Drs. Phil and Laura: Therapists that other therapists love to hate
by Dr. John Riolo
Garry, I’ve got to hand it to you. Our friendship has always helped me test my values. I find myself once again defending people whom I don't particularly like, don't agree with and who probably don't need me defending them, but I do it because it's the right thing to do. I might as well renew my ACLU membership and be card carrying.
Then again I guess I have a natural empathy for therapists whom other therapists love to hate. I wonder why. So I must say a couple of words in defense of Dr. Laura and Dr. Phil, two of America's most popular and successful "media therapists".
Let's start with Dr Laura. I can't think of anyone whose values are more different from mine on many respects from reproductive choice to gay rights. However, while I don't claim to be a regular listener to her broadcasts--which are advertised as not therapy, BTW--her callers generally know what to expect. I can not recall anyone calling in saying something like, “Dr. Laura, I’m unmarried having an affair with a married man and pregnant. Can you give me any advice on how I can convince him to leave his wife? And if you can't help me there, can you recommend a good cheap abortion clinic?”
I don't think that happens very often. What callers get is what they expect, a morality lecture. And, that may be exactly what they want. Contrast this to what many consumers get when they see some of our colleagues. They may discus with a therapist any problem and no matter what it is, the therapist treats their problem as merely a "presenting problem" which to therapists is often of little consequence. The "real problem" that needs the focus of attention, according to these therapists, is the underlying problem, which they believe may be unconscious and totally unknown to the consumer. So these consumers may pay over $100 a pop for years to be treated for a problem they never knew they had, while what was bothering them in the first place goes unattended. At least with Dr. Laura, it's quick, fast and the advice is free. And, the caller can hang up the phone at any time.
Dr. Phil is another of those therapists we seem to love to hate. I suppose the fact that he is rich and successful has nothing to do with it. Of course not! As therapists we have all worked through our feelings of jealousy and inferiority in our own endless analysis that may begun in the 60s and continues to this day.
That he lost or surrendered his license is something that some of our colleagues bring up with some frequency. Well, few people seem to have any facts about that, but it doesn't matter. He doesn't do therapy. He says so. And the guests on his show sign all kinds of releases indicating that they are not receiving therapy but are participating in entertainment. It's simply another version of reality TV that’s so popular today. I see it as a variation of Survivor or Professional Wrestling. It's staged and it's fixed.
Frankly, Garry, I for the life of me can't understand why anyone would agree and sign legal releases to go on national TV and share every intimate detail of their dysfunctional life. But I guess I am from an era when privacy meant something and when we took it seriously. Nowadays people will do just about anything to get 15 minutes of fame or infamy.
But--and this is an important but--Dr. Phil's guests know what they are getting into. They know that if they agree to let it all hang out with Dr. Phil and his millions of fans, they may very well come across as a variation of The Farkels, the dysfunctional family of Saturday Night Live fame.
Now contrast the informed consent used by Dr. Phil with the disregard for informed consent used by many our colleagues who feel a compelling need to use the Internet, which is about as confidential as a megaphone to discuss their patients on open, non secured discussion groups and listservs. Read the special series.
Some therapists will discuss their patient in such detail that even without mentioning the patient's name you could practically draw a map to their door. And they don't feel the need to get the patient’s consent. Some therapists have argued that asking for their consent would frighten them. I don't doubt it. I would be frightened if my therapist said they needed a consultation but thought the only want to get one was to go to 500 or so strangers and yell help I'm stuck. I would be so frightened that I would get another therapist pronto.
Some say it's for educational purposes and it’s necessary to educate future generations of therapists. Some argue that being required to get the patient's consent would be a disaster in terms of the education of future professional therapists. The education of future mental health professionals has many challenges to overcome but somehow I don't think its future rests on our ability to talk about our patients behind their back on the Internet. I hope not anyway.
Lastly, we often hear about the ethics of Drs. Phil and Laura. Gosh, as a profession we throw about ethics a lot. But it can get confusing. I believe you mentioned in our last discussion that, "Other therapists lie to their case managers, presenting case notes and objectives, in approved format, that bear only a passing resemblance to what's really happening in session. (While that's clearly unethical and probably illegal, they justify it by saying they're doing it not for personal gain but to help clients receive therapy who otherwise couldn't afford it)."
Well, you let that little piece of dirty laundry out of the hamper. But do you truly believe these therapists are not doing it for personal gain? In whose pocket does the money go? Someone seems to be getting fleeced. But if you believe that altruism is their motivation, did I mention that I have some Enron stock I would let you have for a bargain?
Unless we have some hard facts should we really be throwing stones at Dr Phil or Dr. Laura?
John Riolo is a psychotherapist, Vice-President of Psychjourney and consumer advocate. He is known as the Insider and sometimes known as the therapist other therapists love to hate. His website Your Advocate Online includes many articles and audio interviews addressing the inner trade secrets of psychotherapy. Listen to his new Internet radio show, The Insider. Contact him at johnr@psychjourney.com