In Treatment, Season 4, Weeks 5 & 6

 

 

I watched the last 4 episodes of this season last week. I had really looked forward to this show. I wanted to like it and be as interested as I was in the first 3 seasons. It hasn’t turned out that way. I have not even felt moved to write about the episodes in the way I did originally. So today I will offer my impressions of the season as a whole and talk about what bothered me about it.

I have said before that I very much like the actors. They do heroic work with what they have been given. But the whole thing lacks the verisimilitude that marked the first 3 seasons. It’s not the acting but the scripts, I think. In Treatment in its original form was notable for being the best representation of psychotherapy in a drama that we have seen. Compare it with Couples Therapy on Showtime and of course, the differences are glaring. Couples Therapy is a documentary series with a real therapist so does not operate in the confines of drama. In a way, comparing the two series is unfair. In Treatment took risks and experimented with format in ways that made it more compelling than it would have been as a normal drama. And it might even be that it paved the way for CouplesTherapy by demonstrating there is an audience for such a series. All of that is to the good. So what didn’t I like this season?

As I have said before the “patients” this season all feel to me like types and not so much like real people. The dialogue too often felt academic and a bit stilted. The stories just don’t ring true for the characters. I WANTED to care for the patients and the therapist, but I couldn’t muster the empathy. The dialogue just lacks believability. I found myself rolling my eyes at the screen and expressing my annoyance out loud, which I guess shows I was engaged at least at the negative level.

No therapist is perfect. Jungians speak of the “wounded healer” — that we are drawn in part to our work because of our own wounds. We deal with those wounds in our personal therapy and analysis so as not to act them out with patients but to have our experiences serve as a source of deep understanding. Brooke like most if not all of us is wounded. That doesn’t bother me. But she, through the course of the season, is an actively drinking alcoholic and is not in treatment herself, not actively, which means she is impaired. The problems this creates actually to my mind dominate just about everything she does. While we learn that Paul is her supervisor, they do not talk regularly and she does dodge him. In this way, she echoes Paul’s dual relationship with Gina. Brooke’s friend/sponsor, Rita, cannot provide all of what Brooke needs. Just as Paul did not get a firm handle on what he needed and wanted until he enters therapy himself with Adele, so Brooke is not getting what she needs though in the closing scene of the season she does call Rita and say she is ready to stop drinking. And that is great but only part of what she needs to do.

One of if not the best episode of the season came in week 5 when Brooke was to meet with Paul. Paul cancels at the last minute which leads to the device of Brooke, the therapist, meeting with Brooke, the patient—a little gimmicky but overall it works. We learn the most about her in this episode as she confronts herself. For me, it pulled together a bunch of things. In a sense, the three patients can, as in a dream, be seen as aspects of Brooke herself. Eladio and Laila both suffer, as indeed Brooke does, from mothers who cannot give what they need. Brooke’s mother was an alcoholic and just didn’t see her really. Like Colin, Brooke contorted herself in an effort to get her mother to like and want her. 

Mother — mother absence, mother problems — is the dominant theme of the entire season. Brooke, who is motherless, gave up her only child at birth and those became absent to her own son. 

Eladio wants Brooke to be his mother, the mother his own could be. He wants unconditional love, which Brooke cannot give him. She can see and feel his transference but every time the emotions become strong and he evokes a big feeling from her, she bolts — literally leaving the room, referring him to a psychiatrist, then to another therapist. She is correct when she tells him she is failing him, but it is not at all clear that she can see it is her own unresolved mother complex and her drinking which underlie her failure.

With Colin, there is a massive boundary violation which she tacitly accepts. He shows up at her house unannounced and proceeds to act as if they should have a session. And, she does not make him leave. The next week, when he returns, they spar and he then attempts to engage her sexually. She doesn’t acceded to his desire but she does not make him leave either. To me, that was mind-boggling. There is no way to remain neutral and objective once that boundary has been crossed. That she agreed to continue to see him is a problem. This is a situation in which I believe the better course of action is to refer him elsewhere and end work with him. Brooke seemed unable to see how deep manipulative Colin is, imagining somehow that she could penetrate his thick defenses. He would momentarily look like she had found her mark but it never lasts. Colin isn’t motivated to do the work of therapy, was only there because the court ordered it. What this case did was provide a platform for some heavy handed talk about  privilege and race that entirely missed the real issues with Colin.

More than once Brooke launched into mini-lectures about theory and technique or ethics. She does this with Eladio, Colin and Laila. With Laila, instead of saying she, Brooke, is concerned that Laila might be having suicidal thoughts, she says the law requires her to ask. That feels clumsy to me and a bit impersonal. When Colin tries to engage her sexually she talks with him about erotic transference!

These things are problems with the writing. As I said before, the actors, especially Uzo Aduba as Brooke, are superb.

Reboots often fail to live up to the original. This is no exception.

So, what did you think?

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 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.

In Treatment, Season 4, Colin 1

Brooke’s second patient, Colin, is a court referral, referred for four sessions of mandated therapy. He was a tech executive who fell afoul of the law and went to prison for financial crimes. The woman with him, a parole officer I suspect, tells Brooke he must attend the sessions and that the basis for the referral is his anger issues. Brooke sees Colin face to face in her home office.

Charming at first, there’s a definite darkness underneath. He complains about the burden of being a privileged white man, knowingly provoking Brooke. Colin tells Brooke he has been therapy before, is glad to be there and glad to be out of prison. He says he “fucked up” his life. His accounting of himself is liberally laced with swearing, which he checks to see if she minds. He denies any history of violence, says he is a pacifist raised by hippies.

Colin looks around a lot and evades Brooke’s questions. He asks about her husband getting her to say she is not married. She says he is her first pro bono patient. He says he wants to talk about her, get to know her. Brooke tells him she grew up in the neighborhood they are in, that her father designed some of the houses in the area.

There is throughout an underlying tension. Colin seems used to being able to charm his way into getting what he wants. Brooke asks questions he does not want to answer. He tells her had a bad day in prison and reached his breaking point — she reminds him that in fact he was put into seclusion. He says he ruined his life.

At every turn, Colin resists giving details about himself and his history. He tried to provoke her but she resists. She confronts his downplaying and evasion. Colin is impressed and says, “You’re good. I hadn’t anticipated that.” But he is angry at her confrontations and is defensive. He claims he gets “pummeled” every time he opens up. “You want me to be safe”, he says, “but I am not safe.” This leads to mini-debate about words and a brief outburst by Colin. Clearly his charm is not working as he expected.

Brooke asks how it has been since he got out of prison. He tells her it’s okay but that people don’t want to be around him. Then he says “I fucked a lot of therapists. How about you? Have you fucked a patient?” and shits on his former therapists. Brooke wonders if he is up to the work of therapy. He apologizes and attributes his behavior to stress. Lots and lots of words but not much meaning.

Colin leaves. Brooke gets up and gets herself a drink.

 Colin is a tough patient. I wonder why Brooke is willing to take him on under the four sessions mandate because it is very doubtful that anything meaningful can be accomplished in that time. No doubt there is a lot to mine in Colin’s history and it likely would take a fairly long time to get him to settle down and actually engage with Brooke in their shared work.

Colin masks his rage and hostility beneath a thin veneer of charm. He talks a lot but much of what he says seems aimed at getting a rise out of Brooke. She skillfully parries his attempts to goad her. My guess is that it is a bit of an exhausting hour — witness her need for a drink after he leaves. And what is that about? Why alcohol? 

What do you think about Colin? About Brooke’s response to him? Does anything surprise you?

Attention Fans of In Treatment!

Ten years ago, HBO’s In Treatment ended its third season with no prospects in sight for renewal. I had blogged every one of the episodes as they were broadcast, a big undertaking for what was then a relatively new blog. I loved the series and see it as the best fictional representation of therapy that I have seen. The liberties taken for the sake of drama and the way the pace of therapy was made to fit the show did not bother me for it was the issues it raised and the interactions between therapist and patient it showed that struck me. And it was a good opportunity to discuss ways the the therapist, as portrayed by Gabriel Byrne, deviated from and/or stayed with the boundaries of therapy. So when it ended, I was very disappointed. I had not only written a lot about the show, but had also used it to teach three courses in my local Senior College.

Imagine my delight when HBO announced a little while ago that it was bringing one of my all time favorite shows back for a new season. And now the debut of Season 4 is almost upon us – starting tomorrow, Sunday May 23.

We will see a new therapist, played by Uzo Aduba, a black woman. And it is set in Los Angeles rather than New York. For an overview of the coming season, check out this article from the NY Times. And I will be posting my comments on each episode starting Monday morning. 

Be Still My Heart

What was rumored a few weeks ago is becoming a reality — In Treatment Season 4! Uzo Aduba (Emmy® winner for “Mrs. America” and “Orange is the New Black”) will play the lead role of the therapist at the center of the season, Dr. Brooke Lawrence.

Back in 2008 when the series first ran and this site was new, I became a big fan and wrote about each episode as it ran. You can find these posts still by selecting In Treatment above and choosing the season you wish to read about. If you haven’t seen this series, I urge you to do so — it is available on DVD and if you subscribe to HBO Max, is available there. And of course, do read my posts and ask questions and comment — more discussion is welcome.

In my mind, this is the best dramatic presentation of therapy I have seen. Of course the therapy is compacted and made more dramatic for purposes of the drama. But still, it is faithful to the basics.

In sadder news, Daniel Menaker, who wrote my favorite novel about psychoanalysis (this is a genre, you ask??), died this week. His book,The Treatment, which was also made into a movie, is based on his own analysis. The book is funny and moving and well worth the read.

Good News!

Photo of Paul
Photo of Paul

Back in 2008 when Jung at Heart was still pretty new, HBO began running a series about a psychotherapist and his patients. The show was called In Treatment. I loved it from the start and I set upon myself the task of blogging every episode, no small feat given that in the first season, there was a new episode every weeknight. I thought then and still believe that it is the best dramatic representation of therapy done to date. If you want to read what I wrote, just click on the In Treatment link at the top of the page — season by season, al the posts are there.

Friday I ran across this announcement — Big news! HBO plans to reboot the series. You can bet I will be watching and writing about each episode. In the meantime if you have questions or comments about the series or what I wrote about it, please post in the comments here.

In Treatment: Jake and Amy

Today we meet Jake and Amy. Jake is restless and agitated because he has arrived for the appointment with Paul and Amy has not. He paces, makes calls trying to find her. Jake does not want to stay and begin without Amy. Amy finally arrives. 

This is their third session and Paul observes that Amy has been late each time. Jake interrogates Amy about where she was, clearly suspecting that she is keeping a secret from him. And then it emerges — they are there trying to decide whether or not to have an abortion and he suspects she has finalized the plans. So among other things, this couple is struggling over whether or not to have another child, Amy’s fears that she cannot do it, and Jake’s desire to proceed. But they are each enacting the other’s ambivalence.

Now, I rarely work with couples; I find it less satisfying than working with individuals. To me, with couples it feels like there are too many people in the room — the couple and all of the shadow couples in their lives that they bring with them. And I simply do not feel as well equipped to deal with them as I do with individuals. So, I confess I had less investment in this episode and found it less engaging.

At the end of the session, when Jake and Amy leave after provoking Paul, he makes a call — to his own therapist. Which is where we go tomorrow.

Tomorrow I pull together thoughts about what we have seen so far.

In Treatment: Laura

I am happy to report, as has Glen Gabbard in Slate, that In Treatment does a good job of portraying psychotherapy reasonably accurately. The session, condensed as it is into 30 minutes, manages convey something close to what actual therapy is like, as close, probably, as television can come without turning to a reality show format, and that would be dreadful.

Our Monday night patient is Laura. Last night and on succeeding Mondays we will see her at her sessions. From the HBO website, we learn that Laura is an anesthesiologist and we learn in the session that she has been seeing Paul Weston, the therapist for about a year. Laura comes to this session in a bit of a crisis and reveals she has been outside waiting for her appointment time(9 am) for several hours. The crisis stems, she tells Paul, from an ultimatum her boyfriend, Andrew, issued that they should get married or break up, an ultimatum that caused a fight and her flight from their apartment to a friend, then a club and sexual acting out with a stranger. A stranger she also characterizes as giving her an ultimatum. In the telling of the events, she reveals that at the crucial moment with the stranger, she thought of Paul,  the therapist, and attempted to extricate herself from the situation. After the revelation of what happened, she runs to the bathroom and we hear her apparently throwing up and then we see her looking at the items on the shelf over the sink. When she picks up what seems to be Paul’s hairbrush and brushes her hair with it, I got a pretty good idea that we would be hearing about an erotic transference. Laura reveals to Paul that she has loved him from their first meeting and that she has felt she has in fact been unfaithful to Andrew all along because Paul is the center of her life. Paul is clearly a bit uncomfortable with Laura’s declaration of love and moves quickly to enforce the boundaries. 

Paul does a good job of opening up what had actually happened between Laura and Andrew, that the ultimatum actually came from her. He is quite believable in the process. Of course he does not know, as we, the audience do, about the hairbrush, which might have been a tipoff for him about her feelings. In a purely clinical sense, I wish he had responded to her declaration of love and desire less defensively, for his need to assert the boundaries at that moment does seem defensive, arising as it likely does from his countertransference. ** Optimally he would have allowed her feelings without reacting in that way and waited to assert the boundaries, because his reaction could lead her to simply refuse to talk about it further and her feelings to fall back into the secrecy in which she had held them for the year she has been seeing him. Confessing to these feelings is already difficult. Her response to his boundary statement, that she will not boil his kid’s rabbit (referring to Fatal Attraction) hints at the complexity of her feelings and a possible anger at his firm, even if appropriate, rejection. 

On the other hand, the portrayal of his discomfort lets us see that therapists are most assuredly human, struggle with feelings and thoughts of their own and sometimes hit the mark while at others missing it, even if only slightly.

The folks who endorse a really tight therapeutic frame would have a field day here. There is plenty to think about for those of us who practice at home and whose offices do not have a separate dedicated bathroom. A home office always means that aspects of the therapist’s private life are visible, though rarely so readily available as that hairbrush. Like Gabbard, I have seldom had patients use the bathroom during a session, but I will be more attentive to what is and isn’t openly viewable just in case.

Tonight we meet Alex.

**For the non-therapists reading, I mean here that her declaration arouses feelings in him, making him uncomfortable, which he acts out by asserting control via stating the boundaries of a therapeutic relationship. 

In Treatment: Sophie

Tonight we meet Sophie, a 16 yr old who has come to see Paul for a professional evaluation for her lawsuit. We see that both of her arms are in casts and she tells us a bit about her accident, while claiming amnesia for any details. 

The episode opens with Paul’s son angling to stay home from school and getting caught out in the process. He storms out of the room telling Paul, “You never believe me!” — which we should know will figure in Paul’s work with Sophie.

Sophie declares she is not interested in therapy. She essentially tells Paul she wants as little interaction with him as possible in order to get the evaluation. So she begins as many adolescents do, with great reluctance and mistrust about the process. Paul, and we, can feel that there is more here to Sophie than meets the eye and he skillfully woos her into talking more than she’d planned and into coming back for 3 more sessions. He expertly gains some trust from her and subtly engages her in the process without pushing hard or making her take flight, though at one point near the beginning she does start to bolt. His work with her was a pleasure to watch.

As Sophie talks about how close she is to her father, who moves so often she has to call 411 to get his phone number, and says that he and her coach are the only two people who love, there is the hint that something is very wrong in Sophie’s world. This accident is not her first one where she flies off a moving vehicle and injures herself in what looks enough like suicide attempts to have been named just that. Two accidents like that in a couple of years for one kid set off alarm bells. And then the drawing on her cast of the mermaid made by her male coach. My hunch is that some sexual boundaries have been crossed. 

Paul is wise to take this very slowly. He has to win her over, to let her develop trust in him, to be the good father, reliable an present that she needs in her life — we see that in her questions about Paul’s daughter.

Nice work, Paul!

Tomorrow night — Jake & Amy