What the Elizabeth Holmes documentary made me think about as a psychotherapist.

I recently watched You Can See Everything, Nathan Fielder and Lance Oppenheim’s documentary about Elizabeth Holmes. Instead of focusing on Theranos, I kept thinking about something I often explore in my psychotherapy work: the stories we tell ourselves about who we are.

What I enjoy most about being a psychotherapist is sitting with people as they try to understand themselves. It’s not only about their symptoms or what brought them to therapy, but about deeper questions. Why do I end up in the same situations? Why is it hard to face certain parts of myself? Why do others see me so differently than I see myself?

The Holmes documentary certainly raised several of those questions.

I’m not interested in diagnosing Elizabeth Holmes based on a documentary. I think our tendency to quickly label people whose behavior confuses or disturbs us often keeps us from asking more meaningful questions.

What interests me is how people build and hold onto their sense of identity, even when it comes at a high cost.

The Stories We Tell Ourselves

In my clinical work, I’m often struck by how people come to therapy with clear stories about who they are.

Some of these stories are comforting, while others are heartbreaking. For example, someone might see themselves as always to blame in every relationship, as someone others never understood, or as a failure despite evidence to the contrary.

These stories don’t just appear out of nowhere. Early relationships, experiences of success and failure, and how we learn to protect ourselves emotionally all play a role.

From a psychodynamic perspective, we look at what the story does for the person. What feelings does it help organize? What experiences does it protect us from? What happens when something challenges that story?

Some of the most powerful moments in therapy happen when a client realizes that two seemingly opposite things can both be true about them.

Someone can be caring and still hurt someone. They can mean well but still make mistakes. They might feel misunderstood but still know how their actions affect others.

Learning to accept these contradictions is often a key part of growing psychologically.

Watching Holmes, I kept thinking about what happens when someone’s identity is so tied to a certain story that questioning it feels like questioning who they are.

We can’t know what she feels inside from the film, but as a clinician, this question feels very familiar to me.

Understanding Someone Doesn’t Mean Agreeing With Them

One of the myths about psychotherapists is that our job is just to validate whatever the client says.

Validation matters, of course. It feels good to be understood in therapy. But good therapy isn’t just about agreeing with someone.

My approach to therapy is relational, collaborative, and sometimes direct. I believe people benefit from a space where they feel emotionally safe but are also challenged to consider perspectives they might usually avoid.

Sometimes, it’s as simple as gently pointing out the difference between how someone sees themselves and how they actually behave. Other times, it’s about exploring why certain feedback hurts so much. It can also mean helping someone sit with the discomfort of facing something about themselves they’d rather avoid.

That’s where empathy and accountability really matter. We can try to understand why someone acts as they do without justifying the behavior. We can accept that the person’s internal experience is absolutely real to them and still not accept that their version of events is the correct one.

In my experience, real psychological change happens when people become emotionally flexible enough to consider other viewpoints without feeling as if their whole identity is at risk.

That’s not always easy to do.

What We See Is Not Always What We Know

The film also made me reflect on how quickly we form opinions about others. As a therapist, I spend much of my time listening, observing, and trying to understand what’s going on beneath what people say.

But my clinical experience has taught me the importance of staying curious instead of assuming I know everything.

Someone might seem confident but actually feel very insecure. They might look emotionally distant but really be upset. They can sound sure of themselves but struggle with uncertainty.

These observations don’t prove what someone feels inside. They remind us to be curious.

In therapy, we get to know someone and build understanding over time. Within this therapeutic relationship, we can explore patterns. A documentary, especially one as unconventional as Fielder and Oppenheim’s, offers only a selective look into a person’s life. Even if that glimpse is remarkably intimate, it is still not the same as knowing the person.

This is one reason I’m cautious about the trend of using psychological labels for public figures. We often hear that someone is a narcissist, a manipulator, or has a personality disorder, but the evidence rarely supports such certainty.

Psychological ideas can help us think about behavior, but they shouldn’t replace true curiosity.

The Difference Between Feeling Understood and Being Challenged

I often think about how important it is for people to experience relationships where they are accepted but also challenged.

Many of us seek out people who confirm our view of ourselves. It’s comforting to hear that our perspective makes sense or that our intentions were good.

Sometimes, that reassurance is exactly what we need.

But relationships that help us notice our blind spots are extremely valuable.

A good therapeutic relationship lets us look at times of disagreement, misunderstanding, and discomfort instead of avoiding them.

I don’t think psychotherapy aims to make us always right, always confident, or free of contradictions.

I think it’s about developing a more flexible and whole sense of ourselves, even the parts that are hard to accept.

That process takes curiosity, humility, and a willingness to question the stories we hold onto.

Why This Matters Beyond the Therapy Room

My interest in these topics has grown during my doctoral studies, especially as I see AI play a bigger role in mental health care.

The Theranos story also reminds us what can happen when confidence, innovation, and a strong personal story replace real evidence.

In mental health technology, we need to be mindful in examining the difference between what feels beneficial and what has actually been proven to work. An AI tool can express warmth, sound self-assured, or make you feel understood. These things alone do not establish clinical competence or safety.

I’m interested in how we can keep critical thinking, professional responsibility, and the value of interpersonal relationships while staying open to new technology.

In some ways, these questions aren’t so different from the ones we face in psychotherapy. New information challenges our assumptions. Can we be receptive to a different point of view without jeopardizing our own judgment?

A Final Thought

After watching the Elizabeth Holmes documentary, what stayed with me wasn’t a conclusion about her as a person or her psychology.

Instead, it reminded me how complicated our relationship with ourselves can be.

We all have versions of ourselves that we work hard to keep. We all face experiences that challenge those versions. Sometimes, it’s easier to defend our view of reality than to question it.

That is part of being human.

Mary Tate, LCSW, is a New York City psychotherapist with more than a decade of clinical experience treating anxiety, trauma, shame, and perfectionism. As the founder of Tate Psychotherapy, she provides in-person therapy in Manhattan and online therapy in New York, New Jersey, Massachusetts, North Carolina and Texas. Mary is a Doctor of Social Work (DSW) candidate whose doctoral research examines the role of AI in mental health care, and she has been featured as an expert source in HuffPost, Shape, and Well+Good.

For psychotherapy inquiries, please contact Mary here.

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