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I usually cringe when I watch therapy scenes in movies and shows. After decades of growling in silence, now it's time to speak up, better late than never. The public deserves accurate depictions of good therapy. Many are suffering and the stakes are too high to display snippets of bad therapy on public view for millions. It can discourage people from getting needed help. Although I think it's a great show, I don't believe the writers of "Ginny & Georgia" did their therapy research for the show and are pushing cliché, ineffective, and potentially harmful therapy stereotypes. I must admit though that it's great that men (especially Zion) in the show are encouraging therapy, and the therapist is a person of color. Still, here are the main errors, in my view, and how it could be better.
1) The therapist had no structure or organization to start therapy.
The way the therapist started the first session makes it look like a disorganized, random, and unplanned endeavor. Therapists are actually organized; we typically have a set of loosely structured questions to guide the process, while also inviting the client to guide parts of it or ask questions. They don't just tell the client to "talk," as they take notes on a blank notepad. Therapy is a collaborative, goal-directed process, with a beginning, middle, and end. Also, when Georgia crashed the session, although it seemed to work out, the therapist should have checked in with Ginny before, asked if any topics were off-limits, and planned the family session with more organization and intentionality.
2) The therapist told Ginny "this is a safe space" a minute into therapy.
This gives the public the idea that therapists may push or force a client's safety, going too intimate too fast. In the same way that people telling each other to "just trust me," doesn't work, safety is earned over time, not expected or enforced in the first minute. The statement also implies that Ginny’s safety is a choice when it's actually an involuntary emotional response. The truth is, therapy, like any relationship, doesn't just start as "safe." Safety grows over time as trust develops, and it exists on a broad spectrum, not a binary safe or unsafe space.
3) The therapist asked about Ginny's self-harm too quickly in
Self-harm, as you'd imagine, is a delicate subject. To disclose it honestly, vulnerably, and openly, the therapist gains the client's trust over time. Asking about self-harm within minutes of starting the session sets Ginny up to possibly feel cornered, pressured, and likely uncomfortable, risking that it become less likely that she disclose. It was still appropriate, however, that the therapist asked about it early into therapy and wanted to identify it's "triggers." I discuss Ginny's self-harm more below in #9.
4) The therapist asked Ginny mostly closed, "yes or no" questions.
Open-ended questions, such as, "What would you like from therapy?" "What are you noticing?" or, "What kind of space are you in?" are preferable to closed questions (ones usually evoking a yes/no answer) because they enable accessing a wider gamut of information to get to know Ginny as client. Most of the therapists' questions were closed in the show, making it likely that she isn't getting to know the nuances of Ginny's personality at a reasonable pace. Open-ended questions also empower the client to lead the conversation more, build trust and client-autonomy, control, and comfort, making the therapist's excessive closed questions another missed opportunity.
5) The therapist seemed to convey sympathy, not empathy
Sympathy is feeling bad for someone and empathy is feeling with someone. The therapist seemed often aloof and emotionally removed based on her tone, body posture, and facial expressions while asking Ginny constantly about her feelings. Most people don’t want to talk about their feelings when the listener appears aloof. The therapist should have displayed a more empathic posture, as if she were feeling with Ginny. This point #5 doesn't pertain to a specific therapist comment, but her overall psychological presence. Overall sympathy isn't validating or normalizing of Ginny's pain, which goes against robust findings in therapy research on what works.
6) Assuming and imposing her own experience on Ginny prematurely
The therapist said she knows what it's like to live in a white community without asking about or trying to understand Ginny's experience of that first. This could have worked well if she listened diligently and patiently to Ginny's experience and then commented on how her own parallels after, but not before. The therapist's approach also risks making the focus of the session more on the therapist than the client.
7) Similar to #6, the therapist asked how Ginny felt without portraying true, genuine interest
The cliché question, "How does that make you feel?" is overused on screen, and usually not within a context a real therapist would ask it. The therapist asked it rhetorically, again, seeming emotionally removed, instead of with genuine curiosity. It's better when this question is asked in a softer tone, when the client is visibly feeling an emotion in the moment.
8) The therapist assigned homework without checking in with Ginny first
Therapy is not school; therapy homework should be collaborative and only implemented if the client is on board. The therapist should have asked Ginny's permission for homework and agreement or feedback as to if it was appropriate or worked for her, or how she felt about it overall.
9) The therapist did not assess and treat self-harm appropriately
Most importantly, asking about triggers of self-harm and substituting dangerous, self-injurious burning with a rubberband appears inadequate in treating Ginny's self-harm. Although the CBT rubberband replacement technique seemed to work in the show (and it definitely can help in certain situations for certain clients), ultimately substituting self-harm with a lighter version of self-harm won't work long-term unless it translates to a healthier coping behaviors, such as turning to a safe person, art, exercise, napping, writing poetry, etc. This is how the therapist should have framed the rubberband, as a temporary solution, paving the way to a longer-term solution, such as improving trust, safety, and attachment security with each of Ginny's parents. The rubberband substitution alone is similar to treating opiate addiction with suboxone or methadone. On this note, in the family session, the therapist said that the "goal of therapy was stopping Ginny's self harm," when better goals in therapy are not just symptom reduction, but transformation, improving relationships, and promoting mental health. Therapy goals are also decided collaboratively, with the client's voice actively included; Ginny never said "my goal is to self-harm less." Lastly: self-harm is usually a symptom of mental health issue, not the root- cause: the therapist should have explored what was happening in Ginny's life that resulted her needing to burn to cope. Addressing the root of the burning instead of the burning itself only would have helped more long-term
I hope this helped clarify some of the misconceptions about therapy. Even if Ginny seemed to benefit from therapy in the show, there are at least nine ways it could have been better and more realistic.
To find a therapist near you, visit the Psychology Today Therapy Directory and/or trauma-informed EMDR therapist here.
