In Treatment (HBO, 2008) is a TV series (closely based on an Israeli TV drama called Be Tipul) which centres on Paul Weston, a 53-year old Maryland-based psychotherapist. Each episode depicts a single therapy session and provides an excellent exercise in dialogue and close camera work. Gabriel Byrne plays Paul and his soft blue eyes, wrinkled smile and lilting Irish accent work well to create the impression of a kind, likeable and intense therapist who is also quite preoccupied by his own troubled marriage and mid-life crisis.
I watched the first seven episodes of Season One this weekend and I was initially quite impressed. The sessions are divided up according to weeks. Monday is Laura (a young woman with Borderline tendencies who falls in love with Paul), Tuesday is Alex (a narcissistic Navy pilot who was responsible for the death of 16 Iraqi boys in a religious school), Wednesday is Sophie (suicidal teenager), Thursday is Jake and Amy (a bickering couple) and Friday sees Paul in his own supervision / therapy. The sessions are addictive and a little over-dramatic but I was pulled in and interested, at least for the first five or so episodes.
What I liked about In Treatment was the experimental format, the extended dialogue, the clever use of the therapeutic frame and other therapy devices. The troubled therapist adds an interesting dimension and I was intrigued to see how the Israeli influence would work in an American series. There were many issues which deserve a lot of discussion, such as erotic transference, empathy, narcissism and so on. What I didn’t like was the inevitable over-dramatisation, the sexual voyeurism, the lack of understanding between therapist and patient and what I took as simply bad therapeutic technique.
Many of Paul’s interpretations made me cringe. As a therapist I know when I’m off the mark with what I say and I had this same sensation for much of the episodes. Paul will gaze off into the middle distance and say something profound rather than staying with his patients and connecting with their experience. Of course a lot of this has to do with the demands of TV and it also has to do with the plot. Paul’s shortcomings as a therapist are partly what make this series interesting. It’s a classic case of “Doctor heal thyself”. One example of a bad interpretation: Paul starts telling Laura, the young woman patient who has fallen in love with him, about scuba diving and the bends rather than focusing on what she’s just presented to him, which is her engagement to her boyfriend.
I was interested to see the reaction on the Internet and it seems largely positive. What I would be more interested in is seeing the reaction from therapists themselves. My own initial impressions after seven episodes are very mixed. There’s a big difference between playing the role of a therapist and actually doing therapy. I really don’t think this is something you can read from a script. Empathy is something you can feel and it’s either there or it’s not. My initial impression was that it simply wasn’t there. Anyone else seen it? Does it work for you?