Lights! Camera! Analysis!

Welcome to the anxious world of a "Checker," now ready for his or her close-up. The rise of reality television programming has signaled an influx of shows that shine a spotlight directly on such psychological issues. A number of alumni and faculty of the Pepperdine Graduate School of Education and Psychology (GSEP) have been right at the forefront of this emerging trend on the shows Obsessed,Sex Rehab with Dr. Drew, andThe Colony.

John Tsilimparis, an adjunct professor of marriage and family therapy at GSEP, sees this development as positive progress for the field of psychology. Psychological disorders of all shapes and sizes have traditionally been kept hidden in the shadows; no one wants to be thought of as strange or, even worse, crazy. He particularly sees this fear of stigma in the patients with anxiety disorders he treats on the A&E show Obsessed, which features people struggling with obsessive-compulsive disorder (OCD), panic disorder, and social anxiety disorder.

“I’m on Obsessed for many reasons, one of which is that I hope the exposure might help normalize anxiety disorders—right now they’re mostly seen as character flaws, or personal weakness,” he says.

Tsilimparis understands how debilitating an anxiety disorder can be. He suffered from panic disorder as a child and in his early 20s, while he worked as a photo editor in his hometown of Manhattan for several major, weekly magazines. Becoming a therapist and now using his expertise on Obsessed allows him to give hope to those going through similar experiences. “I found my purpose, and hopefully the show provides education about OCD and addiction—the more people are educated, the more the conditions become normalized and destigmatized.”

His first patient on the show was a “checker” whose nightly four-hour routine was limiting her ability to lead a functional life. Her disabling fear of danger stemmed from the trauma of losing her father in a freeway accident years earlier. Cameras rolled as Tsilimparis led his patient through intensive cognitive behaviorial therapy (CBT) sessions, including the process of easing her back onto Los Angeles freeways after years of sticking to side roads.

“In terms of the techniques and interventions I use as a therapist, working on this show is no different from private practice,” notes Tsilimparis. The biggest difference, he says, is the strict time frame of television; he had just three months to work with his “checker.”

Jill Vermeire, a 2002 alumna of the GSEP marriage and family therapy program, has an even more limited time frame with just 21 days to treat her patients on the VH1 show Sex Rehab with Dr. Drew. The show portrays celebrities trying to overcome the ultimate taboo of addiction: sex addiction.

“I had my reservations about reality television because it can be so contrived,” admits Vermeire, who was recommended to producers by colleagues. She finally came around to the idea after learning that a clinician she greatly respects, Dr. John Sealy, would be a consultant to the show. That turned her mind to its possible benefits. “I realized this was a way to start bringing the addiction into public knowledge, and so I thought I’d take a chance on it. I was very aware that there could be criticism, but it was an opportunity to do something that had not been done before.”

One of the biggest criticisms of reality television is the complaint that it often doesn’t seem very “real” at all. Since the Dr. Drew show features relatively famous people, including former Miss United States Teen Kari Ann Peniche, Saigon Kick drummer Phil Varone, and surfing star James Lovett, Vermeire knew that the extra exposure offered by the show would be a likely draw for its participants.

“But my theory about addiction recovery is to just get that person into rehab, no matter what their motivation is for seeking recovery,” she says. “Most of our patients on the show, I think, are motivated because of the television aspect and to help their careers but, even if they don’t realize it, a large part of them really wants help. I still see a lot of them and they’re still committed to the process without the cameras.”

While the issues raised in Sex Rehab are very personal, Miatta Snetter, who earned her master’s and doctorate of psychology at GSEP, sees the mental health reality television phenomenon as having more of a “living vicariously” appeal than a voyeuristic one. Viewers who suspect they have a problem might benefit from advice and techniques offered by the shows, while those with a suffering friend or relative can persuade that person to watch the show or seek help.

“It’s a wonderful opportunity to allow psychology to enter people’s homes in a different way,” says Snetter. “I think viewers are looking for answers. The natural state of humanity is to pursue information, and psychology brings answers and information about improving your current condition.”

“We show viewers that they’re not alone,” agrees Vermeire. “My patients and viewers are grateful that someone is putting a name to their problem, which hopefully takes away some of the shame of the addiction.”

While viewers are able to see Tsilimparis and Vermeire treat individual patients with specific, personal, and, yes, sometimes shameful problems, Snetter is part of a different trend that is emerging in the media: survival psychology. An expert on trauma, she was thrilled to be invited to give expert commentary to the Discovery Channel’s 2009 show, The Colony. The “social experiment” featured 10 ordinary Angelenos who were asked to survive and rebuild a community in the wake of a simulated global catastrophe, adding a psychological twist to the genre of popular survival shows, such asSurvivor andMan vs. Wild.

The group had to learn new, basic skills, and cope with an enemy group of survivors. The show invites viewers to ask themselves ethical questions about the fundamental aspects of coping with survival, such as what choices would you make to save your family? Would you steal or scavenge? Hide or ambush? Sacrifice—or murder?

“As a clinician and mental health professional, I’m most interested in how individuals are able to tap into resiliency factors during a stressful event to survive and even excel under these conditions,” Snetter explains.

She began her career treating veterans with post-traumatic stress disorder, which is very often suffered by victims of catastrophe. “The show raised a number of things about the human condition and our response when under a great deal of uncertainty. We all feel more comfortable with predictability, and will do whatever we can to create comfort and predictability. By watching a TV show or movie about survival, viewers can question their own instincts without actually experiencing that dangerous situation.”

It all comes down to preparedness. Be it the possibility of someone you love becoming an addict, or a child being diagnosed with schizophrenia, or the “big” earthquake finally hitting Southern California, watching shows that address these things can provide comfort and, more importantly, information.

“In the same way that people are turning to the Internet for information, therapy in the media is changing and there’s a real hunger for shows about this,” says Tsilimparis.

Since reality television is still fairly new, the ethics of psychology practice within that genre continue to be discussed and evaluated. Pamela Harmell is a lecturer in psychology at GSEP, former president of the Los Angeles County Psychological Association, and an expert about ethics in psychology. While she agrees that mental health on reality television can and does raise awareness and educate viewers about conditions, she is concerned about sensationalizing the conditions.

“There’s clearly no breach of the confidentiality code when a person agrees to waive their right to that confidentiality, but instead of getting the help they need privately in an office they’re doing it publicly with a certain amount of self-consciousness,” says Harmell. “You can’t help but know the show needs viewers so they also need extra drama or a hook, like an affair or something sensational.”

Vermeire, who has also appeared as an expert on Nightline, Extra, Access Hollywood, andOprah, counters that argument, saying that the scenes of real clinical work and treatments are often simply left on the cutting room floor in favor of the more dramatic moments. “I have no say in how the show is edited and I don’t think producers think those parts are entertaining so, no, you’re not going to see it. Television relies on ratings.”

She adds that while Dr. Drew himself warned her that she would need to make peace with the fact that it’s a TV show first and foremost, she sees no reason to dumb anything down for the general audience.

“My feeling is that if they showed more healing and therapy techniques, the ratings would still be as good. But I always remember that even if one person watching is helped, then I’ve done my job. And I believe a lot have been changed significantly.”

Tsilimparis thinks back to the “checker” on his first episode of Obsessed. She began the show as acutely symptomatic, he says, but her treatment went “very, very well.” She spoke about how her lifestyle has completely changed during an appearance on a different kind of “reality” show,Larry King Live, last December, when therapist and patient appeared together to discuss anxiety disorders.

Her successful recovery speaks to the heart of what Tsilimparis, Vermeire, and Snetter do as professional psychologists—they try to improve lives. None can deny the dynamic is different when a camera is added to the therapy mix. But ultimately, helping patients make positive changes to their lives while showing viewers what therapy and psychological practice can make possible is what they all strive to scratch off their own personal lists. Check!