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2005 July/August (1)

Friday, 02 January 2009 11:28

The 8 Minute Cure

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The 8 Minute Cure

Can Watching Dr. Phil Change Your Life?

by Michael Ventura

You sort of know who he is, even if you don't know who he is. You may not watch afternoon TV, you may be in bed by the time The Tonight Show airs, you may not like talk shows in general, but our media-infested world buzzes certain names into our ears until they're inescapable--names like Leno, Oprah, Dr. Phil. So you know, by a kind of osmosis, that Leno is a comic, Oprah is a force of nature, and Dr. Phil is some sort of therapist. And you know he's "huge," as we say of "hot" celebrities. You see his name at the top of bestseller lists, you see his face in bookstore displays--a genial, ruddy, not unintelligent face. There's something accessible about his presence and he's . . . some sort of therapist.

For those aware of him only out of the corner of the mind's eye, so to speak, it may be something of a shock to learn that, for millions, Dr. Phil is the therapist, paying daily house calls via TV to countless living rooms. His TV show is watched by an average of 6.6 million people every day, and five of his books have been number one on the New York Times bestseller list. He not only offers celebrity endorsements for weight-loss products and regularly goes on sold-out speaking tours around the country, but even has a muppet on Sesame Street named after him--"Dr. Feel." So you might ask yourself, as I asked myself, "What's going on in this world when the dominant male star on daytime TV is a clinical psychologist?"

A few months ago, The Economist shed some light on why a therapist might command so much attention: "About one in five Americans now suffer from a diagnosable mental disorder. The National Institute of Mental Health estimates that more than 13% of Americans--over 19 million people between the ages of 18 and 54--suffer from anxiety disorders, 9.5% from depressive disorders and millions of others from conditions ranging from post-traumatic stress disorder to schizophrenia and bipolar disorder." In addition, "in 2001, 5.5 million more Americans were taking prescription drugs for mental health problems, or problems of substance abuse, than was the case only five years earlier."

Of course, statistics on psychiatric diagnoses are questionable at best. How many people who are simply going through a hard time are classified as "depressive"? How many recovering from traffic accidents have "post-traumatic stress"? Still, there's no denying that in post-9-11 America--with its color-coded terror alerts, two continuing wars, rising gas prices, and an uneasy economy--the general level of anxiety is higher than it was during the boom years of the '90s. So, while it may be an exaggeration to state that one out of five Americans suffers from mental disorders, it's a safe bet that the general level of fear and uncertainty is higher than it's been in the memories of most people born after the Depression. The social climate has never been riper for a TV therapist. It's no wonder that many are calling out (as they do every day on his show), "Help me, Dr. Phil!"

Who then is Dr. Phil? What sort of help does he offer? How did he show up on the scene, and what is his scene?

 

Enter Dr. Phil

In the '70s and '80s, for the first time in the history of recent civilization, it became acceptable to speak openly of the terrors in the family closet. The women's movement, the men's movement, Adult Children of Alcoholics, and various survivor movements outed the all-too-common agonies that had previously been terrorized into silence. Every conceivable variety of incest, abuse, addiction, and destructive relationship became part of our daily dialogue.

This phenomenon represented a tremendous breakthrough for psychotherapy. After nearly a century, its insights and practices had finally filtered into the general culture to the extent that lay people, many of whom hadn't had direct contact with therapy and therapists, incorporated the language of the consulting room into their lives. Psychotherapy served as a powerful ally to this self-disclosure movement, giving it legitimacy and authority. Secret shame was publicly confronted, taboos were swept aside, and what had been unspeakable was not only spoken, but shouted from the rooftops, and from our radios and televisions.

There can be no denying this movement's fundamental benefits. Millions have been helped and healed, abusers have been held to account, and the onus of shame has been at least partially lifted from sufferers and victims. But it's just as undeniable that things went too far. For many, traumas were enshrined and victimhood became a central source of identity. What began as curative became a new kind of malady.

For many people, including therapists, it became obvious that identifying trauma is valuable, while identifying with trauma is destructive. Victimhood devolves into whining, and whining is tiresome, solves nothing, and leaves people stuck in their traumas. It also became obvious that new strategies were necessary--strategies that focused on coping in the present, while not denying the past.

Many therapists worked hard developing and refining new ways of helping clients deal with a traumatic past. But many outside the circles of therapy--either through ignorance, financial necessity, or simple distaste for the process--were still in need of something or someone to point the way out of victimhood.

Enter Dr. Phil. Tune him in and you see an affable, vigorous, eloquently plainspoken man, radiating certitude. His presence on screen has a 3-D effect. He looks directly into your eyes, talks directly to you, effortlessly including you in every conversation with his guests. He seems not to be "on television," but rather to emanate from the television. Jay Leno and Oprah Winfrey are in studios somewhere, and you watch; Dr. Phil is in your room, and you react. No man since Walter Cronkite has commanded the television medium with such seemingly effortless intimacy. Authoritative and comforting, Dr. Phil confronts victimhood with what has become his signature phrase, a challenging injunction spoken with earnest concern: "Get real."

 

A Star Is Born

Dr. Phillip Calvin McGraw, a clinical psychologist, began his practice in his native Texas in 1979, just as the revelation of taboo secrets was picking up steam. He practiced therapy for 10 years during the heyday of tell-it-all trauma. He quit clinical practice because, as he's famously said, he "didn't have the patience for it"; he saw no virtue in whining, or on dwelling upon pain. And the intricacies of therapeutic delving didn't suit his solution-oriented mind. But he did see that psychological insights might be commodified and sold.

He cofounded Courtroom Sciences, Inc., a company that employed psychological research to assist trial lawyers in areas like jury selection. His company's client list is impressive: Exxon (in court over the Exxon Valdez oil spill), The New York Times, many Fortune 500 companies, and, as fate would have it, Oprah Winfrey herself. Oprah had offended the cattle industry and was fighting a suit in an Amarillo court. She hired Courtroom Sciences, Inc., won her case, and hit it off with Courtroom Sciences' Dr. Phillip McGraw.

Invited on her television show, he became a Tuesday regular, and her Tuesday TV ratings quickly became her highest. On Oprah, he morphed into Dr. Phil, a doctor who had no patience for victims. His attitude might be summed up as: "You can talk about that stuff, and that's good, but now get real. What are you going to do about it?!"

Dr. Phil struck a nerve--and had a point. To people identifying solely with their pain, he offered other, more traditionally American, self-reliant avenues of identity. Dr. Phil was a corrective to a victim-oriented psychology that had bloated into a fad.

His approach might have been popular coming from any charismatic guy named Phil, but he's Dr. Phil. His background as a clinical psychologist was his entry pass, his source of authority. Clearly, he wasn't practicing psychotherapy on Oprah. Just as clearly, though, Dr. Phil spoke for himself, but as a psychotherapist. As his website says, he draws on "30 years of experience in psychology and human functioning." In the context in which he's presented, there's no mistaking that, when he speaks, we're listening to a therapist.

With his popularity proven by her Tuesday ratings, Oprah and her producers conceived a wider format for him-- The Dr. Phil Show. It was an instant megahit, second only to Oprah herself in the daytime ratings. Dr. Phil went from being a celebrity to being a phenomenon: tune in the show, buy the bestselling books, visit the website, and get real.

But the question remains, what's the reality behind "get real"?

 

An Internet Phenom

Dr. Phil's "get real" is based on an appealing assumption: that well-informed common sense can be successfully applied to any dilemma. Here's the dilemma; here are your options; choose and enact the wisest option, and the dilemma will be fruitfully resolved.

It sounds like it should work. Certainly, for everyday situations, there's no arguing with it. There's not much to argue about for complex situations either, at first glance anyway. For instance, here, on his website, is Dr. Phil answering a mother who can't believe her daughter is gay--the "get real" approach:

"Homosexuality is not a learned behavior. A sexual orientation is inherited; you are wired that way. Certainly some people will experiment with a gay lifestyle, and a gay person might experiment with a heterosexual one. If she is really gay, she will find a place in that life and in that community. The important thing is that you just love her through that. What difference does it make if she is gay? Accept her, support her and do not be judgmental. It is difficult enough for her to live openly and honestly in this society; don't put your judgment on top of that."

Is this sound advice? In most cases yes, though if you're a fundamentalist convinced your gay daughter is doomed to Hell, "What difference does it make?" brings up major issues that can't be solved by love alone. Is Dr. Phil's statement a brave thing for a public figure to say? In today's cultural climate, his stance probably angers a hefty chunk of his audience. He's clearly not pandering. He's taking a stand that the vast majority of therapists would support and that gay activists must welcome.

 

But it's no small thing to drop judgments about your child. Most therapists know that the "real" work begins after the paragraph is read. Therapy might come next, because, for most people, taking such a step alone is beyond their emotional resources. In fact, such a situation is exactly what therapy is for. But in that web offering, there's no suggestion that if you find these issues too difficult, you might want to seek counseling.

Dr. Phil's advice falls loosely into the category of self-help. Now self-help is, by definition, something you do yourself, without the need of additional relationships. If you're in good enough shape to do that, then books and sites are enough, and you aren't in need of therapy or any other kind of help. The danger is when you're not in good enough shape or haven't the coping skills to get real and make the self-help sites and books useful. Then you may pile up self-help advice as an act of denial that keeps you in the problem. In that case, self-help becomes like self-medication: you may be alleviating symptoms without treating the disease.

Any person of common intelligence can see that what's on the website is bare-bones stuff. More help may well be needed, and it's offered: the appropriate Dr. Phil book is displayed alongside the site's spare advice, with a convenient link for purchase. He definitely wants his website to be part of your life, because it's a colorful hook for his books and a running ad for his show. The show hawks the books and the website, the website hawks the books and the show, the books cite the show, and the show cites the books--a perfectly contained conceptual universe in which there's never the slightest hint of doubt. The instructions are so clear and unnuanced as to be absolute. Over and over, in his writings and on his show, there's a clear message: everything will be all right, if you do what Dr. Phil says.

Dr. Phil sells certainty. In an ever more uncertain world, a world craving clear direction, certainty certainly sells. But is Dr. Phil really so certain? And is he even offering self-help? Not according to a link on his site's first page, "Legal Disclaimer."

 

"All material provided on the DrPhil.com web site is provided for entertainment, educational or informational use only, is not necessarily created or approved by a certified mental health professional, and is not intended to be used in lieu of medical or emotional therapy for those in need of psychiatric or emotional care. We suggest you consult an appropriate health care provider or servicer in your community . . . ."

In politics this is called "plausible deniability."

The honorable alternative of self-help is demoted to the adjective "informational," as though to deny any serious intent. The message is: if you follow Dr. Phil's advice, you don't need a doctor--unless of course you do, in which case, Dr. Phil isn't your doctor. It says so in the small print.

The disclaimer makes an admission many of his fans might find disquieting: Dr. Phil does "not necessarily" have much to do with the content of the site that he says should be part of your life; nor does he "necessarily" stand behind its content, nor does any "certified" psychological authority. "Get real," indeed! To get real therapy, or substantial help of any kind, you must look elsewhere.

TV perhaps?

 

House Calls

Before tuning in to Dr. Phil, let me say that during the course of my life, I've seen four "traditional" therapists, amounting to some seven years in the consulting room. The first was Freudian, the second Gestalt, the third Jungian, the fourth--she didn't name it, but it was practical. All four were useful to me, and all four had much in common. The setting, for one: a consulting room is usually smallish and modestly furnished; the decor is tasteful, quiet, comfy; the lighting is gentle, intimate. The physical space between patient and therapist is well defined but living-room close. Two human beings have made an appointment for some serious talk. There are long silences. There are outbursts--I'm free to disagree, free to walk out. I'm paying for a service, which means I have a right to expect something. My therapist and I are protected by laws, both civil and professional, which regulate our boundaries and guard our privacy. Within those boundaries, a personal relationship develops: we have a stake in each other, my therapist and I.

There's nothing more alive than two people sequestered in a room who must deal with each other as human beings, and it's the aliveness of that contact that ultimately heals. Therapy is primarily a private, secluded relationship that develops over time, and therapist and patient must have the patience to get to know each other and to work on complex dilemmas that can only be addressed and solved gradually.

The words patient and patience are connected--both derive from Latin pati, to suffer. This is one reason I regret that the old usage patient has been replaced in psychotherapy by client . Speaking for myself, I didn't feel remotely like a client in therapy. I was a wounded, suffering, panicky person in need of help and healing, and I felt not at all demeaned if the fact of my situation was acknowledged by the word patient. Medical doctors can have "patients," why can't therapists? My being a "patient" also (so I fancied) gave my therapist a little more responsibility and class than, say, a lawyer or a publicist, for whom I'm certainly a "client." I was definitely not a "guest" or a "contestant," as Dr. Phil refers to his TV consultees. In any case, it's through my experience as a patient that I viewed Dr. Phil's TV show.

Contrast the consulting room with a television soundstage. A soundstage is bright--much brighter than it appears on TV. Watch any talk show or sitcom and you'll see that no one casts a significant shadow, barely any shadow at all (a living metaphor that Jungians can have fun with). For people to cast no shadows, no matter how they move, lots of light is required; banks of lights overhead, pointed every which way. Performers (talk-show hosts, actors, newscasters) are used to all this light, but watching TV can't possibly prepare the uninitiated for the bright reality of a soundstage. Dr. Phil's patients/guests--mostly working-middle-class folks from all walks of life--are like deer in the headlights. (Imagine walking into a consulting room and squinting into a thousand-watt spotlight.)

 

To that unnatural brightness, add a live studio audience. The vast majority of workaday people have never addressed a large room full of strangers. Nothing can prepare most patients/guests of Dr. Phil's for walking onto that soundstage, where their intimate problems will be the subject of "entertainment" and "information," to crib from DrPhil.com's disclaimer.

On that stage, the patients/guests interact with a consummate performer, who's also what we call "a star." They've already invested him with tremendous authority or they wouldn't be there. They've relinquished their privacy in return for his help. Now, under the bright lights, in front of rows of peering strangers and with Dr. Phil himself, they must make their stand. By definition, they're troubled. Now they're also surrounded and outnumbered. Can healing possibly take place in such an arena? What could be further from the environment and process of therapy? Yet these people think they're going to a doctor.

Any TV program, by virtue of its repetition, partakes of ritual. Quiz show and sitcom, newscast and episodic drama, talk show and sports show, each establishes a format and rhythm, enhanced by repetitive theme music, which creates a particular signature. A prime pleasure of television viewing is to sync in with the ritualistic repetitions of each favored program, surrendering to the (usually narrow) spectrum of responses that the program dependably, predictably elicits. A successful program achieves its own defined space, which it repeats and repeats and repeats. Each program is, in an archetypal sense, a kind of Mass, with its own particular and peculiar Communion. You know what's going to happen before you get there, though you don't exactly know--and this knowing-but-not-quite-knowing sustains both the comfort level and the interest.

Dr. Phil's TV show works this form masterfully.

To appear on the show, you send Dr. Phil a home video in which you reveal your troubles. If he and/or his staff chooses your video, they interview you on film, and sometimes place cameras in your home to watch your troubles firsthand and collect clips to be aired on the program. If they decide you're telegenic enough, you're invited on the show, where your average screen time with Dr. Phil is eight minutes (though subjects that are especially telegenic get more).

 

In those eight minutes, your situation is presented and analyzed, a solution is proposed, and you agree to it--cue up the applause! Dr. Phil has famously said, "I've never been under the impression that we're doing eight-minute cures on television." One wonders if the same can be said of his audience or his patients/guests, since he works so hard to give them precisely the impression that he can cure them.

In any case, viewers know when they tune in that they'll see footage of people much like themselves, beset with various dilemmas, and the footage will conclude with the cry, "Help me, Dr. Phil!" The subjects will be trotted out, talked to and talked about; various products will be hawked. And as the show ends, Dr. Phil will stride up the center aisle, to be greeted by his wife, and the two will walk off hand in hand while the audience applauds. There are variations in the middle, but the beginning and end are invariable.

Such is the essence and core of Dr. Phil's house call.

The opening footage of the first Dr. Phil Show I watched was calibrated to excite fear and disgust in whoever watched it: "nanny-camera" shots of babysitters beating and abusing infants and small children. The viewer couldn't help but think in terms of "monster" and "victim." Monsters and victims are common enough in our world, but in the consulting room, both are subjects to be understood. On the tabloid screen of Dr. Phil, both are excuses for titillation. After overwhelming viewers with this footage, Dr. Phil inserts, with all possible seriousness, "We're not saying that everyone's at risk." What he ­doesn't say is that there are millions of babysitters, nannies, and day-care workers, and only a tiny percentage of them are abusers. He also doesn't say we live in an economy in which many mothers have to work and have no choice but to employ the services of care providers. Instead, he makes working mothers feel guilty and frightened for a choice they can't avoid.

Immediately after his not-everyone's-at-risk qualifier, he shows staged "docudrama" footage of a true case: a 2-year-old who drowns because of a babysitter's neglect and bad judgment. The footage is far more powerful than the disclaimer. What can it do but excite--and excite is the proper word--guilt and fear in any insecure parent employing a babysitter? Meanwhile, on his soundstage, women who've lost their children to negligent providers, or whose children have been injured by same, sit unhappily in uncomfortable chairs.

 

What does Dr. Phil say to these grieving, piteous women? With the earnestness of a preacher and the authority of a cop, he tells them, "You've got to turn this thing around. Time heals nothing. It's what you do in that time that begins to heal the loss."

All the poor women can do is nod and, haltingly, agree.

Then Dr. Phil mixes good sense with vague sentimentality, both spoken in that preacher-cop delivery that makes you hang on his every word, never quite knowing whether you're about to be redeemed, arrested, or both. Good sense: "How much you loved that little boy isn't measured by how much you suffer." Vague sentimentality: "You can honor his life by doing a couple of things . . . by finding meaning to your suffering . . . something good has to come of it . . . I don't know what it is for you, but if you use the experience in some way . . . ." What could be more vague, in this context, than words and phrases like "meaning" and "something good" and "in some way"? Even Dr. Phil admits, "I don't know what it is for you." Then he says: "Do you think you're ready to try that?"--as though his "that" is something concrete. They nod. "I'll get you some good professional grief counselors, will you do that?" At last, something concrete. They agree, numbly, their faces set in baffled depression.

But Dr. Phil has just made an interesting admission. They need therapy, which isn't what he does. What he does is spectacle. For isn't it lascivious fun to watch other peoples' embarrassing miseries?

And it works. All our buttons have been pushed; we've been treated to a televised tabloid spectacle designed to arouse one basic feeling: fear. Fear of our surroundings, our neighbors, our world. And fear, as Dr. Phil knows, is a profitable commodity. So he introduces a woman who heads a company that installs nanny-cameras. She describes the price range of her installations and services. Money will change hands. Which hands, we don't know. But the object of the program has been to get fearful parents to spend money--and to spend money on something his guests and viewers probably don't need. What those women really need, even according to Dr. Phil, is grief counseling, i.e., therapy--personal, professional contact, committed to the slow, grueling process of learning to live with tragedy. But that fact gets lost in the program's emotional bath.

A guest's need for therapy is never the message Dr. Phil's viewers are left with. The image the show imprints is that of a tall Texan brimming with certainty--not unlike the present occupant of the White House--who has all the answers and is never wrong.

 

The Healing Power of Celebrity

For some years now, well before Dr. Phil came on the scene, television has thrived on shows featuring the public exposure of privacy: courtroom and discussion programs in which people from all walks of life--usually, though not always, people of the lower middle class--expose their most intimate difficulties, often in raucous settings. Couples quarreling, mothers and daughters fighting over the same lover, abusers and abused, all indulging in a kind of public celebration of humiliation. What would be anyone's motivation for exposing themselves in this way? Clearly, to be on TV confers a sense of reality and importance upon their lives--for in their subcultures, what's important is on the TV. To be on TV is to be real to oneself; it's to have one's existence confirmed by this culture's arbiter of existence. This is the syndrome on which Dr. Phil thrives.

In fact, he's unthinkable without it. The people who send him videos ("Help me, Dr. Phil!"), as well as those who watch, are counting on the healing power of celebrity itself--the authority of celebrity in our culture. To be closer to celebrity is to be closer to power, and is, symbiotically, to be more powerful. In that sense, Dr. Phil is a magic act, a witch doctor if there ever was one (shaman is the polite word). He confers a whiff of his celebrity upon the people he displays, and, in this form of teleshamanism, that's supposed to effect some measure of cure. His patients/guests hope to feel more real, more worthwhile, by being more of a celebrity and rubbing up against celebrities. They're on TV so they must be important--their shift from anonymity to celebrity will somehow magically help solve their problems.

Dr. Phil is an ¨uberelectronic daddy-figure, and his audience his children. He creates a relationship that's mere mystification. You can have no relationship with a human being named Phillip McGraw. You're "interactive" (as the fashionable phrase goes) with an image called "Dr. Phil"--psychology's Barbie Doll--on which you can project all the help you crave.

A show devoted to two boys obsessed with sports--basketball for one, football for the other--demonstrated perfectly Dr. Phil's ability to use his guests to display his particular brand of teleshamanism. Both boys had good grades in elementary school, but now, in the early stages of high school, they do nothing except play sports, and their mothers are desperate. Before introducing the first boy and his mother, Dr. Phil endorses and heavily plugs the movie Coach Carter, to be released later that week. He even shows clips. The movie depicts the true story of an inner-city high-school coach who, by all accounts, had a tremendously positive effect on his young players.

 

Then Dr. Phil introduces, to the adulation of the audience, the actor Samuel L. Jackson, who plays the coach. Then the real Coach Carter comes on. It's no exaggeration to say that the studio audience beams in all this reflected "star"-light--a TV star, a movie star, and a real-life guy who's so great they made a Hollywood movie about him. The screen fairly shimmers with celebrity-power.

Into this highly charged environment comes a terrified boy (the basketball kid) and his almost equally intimidated mother. The boy is convinced that he's going straight from high school into the NBA, though he admits he's not an exceptional player, not the best on his high school's team. In short: he's delusional. "When I can't play basketball," he says, "it's like I'm a drug addict." The kid himself makes the connection between basketball and drugs, but nobody picks up on it. That would be too much like therapy. Never is it suggested that the onset of adolescence and the slow realization of the kind of world he'll soon be asked to confront on his own has terrified this boy so deeply that the only place he feels safe is on a basketball court, and the only safe and meaningful future he can imagine is as an NBA player, shielded by money and celebrity from the rigors of the world.

This child is now harangued by Samuel L. Jackson, Dr. Phil, and Coach Carter, who lets slip the only cogent sentence of the hour: "You can't solve a problem on the same level as the problem."

Tell that to Dr. Phil.

 

The quips of the movie star and the star therapist get immediate audience applause, while the kid stares into the TV monitors on the soundstage with a fixed look. Of course he agrees to anything they say to him. What choice has he? How many frightened high school kids could stand up against all that star-power?

And Dr. Phil's solution to the boy's problem? A video is shown of a player on the same team as the boy's hero, telling him how important school is. Then he's told that if he gets his marks up, he can go to an NBA play-off game and meet his hero. Nobody displays the least interest in what the kid actually feels, or recognizes that he's feeling anything at all. Everybody tells him what to do, and he just nods agreement.

In the next segment, the football-obsessed kid, who thinks he'll be drafted into the NFL directly upon graduation, gets the same treatment. Then both boys are given jerseys identical to those of their heroes and assured that, if their marks go up, they'll get to meet their heroes. The problem is being addressed on the same level as the problem (and isn't that the essence of "self-help"?). But in reality, the problems of those boys aren't being addressed at all. They may be coerced into getting better grades, but how will intense exposure to the object of their delusions do anything but deepen their delusional desires? How does this "treatment" address their fears?

They sit there, beside their mothers, with the jerseys on their laps and their problems "solved" by superexposure to celebrity of every conceivable variety. How this might help families watching who have the same problem isn't addressed, and with good reason. And what's actually happened? Two terrified children have been exploited for the promotion of a movie.

One might well ask why the studio audience doesn't rise up in arms about such exploitation. But like the "guests," the studio audience has a great deal invested in Dr. Phil. They're invested in seeing the show they expected to see--the ritual they're accustomed to, enacted for their benefit, in their presence. If they didn't believe in the efficacy of Dr. Phil, they wouldn't be there. It would take an exceptionally self-possessed person to get disgusted and walk out, and the camera--the all-seeing eye of the program--wouldn't record their exit.

 

And yet, and yet . . . I wonder about Dr. Phil. His sincerity seems unfeigned. While it's hard to believe that he's oblivious to the crassness of his enterprise, it's equally hard to believe that he ­doesn't intend good. Nevertheless, meaning well doesn't excuse his means. A therapist friend said to me, "The show isn't cynical." Sorry, no. The show is cynical. Deeply and fundamentally cynical. It's cynical in direct proportion to how much it pretends not to be cynical.

Whether Dr. Phil himself is cynical--that's another issue. He may not have had the patience to practice psychotherapy, as he's famously said, because he may sincerely believe that digging into the depths is a waste of time. That's surely a defensible position. But the show is a different matter. Not only does the show ignore the depths, the show ignores the danger signs. Further, the show goes out of its way to ignore danger signs. That's cynical.

The Depths of Shallowness

Addressing a problem on the same level as the problem, and thereby deepening the problem, is one of Dr. Phil's formulas. Case in point:

 In January, Dr. Phil displayed six overweight women desperate to slim down to fit into their wedding dresses. In fact, some of them had scheduled their weddings at least once before, but canceled because they felt too overweight to walk down the aisle. Dr. Phil treated this strictly as a weight problem. The idea that they might not be losing the weight because they were frightened of getting married never came up.

These women were presented as "contestants," who, if they met Dr. Phil's weight-loss goals, would win upgrades of their wedding rings and many other gifts. "I'm going to throw every resource I have to help you lose the weight." "This isn't about willpower, it's about programming." "The wedding day is often the biggest day of a woman's life. All eyes are on her. Now there's a big problem if she's--too big." The implication being: her family and friends, and his family and friends, can't love or approve of her unless she's of an acceptable size.

 

Dr. Phil doesn't know or care or question why being fat is such a shaming thing in America, or why it's unhealthy. He's content to exploit the culture's loathing of fatness (even while we're a culture of fatties).

What does Dr. Phil tell these fleshy women? "The only way you can fail is to stop talkin' to me. 'Cause if you keep talkin,' I'm gonna keep pushin'." Dr. Phil says outright that he's The Answer. He's The Guarantee. His claim is to be Therapy personified. "The only way you can fail is to stop talkin' to me."

And the audience is delighted at the announcement that a copy of Dr. Phil's bestselling weight-loss book is under each and every one of their seats. Almost as an afterthought, he informs us all that the book is "out in paperback now, by the way." By the way, indeed. Of course these women should lose the weight; obesity, some studies show, is as unhealthy as smoking. But health is barely mentioned, much less stressed.

It's about fear. And it's about money. This program not only played upon the fears of these women--and of the millions like them viewing at home--but Dr. Phil used his considerable charisma to reinforce their fears and their shame, so that millions more would buy his book.

Dr. Phil may be sincere. He may himself be stuck in the illusions that he's selling. But the show isn't about therapy. It's about selling. And its immense popularity is, in large part, about buying. Dr. Phil exploits a consumer society's delusion that you can buy something--a book, a pill, a "programming" regimen--that'll fix your broken, sad life.

 

What may the Dr. Phil phenomenon mean for psychotherapists?

In one sense, nothing. Patients walk into your consulting rooms every day beset by illusions (as I certainly have), and Dr. Phil, if he comes up at all, is just one more illusion you need to help them through.

In another sense, a lot. Dr. Phil is the opposite of you. With, according to his website, 22 million books in 37 languages, countless hours of internet log-ons, plus (when you include reruns) an infinite number of television hours worldwide, he takes his viewers and readers to the limits of simplification. If they need to go beyond the banal and simple, they need you. Which is to say, they need the patience to be patients--they need the gradual fix, the personal touch. The working therapist is everything Dr. Phil isn't.

So the most famous psychotherapist in the world is the most famous therapist in the world precisely because he doesn't do therapy. And therein lies the secret of his phenomenal success. Therapy is personal, and messy, and takes time. What Dr. Phil sells is standardized, and efficient, and takes eight minutes. Therapy is expensive, and insurance covers less and less of it. Dr. Phil's website and TV show are free, and you can purchase the books at a discount at Border's. You can buy Dr. Phil, or click him on your remote. Your assumptions and defenses can remain intact, because, unless you're one of his unlucky guests, you're always at a safe distance from him. Therapy is serious work. Dr. Phil, by his own disclaimer, is entertainment--given that you're entertained by the heartbreak of strangers.

"Get real," counsels Dr. Phil.

But, alas, those two words take us back to where Dr. Freud began: What is the nature of human reality? What does it really mean to "get real"? And then the complications start. And where complications start, Dr. Phil stops.

Dr. Phil--the Anti-Therapist.

Michael Ventura's biweekly column appears in the Austin Chronicle . Letters to the Editor about this article may be e-mailed to letters@psychnetworker.org.