Film Review: The Therapeutic Relationship in "Stutz"

Recently, a friend called and said, “You have to watch the film Stutz. I can’t wait to hear what you think.” I was intrigued and thrilled to have a new Netflix recommendation.

Stutz is a documentary featuring a successful psychiatrist in LA and his patient, Jonah Hill, actor, comedian, and filmmaker. Spoiler alert: This film guides viewers through an inside look into really good therapy. I did not expect, however, to see it with a psychiatrist in this way, and certainly not on Netflix.

For confidentiality reasons, it is rare to observe real-time, individual therapy sessions. Furthermore, I have never seen the psychoanalytic dialogue turned around to focus on a doctor’s personal struggles. The film presents a radical shift from traditional psychiatric care to include reciprocal healing for both doctor and patient through Stutz’s tools and unexpected emotional intimacy. I watched with wonder as Dr. Stutz, and Jonah exchanged “I love you” sentiments. Was this a wise move for Stutz?

The format of this documentary calls into question some professional and ethical codes of conduct. Was Stutz still treating Jonah while making this film and potentially profiting, at least in terms of notoriety? Was the blurring of boundaries (i.e., the therapist part of a business venture and sharing personal aspects of himself) appropriate and ethical?

The American Psychological Association guidelines about dual relationships echo what most professional bodies uphold:

A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist’s objectivity, competence, or effectiveness in performing his or her functions as a psychologist or otherwise risks exploitation or harm to the person with whom the professional relationship exists (APA, 3.05, Multiple Relationships).

Also,

Psychologists strive to be aware of the possible effect of their own physical and mental health on their ability to help those with whom they work (APA, Code of Conduct, Principle A).

While there were potential risks, I support Stutz’s decision to make this revolutionary film. I recommend it as a “must-see” for adults, older teens, and counselors from all disciplines. Stutz successfully demonstrated how his vulnerability, authenticity, and transparency invited the radical notion of mutual healing. Could this become a new trend?

I believe that we heal through our relationships, the origination of our human struggles. In my experience, optimal transformation cannot happen alone. It takes the mirror, inquiry, support, and compassion of another to make lasting shifts in thoughts, feelings, and behaviors.

Stutz demonstrated the extraordinary power of the therapeutic alliance for both doctor and patient through an honest, open, albeit edited and directed working relationship. In my opinion, the cognitive behavioral and mindfulness tools, creatively conveyed with catchy directives and animation, were secondary to the reciprocal, trusting relationship.

There were distinct areas of traditional psychiatry missing from the film, and other non-traditional aspects were included that made Stutz engaging and brilliantly effective.

What was missing from Stutz that is usually present in traditional psychotherapy?

(I assume some of these were discussed off camera).

• No identification with symptomology or diagnoses. We did not hear the typical client phrasing about mental status (i.e., “I’m depressed” or “I’m an addict”).
• Limited distinction between the roles of “doctor” and “patient.”
• No discussion of medication or a medical treatment plan.
• No traditional desk, diplomas, steno pad, couch, or hierarchy is demonstrated in the seating arrangement.
• No one asked the stereotypical question, “How does that make you feel?”

What did we see instead?

• Stutz openly shared his personal challenges. While this is important to any healthy relationship, therapy usually involves minimal sharing by the treatment provider and only where it benefits the client.
• Stutz allowed the roles to be reversed, which is rare. Therapists do not invite clients to nurture, probe, or confront them as they process their own difficult emotions. That’s a big professional “no-no.” Stutz seemed proud as Jonah confronted his cognitive dissonance and deflection when attempting to make jokes to avoid his feelings. The irony was palpable as a comedian told his doctor to stop telling jokes.
• The film highlights the universality of the human experience. As Stutz says, no one is exempt from pain, uncertainty, or the need to do the work. Stutz reminds us that there is constancy to the work of peeling back the layers of misgivings, mistakes, and misunderstandings in our lives while moving into new levels of freedom and choice. Stutz modeled how he accepts reality as he shakily drew his stick figures, napped on set, and contemplated his dysfunctional childhood and Parkinson’s disease.
• Both men had distinct familial messages about being men that left them insecure about dating. These revelations invited candid emotion and empowered action. During the credits, Stutz revealed that he reached out to a love interest. I found myself applauding (literally) these men for the renewed hope and confidence they activated in each other. I believe in their rights to a healthy and happy ever after while continuing to do the work, of course.
• Stutz utilized non-traditional therapeutic strategies, including a heart-expanding visualization and concrete, visual cognitive behavioral cue cards to communicate his theoretical interventions. It was inspiring to observe a psychiatrist offering a meditation on love.
• The set included two chairs in proximity.
• Both men shared their feelings about each other, stating, “I love you, I’ll miss you, and I don't want to lose you.” This is not the norm in psychiatry–ever. I commend Stutz and Jonah for owning and communicating their emotions.

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This multi-layered, transparent, novel, and loving healing process (done very carefully) might be the perfect prescription for the emotional and psychological aches that have become endemic to our society today.

My Wonderings

• Where does this leave the ethical boundaries in the helping professions?
• Can we support more blurry lines in regard to therapist sharing?
• Can therapists say “I love you” to clients and support them with their own self-reflection, self-discovery, and vulnerability?
• Can love and healing be discussed, taught, and modeled through collaborative, contemplative, and reciprocal exchange in therapy?

Hmmmmmm…

To find a therapist, visit the Psychology Today Therapy Directory.