Stutz: The Ethics of a Public Psychotherapy
Jonah Hill has produced a film that seeks to de-mystify therapy and share its benefits by bringing his own shrink Stutz, literally into the frame. Noble, maybe, but is it ethical?
For too long the process of psychotherapy has either been hidden from public view in the cloister-like privacy of the consulting room, or fictionalised in ways that fall quite short of conveying the actual experience of it. Jonah Hill has produced a film that seeks to de-mystify therapy and share its benefits by bringing his own shrink Stutz, literally into the frame. Noble, maybe, but is it ethical?
I'm all for demystifying therapy and finding creative ways to share its insights more widely - in fact I've devoted myself to that very idea throughout my career. But getting this right is tricky because there is a balance to be struck between preserving what makes therapy therapy (namely that it's private) while at the same time making all the great stuff that therapy has to offer more publicly accessible. For me, this has been about making a distinction between the act of psychotherapy itself and something else that is not psychotherapy but still conveys its ethos and sensibility.
Early in my career, I had to confront this balance when I was invited to be a commentator on the reality TV show Big Brother. While I wasn't going to be doing actual therapy with anyone, I was going to be applying my skills as a therapist to better understand the individuals in the house - individuals who were there by consent. Yet I was deeply conflicted about participating. Being on the show appealed to my narcissism for sure, but there were alarm bells ringing in my conscience about whether or not it was ethical.
Despite the participants' consent, I still felt I was engaging in a show that was fundamentally exploitative. In the end, narcissism won out - though I did attempt to strike a balance by deciding to use events in the house as illustrative of psychological processes instead of diagnosis, and to do so with respect. It was a clunky balance, but it's what I chose in the end.
It's something I would probably not repeat today. I have however, contributed therapeutic content for the media over the years that I am more proud of. None of these, however, were carried out with actual psychotherapy patients, and a lot of preparation and thinking went into how best to do it.
Stutz is different. Stutz features a real therapist and a real patient, lifts them out of the privacy of the consulting room and hoiks them right onto Netflix.
Boundaries, boundaries, boundaries:
Among the key features that make therapy work are its boundaries - confidentiality, consistency, and trust. Therapists must also ensure that they do not enter into an exploitative relationship with their patients. That means an acute awareness of any condition in which a client might be used for the therapist's personal gain, like accepting generous favours or expensive gifts. But what happens when your patient is a famous actor and filmmaker, and wants to make a film about you? The appeal to narcissism must be great indeed, but is it necessarily exploitative?
Here's where it gets tricky again. While firm and reliable boundaries are the foundation of psychotherapy, so is the capacity to work thoughtfully and flexibly with them. For example, while it would generally be unacceptable to meet a patient outside session times for a beer, there might there be wiggle room if your patient wanted you to be present at an important event, for example, a public lecture or art exhibition. So long as these things are worked through, you could argue a range of non-traditional possibilities that might happen that could be quite enriching. What Jonah Hill and Phil Stutz did, however, is really next level.
I watched Stutz with a fair bit of reservation, expecting to have a strong negative reaction to it. In the end, I was surprised to have liked it as much as I did. I thought that Jonah Hill's honesty about his struggles was courageous. His naked honesty, I'm sure, will be a great help to the many people who will watch this film. He has effectively opened the doors on a therapeutic process (however, not one you should expect) and was effusive about how much therapy has helped him: he was an evangelist for therapy (or at least for Stutz).
The relationship between Hill and Stutz was clearly deeply established and trusting; and the trust goes ways. While Hill clearly put his vulnerable self in Stutz's hands during his therapy, in the filmmaking, those roles were reversed. Stutz was relying on Hill to do a good job as a filmmaker - this film would be Stutz's legacy: as a person, as a therapist, and for "his" ideas (more on this later).
While Stutz's approach is not really what you'd expect from a therapist (and it is a movie after all), he drew on all the familiar themes you'd expect; depth of listening; making interpretations; linking the past to the present; and inner child work. The most important part of any therapy is the quality of the relationship, and while we can't see what happened before they started filming, we gather that they have developed a deeply trusting one - one that just might enable a film like Stutz to work.
What Doesn't Work:
It's just not really what most therapy looks like. As psychotherapist and author James Davies points out in this Vice piece, Stutz eschews a lot of what would be considered good practice, instead demanding "total faith for healing and life-transformation to occur." There is certainly more guru here than therapist.
But what really grated on me was the way in which Stutz has clearly pulled from a variety of therapeutic approaches without giving any credit where credit is due. It's not that you have to give references in therapy, but there were several occasions where he waxes lyrical about "my ideas" and how he wants to preserve them for posterity (perhaps in a film?) when they are clearly derivative of others. There are elements of psychoanalysis, gestalt, Jungian analysis, schema therapy, transactional analysis, just to name a few, but in the film, they all appear to come directly from Stutz's impossibly fertile mind.
A nod to the giants upon whose shoulders he stands would go some way to diminishing the guru position he seems to enjoy occupying. But Stutz has got a book to promote - The Tools - so I guess he has reason to claim them as his own intellectual property.
Yes, I admit that I sound a bit cynical here, but I have great admiration for the originators of these brilliant ideas and he should at least acknowledge that. I am totally behind reconceptualising them in ways that are more useful, but "rebranding" them all together seems disingenuous to me. Though his conceptualisations are innovative, the ideas are not new.
And one more thing... These ideas were not originally conceived to be used as "tools" to fix people within isolation. Stutz could not have applied them so successfully with Hill outside the context of their therapy together. Someone picking up Stutz's book will not get that from his tools alone - they'll get that from psychotherapy. Real healing comes from the application of long-studied ideas within a caring relationship. The film ultimately communicates that there are easy fixes to problems; you just need the right tools. This unexamined consumerist approach (with books and movies to sell) sadly undermines a film that has so much good, and it could have been easily avoided.
But is it ethical?
If you've kept with me this far, you'll be disappointed that my answer is "I don't really know." If the film had been less good, I would have been happy to say "no". But its goodness tips it into a grey area. Also, I believe that the film will do good, and I believe that Hill and Stutz on balance are good. So on balance, I more prefer that this film is out than not. I think they both took enormous risks, and I admire their bravery for pursuing it.
How this film may have affected their therapeutic relationship as it stands today is an unanswered question. While there might be something nice seeing them sitting a the same table together at the Oscars, one might wonder whether there might be a tinge of sadness on Hill's side that in making this movie, he will have lost his therapist. Whether what he ended up with was something even richer is only for Jonah Hill to decide. And the only person who can really answer to the ethical question of making the film at all, whatever Jonah Hill wanted, is Phil Stutz.
We'll be discussing this in our monthly Psychology and Culture discussion in the Stillpoint Community Monday, January 9th at 5pm UK time. You can join for free by starting a two week free membership with Stillpoint.
Aaron Balick is a psychotherapist, writer, and director of Stillpoint, an international hub for exploring psychology inside and outside the consulting room. He is the author of The Psychodynamics of Social Networking connected-up instantaneous culture and the self; Keep Your Cool: How to deal with life’s worries and stress; and The Little Book of Calm: tame your anxiety, face your fears, and live free. He is an honorary senior lecturer at the Department for Psychosocial and Psychoanalytic Studies at the University of Essex.
Stillpoint is an organisation that aims to make psychology more publicly accessible, through events, online content and a virtual community for the psychologically curious.