Media Portrayals of Psychotherapy, Part I: The West Wing

"I didn't earn a doctorate in clinical psychology just so I would have to wear a tie to work." Stanley Keyworth (Adam Arkin) is the supersmart-smug-arrogant psychotherapist. He's real fast with the interpretations, but this is television. I've used the "you can probably stop trying to win the approval/love of your (dead) father/mother, because it's never, ever, going to happen" line dozens of times.

 

 

 

Dr. Philm

"In this episode of The West Wing, Psychiatrist Stanley Keyworth (Adam Arkin), the man who treated Josh (Bradley Whitford) for trauma after the shooting incident, is brought in to address President Bartlet’s post-Iowa insomnia.

This TV session between shrink and patient begins simply. President Bartlet hasn’t slept in 4 nights. Dr. Keyworth runs through initial questioning, intended to reveal any potential physical, lifestyle or environmental factors affecting the President’s ability to sleep. Is there too much too much light in the room? Are there temperature fluctuations? Any noise?

Planes flying overhead are ruled out (planes are not allowed to fly over the White House).

Finding nothing of use he moves on to psychological factors, such as stress. Is there any stress in Barlet’s job?

President Bartlet explains, matter-of-factly that,  “Well, congress was investigating me. And I was censured. Then I had to give the State of the Union. I’m running for re-election, things are blowing up everywhere and I’ve chosen the general assembly of the U.N. to define a tougher foreign policy. Not unusually stressful, no.”

Despite the atypical specifics of Bartlet’s job, Dr. Keyworth is determined to treat him as any other patient.

When Bartlet scoffs at Dr. Keyworth’s $375/hour bill rate, and evades questions, Keyworth replies with what he states he’d “say to any other patient”: 

“… screw around if you want, but it’s your money. It’s about to be my money, and I sleep fine.”

Bartlet begins to open up from there, revealing issues with his father; childhood abuse and his lingering desire for his father’s never-attainable approval. 

Keyworth makes note that Bartlet is graded on a “hell of a curve” these days. “Lincoln freed the slaves and won the Civil War.”  And he did it even though it meant losing half the country.  

Are Bartlet’s actions based on what he feels is right? Or are they for sake of national – and paternal – approval?   

Is the discontinuity between his actions vs. what he knows to be “right” keeping him up at night? 

The 2-hr (double) session ends, at the declaration of Dr. Keyworth. The President expresses shock and states that they are done “when he says they are done”. Dr. Keyworth makes it clear that, in this case, that’s not how things will work.  He intends to be, as he explains to the President, “the only person, in the world, other than your family, who doesn’t care you’re the President.” 

For TV psychiatry, a remarkable amount of time is spent with the Dr. questioning and listening. Dr. Keyworth begins to deliver analyses only during the last 3rd of what we see in the session. Premature in real life. But impressive for a TV portrayal."