And so we begin Season 4 of In Treatment. This is a show which does a reasonably good job portraying psychotherapy. Each session is condensed into 30 minutes, shorter than actual sessions but manages to convey something close to what actual therapy is like, as close, probably, as television can come without turning to a reality show format.

Let’s start with what is different from the get-go in this season. The show is set now in Los Angeles rather than Brooklyn. The colors of Brooke Taylor’s home office reflect a brighter California palette rather than the more somber browns and leather of Paul’s Brooklyn office. Like Paul, Brooke has her office in her home. For the past nearly 15 months nearly all therapists have been working with patients from their homes via video connection or telephone. In the first session, we see Brooke work as most of us have been, in the virtual space of video connection. This season we see in both therapist and patients a heightened sense of the need for diversity, which is a change from the first 3 seasons. We see from Brooke’s email box and photos that she has some kind of relationship, perhaps as a protege, with Paul Weston, the therapist from the earlier iteration of the show.

Our Sunday patients are Eladio and Colin. We learn from Episode 1 that Eladio is a home health aide employed by a wealthy family to care for their son; the empolyer is paying for Eladio to see Brooke. The season opens with Brooke receiving a phone call late at night. She declines the call but the caller immediately calls again and we see it is Eladio. He tells her he didn’t expect her to answer then tells her a dream. 

Next we see Eladio is video session with Brooke. Brooke apologizes for answering the phone the previous night. In what follows we learn that Eladio has not spoken with his mother for 4 or 5 months, that she had COVID and that she refused his help. And we learn he is an only child though his mother told him there was a stillbirth before he was born.

Brooke tells him he can call her in emergencies. Eladio reacts to this, telling her not to do that, to do what feels to him like rapping on the knuckles—this suggests his desire for unlimited access to Brooke. She tells him it is up to her to set boundaries. He rather quickly tells her he wants a referral for medication because he isn’t sleeping. She says she needs to know him better before she can feel comfortable making such a referral and she quotes Jung —“There is no coming to consciousness without pain.” She lets him know she is not casual about meds, that this work is not fast and that hers is not a results oriented practice.

Eladio then tells her he was diagnosed Bipolar I in college and is on lithium which he takes when he can afford to buy it. His employer does not know about his diagnosis. That he used to work with old people that he would become attached to then they would die. — that is when his sleep problems began, he says. That he fell in love with an addict who abruptly cut him off. Brooke tells him it sounds like he is haunted. Then Eladio asks her if she is going to take care of him, be his family. The session ends abruptly when his charge needs assistance.

So what do I notice?

First, like Gabriel Byrne, Uzo Aduba is riveting in the part. She is beautifully dressed in bright colors very like the furnishings in her home office. My sense though is that the orange chairs in the office are not especially comfortable and she shifts about in her seat as if that were the case. The chairs look great, but for a day’s worth of work? Maybe not so good.

Setting boundaries with Eladio right from the beginning is important. That after having seen her only twice he calls her late at night is an indicator for her that he needs boundaries. A friend of mine and I spoke recently about late night calls and that we have rarely if ever had any while in private practice. So Eladio’s call is at least unusual. And we see as the session progresses that he is hungry for a mother, being somewhat estranged from his own and having experienced so many losses. Brooke’s observation that Eladio is haunted — by the deaths of his never known sister and the patients he cared for and the disappearance of his addict lover — stands out and leads Eladio to express his need for family and care. 

What do we learn about Brooke from this first session? Her father recently died, so we know she is grieving. It looks like she lives alone. So we know that she, like most of us, is dealing with her own pain and issues as she works with her patients. Surely Eladio’s losses bring her own to her mind, as happens again and again in depth psychotherapy.

Now a quibble. In looking for the whole of the Jung quote, I learned that Jung never said: “There is no coming to consciousness without pain.” 

What he said in two separate and unrelated statements was:

“Seldom, or perhaps never, does a marriage develop into an individual relationship smoothly and without crises; there is no coming to consciousness without pain”. ~Carl Jung, Contributions to Analytical Psychology

and 

“People will do anything, no matter how absurd, in order to avoid facing their own souls. One does not become enlightened by imagining figures of light, but by making the darkness conscious.” ~Carl Jung, Psychology and Alchemy

With that small correction, still I am delighted that Jung is mentioned. And this sets Brooke within the field of depth psychotherapy and explains her statement to Eladio that hers is not a “results oriented practice.” It doesn’t mean that patients do not change but that particular results are not the goal.

What are your thoughts? Comments? Impressions?

Later today, our second patient, Colin.

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