In Treatment — the first week

Photo of Paul

So now we have seen Paul with each of the four patients and also seen him with Gina — his therapist/supervisor/sounding board. Themes emerge.

 ~~ Laura with her disappointment in Andrew and her infatuation with Paul

 ~~ Sophie who cannot put into words what she is suffering at the hands of her coach and father

 ~~ Alex who has no room in his sense of himself for the pain and horror of having done great harm in service of his mission

 ~~ Jake & Amy whose unborn child is the container for their discontent and product of their ambivalence about each other

 ~~ And Paul whose patients set him swimming in a sea of painful feelings which underline his own — in his marriage and with Gina.

Love and longing and disappointment and sex  and fear and anger — the stuff of therapy. 

There has been an extended discussion in the comments to my post on the first episode, not surprising given that Laura’s declaration of love for Paul touches on a lot of issues. I liked what Gina suggested last night — that yes, erotic transferences are common, but when the therapist experiences problems handling one or has a strong response, that is an indicator of an issue within the therapist, most often in his own marriage. And this is why Gina repeated several times that Paul needs to get help, i.e. supervision, on this, because his own marital issues make the risks of mishandling or even acting out with his patient higher than usual.

Good therapists understand that we will get our own issued tripped by patients and that sometimes this creates enough confusion in us that we need to be able to talk with another experienced clinician to help us deal with the problem. Supervision of this kind is far less about the patient than it is the therapist, a kind of therapy for the therapy. It is not an easy process and often the line between therapy and supervision is a fine one indeed. It is not a sign of failure or lack of skill for a therapist to see and act on the need for supervision; indeed it is a sign of a therapist who is deeply committed to being as ethical and conscious about the work as is humanly possible. No therapist is without blind spots and personal issues. The key is to remember that and be willing to recognize our need for help.

So, what do you think?