Do No Harm: Why Televised Rehab Isn’t

Most people have never been famous, but nearly everyone has suffered psychological discomfort, or knows someone who has. In an attempt to explain the iatrogenic effects of televised therapy, I’m going to ask you to empathize with a subset of patients most people envy: celebrities.

Inherent in all psychological trauma is the belief that nobody understands you and no one can help you. Seeking treatment is a brave step as it requires you to reach beyond traditional support systems (family, friends, church), whom you believe to have failed you, in order to share your darkest fears with a professional stranger.

The comfort and safety of confidentiality and privacy are the cornerstone of all therapeutic interactions. Whether you’re seeing your doctor for a suspicious lump, a substance abuse counselor for meth addiction, AA to overcome alcohol, or even a peer crisis counselor, your expectation of privacy and safe space are so integral to successful treatment that it is codified into pretty much every government, corporate, & non-profit regulatory structure. It is drummed into practitioners in med school and psychology classes. It is a condition of joining a 12 step program. It is sworn to uphold before certification for peer counseling. It is punishable by law when violated in the United States via HIPAA and state licensing boards.

Of course, in the United States we also have release of liability forms. You know, just in case someone who is replacing love with fame needs to up their exposure on national television.

Confidentiality is integral to seeking & sticking with successful treatment. Few people would visit the doctor if they had to announce they had rectal bleeding to the waiting room. No one wants to admit they have scary thoughts or were sexually assaulted in the public square. Even people who choose to share their stories on Oprah usually have gone through a successful course of treatment. They are well now & can consent to speaking publicly about their troubles & recovery without interfering with their health.

This changes when we ask people who are barely able to function outside of a live-in treatment facility to sign a waiver allowing cameras to follow their recovery. The “celebrities” who join such programs not only have issues with addiction to substances or feelings; they also are desperate to get back in the public eye. They are in need of work as they’re low on funds. Many would sell their soul to get back on TV. Does this sound like a healthy, fully informed decision to you?

Much of the reason these people are no longer working is their substance addiction, but while lack of jobs and money may make it difficult to obtain anything that will make them feel better, it does not decrease the drive. For the fame addict, being back on TV is part of the high. Putting them back on TV is as bad as giving them more booze, more speed, more food, more meaningless sex.

Fame is a poor substitute for stable, loving relationships. For many of these people, stable loving relationships are as alien as paparazzi & red carpets are to us. How are they to overcome all their addictions (& the issues addiction masks) if one of those addictions is being fed? How are they to learn normal human interaction if their every move, tear, & breakdown is being filmed?

It is not possible to give informed consent to camera coverage when you are not well. It is not responsible therapeutic technique to take confidentiality, privacy, & safe spaces away. Dr. Drew Pinsky (among others) either doesn’t understand this, or does & chooses to ignore it.

Either way, would you trust him to help you?

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4 thoughts on “Do No Harm: Why Televised Rehab Isn’t

  1. Deb J. says:

    I totally agree with you. BTW, sorry I missed u today. Called PE but u left. Deb

  2. Andrew says:

    Sorry for the delay on my thoughts. Haven’t been on my computer in a few days. At any rate, here are my thoughts:

    First off, thanks for writing this. You helped me crystallize the uneasiness I’ve had about television therapy since before I even got into the field. Also, your point about feeding the addiction is well taken, and spot on, as is your comment about what addictions mask. I’ve worked with the addicted population for several years now, and my focus has always been to deal with the underlying issues, and then treat the addiction in order to help the client better get at the underlying issues. An addiction is just an unhealthy way to attempt to meet a need, regardless of what that addiction is, so the focus should be on the need.

    You also raise a really good point about informed consent. Is a person really giving an informed consent when the carrot of his or her addiction is being dangled in front of them?

    Does that mean that celebrities can’t be helped in this format? I think they can if they really want to work and it isn’t for show. And, I think that on some level, however small, television therapists want to help, and not just exploit. At the same time, it’s really said I even have to couch it in that language.

    I do have one niggle, though. I don’t believe that “inherent in all psychological trauma is the belief that nobody understands you and no one can help you.” In some client populations such as severe depression this is very common. But, many clients come because they want help and know that going to a professional is a way to get help and a way to get understanding.

    • kelliejane says:

      In re: the niggle, I thought I had addressed your point by discussing why people end up going to professionals, but that might not have been clear. I agree w/ you! 🙂 We seek professional help because nobody in our usual sphere gets it, or we are ashamed. Implicit in this is the fear that no one can understand the pain. I hear
      that a lot from sex trauma, war trauma, anxiety, & depression clients/peer groups.

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