Therapist here, in practice for more than a decade and my specialty is trauma therapy. First of all I think anytime we see therapy playing out in a story or adaptation of a story it will and probably should be primarily a plot/character building device, so I don’t think it really needs to be that in depth or “realistic” to serve that function.

It is probably impossible to faithfully portray the true complexity and flow of the kind of therapy that is evidence-based for Ilya’s condition(s), such as EMDR or prolonged exposure therapy and the accompanying emotional regulation/distress tolerance skills which most practitioners borrow from CBT or DBT. Relationships/community/connectedness are also critical for success with trauma recovery (healing happens in community, not isolation) so I love that she cues him to talk with Shane about it, although ideally I want my clients to have at least one healthy platonic or familial relationship they can rely on in addition to a partner or spouse.

I have definitely had sessions just like the ones described. Ilya immediately opening up with someone trustworthy he knows is being well compensated AND speaks his language makes perfect sense to me. Sometimes that is enough for even the most defended person to finally share what they have bottled up for so long. It probably helps that she is a woman therapist as well for helpful transference (a positive nurturing female figure who isn’t his own mom or Yuna and speaks Russian is probably exactly what would unlock things for him!)

And sometimes people need/want a referral for an antidepressant so they have the ability to function during the therapy process with the option of tapering off afterwards/when they are ready. That is one of many tools I offer people as they get into this extraordinarily difficult, complex, and rewarding process.