a different way. It’s a venue that people are already using in a therapeutic way, many times without even realizing it.”

Counselors should incorporate things that people already use or do in their everyday lives into therapy, Hendricks says, in part because this increases their comfort level. That’s why movies can be so appropriate as a tool in counseling. “It’s difficult to reach someone and really be effective through counseling sessions for one 50-minute session a week,” he says. “So we need as many adjunct things as possible, and it’s not hard to get people to watch a movie. It’s something that you can use to extend your therapy.”

A different perspective

Cinematherapy involves requesting clients to watch movies or movie clips with themes or situations similar to those the counselor and client are working on, with the purpose of discussing the movie themes in session, says Mary Ballard, a professor in the Department of Counseling and Human Development at Southeastern Louisiana University. Using movies in counseling can be time intensive, Ballard says, because counselors must screen the movies beforehand to determine which ones might be a good fit for their clients.

But the payoff can be significant as well, Hendricks says. Instead of simply talking about their issues with a counselor, when clients watch a movie, they process the issues and emotions affectively, he says. For instance, Hendricks might ask a client struggling with an addiction to watch Changing Lanes. In the movie, one of the main characters is in recovery but is still exhibiting many of the behaviors associated with addictions, including rationalization and thinking about drinking. “The character calls his sponsor, and the sponsor tells him something to the effect of even though you’re working the 12-step program, you’re really still a drunk,” Hendricks says. “What it does is help the client to identify with the character. Rather than looking at it through the filter of denial that they have a problem, they’re really living through the character [and] identifying with the struggles he’s dealing with.” That scene gives addicted clients an opportunity to see themselves, Hendricks says, and might ease them into working with the counselor on some of their issues surrounding denial.

Clients often gain a much deeper perspective on their personal issues by observing how the characters in a movie are affected by or attempt to handle similar issues, Hendricks says. When clients watch movies, he says, they’re “not processing it in their head; they’re processing it in their heart.”

Ballard says that, generally, clients are better able to begin talking with a counselor about a movie character’s struggles than about their own issues, even if those issues mirror each other. “[With movies], clients get to view others experiencing similar problems and situations,” says Ballard, who is also a past president of IAMFC. “This takes them out of the line of fire and lowers their defensiveness, making them much more likely to open up and discuss alternative ways of being. It’s always easier to see what’s wrong with others.”

It can be difficult for clients to talk about themselves and the role they play in the problems in their relationships, Ballard says, but when they watch the same issues occurring in the lives of others, it’s sometimes easier to recognize and discuss. “In other words, it’s not threatening at all for me to talk about a woman who makes one bad decision after another and keeps ending up in the same depressed state time and time again,” Ballard says. “I may talk at length about how she doesn’t seem to care enough about herself to stay away from people who continually choose to mistreat her. Or I may talk about a mother who is clearly obsessed with living her unfulfilled life through her daughter. Similarly, families may laugh and joke about a dysfunctional movie family that continues to meddle in each other’s lives, absent of any healthy boundaries. Once clients have discussed movie themes, the counselor may have them talk about how they are similar to or different from the movie characters.”

Watching someone else’s issues in a movie can make all the difference for clients, Ballard says. “It’s all about backseat driving. It’s much easier to see and understand the problems that others are having than to recognize some of the same issues in your own [life]. Distance creates perspective. Movies provide that distance. Counselors can then bridge this distance through the use of interventions that fit their own personal counseling style.”

When people get “stuck,” Hendricks says, it’s often because they’re too close to the issue to see it clearly or because they’ve developed resistance or denial. Movies help clients externalize the issues with which they’re struggling rather than holding those issues internally and remaining unaware or in denial about them, he says. Movies also allow clients to look at their issues from a more objective viewpoint. “Then the client can come to an innate level of awareness of the issue by watching the movie rather than the counselor hammering it home,” Hendricks says. “To me, that’s a much deeper level of awareness.”

A common element of family struggles is being too close to a situation to recognize that an issue exists, Hendricks says. Movies can help families externalize what they’re a part of, he says. “If a family is unaccepting and critical of one another, a film such as The Blind Side might be used to illustrate a system that is accepting and supportive,” he says. “Instead of the therapist pointing out to a family that they are not accepting of one another, which may lead the clients to have feelings of defensiveness, the family will instead [watch the movie and] identify their communication issues from their own viewpoint. When they do this, they are accepting responsibility for their own actions. Thus, the clients’ defensiveness is reduced and they have a much more authentic and less threatening counseling experience.”

I’m not alone

A wide variety of clients can benefit from cinematherapy, but Ballard says families experiencing difficulty transitioning from one stage of development to another in the family life cycle make especially good candidates. “Certain developmental tasks are associated with each stage of development,” Ballard says, “but when couples and/or families fail to accomplish these tasks, they can become ‘stuck’ and unable to move to the next stage, which can create heightened stress reactions and an inability to successfully communicate. For example, a parent who becomes stagnant in [Erik] Erikson’s ‘generativity versus stagnation’ stage may be unable to separate and differentiate from teenage children, thus prolonging the launching stage of the family life cycle and delaying the middle-aged stage. This could potentially delay the social and emotional development of the young adult child and postpone the parent’s experience of the empty nest, which is paramount to the middle-aged stage.”

Ballard says the best movie she’s seen addressing this family situation of late is Toy Story 3. “The entire movie builds toward the main character leaving home to attend college,” she says. “It is sure to arouse powerful emotions for any parent or teenager approaching this stage of family development.”

it’s safer for them to come around to how it might resonate in their own lives.”

Cinematherapy also provides an alternative way for counselors to address topics that are difficult to approach, Hendricks says, such as internalized homophobia or racism. For example, a counselor might assign parents whose child is coming out as lesbian, gay, bisexual or transgender a movie with LGBT themes to see what feelings the film stirs. Hendricks is excited about the recent release The Help because of the opportunities it will open to discuss internalized racism or persecution with clients.

No matter the client, Hendricks says, cinematherapy can also instill a sense of hope and optimism. Movies often have happy endings, he points out, and even if a character does something with which a client disagrees, the counselor can ask the client what he or she would do differently to secure a different outcome. “It might give the client hope that it could turn out differently for him or her,” Hendricks says.

Movies can also generate a feeling of universality, Hendricks says. “We all experience the same emotions. It’s the feeling of, ‘Wow, this person on the screen is feeling the same thing that I felt and I’m not alone. I’m not the only person who ever felt this.’ That in itself gives a sense of hope.”

The potential is also there for a client to become emotionally connected to the story line in a movie, Hendricks says, and that emotional connection can transfer into stronger motivation for change.

Ballard agrees that cinematherapy can be motivating. “Movies give clients the opportunity to see others with similar problems, even if only metaphorically presented, using different thoughts and behaviors to work through their problems,” she says. “This, in essence, models for clients alternative ways of being and oftentimes motivates them to pursue their own solutions.”

Delving in

Counselors interested in integrating cinematherapy into their work should first seek training, Hendricks says. Workshops and books on the topic are available, he says, and counselors might also consider joining the Association for Creativity in Counseling, a division of ACA.

Both a love of movies and the willingness to invest the time and energy to screen movies for potential use with clients are necessary, Ballard advises. In addition, counselors must take care in determining if cinematherapy is an appropriate match for clients, whether individuals, couples or families. Clients who have experienced recent trauma, couples with a history of violence, clients who are mentally ill or those who cannot distinguish fact from fiction are not good candidates for cinematherapy, Ballard says. “Counselors need to be mindful of inappropriate language, sexual content and violence level when assigning movies, especially if young children will be participating,” she says. “Religious beliefs and cultural backgrounds should always be assessed to avoid assigning movies with offensive content.”

In addition, Ballard says counselors should never assign a movie that might evoke strong emotions without first preparing clients. “For example, movies with themes of death and dying can be very therapeutic but also very difficult for clients to view,” she says. Ballard also encourages counselors to build their own DVD libraries because clients are more likely to watch a movie for homework if the counselor provides them with the film.

From a practical standpoint, Hendricks recommends allowing clients enough time to process the movie. “Don’t rush clients in their processing,” he says. “You might want to get through all the questions in one session, but it might take the client a few sessions. You need to follow the client’s lead.”

If counselors prepare carefully, movies can add significantly to the effectiveness of therapy, say Hendricks and Ballard. Case in point: In a recent discussion Ballard led with a group of children ages 10 to 12, the conversation turned to the new movie The Smurfs. “When I asked what if any lesson was learned from the movie, many of them replied with themes of always be yourself, follow your heart and don’t let others change your mind when you know you’re right,” she says. “I’d say those are some pretty powerful lessons.”

 

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Movies for Addicted Youth

Bret Hendricks, an associate professor of counselor education at Texas Tech University, has done extensive work with adolescents in the juvenile justice system who are dealing with addictions. Through the use of movies and movie clips, he believes his clients have made significantly greater progress than they would have with talk therapy alone. After watching relevant movies, some of Hendricks’ adolescent clients have expressed a desire to reach out to their families, those they have victimized or even their probation officers. Hendricks shares a few of his favorite movies to use with addicted adolescents and the reasons why he likes those movies:

  • 28 Days: An excellent film illustrating treatment and recovery.
  • My Name Is Bill W.: A film about the founder of Alcoholics Anonymous.
  • Stand and Deliver: Excellent for promoting self-awareness and self-concept.
  • Drumline: Great film about self-concept and reaching one’s potential.
  • Clean and Sober: Another film that illustrates recovery and treatment.
  • The Wizard of Oz: Great for addictions. What journey did Dorothy have to experience to come to realizations about her own life

— Lynne Shallcross

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