Patients have been talking about a TV show I'd never heard of: Clean House.
It's a reality TV show where they come in and help the clutter bugs get rid of their stuff. I've never watched it (obviously). This is entertainment? My patients say they watch it then go throw some of their stuff out. Entertaining and therapeutic. It's funny (as in kind-of-ironic, not ha ha), but people spend a lot of time in therapy talking about their clutter and the piles of paper they can't part with. I suggest bonfires, but hey.
So I started thinking about this whole reality TV show concept, and the fact that I'm writing about psychotherapy (now done with 2500 words of What Is Psychotherapy). I had this fantasy about having a real life therapy podcast. Roy once talked about how there was bound to be a reality therapy TV show. Couldn't I do a start-to-finish psychotherapy podcast and put it on iTunes? I've got the microphones, and I could probably get Roy to teach me how to use all these gadgets. It might be interesting, it might be something people could use to teach (Gosh, that therapist says dumb things!) or it could be really boring. How does one logistically recruit a patient for such thing? Is it ethical (hmmm...) to offer free psychotherapy in exchange for allowing it to be broadcast on the internet? Could anyone relax and be themselves? What if it got up close and personal and the patient wanted out? Obviously, you stop, but then what becomes of the therapy? Funny, they didn't deal with these issues in medical school.
Okay, it's not happening. It was just a fantasy. I'm going to clean out my closet now. For real.
I'd LOVE to follow a podcast series of real-life therapy with a patient. I rather doubt a patient would agree to that, though. Perhaps one would for free therapy. I had a hard enough time telling my psychiatrist my history. I can't imagine ever telling it while a podcast is taping. Even day to day sessions are so personal I find it hard to believe you'd have a volunteer who'd be themselves and natural and uncensored.
I think some people would go for it. I'd do it for free therapy.
The BBC has had shows like that for a few years. Something about them is so addicting. But always it's sorta funny-grotesque when people cry because they get rid of their crap. It does sorta inspire people like me who are packrats and just plain have too much stuff. For me, just seeing HOW to get rid of stuff is a big help. It's kind of like a cooking show for people who never cook.
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Psychotherapy in the blogosphere has been written about in this blog (http://www.jung-at-heart.com/) and particularly the creation of a therapeutic space by the therapist and patient (http://www.jung-at-heart.com/jung_at_heart/therapeutic_space_revisited.html). To address the ethical issues you could write a research proposal and take it through an ethics committee. General principles of online therapy are covered in this book (Kathleene Derrig-Palumbo, Foojan Zeine. Online Therapy: A Therapist’s Guide To Expanding Your Practice. Norton. 2005). A quick medline search using keywords 'blog' and 'therapy' showed this reference which could be useful for a research proposal (Am J Psychother. 2008;62(2):143-63.Psychotherapy 2.0: MySpace blogging as self-therapy.Tan L).
I see so much value in a real life therapy podcast or video. My pdoc is such an amazing therapist I have sometimes wondered if he could videotape, or record some of our sessions for teaching purposes. It would be so great both for new therapists/psychiatrists to see it done well.
I think in my case too, it would be great for new drs to see how supportive therapy works for patients with difficult to treat illnesses.
Also, I really think it might work towards both destigmatizing and demystifying therapy for those reluctant to go.
I'd volunteer;>) Hope you look into this. It's a great idea.
Thank you all for your words of encouragement! Just the thought of dealing with the mics and mixer and equipment is enough to discourage the whole concept.
Yes, framed as a research project it would go through an Ethics Committee. But I'm in solo private practice, there's not an Ethics Committee! No clue how something like this would work through my academic appointment, but my guess is that since it's not research, and it's not funded, and there might be the potential for liability, and it doesn't relate to my work in the clinic, that the hospital's IRB (institutional review board) wouldn't touch the strange practices of a solo practitioner in the community.
Just enjoying my fantasy. At the moment, the contents of my bedroom dresser are in a pile on the floor, waiting to be neatly sorted through. And yes, I'm serious.
I watched a few short clips of "Clean House" on the web and found it a LOT easier to tart sorting and pitching things out for the last hour. It really was an inspiration. Their homes are way worse than mine and if they can do it I can.
Just watching a few episodes of Clean House inspired me to declutter my own living space. As I watched the show it was encouraging to see that people who were much worse off than me found a way to get rid of things, plus it helped me to see that my home could easily become like that if I did not start now.
You bring up an interesting point about ethical situation not taught in school. Society has changed so much even in the past few years that what was considered taboo then might be okay now, or vice versa. Things that I learned in undergrad just a few years ago are not out of date, and if I was not in graduate school and I did not like to read professionally, I am not sure how I would be able to keep up with it all.
Part of the role of going through the ethics committee as I understand it is addressing the issue of liability. This would be through a university ethics committee even if you have no affiliation if the US is similar to the UK. In terms of insurance, there may be a number of companies who are willing to insure this although this would most likely depend on local negotiation. There would be some costs (including time) involved but the study could be submitted for publication, would be innovative and could perhaps be a starting point for fostering further debate or even a paradigm shift in practice (web 2.0 therapy!) particularly if there is a case series with recommendations on protocols (the inclusion of questionnaires (e.g. online surveys) not just for the analyst and analysand but also readers would provide valuable information and could make a quantitative aspect to web therapy routine). While this is all speculation at this stage - if it did become a reality - then it would have all have started at this blog!
I have huge clutter problems.. We sometimes talk about that in our therapy session (DBT) as a part of skilss training. Because of BPD, I have bouts of depression and it shows in my home. I don't clean, I don't throw away anything.. I'm just so helpless that my husband has to do everything. And then the mind gets even more depressed when the appartment begins looking like dumpster with trashbags, dust and ads. etc. A big learning step has been for me to realize that by doing something first (when I don't feel like it) I can take control again and the action itself gives me power and more hope.
About reality-tv.. I like it. In today's society we keep believing that everyone is so strong and able all the time. In reality-tv we can see that other people also have problems (and that they can overcome them) like putting on weight, addictions etc. I like shows like Dr. Phil, X-weighted, How To Look Good Naked etc. I'm not personally interested in shows like Big Brother, Temptation Islands or Survivor.
Here in Finland, we used to have a psychiatrist Ben Furman, who's show was very popular for years, in which people talked about their problems like anorexia, adhd, hiv positive.. The show was more informative than therapeutic, but it did brought psychiatry and psychology to everyday people.
Nowadays I think that HBO's "In Treatment" captured quite well what a therapy session feels like. UK Channel 4's "Shrink Rap" also gets to quite close. :-) I think we still have a way to go to confront stigma that surrounds mental illnesses. Reality-tv therapy sessions would help in that, I think.
I think it would be interesting, and I might even be the (anonymous) patient for free therapy.
Most of my anxiety is related to lack of control, most evidenced by my clutter. That's why I love those shows - it feels good to see someone else conquer the clutter monster.
Let us know if you proceed with the podcasts - how is that different than the Dr. Drew show in terms of ethics?
I love it.
Come on, you've got to have one exhibitionist in the bunch.
Or you could say it was acted out, but not really. Or do it with Clink.
I seen that show...I think "oh *#$%, that's gonna be me. social outcast and disgusting pig, mocked by millions. get cleaning now!"
I think that would be a good idea to do a podcast of a session. You can then put it up on the site here and people can listen in. Im sure there will be some reality show - they already have drug rehab so why not?
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