It's good to talk – but when did therapy become must-see TV?

Even when it was taken more seriously on TV, as a means of tapping into a character’s thoughts like those of Tony Soprano in his mournful sessions with Dr Melfi, the understanding was that this was fictional entertainment; the idea of actual people laying themselves this bare for our viewing delight would have been unfathomable until reality TV altered our expectations of openness on screen. But now it seems everybody wants to talk, even if we Brits, with our slightly loose upper lips, still have nothing on our expressive Stateside counterparts.

For more proof if needed of Ricky Gervais’s maxim that "people now get famous living their life like an open wound", look no further than Couples Therapy (iPlayer), which since 2019 has seen real-life patients take their problems into the New York office of the calm, compassionate Dr Orna Guralnik.

Season 4 includes Molly and Josh arguing about doing the dishes. Molly: "I don’t like to leave them, he says he’ll take care of it." Josh: "I did them last night and every night for the last 20 years." I’m not a professional, but something tells me this isn’t about the dishes. Couples Therapy is a global hit, and highly addictive – for reasons both noble (cheering at a communication breakthrough for a pair who have struggled for years) and slightly ignoble (the age-old delight in inspecting other people’s washing).

Now the BBC’s Wellness Week is the cue for a bunch of leading UK therapists to follow suit and invite the TV cameras into their consulting rooms. Change Your Mind, Change Your Life’s first episode follows three people through their initial sessions: Nicole gets anxious when driving; Muna can’t face being left alone; James is a former athlete who has issues at work. One therapist explains the challenge of dealing with a patient whose "stories and emotions don’t match" and there’s clearly a Columbo-like satisfaction in digging around in a client’s childhood for the root of the problem.

Of course, such a TV format has its limitations. The very act of being filmed in such a sacred setting must raise questions about the motives of both patient and counsellor. Viewers versed in therapy-speak from a thousand podcasts will cringe at phrases like "you didn’t have yourself back then, but you do now" as a TV-friendly over-simplification of complex issues.

Conversely, those queuing for mental health support on the NHS might wonder at the prohibitive cost of such sessions as these, and the luxury of someone being able to question "What do people think of me?" when so many others are asking "Shall I pay for food or heating?"

But this is the stuff of people’s lives. The terror of Nicole’s panic attack is palpable, as is her relief after a few well-chosen therapeutic words. It’s clearly good to talk, and no bad thing when we’re told one in four people in the UK will experience a mental health problem each year.

Meanwhile, much of the distress presented here would appear to boil down to one of three things: social anxiety, status anxiety and loneliness. Or, as one therapist puts it: "The story becomes – I’m a failure, I’m worthless, I’m not lovable."

Quite how we’ve created a society where so many people tell themselves such a story is probably the stuff of a bigger conversation.

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