written by Rachael Klug

therapyspace.online ;  tutor for the Academy for Online Counselling and Psychotherapy acadtherapy ; Board member Association for Counsellors and Therapists Online https://acto-org.uk ; mBACP

Rachael Klug explores the few highs, but mainly the lows of Hang Ups from the viewpoint of a professional and trained online therapist:

The portrayal of therapy on the screen is problematic, as every attempt I have seen demonstrates. You have the sinister, invasive ‘Gypsy’, with the vampish therapist preying on client’s intimate relations. Then there’s the intriguing ‘In Treatment’. ‘In Treatment’ is a case in point, for here you have the closest depiction of a therapeutic relationship between clients and therapist, certainly that I have seen on the screen; Gabriel Byrne’s therapist really cares for his clients, but too much. He loses his boundaries with his clients, developing erotic relations with one, so in the end he loses faith in therapy itself.

So, it was with interest that I heard there was going to be a comedy series based on online therapy with a comedian that I much admire, Steve Mangan, playing the key role. In the pre-viewing interviews, I read that Steve Mangan had been advised by a humanist psychotherapist, so I was even more interested to see how this might develop as it looked on paper that he had really done his homework.

‘Hang Ups’ is a mixed bag of a comedy. There are mostly disappointing bits with lazy depictions of clients, as well as therapy itself, for cheap laughs, but there are some gems hidden amongst the tired old stereotypes. I am in danger of sounding very moralistic here, but as someone who works with people who are courageous enough to reveal their innermost vulnerabilities, I find it shoddy to stereotype clients in difficulties to try to get some supposedly comedic affect. Steve Mangan has clearly not studied clients exploring their vulnerabilities for his depiction lacks sensitivity. An example is the villain of the piece, the very sinister-looking, violently-threatening, debt collector, Neil, who Steve Mangan’s therapist gives therapy to in lieu of debt repayment, or so he hopes. Even if we put the major ethical infringements aside in the therapist even offering therapy to his debt collector, the depiction of the issues Neil is tackling is just crass. Neil reveals, casually, that he had sex with his mother at 15, and then with his cousins; ‘well, it sounds like you were all kept very busy’, retorts the therapist. Sorry, Steve, but jokes like this about abuse survivors went out years ago, especially in the wake of the #metoo campaign and revelations about childhood abuse. I would have hoped that comedy had moved on, mainly because IT’S NOT VERY FUNNY.

It’s a shame, because if Steve Mangan had really done his research and seen how the therapeutic relationship works, he could have cleverly woven pathos with its greater understanding from the clients’ perspective, with laughter which takes sensitive skills, and makes for some of the most genius comedy scripts.

And it’s not just the characterisation of the clients and their issues that’s shoddy, the actual therapy itself is utterly hapless. Yes, there are some funny bits, such as racing around the house trying to find the charger cable, that most of us who work from home will recognise. But, overall, his depiction of online therapy is as far from the mark as you can get; so far, that it’s just bizarre and so falls flat as a comedy. The third episode, with the son listening outside the therapist’s open door, as he sets up the daughter’s teacher to call in for therapy to reveal his relationship with Steve Mangan’s daughter, crosses so many ethical red lines it’s just cringeworthy. Steve Mangan’s therapist seems to have very little concept of boundaries, something in common with other depictions of therapy on the screen, and when his helper friend showed surprise that Steve Mangan’s therapist had any therapeutic training in the first episode, his friend was spot on – for this therapist clearly has no understanding of therapy, certainly not in online work! But even further, the so-called therapy shown in the series, is so far removed from any therapeutic experience I could recognise, it’s just so far from the mark, it has no relation to therapy and so is just daft. I am left wondering where was Steve Mangan’s research on therapy; how has he developed a show that has such little relation to what actual therapy is? My concern with all this is that it would give anyone who hasn’t experienced online therapy such a misleading view of what it’s like, that it may well put off some of those who may have sought it for support.

BUT, there are parts that really do work, hence it’s a mixed bag, and I want to focus on the gems in it for they raise really important aspects of working as an online therapist.

‘Why are you looking at me directly in the eye?’ Richard E. Grant’s psychotherapist is a classic and his opening scene in the first episode is done brilliantly. Here, we have a traditional face-to-face psychotherapist wrestling with the new technology to brilliant effect. In the small scene, Richard E Grant’s therapist captures the difficulty of working online in his dilemma about where his client should be looking. How can he replicate the couch so his client, Steve Mangan, can reach into his subconscious? By getting poor Steve Mangan to stare ‘obliquely’ at the curtain. In my training for online work, considering where we are looking and whether we can maintain eye contact when online was an important part of early discussions about working with a webcam. Some of my clients like to work with the webcam, others prefer live chat or audio only. The essential difference with online work to face-to-face is that the client has the choice; they are immediately empowered by collaborating with their online therapist in setting up an online space that works for them, be it audio or webcam.

Richard Grant’s therapist also misses a major point about online work – the screen! Who needs a couch to be able to explore one’s subconscious self when we have a screen that enables that closeness of thought between therapist and client, or as John Suler (*see reference below) put it, the ‘mind merging’ potentials of online work. Conversely, some critics of online therapy in the psychotherapeutic world criticise online work precisely because of the lack of physical presence. Perhaps there is a misunderstanding of the nature of presence in the relationship between therapist and client, or that they have not yet experienced the powerful connections that can develop in the online world. Looking into the eyes does not have to underpin a close therapeutic relationship, as the couch demonstrates.

‘I can talk about the showers’ Which leads me to another important aspect, disinhibition in online work. So the client with the ‘fucking cats’, suggested immediately that they talk about sex. ‘So can we sort of hurry this bit now, can we sort of zap through whatever it is you need to know. I can have a cry, we can all go home.. can we sort of speed that up?’ Anyone that has worked online has to manage two major facets of online work; disinhibition and the speed that can happen. Again, referring to John Suler* who was the first to recognise the disinhibition effect of working online, the screen can diminish defences and resistances with many clients feeling freer to explore and disclose their intimate selves. Be it because of the anonymity afforded by working online, or the feeling of invisibility, many clients feel able to open up their deepest vulnerabilities very early on in the therapeutic encounter. This means that the therapist must have training to know how to manage this sensitively and with understanding. And, no, Steve Mangan’s expressive eye brows whenever a client discloses a most delicately-held revelation, is not ethical and good therapeutic practice.

#engaged with the whole session. The young woman who comes to therapy because she thinks she’ll ‘be good at it’ and wishes to post up screen shots from the session to increase her number of Instagram likes, is a real dilemma that online therapists face. The online world is one that pursues connectivity and social media is at the forefront of this drive. So just how does an online therapist work in this interconnected world to secure a confidential space and resist the pressures from social media? This was the one spot where I thought Steve Mangan’s therapist handled the situation with consideration and care; he talked about providing a secure space to explore feelings for the client. However, her riposte that she has nothing to gain from talking about her feelings if there’s no one there to hear, went unanswered. I found myself screaming at Mangan’s therapist ‘BUT you’re there to hear her!!!’ In training for working online as a therapist, these sorts of issues are expounded upon, so we can work confidently in securing our clients’ confidential therapeutic space. In our contracts with our clients, we agree not to connect by social media, so this is clear and understood from the start.

The solution to all of these challenges in working online therapeutically– training! There is no-short cut in this; there is no, ‘ok so let’s Skype next session’. No therapist would attempt group therapy work without experiencing it and training in it, so no therapist should really try out working online without having had their own sessions of online therapy and training. This is the reason d’etre behind the Association of Counselling and Therapy Online ACTO; to promote safe and competent online therapy. We know online therapy is incredibly effective in helping our clients heal from difficult and complex issues. Our passion is in providing online therapy in a way that has the client’s best interests at heart, so they can work with us securely and safely.

I am hoping that this review of Steve Mangan’s Hang Ups hasn’t sounded like a moralistic critique from the hallowed ground of psychotherapeutic preciousness. So far, I have watched three episodes, but do I think it may improve over the series? Unfortunately, the answer is ‘no’, based on the rapidly diminishing representation of any semblance to online therapy as I understand it witnessed in the first three episodes. I am all in favour of dramas that attempt to portray the therapeutic experience so that it can become more part of the fabric of everyday life, even for comedic affect. But please, get the clients and process of therapy right. Online therapy is not about quick-fire responses for comedic affect, it is about developing deep connections that explore sensitive vulnerabilities. And above all, respect the clients’ courage and ingenuity in facing some of the most difficult issues life can throw at you.

*John R. Suler (2016) Psychology of the Digital Age: Humans Become Electric, Cambridge University Press, Cambridge, UK.

 

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