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Therapy Hell: In Treatment on HBO

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We’ve now had five weeks of the HBO series In Treatment, enough time for me to develop an opinion worth posting. For anyone without HBO access, or who hasn’t seen the show, briefly: Paul, a therapist played by Gabriel Byrne, conducts sessions in a large room of the house he shares with wife Kate (Michelle Forbes) and two kids, teenager Rosie (invisible to date) and pre-teen Max (prodigy/social misfit). Four nights a week we’re privy to Paul’s sessions with clients, and on Friday night we attend his session with his own shrink, Gina (Dianne Weist).

laura_sm_on.jpgIn the premiere episode, Laura (Melissa George), who’s been seeing Paul for a year, professes her love for him. It’s a case of erotic transference, to use shrink jargon; even Laura recognizes the dynamic, though she doesn’t always keep it in perspective. Soon it becomes clear that Paul feels the same, although so far he’s been responsible enough not to tell Laura. He’s sufficiently obsessed that he goes to see his former therapist for the first time in eight years. Before he gets there, though, he, and we, endure three more sessions with patients—and endure is the right term for the way Byrne plays Paul. On Tuesday, Alex (Blair Underwood), alex_sm_on.jpga Navy bomber pilot who fought in Iraq, has his first session. On Wednesday, jake_and_amy_sm_on.jpgSophie (Mia Wasikowska), a teenage gymnast, arrives, sporting two broken arms from a car accident; and on Thursday it’s a couple’s free-for-all with Jake and Amy (Josh Charles and Embeth Davidtz).

Every single one of these people seems to despise Paul and the therapeutic process. They hurl insults at him, refuse to examine their behavior or motives, and meet Paul’s occasional insights with ridicule. When Alex and Laura meet by chance outside the office, they immediately jump into bed—an obvious act of hostility towards Paul, expressed in their respective sessions, when they give him the details of their sex and ply him for information about one another. I can’t help wondering why any of them came to therapy in the first place, or why they stay. Only Sophie sophie_sm_on.jpghas an excuse: she’s come under orders of an insurance company, needing a report stating whether her bicycle ride into traffic was intentional (quite likely: Sophie’s suicidal). The rest of this motley crew allegedly made a conscious choice to engage in self-exploration, yet they resist Paul every step of the way. “I don’t want a depressing session,” Laura tells him, and he nods sleepily in agreement.

Finally, there is Paul’s disintegrating marriage. In the second or third episode Kate tells him she’s having an affair, and the next week she runs off to Rome with her lover—taking along son Max, a detail that Paul throws out during his session with Gina, stunning in itself, but never explained.

I’ve been to more than a dozen therapists in my well-examined life, and for several years I was involved in peer counseling. Some of my shrinks were better than others, a few were awful—and I left those early on. My last therapist got me better than any one of them had previously, and for that reason my time with her was useful. I’ve always found it difficult to pinpoint exactly how, indeed if, therapy is actually responsible for change; for one thing, we never know what might be the natural result of living and learning from day to day. Five or six years ago I came to the conclusion that I’ve gotten as much as I’m ever going to from this strange ritual, and I won’t be doing it again–though I’ve learned to never say never.

I offer my therapy history as credentials to say that Paul is a really shitty therapist. I sit in front of the television coaching him madly, shouting out the questions he should be putting to his patients. Why did you do that? I scream, but Paul just gives an insincere little laugh and lets his patient ramble. Half the time he looks like he’s about to nod off, and he has a disconcerting habit of clutching his own hands, almost wringing them. Gina, his therapist, is only marginally better.gina_sm_on.jpg Ask him why Kate brought their son to Rome! I shout. Ask why he let her! But Gina ignores the fact entirely. She’s more apt to be interested in Paul’s interactions with her (actually, this, at least, is typical shrink behavior). “I don’t know what you want from me,” she whines. “What role have you assigned me?” There’s some thorny history between Paul and Gina, the details of which are used as audience teasers—to date we haven’t gotten the full story.

melfi.jpgTelevision’s never been good at portraying therapists: the only one who was realistic and competent was Tony Soprano’s shrink Dr. Melfi (Lorraine Bracco). Otherwise the psychiatric field is littered with buffoons and perverts, while their patients are laughably bonkers. TV hasn’t caught up with reality, with the contemporary therapy patient, who’s not sick, but uses therapy to learn about herself, to change behavior, to grow. Thanks to television, my mother was baffled as to why I spent time, money and energy in the offices of head doctors. Because of Bob Newhart, I’ve occasionally run into people who were9881.jpg embarrassed to learn I saw a shrink. I don’t think HBO intended Paul to appear incompetent, but he is, and infuriatingly so. In Treatment not only contributes to misinformed ideas about the therapeutic process, but blows an opportunity to correct them.


One response »

  1. I agree that Paul is just a terrible therapist — he lets his patients and sessions get completely out of control, he gets personally involved in their situations, he lets their situations get under his skin, and the whole nine yards.

    On the other hand, I guess the show is supposed to be more about him than about the patients, with all sorts of drama compressed into 9 weeks. It’s a soap opera, but having invested 5 weeks so far, I guess I’ll see it through.

    Good to see you here, Michael, and thanks for the comment–you’ve specified what I only generalized about Paul as a therapist. Even if the show’s supposed to be more about him, if it’s going to show him practicing therapy, it should present good therapy–because they never give the impression he’s supposed to stink; in fact, he tells Gina he’s a super therapist: on top of it all, he is deluded.–MS

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