This is a project about images of therapy and how they influence people, featuring an essay and gallery of drawings.
Therapy spaces
I remember a discussion about how to sit in relation to a client when I did my core therapy training in the mid-2000s, but not how a therapy room might look. I consulted the literature about setting up a practice when I started my own in 2013. The consistent advice was to work in a room with little ornamentation, to give away as little of yourself as possible to avoid intruding upon the work. This view was reflected in conversations I had with others about the therapy rooms they had visited as clients, and my own experiences of therapy spaces. Indeed, the British Association of Counselling and Psychotherapy, the professional organisation to which I am affiliated, has things to say on the matter. In Setting up a therapy room, a 2010 BACP information sheet, Julia McGuinness cites an earlier paper by the Australian Institute of Professional Counselling and states:
Walls are best painted in pastel background colours – blue, green or cream – rather than agitating or aggressive primary colours such as bright red or intense yellow […] Decorating walls with a selection of pictures – evocative or abstract – may give information or indications about the therapist’s personal preferences, or prompt valuable client responses. Other therapists prefer a sparser environment with minimal distraction.”
Making it my own
I felt guilty at first because my therapy room is also my office in my home, it contains my archive and books, it is not a blank space, it is full of me, it’s dark and, for a long time, the walls were painted a deep raspberry pink. Then I felt angry at the assumption that a creamy blank space might be available to me, I recalled reading Stephen Grosz’ bestseller, where he describes what sounds like a very privileged workspace. I live in London where space is very expensive.
Over time I was comforted by images of therapy rooms that did not fit the anodyne brief. The excellent therapy I had in a woman’s front room in Hainault one time, where I appreciated her collection of colourful crockery. Freud’s workspace bristled with knick-knacks. In the Shadow of Freud’s Couch includes wonderful photographs of many unique therapy spaces. I started to reflect on what a healing space looks like and felt better about my own therapy room.
The idea of a therapeutic space devoid of personality is not necessarily ideal. I had some NHS therapy that took place in a windowless cell-like room with stained chairs and a panic button on the wall. It was certainly pastel-coloured but it was as grim as hell, the space felt coercive and neglected. I would bring in objects from home to try and cheer it up and anchor me during sessions. It occurred to me that the BACP advice overstepped the mark, this is consistent with their organisational hubris and entitlement and is based on culturally constructed value judgments. Those values are not mine. What had been presented in the literature as the gold standard therapy space is not a universal and informed truth; pastels are not for everyone!
Therapy culture
My thinking around therapy space décor prompted me to recognise that psychotherapy is a culture. It has norms, histories, guiding philosophies, and so on. These norms are culturally specific and reflect the usual class and race dynamics, but also the influence of medicalisation, underlying philosophy, public health economics and other factors. This culture is usually taken for granted, it isn’t dissected or named. I think that’s a shame because it would help clients a lot more if they knew what they were dealing with and if these underpinnings were explicit and not just assumed.
More recently I’ve become interested in what therapy looks like. Obviously it looks like a lot of things even though certain images of therapy resurface repeatedly. But I also think it’s hard to represent.
- Therapy is often idiosyncratic, despite efforts to standardise the process, which makes it hard to pin down.
- There are instances of people doing therapy in public to educate or entertain, but for the most part it is something that happens in private, confidentially, unseen. It happens within a relationship; how might one show that, the non-romantic intimacy of long-term work?
- It takes place over time, and that is hard to show too.
- More people are interested in therapy than when I was young, but there remains a lot of ignorance and fantasy about it.
New clichés are emerging and the relationship of representation to practice is dynamic. How do images of therapy contribute to the fiction that is co-created in the space? I’m curious about what therapy imagery shows and obscures, and how that relates to my own practice.
Drawing images of therapy
I found drawing very soothing during the first COVID lockdown in the UK, both on paper and digitally. I’m not “good at drawing,” my lines are wobbly, haphazard and naïve, not neat and tidy. None of this stops me! I was encouraged by Lynda Barry’s work, alongside the daily drawings produced by my friend Durbahn, and conversations with my own therapy clients about drawing and painting. Sometimes I draw with clients. I enjoy the rawness of my drawing, the humour and imagination, I like the process and the feel of making a drawing, it’s a pleasurable activity.
Method
To try and answer some of the questions I had about what therapy looks like and what that means for my practice, I decided to collect some images of therapy. At first I planned to share them on my social media without embellishment but then I thought it would be interesting and more original to draw them and see what came out of those drawings. I used a tablet and stylus and liked the simplicity of my line drawings and flat colour. I searched online with keywords, starting with stock images and then I went on to draw therapeutic concepts and influential people. Themes emerged, which I will list below. There were a few mistakes with picture resolution, which is why some of the drawings look a bit fuzzy. I didn’t resize anything. I ended up creating 104 drawings over several months.
By the time I considered a taxonomy of thematic colours for the drawings I had already gone too far into the project and didn’t want to re-draw a lot of images. Sometimes colour didn’t matter and sometimes it did. I drew white people as grey the more fed up I became of looking at them. The founding fathers of psychoanalysis I drew in pinks to try and feminise the patriarchy. I couldn’t bring myself to draw Freud’s eyes, I think I felt that this project is not for him. I often used pastel backgrounds in recognition of the BACP advice on therapy décor mentioned earlier.
Themes
Furniture: couches, fancy furniture and the cheap stuff, pebble pictures, tissues and plants.
Clipboards: always there whether I draw them in or not.
Celebrity Shrinks: experts who have all the answers.
Neorecovery: please see Recovery in the Bin’s definition of the term in the references below. I drew images that have been used to illustrate mental health, CBT, mindfulness, and medication.
Corporate: mental health organisational logos, drawn all wrong.
Anti-aspirational: a decommissioned mental institution, secure wards, a counselling van parked up by a market in Milton Keynes.
Feelings: depictions of anxiety and depression.
Group: hands, hair and eyes.
Boss Dads: therapy is feminine labour built on patriarchal foundations. I’ve included a daughter and a token woman.
Agony Aunts: Anna Raeburn, Claire Rayner, Denise Robertson and Marge Proops.
Pop Culture: a handful of the many representations of therapy in film and TV.
Trailblazers: people and a couple of publications that have influenced me.
My Work: what therapy actually looks like, my uniform and my workspace.
I played with the repetitive symbolism in the images, introducing absences to draw attention to particular things in the pictures. Sometimes I would draw the people and ignore the background, other times the background was more compelling to me, or the objects in the room. Sometimes I left out facial features, to focus on the bodies or the clothes. I enjoyed the mystery these interventions added to the drawings.
I noticed that hands were very important in these images, they are expressive and group work images seemed to be all about the hands trying to build consensus. Sometimes I just drew the hands and left out everything else.
I drew a lot of ageing flesh. Laughter lines, wrinkled skin, wild hair. Therapy is an oldster’s industry, thank god. The agony aunts were particularly satisfying to draw, I felt a new respect for these wise and glamorous women at the top of their game.
What the drawings of therapy revealed
The images of therapy expose so many fantasies about what a therapist is and does.
Therapy is aspirational
The founding patriarchs of therapy and the current crop of celebrity therapists ooze wealth and confidence, expensive watches, gravitas. Therapy is aspirational. Therapists advertise their spaces with pictures of fashionable furniture in tastefully-decorated rooms. Mid-century modern, Scandinavian lines, Eames recliners that cost thousands all crop up regularly in the imagery of therapy. These symbols sell a very thin view of success.
It’s an ideal that influences therapy interiors of more modest means through the ubiquitous Poäng bentwood and Tullsta tub chairs from IKEA, both of which are barely accessible to someone with a body like mine, and the tastefully dull photographs of pebble piles that, once you spot one, you find everywhere. Cheap things trying to look fancy. It made spaces that didn’t quite make it, maybe a room with the wrong sort of cushion, or a settee that is too saggy, feel subversive and exciting to me and I found myself drawn to anti-aspirational therapy spaces.
Therapy is for white middle class people
Black people rarely feature in images of therapy, despite being over-represented in the more coercive parts of the psychiatric system. Therapy looks like a world of white people in over-exposed photographs that make them appear even whiter, with all the white supremacist connotations of cleanliness, efficiency, expertise and business-like rationality that that visual tactic is trying to project. But pop culture is presenting black clients as a possibility, for example Arabella visits a therapist in I May Destroy You; Ellen DeGeneres comes out to her therapist played by Oprah; Blue Therapy presents a more racially inclusive view of therapy-as-entertainment. Working class people certainly suffer, but I couldn’t find representations of this demographic healing in therapy.
Therapy is the brain
The neoliberal public health discourse of “mental health” emerges through reductive therapeutic imagery of the brain and CBT diagrams. I could have built this project entirely on brain imagery, there is so much of it. But radical practitioners are warning about the reductive nature of this view, for example in Lisa Fannen’s study of psycho-emotional health, politics and experiences in Warp & Weft. Feelings are depicted in a similarly limited fashion, the head-clutcher stereotype predominates. In reality emotions are much more subtle and misery is often hidden.
Therapy is a clipboard
Therapists in stock images are often too young; they sit too close to their clients, which makes it look as though they have few relational boundaries; clients are mostly in repose; and they all hold clipboards and pens. I don’t know what the clipboard thing is about. Does it symbolise listening? Expertise? I have not encountered any clipboard therapists in my career as a therapist, apart from maybe an intake session.
Gallery: What Does Therapy Look Like?
References
Barry, Lynda. 2010. Picture This: The Near-Sighted Monkey Book. Montreal: Drawn & Quarterly.
Durbahn https://durbahn.net
Fannen, Lisa. 2021. Warp & Weft: psycho-emotional health, politics and experiences. Edinburgh: Active.
Gerald, Mark. 2019. In the Shadow of Freud’s Couch: Portraits of Psychoanalysts in Their Offices. London: Routledge.
Grosz, Stephen. 2014. The Examined Life: How We Lose and Find Ourselves. London: Vintage.
McGuinness, Julia. 2010. P16 information sheet: Setting up a therapy room. edited by British Association of Counselling and Psychotherapy. Lutterworth: BACP.
Recovery in the Bin, Edwards, B. M., Burgess, R., and Thomas, E. 2019, September. Neorecovery: A survivor led conceptualisation and critique [Transcript]. Keynote presented at the 25th International Mental Health Nursing Research Conference, The Royal College of Nursing, London, UK. Available: https://recoveryinthebin.org/neorecovery-a-survivor-led-conceptualisation-and-critique-mhrn2019/
Work with me
Drop me a line to find out what therapy actually looks like!