Saturday, May 30, 2009

In Treatment

So I finally wrapped up the current season of HBO's In Treatment. I will try to be brief.

It is easy to take potshots at the show's ludicrous inaccuracies: the melodrama, the boundary violations, the additional boundary violations. In this show, therapy is aerobic exercise--patients and therapists jump up and pace, hurl objects, and/or run out of the office. Is this how they do things in New York? Where I come from, passive aggression works just fine--why work yourself into a tizzy when you can just lapse into sullen silence or fail to show up for your next appointment? But that sort of thing takes precious time on screen, and doesn't get the blood pumping.

Perhaps the most unrealistic aspect of the show is the fact that Dr. Weston ("Paul" of course to his patients) is a remarkably astute therapist, except for his Texas-sized blind spot as regards therapeutic boundaries. His formulations and his interpretations seem suspiciously on-target, considering how at sea he seems to be in his own therapy with Gina. And yet all his patients vociferously challenge his therapeutic authority--again, this comes across as somewhat contrived.

Considering that this is television, I suppose one can fault the cases for seeming too pat and tidy. I haven't seen the first season of the show, but in this second season the unifying theme seemed to be reversals of family responsibility, that is, children having to compensate for parents incapacitated by mental illness, grief, or a sheer inability to cope. This happens, to be sure, but does it happen this often?

For me, the single most piercing exchange of the series occurred in Paul's tumultuous penultimate meeting with Gina, in which he questions his entire mission as a therapist, and (jokingly?) expresses his intention to become a "life coach." He notes, as every occasionally despairing therapist must, that his patients seem to want love and/or pills more than they want what he offers, which is understanding. Gina's crucial comment is that even if he could, as their therapist, provide love to his patients, they would be unable to receive it, for that is why they are in therapy. If the offering of advice or "therapeutic love" amounts to feeding people fish, then true therapy is teaching people how to fish, as the saying goes.

3 comments:

Retriever said...

Only saw the first 15 (free) episodes when they were on ITunes last year. Entertaining but leave one with the idea that insight is attained in 15 minutes, that patients are mostly YAVIS and merely neurotic as opposed to suffering from intractable illness or addiction or worse...Sceptics of the value of therapy would be reinforced in their view that it is a luxury for the self-absorbed and frivolous and badly behaved. Even a sexually exploited kid is so pretty and appealing that one doesn't feel as much sympathy as one might to a real life one.

I enjoy the show, but it's to real therapy as chocolate bars are to a boring but nutritious home-made dinner....

House is better. I don't want to smack him upside his face as often as I find myself irritated by Paul. House is a rascal, but more self-aware. As you note, Paul is so clueless about himself that it's a wonder he can understand his patients so well....

michelle said...

"Where I come from, passive aggression works just fine--why work yourself into a tizzy when you can just lapse into sullen silence or fail to show up for your next appointment? But that sort of thing takes precious time on screen, and doesn't get the blood pumping."

This fabulous line had me grinning. I can assure you that in exciting old New York City, at least in my 10 years of therapy here, there hasn't been too much tizzy-working, neither in my own therapy experience, nor in that of my others I know.

But the next time I find myself irritated by my psychiatrist-therapist, I will think of your line and have to smile.

Thanks!

Anonymous said...

I get the feeling that the prosaic realism of everyday psychotherapy has been whitewahsed with the melodrama of the characters' glamourous untidiness and various dysfunctions; but that's not necessarily a bad thing since it is a tv drama afterall. Still engaging, if not a little cringe-worthy at times. I didn't care much for the characters in the first episode, but became a little more sympathetic as the show progressed - out of habit, deeper insight into their troubles or maybe identification?.. I don't know. Interesting enough to watch the 2nd season.

Yes, I prefer House's unwavering cynicism. Paul makes me nervous with his half-hearted doubting.