As we eagerly set our DVRs to record HBO's "In Treatment," which starts its new season this Sunday, we're wondering if any of the doctors or mental health experts in the Open audience will be tuning in -- especially you purveyors of the talking cure -- and be willing to offer your own, expert post-episode analysis this season?
I'm a big fan of the show, but I know we'd love to hear what the experts really think of it. If any experts out there are ready to accept the challenge, drop me a note, or chime in below. We'll turn to you after our time with Dr. Paul Weston is up.
Emily Holleman
Mignon Khargie
Scott Rosenberg
Thomas Rogers
Rebecca Traister
Dan-onymous
Salon.com
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The way he does therapy, those people will be there for a long, long time. Give me a cognitive-behavioral approach anytime.
Feel free to delete what was put in accidentally. Thanks.
But -- saying that -- the portrayal of Paul as a depressed, acting-out therapist (at his worst) and one laden with unresolved countertransference (a cardinal no-no) is an accurate portrayal of a mental health professional having a mental breakdown.
And there are a significant number of very smart, very dedicated men and women mental health providers in this category.
Paul is the poster boy for many mental health professionals who either enter the field with unresolved issues or who burnout during the course of extensive caretaking of patients and it is time that his/her face was seen.
I also must add that I winced last season at the so-called "supervision sessions" and wished that the supervisor was supervised. Although she totally looks the part and is a magnificent actress DW was as acting-out as her supervisee (Paul). She should have never taken him on as a supervisee once she realized he needed extensive therapy for himself and his marriage.
The people I know who love this show are therapists who recognize that there is a bit of Paul in all of us in the mental health field.
As an aside: did you get my pm regarding my lunch plans in Midtown?
Grif: Hey, go for it.
Saturn: Don't wait for an invitation -- I'd love to read that! I take it you're hooked?
Judy: Interesting insights! I hope you'll write more about it!
MMM: It's actually not a documentary; it's a half-hour drama.
I do remember once seeing a therapist walking down the hallway after leaving a session with a my ex-and me. That therapist looked like he had the world on his shoulders. This will sound nuts ;0) but you know how when you talk to your dog about stuff he starts to sort of absorb it and seem so very sad. Perhaps therapists are like that too.
Tough way to make a living.
I agree with Judy's mixed feelings about the show. Sometimes the way therapy gets portrayed on film makes me want to pull out my hair, and this show certainly had its frustrating moments (a few times I was literally begging Paul to pick up the damn phone and CALL CHILD PROTECTIVE SERVICES ALREADY!!!). Some of the inaccuracies can be explained by format and dramatic necessity, and some I suspect come from the awkward-at-times translation from an Israeli to an American context. It would be useful to learn more about the way therapy developed and is currently practiced in Israel.
I also agree that the portrayal of Paul is a painfully-accurate depiction of a practitioner falling through a counter-transference rabbit hole. Or, now that I think about it, maybe it's more accurate to say that he's falling in and out of a looking-glass world, never sure if he's seeing the real world or the world of distorted reflections. And much as I would get a kick out of seeing a therapist hero who actually knows how to get the job done right, for a change (at the least it would be good PR!), I think Paul's character raises important questions about the relationships that develop between therapist and client when the therapist is granted too much scientific and moral authority. It becomes a smoke-screen that therapists can use to hide their darker impulses from their clients and themselves.
Wow, that was longer than I intended. Guess I will have to put up a few posts about the show! :) Looks like we'll have a great conversation in store for us here.
Stellaa: I do miss Melfi.
Nurse: My apologies -- I've broadened my post to include mental health experts (though I'm keeping the headline!).
Dona: Really looking forward to your participation!
I confess ab initio a pre-existing transference to both Gabriel Byrne and Diane Wiest. This, not the subject matter, provoked my interest in the series. So far, I would have mixed feelings about each one's behaviour as therapist and supervisor. I would concur with those comments reflecting dismay at Paul's countertransferential dilemma and what I see as acting-out, too. But not having watched the entire series, I cannot comment further yet.
You can count on me.
I've watched a few episodes of In Treatment and I've found it to be unbelievably self-reverent. Therapy is by definition about self-absorption to some extent, but the therapist and his patients are narcissistic in my opinion. I like Gabriel Bryne and Dianne Wiest and I've watched it for them. I've had therapy that was good, bad and indifferent and none of it was anything like this. I don't blame therapists for not watching it; it's the same reason why I don't watch TV or movies (usually) about journalism because they always get it wrong.
All I can say is: Bring back Huff!!!
As for "in treatment" I have only seen one episode and I found it compelling. When Paul goes to his therapist, lamenting that he avoided sleeping with his own former patient, not because of his ethics or by sheer force of will but because his body seemingly betrayed his desires-- he had a panic attack. When his therapist re-frames the event, forcing him to acknowledge that his morals forced his body to rebel, I thought it was a very elegant example of the mind/body connection. I only saw this one episode but I would watch again, based on that one alone.
So, as I said: I'm a novice, not a pro, but I'll watch this weekend and respond if I feel like I have something meaningful to add.
And thanks again, Kerry, for all you do.
Besides the obvious onerous breaking of serious ethical boundaries by going on with therapy though the therapist was sexually obsessed with his client, there was another thing that constantly annoyed me. I remember reading that Byrne said he 'never had therapy'. (This is amazing and disappointing for an actor.) This shows in his acting because he hasn't had the experience of having a therapist not buy into his joking 'meta-message' by smiling, and he does it repeatedly. The client (several did this) smiled or joked or otherwise said in 'meta' ways that they dismissed the importance of what they themselves were saying and Byrne always smiled or laughed as if he were colluding with their dismissal. (I have not figured out how to put this very well as I've thought about it since I heard the series was coming back; I don't know if I'm being clear.) An experienced therapist will just continue listening, knowing that if a client is adding a humorous dismissive color to his/her statement there is still something the client is being serious about and will react or respond to the seriousness of the comment and will avoid joining with the client's attempt to dismiss it by responding with a smile. Byrne doesn't or didn't understand the necessity of staying with the serious intent and not betraying his client by 'keeping it light'; his is the reaction of a rookie therapist who is uncomfortable with seriousness and the uncertainty of not knowing where it may go, and not of a therapist with the experience Byrne's character is supposed to have. When a therapist colludes with a client's attempt to lighten up what s/he is saying, though it has serious content, s/he and the client may be more comfortable but disallows the client the opportunity to face the depth of feeling about what he is offering; therapy is slowed and sometimes doesn't get anywhere at all.
Without disclosing too much, I have gone to counseling / therapy during several difficult periods. Paul's style reminds me very much of a therapist I had that I ended up despising for his passive aggressive style (among other things). I had better luck with a behavioral-cognitive approach as well.
I do agree with the actual therapists here that the ethical breaches and some of the other melodrama are cringe-worthy.
To the therapists and other professionals in the field that have responded...I personally wouldn't have minded a therapist much like the make believe one in "In Treatment." The trouble with far too many experts is that they forget what is important to the person that they are supposed to be treating. Living life is an individual experience and most of us muddle through without causing great harm to ourselves or others. But then of course there is a field of study that suggests that there are ways, rules really, that we should all abide by to live almost perfect lives. In the end, we all find out that living life can be quite an experience, full of wonder, joy and at times great pain.
Just how is anyone supposed to make the ride less painful? Until the "science" can intuit just what it is that makes us smile or cry, the we will all just have to rely on individuals that stop by our lives briefly and allows the sun to shine on our darkness.
Needless to say, I'm not much for therapy although I've experienced it more than once and the process ended with me living with me and my faults. I like the tenor and tone of "In Treatment," the fact that the therapist is human and fallible and that the people he treats are just like the rest of us; human.
I think your take on the shrink played by Byrne is apt. I will add one thing--the series itself has him talk with his shrink, Gina, about how her original evaluation of him at the Institute where he trained, before he went out on his own, was that he was too inclined to want to "please his patients" get on their good side, assuage them and want their approval! So the writers themselves set Byrne up to play a shrink who has a problem confronting his patients. This came out in one episode with Paul and Gina. However, I do agree with you that it's really something that the actor never had therapy himself but had the hubris to play a therapist--but hey he's an ACTOR not a rocket scientist! However, I read recently that he is now in therapy! Ha ha, maybe the show drove him to it!
At any event here we are all serious(?) adults totally addicted to this program so they got what they were going for--an audience, some controversy and discussion and attention! Hey, it beats America's Next Top Model in my book and all the other crap that's out there.
I tried working in therapy with several people and found one, fortunately, to whom I could relate human to human. One of the most wonderful human beings I met helped my family as my father was dying and then visited our home when we sat shiva. This is rare but beautiful. He died recently at 83, still seeing patients.
Hint: Tag it "in treatment."
Saturn, What's Kings? Is it a political show? B/c I loved West Wing. Was it something like that?
I mean, I can imagine being a therapist and cringing, but I think that's the point. He is a very troubled therapist, who nonetheless manages to do some good (Sophie? Maybe?)
I think we all have a lot of transference going on because Gabriel Byrne is, in fact, God and so we think he's being depicted as a hero, when he isn't.
One half-hour to go, here in SF!
The problem with Paul is that he wants to use the unconscious to make interpretations for his patients, but he fails to believe that his unconscious is driving his own problems...
The unconscious is where we live... it totally drives our behavior in an often quiet and insidious way. Paul can admit this when it suits him, makes him look good as a therapist, or seems to asnwer a milder dilemma.
But when the issues are larger and more onerous Paul doesn't want to go there. He doesn;t want to believe that he could have stoipped himself on the way to Laura's house... or at the door... or at the living room... he had many places to put a stop to his behavior. But he was acting out own narcissism, preying on her issues and vulnerability. He seemed to have the insight when he interpreted to her that she sought a father figure to be the man in her life... but he drops the idea in an instant when she doesn't want to hear it.
He can't quite admit he felt homicidal when Alex provoked him about his wife and about Laura. He lost it with the patient and probably should have been charged with assault! Is it really such a surprise that Alex then went on to act out his death wish? After all his therapist too agreed he should be dead! (Though ostensibly for different conscious reasons!)
Therapists take an oath and are bound by licensure to maintain boundaries in an effort to keep the client safe. This is because dependency on the therapist is part of the treatment process. It may not seem so obvious to most, (and it may be hard to accept) but the dependency is part of the trust process. The client needs to be assured that the therapist remain neutral and uninvolved. If the therapist becomes involved the treatment and the client must be preserved. (Transfered to another client, or in some cases the therapist needs to get into therapy to sort out his or her own boundaries.)
Like it or not, the therapist becomes a parental figure. If the client is allowed to have a sexual experience with the therapist it is experienced by the client as if the parent had molested them.
The burden of responsibility for that boundary is always on the therapist. Always.