Phil McGraw has been the public face of psychology for the last twenty years, and America needs to take a long, hard look at his television empire to see what's right and wrong with how he portrays mental illnesses and their treatments. McGraw, aka "Dr. Phil", has had a syndicated television show for the past 18 years on which he invites guests to discuss their struggles with mental health and substance abuse issues.
McGraw got his start on Oprah, where he built up a national reputation as a no-nonsense psychologist who helped Oprah's guests face their problems. He had met Oprah while helping her on a lawsuit involving the Texas Beef Industry, and he quickly became a regular stable of experts that included Dr. Oz, Suze Orman, and others.
Before Oprah, mental health had rarely been discussed on national television, with the possible exception of Dr. Joyce Brothers, who made a name for herself as a guest on late night talk shows and with her own much more low-key talk show. Daytime television was still evolving in the 1990's, but shows like Geraldo, Phil Donahue, and Sally Jesse Raphael set the tone by inviting weird, disturbed guests onto their shows to make a spectacle of themselves and drive ratings. Some of it was staged and some of it was real, and the audiences rarely cared. It was voyeuristic looks at other people's problems, to make viewers feel better about their own struggles.
Oprah Winfrey changed the direction of daytime television somewhat with frank discussions about important issues like weight loss, sexual abuse, and marital problems. She bravely shared her own struggles with weight and childhood sexual abuse and invited celebrity guests to do the same. (Unfortunately, the freak show element of daytime tv eventually crept into Oprah's realm and that of all who followed her.) Dr. Phil came in and took over the mental health issues for daytime television, and found himself expanding his influence with his own show in 2002.
Doctor Phil's approach can generally be described as tough love. He uses his Texas sense of humor combined with a direct and tough questioning approach to break down many of his guests to get to the heart of the matter. This makes for engrossing television, but most therapists don't care for Dr. Phil's methods. The idea of making substantial progress on complex mental health issues while in a public forum like the Dr. Phil Show is unrealistic, but some viewers undoubtedly believe that this is what therapy is like. Dr. Phil does offer help to guests on his show for follow-up after the show ends, but he passes that responsibility on to others.
Tough love can be particularly effective on people with addiction disorder. Drug addicts, alcoholics, and other addicts are blinded by denial of their situation, and sometimes a tough, unrelenting interventionist approach is the only way to get them to see reality. That approach is extremely inappropriate for those with depression or anxiety, as it only forces them to turn further inward and feel worse.
There are many controversies that have come up related to Dr. Phil's show. (The list is long, but a google search brings up the highlights.) Some believe he's taken advantage of celebrity guests like Britney Spears, Shelley Duvall, or Todd Herzog to get bigger ratings. Staff on his show have been accused of enabling destructive behaviors of guests to get more interesting and dramatic shows. McGraw promotes many businesses on his show, some of which have been criticized for poor services, and many of which have ties to him or his family.
Some serious ethical charges have been lobbed against McGraw, including a dubious weight-loss program that he promoted and discontinued after reaching a $10.5 million settlement. His ex-wife accused him of being domineering, high-strung, and unfaithful, but his current wife has been with him for decades and is integral to his show. And his ex-business partner accused him of stealing materials from their seminar company, Pathways, that he later used on Oprah and elsewhere.
I recall when Dr. Phil first appeared on Oprah and found his no nonsense "How's that working out for ya?" appeal irresistible. I bought his books and watched his appearances for several years. I have no doubt he's helped many people, including his guests and viewers at home. But now after twenty years I have concerns that the fame has gotten to his head and the push for money and ratings has clouded his judgement.
Dr. Phil is one of the highest paid people on television, and his net worth is in the hundreds of millions of dollars. (He recently was criticized for accepting $7 million in forgivable loans under the CARES act for Covid relief.) He has a PhD in psychology, but gave up his license in 2006. His show is more and more a freak show for voyeurs to watch than a showcase of therapeutic techniques. There should be a huge disclaimer at the start of every show that this is NOT what actual therapy is like.
Daytime television today, (as well as prime-time "reality" television), suffer from a constant need for drama and compelling stories. Shows like Maury Povich and Jerry Springer still carry on the chair-throwing, shouting matches that audiences seem to like. My heart was broken this year when I found out that the one daytime personality I still admired, Ellen DeGeneres, was exposed as a mean, self-centered person who taunted some of her guests. There is something wrong with this medium, and I believe Dr. Phil is aware of that and exploiting it anyway. Live paternity tests may be riveting television, but why are we even taking part in such personal, nasty stuff?
Don't get your only mental health advice from Dr. Phil or any other television show. If you find something that helps you, great- but take it with a huge grain of salt. Seeing others struggling helps break down stigma if nothing else, (as long as you don't see it as making fun of them and turning them into freaks.) Don't take political advice from cable television pundits, medical advice from Dr. Oz, or financial advice from Jim Cramer. These guys are entertainers first, experts last. They live and die by ratings, and the things that produce ratings- celebrities, drama, violence, yelling, shocking surprises- don't necessarily help any of us.
In researching this, I sought out what actual therapists think of Doctor Phil. Groups like NAMI have criticized several of his shows, and most therapists I found think that he does more harm than good. He is not a medical or psychological professional anymore- he is a television personality selling a certain type of entertainment. Certainly there are some useful things that have come from his shows, but daytime television was never meant to provide meaningful therapeutic advice. Consult a real mental health professional if you want real help.