While stigma against receiving mental health care is shrinking, understanding the process of therapy and counseling likely remains unclear to many. How do people get happy and feel better through therapy? Does media ever show it right?
After channel-flipping the other night, I tuned in to watch the recent two-hour season premiere of House, MD. I have enjoyed many episodes, but I am not a regular viewer who focuses on the names of the characters/actors or registers details of the ongoing series, so this is not a review. Rather, I am sharing my reflections as a veteran therapist on the show's depiction of mental health and the character, House. His behavior and choices as an inpatient in this episode are striking metaphors for how people can self destruct in daily life.
Under pressure, House "voluntarily" committed himself to a psychiatric hospital for drug detoxification (and other mental health issues). He had lost his medical license. He needed a medical release and recommendation from the chief psychiatrist at the hospital to get it back. House's goal was to detox, regain his license, and return to his old life as quickly as possible. He did not want to change beyond detox.
One source of my fascination with this show was how easily I saw the hospital ward through House's eyes — not as a place of emotional healing and growth but as simply people and a place to be manipulated for his purposes. Still I expected (and wanted) House to be successful with his manipulations. My goal was his goal of a speedy discharge when, even though in my reality as a therapist, I knew he needed therapeutic help well beyond drug detoxification.
In classic House style, after detox, he initially attempted to resist therapy through his typical bullying and manipulative strategies. His plan was to cause so much trouble and disruption that the facility would rush to be rid of him. Initially, he tried to control his environment by disrupting group therapy.
Then he manipulated other hospital inpatients and caused them distress. For this, he was sent to the padded room for seclusion because he wouldn't play nice. His next attempt to secure his release was to incite a ruckus over a ping-pong table without a net or paddles — again off to a stint in the padded room to regain control. The chief psychiatrist was highly skilled to handle House's every manipulative power move. I smiled with support for House and frowned at the psychiatrist.
House feared losing himself and resisted his prescription meds. He eventually pretended to take the pills and "cheeked" them; but his deceit was uncovered by the psychiatrist's clever use of sugar pills. If House was taking his meds (the sugar pills), the urine he provided for testing should have been drug-free; but House had 'borrowed' urine from another inpatient, which tested positive for prescription drugs. Gotcha! I was still rooting for House and thought 'darn it' again. That psychiatrist was smart and a step ahead.
While his leadership and intelligence were openly recognized by the chief psychiatrist, House was too smart for his own good and every effort he made to deceive was taking him further from his goal of release. But he continued his self-destructive games with my support.
I even suspected the chief psychiatrist of being less than an honorable man because House thought so. He observed the doctor's weekly afternoon meetings with an attractive woman. He recorded her license plate and finagled a call to his best friend to seek her identity through the plates in order to blackmail the psychiatrist for his release. Ahead of House's game, the psychiatrist had defused the plot. He forewarned House's friend to expect some future request that would be counter-therapeutic. So his friend declined to help. I almost supported his refusal, and felt his tug of emotion. I also felt myself beginning to come around to treatment for House.
In yet another act of huge arrogance, House second-guessed and interfered with the treatment of a particular delusional inpatient. He thought he knew better. As a result, the young man nearly died by jumping off a roof as House watched. Not until this crisis of self-confidence did House become reluctantly open to the help offered. He felt defeated and was beating himself up over his mistake. House changed his goal of getting out to a goal of getting happy.