Pop culture references inform, improve cognitive behavioral therapy

DENVER – Pop culture references and metaphors in cognitive behavioral therapy improve therapeutic relationships and educates patients, according to a panel discussion at the Anxiety and Depression Association of America annual conference.

“In thinking about how we promote awareness of mental health and CBT in particular, why even use pop culture metaphors? What’s the point?” Kristin Szuhany, PhD, associate professor of psychology at NYU Grossman School of Medicine, asked other panel members.

“I do it because I like it; it’s fun,” Jason von Stietz, PhD, of the Cognitive Behavior Therapy Center of Southern California said, adding that movies, television and sports are an essential part of his leisure activities.

Von Stietz recalled growing up and needing something different from family history and anecdotes to serve as character-shaping tales. He recognized that pop culture is rife with stories people care about, which bring about strong emotions and which people learn from and try to emulate. As a result, these stories can help ease fears of those resistant to treatment, as relating to pop culture can be a valuable shared experience between therapist and patient.

“In process-based treatments, as long as you have these core components (of therapy), it gives you a lot of freedom to convey those principles. In architecture you can use a metaphor to introduce a rationale, you can use it to introduce a concept, and for patients, you can use it for media,” Simon Rego, PsyD, ABPP, of Montefiore Medical Center in New York said.

Rego added that songs and lyrics from movies and television are also excellent tools from which to embed therapeutic principles or practices, though it can backfire as a particular “earworm” may hinder the necessity to shift from one reference to the next between patients.

Delving into pop culture is a good entry point for introducing topics that can be difficult for patients to discuss, and serves as a counterpoint to “death by Powerpoint,” Jessica Stern, PhD, from NYU Langone Health said.

“It creates a safe space to broach a topic which can be uncomfortable, and research has shown us that humor can be beneficial, if intentional and well-placed,” Stern said.

She added that indulging in popular metaphors and references are a good way to humanize therapists as active participants in the world around them, to prevent too much personal disclosure and to better connect with patients.

“I love TV and movies,” Szuhany said. “And now, we have heard several strategies to adapt our therapeutic process to meet our patients’ needs.”