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We Asked a Therapist How Real the Shrink-Patient Relationship Is in Big Little Lies

Dr. Reisman takes some drastic measures, after all.

Roni Jacobson

Image: Hilary Bronwyn Gayle/courtesy of HBO

In the penultimate episode of Big Little Lies, Dr. Amanda Reisman, played expertly by Robin Weigert, pushes Celeste harder than ever before to leave her abusive husband, Perry.

Celeste is outraged. "I don't think a therapist should be this...I don't think you should be behaving like this," she says.

"I'll get you the number of the Better Business Bureau; you can report me," Weigert retorts. "In the meantime..." and she proceeds to guide Celeste through making plans to get out.

I wondered: Is that really how marriage therapists handle abusive relationships? Celeste (Nicole Kidman) was right in assuming that in marriage counseling (and therapy in general), a therapist typically takes a somewhat passive role, interjecting with the right questions at the right moments, prompting clients to come to their own realizations and insights about their problems and how to solve them. But cases of abuse necessitate a different, more expedient tack—one that the therapist in Big Little Lies appears to have been using, and that happens in real life, too, according to an actual therapist.

Couples who are in an abusive relationship "almost always" try to hide that fact about their relationship, says Jason Whiting, a professor of marriage and family therapy specializing in domestic abuse at Texas Tech University. Instead, Like Perry and Celeste, they usually say they are "having communication problems," or "will downplay the violence and describe it as just fighting," Whiting says. Whiting separates couples into two types: those who simply have conflict resolution problems that manifest in aggression, in which case either partner (in heterosexual relationships) can be the aggressor, and what he calls "intimate terrorism," the type of abuse we typically see in movies and television, which is primarily about control. This type of abuse is 90 percent male-on-female. The abuser will generally try and put on a good front, "or be charming, minimizing or denying," and say things like, this is "our problem, not mine."

Despite the abuser trying to cover their tracks, a trained therapist can usually spot an abusive situation fairly early on. In general, however, even for couples who are not violent, it is good practice to separate the pair and interview them separately, at least in the beginning. It is usually in these individual sessions that patients reveal more about the abuse.

At first, for reticent partners, the tactics are similar to traditional therapy. "If you ask them outright if there is violence in this relationship they will bolt," Whiting says. "But if you ask them more specific questions about what happens next," they are more likely to keep talking. This is not unlike how Dr. Reisman got Celeste to sit down when she was about to storm out the first time she was confronted about the abuse.

Still, it's always a fine line. "Most couples don't want to hear it," Whiting says. "You're not trying to push agendas onto them."

There is one situation in which the therapist would actively encourage the patient to leave. "Imminent violence is the line," Whiting says. "One of the main questions you would ask would be would be about safety. If they say 'I can't go home,' there may be a time when we say we need to get you in somewhere with family or friends or a women's shelter."

Dr. Reisman appears to have followed best practices when treating Celeste and Perry. Whiting recommends that someone in her position join a support group, which can often help people in denial recognize that what they are going through is abuse. He might also encourage her to "make a safety plan if things start to escalate"—something Dr. Reisman does when she tells Celeste to get an apartment and make sure the fridge is stocked. The safety plan is important not just to provide a safe space the person can run to when things inevitably turn violent, but also for getting them to leave in general. "Steps like that can help people face the reality of it and have a supportive or empowering experience," Whiting explains. Living with an abuser, you begin to doubt your own worth and ability to make decisions. Making a plan with a therapist can help give a person back that sense of control.

"Most people actually do leave abusive relationships—it seems like they don't because it can take a long time," Whiting says, adding that it often takes about seven tries for a person to finally leave. So in most cases doesn't take the abuser dying for the other partner to finally be free.

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