The Reality TV Obsession: A Psychological Investigation

The Reality TV Obsession:
A Psychological Investigation


By Psychiatrist and Addiction Specialist Reef Karim

Introductory note from BHC Editorial Director Robin Jay: In 1948, when the television show Candid Camera aired pranks designed to capture the reactions of embarrassed participants – participants who were the average joe’s on the street, not actors – no one would have categorized the show as “Reality Tv.” But by 2002, when the television series Survivor began to enthrall weekly viewers to voyeuristically watch jungle-ridden public citizens compete for $1 million, the term Reality Television was coined and quickly became a household term. In 2001, when the television writer’s strike took place, the genre of television known as Reality TV received the booster shot it needed to skyrocket. The unscripted nature of the programs was the ideal workaround for producers who desperately needed to produce television shows without professional writers – and it was nice on the purse strings, as well. On average, it costs about $3 million to produce a popular sitcom with paid writers and actors, but it costs about $750,000 per episode to make a Reality TV show.

As a result, today viewers can tune in to Reality TV shows to see chefs vie to become the next Iron Chef, to see dozens of women compete for a possible proposal of marriage from a bachelor, to see couples guzzle down live roaches and bathe in a vat of rats to win cash, and to see people undergo plastic surgery to become attractive. The Reality TV options are now too endless to list. And while this genre of television is less costly to produce – a positive virtue in this sluggish, advertiser-strapped economy – what is the potential long-term impact on the participants and viewers? For example, what happens to the participants who lose drastic amounts of weight and then return to normal life with no cameras? What happens to couples who become engaged to marry within six weeks of meeting their partner who has simultaneously been dating a dozen others? Is it just a curious coincidence that nearly every couple on a reality series – Britney Spears and K-Fed, Jessica Simpson and Nick Lachey, Hulk Hogan and Linda Bollea for example – have split? And what happens to children whose parents go through a nasty public divorce, as in the case of the couple in John and Kate Plus 8?

Behavioral Health Central decided to inquire about these issues and contacted Dr. Reef Karim, a Psychiatrist and addiction specialist in Beverly Hills who has appeared on many nationals television programs to discuss this very issue – and who has also appeared in Reality TV programs himself. Dr. Karim is the Founder of the Beverly Hills Center for Self Control & Lifestyle Addictions. The center focuses on treating impulsivity and self control including: anger management, stress management in addition to lifestyle addictions such as: sex addiction, gambling addiction, food addiction, shopping addiction and videogame addiction. He also treats mood (depression, bipolar), anxiety disorders, ADHD and chemical substance use disorders and is well trained in both psychotherapy and psychopharmacology. Dr. Karim researched this issue for us and provided the following commentary. You can also listen to our interview by clicking on the media player on this page. And for more information about Dr. Karim (or Dr. Reef as his patients call him), go to

The Reality TV Obsession: A Psychological Investigation
By Psychiatrist and Addiction Specialist Reef Karim

Are we all becoming obsessed with Reality TV? Seriously, think about it…
For some, it’s being on the show. It’s their 15 minutes of pure, exhibitionistic experience with fantasies of fame, stardom or at a minimum…popularity. Perhaps it’s an attempt to move up their social standing or a conscious or unconscious attempt to gain the attention they so desperately needed but never received in their developmental childhood years.
For others, it’s watching the show. It’s a voyeuristic digestion of “reality” while identifying with real life characters who openly display their eccentricities and/or pathology across our television screens. We watch sex appeal, flirtation, jealousy, rage, competition, conflict, anxiety, shame, impulsivity, hedonism, intoxication, narcissism, sex… the list goes on and on. In a way, it’s much safer to watch it play out on television than to experience it ourselves. And their lies the potential problem. Is reality television just entertainment or does it have a deeper psychological effect on us?

Unless you’ve been living in a cave the last decade (and I think even the Taliban knows about “Survivor” and “Big Brother), you’ve undoubtedly been exposed to this global phenomenon.
From a psychological perspective, reality television is fascinating. It makes the “fantasy” of celebrity status accessible to anyone – particularly if you’re willing to put it all out there. But, at what price? As a psychiatrist, addiction specialist and relationship therapist, I’ve been faced with many questions about the psychological impact of media and specifically reality television. As such, I decided to write this article and I’ve listed five questions I repeatedly get asked.

1) How do reality show participants deal with the “withdrawal” effect when the cameras are shut off?
I’ve interviewed many reality show participants and the “withdrawal” effect makes sense. When you’re basically “exposing” yourself mentally (and for some people – physically) for weeks at a time with constant cameras, crews, producers, experts and sometimes fans giving you constant attention and then suddenly it all abruptly ends, how do you deal with that? The answer: Aftercare Participants should continue on with treatment (if that was the focus of the show) or at a minimum, there should be a therapist brought in (during taping or after) to work with the participants. We need to realize that “Reality TV” does have a psychological impact on its participants.

2) Are Reality TV participants screened?
Obviously, every participant is “cast” on reality television shows. There are shows that utilize psych testing (a battery of written tests and sometimes interviews that are scored and can help evaluate one’s psychological health) which can be useful for screening. But, what are you screening for? If you screen out anyone who’s got a personality problem (narcissistic, borderline, histrionic) or poor coping skills, a producer may ask “well… then how do you get good television?” Reality television participants have occasionally had bad outcomes and perhaps screening for a significant psychiatric history or substance dependence history (like quite a few current shows do) would be helpful to avoid worsening their symptoms due to an acute stressor they may not be equipped to handle. If the show is about mental
health or addiction, then a strong support staff and aftercare is imperative.

3) Can Reality TV be damaging to someone’s mental health?
The answer is absolutely “yes”. If an individual is mentally/psychologically unprepared for the potential humiliation or competition or adoration that will be quickly be put upon them, it could have negative effects on their psyche. We’ve heard of mental breakdowns and even an occasional suicide after a reality television show finishes taping. Now, it’s much more likely that those individuals had predisposed mental health conditions but we can’t negate the stress of doing a show and/or not having aftercare as a great concern for certain individuals. Additionally, screening out major mental health disorders or major substance use disorders is very important.
And for those people watching at home, the hope is they don’t just live life vicariously through reality television participants. If an individual doesn’t need stimulation or activity in their own lives because they’re getting it on television (reality or not), that’s a problem.

4) What kinds of people are attracted to reality television?
Some people will argue that you have to “have some kind of problem going on” in order to want to be on a reality show – a personality disorder, an attachment problem from childhood, a desperate need to be famous, etc. I don’t necessarily believe that. Although there’s no doubt that some individuals are feeding their inner troubles by going on a reality show, there are other participants on shows for the money or for competition or they’re trying to jump start an acting or hosting career and some people just want to have fun and help people through the medium of television.

5) Can a Reality TV show be a good thing for its participants and viewers?
Although most reality shows play on our sensationalistic thirst for sex, competition and conflict, we sometimes learn from these shows. We might learn more about addiction or mental health or running a company or we might get more motivated to start dance classes. The shows could have a positive effect on our lives if they motivate us to actually go out and learn a new skill or read about a subject or get help for a friend or family member.

But we have to keep things in perspective. Our society has changed over the last decade. We’re now much more of an ADHD, distractible, novelty seeking, numb, over-stimulated, high tech society and we’re paying for it with our mental health. As one of my friends so eloquently says, “you always gotta pay, one way or another”. Although our technology is beyond impressive and changing every day, we are suffering in another way – our divorce rates are up; our family unity is down; our emotional skills in dealing with anger, conflict and anxiety are… not so good… and most importantly our ability to connect with each other authentically has been seriously challenged.

Personally, I have a problem with a few reality shows (particularly those dealing with kids because I don’t think kids are really mentally prepared for what they’re experiencing ) but overall I believe reality shows could do some good – they don’t have to just be sensationalistic – they could also be educational.

The way to improve reality television is to make it more “real” with more experts. The more authentic we can make reality programming, the more motivating and/or educational it can be. At one time, the average television producer thought reality television was “just a phase”. Well folks, it looks like it’s going to be here for quite a while. So we might as well try and make it more credible.

Experts can consult, create or produce shows that help people develop insight, coping skills and better functioning through instruction, expert treatment and experience. As life is all about human connectedness and passion, perhaps the voyeuristic nature of reality television could help motivate us to be better people.
One can always dream…

Dr. Reef Karim

“A great distracter is seeing someone else’s emotional pain so we don’t have to think of our own.”
Dr. Reef Karim

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