InTreatment, Season 4, Week 4

Week 4 — what to say? Brooke is deeper into her relapse, pursuing unconsciousness with a vengeance. It is painful to watch. Everyone that we see her with tries to connect with her and every time at the critical juncture, she flees either literally or figuratively.

Eladio confronts Brooke — “What am I to you?”. He feels her double messages, tells her she runs hot and cold. He wants her to be with him as he is with Jeremy, his charge, whom he loves and loves enough to be honest with. 

Colin, who like the good narcissist that he is, is at turns charming and maddening. He invents stories to tell her and when caught in the lie, makes another story. She does not really respond to the one naked thing he says which is “I want you to like me.” Underneath we know he feels that he can only get people to care by doing his charm offensive, that if he is real, he will be rejected. He succeeds in making Brooke angry and she tells him she had promised herself no more narcissists because they don’t change, shooting her own arrow into Colin. She would need to hold her therapeutic stance, to let him feel, and to work to get deeper inside his need, his desire to have her like him. One wonders how she might respond differently were she sober and not mired in her own lies and emptiness.

We see how really wounded Laila is this week. Brooke is better with her but seems not to get until the end of the session that Laila is likely suicidal. 

And then Adam, who isn’t especially appealing but who tries to connect in some way with Brooke. At the beginning of the week he offers to have a child with her if that would help. And he accurately identifies that her son, gone from her since birth, is more of an idea than a reality, hence his suggestion that they could have a child together.

Brooke has another bender and this time it is the last straw for Rita who tells her she can’t stay, that when Brooke is ready to stop drinking, she can call her. Brooke complains to Adam about Rita and sadly, he colludes with Brooke’s claim to victimhood. He again tries to connect with her. They have sex but she seems hardly there—to be fair, she was drunk so unable to be present. Then as they finish, she passes out, becoming literally unconscious finally.

Watching Brooke this week was depressing. And made me angry. I wanted to shout at her and at the writer’s who have created this mess. Many years ago, I and some friends attending a family therapy workshop volunteered to role play a family for the workshop leader to “work” with. The family we fell into being was rather like the characters in this season — types, exaggerated, unrelenting. We became caricatures of family. 

I don’t know where things can go with the rest of the season. A suddenly seeing of the light on any of their parts would feel phony. Yet sliding down even further a bleak prospect. 

I noticed today that HBO has released all of the remaining episodes.I plan to watch them this weekend and next week post about what I see and reflections on this season and tissues it raises. For now, color me less than pleased.

In Treatment, Season 4, Week 3

Here we are at week 3 and I remain ambivalent about this season. In fact it took me until today, several days after they aired, to watch this week’s cases. So this week I want to focus on what it is that makes me uneasy about the characters this season, especially about Brooke.

I am beginning to feel that what appears to me as maybe sloppy work with her patients can be attributed to the fact that Brooke is drinking and has been, we learn this week, since her father died. All therapists are human with human problems. Our personal lives can become messy and troubled. But we have an ethical obligation to deal with intrusions from our personal issues into our work. And Brooke is not meeting this obligation. Yes, she talks with Rita who is, in addition to being her friend, is her AA sponsor. In a way this is a dual relationship not unlike the one Paul had with Gina. Dual relationships are problematic because both roles ultimately get short-changed. And Brooke needs more than a friend and sponsor to deal with her problems. AA can be great for gaining and maintaining sobriety, but Brooke’s issues, just from what we know so far, run deeper than her alcohol use and to a degree certainly drive her desire to drink. We don’t hear this week about Brooke dodging Paul and her regular supervision but there is no reason to believe she changed her behavior.

In each of the sessions with the three patients we see, Brooke jumps away from strong expression of their feelings. Eladio spoke movingly and intensely about his care for his charge, that he loves him which Brooke in time connected to his own need for care and for good mothering. Eladio responded by wanting to end the session early and instead of gently encouraging him to talk about what he was feeling, she assented and then immediately called her psychiatrist friend to refer him for evaluation and possible medication. When she calls him to tell him, she also tells him she questions his bi-polar diagnosis, which makes me wonder why she didn’t explore this with him further before or even if making the referral. I suspect it was Eladio’s strong emotions which elicited what looks to me like a countertransference response from Brooke.

Then Colin began with wanting to please her, to make her like him. They sparred throughout the session. Brooke becomes a bit coy in manner with him at times. At the very end he asks her if she likes him and rather than stay with that, with his, for him, rather naked need, she pushed him away. If he stays for just the mandated 4 sessions, they have only one session left. He has said he just wanted to get that requirement met and done, yet he did not show signs of wanting to bolt most of the session and with some encouragement from Brooke might well begin to sink into the process.

Finally Laila whose grandmother pretty much tells Brooke that she is not doing her job to prepare Laila for college and intimates that there won’t be many more sessions. The work with Laila, as with Eladio, for most of the session is pretty good. But, as with Eladio, when strong emotion led Laila to defend against it by taking out her phone to text her girlfriend, Brooke exits the room. She doesn’t stay and challenge Laila or encourage her to talk about what she is feeling. She just gets up and leaves the room, ostensibly to get something to drink. Laila gets ready to leave, says goodbye to Brooke who says she will see her next week. And then Brooke takes out a bottle of vodka and pours some into her energy drink. Once again, strong emotion leads Brooke to flee.

Finally in the time with Rita, the dimensions of Brooke’s behavior become clearer. Rita is caught between wanting to soothe her friend and doing what she knows as her sponsor she should do given that Brooke has relapsed. In the end, she yields to the friend side, which is a shame because Brooke needs someone to hold her accountable. Underlying the drinking on this day is news she received that she would not be able to reconnect with her son who was placed for adoption right after birth. So Brooke is grieving the death of her father, the loss of the hoped for reunification with her son, among other things. She needs help and so far at least is not only not seeking it, she is actively rejecting it. 

I am anxious to see how much more of a train wreck Brooke will create in the remaining weeks and which of her patients will settle down into therapy and stay. 

What do you think?

In Treatment, Season 4, Week 2

In the second week of this season’s In Treatment, I remain ambivalent. I like all of the actors and do not especially like any of the characters. I struggle to understand why Brooke, who describes herself as some variety of longer term probably psychodynamic therapist is seeing these patients. 

Eladio is a good candidate for depth therapy *if* it weren’t dependent on his employer paying. He would be a tough one to work with because of his history with probably drug use and shakiness of his life circumstances, but he seems psychologically minded, can reflect on himself and is so very eager to attach to Brooke. But his employer is looking for a resolution to Eladio’s insomnia, not for his personal growth so the resources for long term work are not likely there. I understand the appeal of working with Eladio and how Brooke is somewhat seduced by him, so she is going to have to keep an eye on her countertransference with him and be ready for him to leave well before he is actually ready.

Why Colin? Referred by the court — which is already an issue because Brooke is being hired for reporting on her assessment of him, not by him for therapy. In my experience these kinds of referrals rarely go anywhere past what is ordered, because the patient is not the initiator of the referral or the work. So she has accepted him and as a pro bono patient too — why? And why is the court not paying for the four sessions which it has ordered? So I am puzzled by the fact that Brooke accepted the referral. The verbal fencing he does with Brooke and the avoidance of anything resembling real  insight would wear thin pretty quickly. That he is there to get an approving report from Brooke feels to me like the only real skin he has in the game and the major reason he is there at all. The fact that he has crashed and burned his life could be the impetus for real work in therapy, but only if he is willing to drop the mask and be vulnerable. 

Then we have Laila.It is never clear that much if anything Laila talks about is really personal. Her character is drawn more as a type than as a person. The one place where I could feel her was when she talked about the way she and her girlfriend created imaginary worlds together. There was a playfulness and creativity in what she described that is very different from the brittle intellectualizing she more usually indulges in. We see in her talk about her relationship with her girlfriend a look into who Laila is underneath the mask she wears. She tells Brooke a dream, which Brooke deals with entirely as about the reality of being a black woman, which certainly is part of it. But she makes no attempt to bring the dream back to Laila and what is says about her life today. The Jungian in me wishes she had invited Laila to actually work on the dream with her as that very well might have opened this therapy up a lot more. As with the other two patients, there is every reason to feel the work with them will be short term. Laila is going off to college for one thing and her grandmother brings her to Brooke to prepare her for college. These patients seem misaligned with what Brooke purports her practice to be. 

We learn in Monday’s segment about Brooke, that Paul, from previous seasons, is Brooke’s supervisor. Rita says she thought Brooke talked with him every week. We have seen Brooke dodge his calls and emails so we know Rita is right when she asks if Brooke is avoiding him. That she is doing so is a big red flag given Brooke’s issues. It is clear that Brooke has some issues with Paul in fact, referring to him as the “world renowned Paul Weston” out of anger maybe or envy. In the process of her talking with Rita, we learn that she has thought about having a baby with Adam. We know from earlier that at age 15, she had a baby which her parents made her surrender for adoption. And now she wants to find her son.  So we have Eladio wanting a mother and Laila without a mother and Brooke struggling with the loss of her father and longing to find her son — a potent stew indeed. I was intrigued that Rita sat in one of the chairs and Brooke on the couch, reflecting perhaps the way she and Brooke are relating, more as therapist and patient than as friends.

As I said before, I like the actors this season but find the characters they are playing kind of lacking. The three patients seem like types rather than full fleshed people. They embody an issue or group — Black American teens or privileged white men or essential workers who aren’t treated that way — more than they stand out as unique individuals in need of help. Plus we haven’t heard at all how the changes wrought by COVID has impacted them, which seems quite unrealistic. In my practice my patients regularly talk about issues and feelings they have arising from the pandemic so how can it be that this is not a major element in this season?

What are your thoughts? What do you like? Dislike?  Let’s talk about it in the comments.