Tag Archives: “In Treatment”

May 07

“In Treatment”: Therapy for the Masses

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With a new and fourth season of In Treatment coming to HBO Max later this month, starring Uzo Aduba as the therapist, I’m posting today about the first three seasons (2008 to 2010). This series about Paul Weston (Gabriel Byrne) both providing therapy and receiving it was based on Hagai Levi‘s Israeli series Be’Tipul, which ran two seasons.

As reported by Gaby Wood, The Guardian, Be’Tipul‘s Levi was motivated by a desire to reduce mental health stigma in Israel. Levi felt that whereas in the U.S. “people mention their therapist at the drop of a hat,” not so in Israel. The series went on to become popular among clients, therapists, and many more, including those discovering acceptable therapy depiction for the first time.

In the American-made In Treatment Paul Weston’s therapist is Gina (Dianne Wiest). While Paul is a “boundary-challenged, deeply conflicted, terribly appealing psychotherapist” (Michelle Orange, New York Times), Gina “[cuts] through Weston’s self-absorbed obsessions” (Peabody Awards).

Clinicians and critics had varying but mostly positive opinions about In Treatment‘s portrayal of therapy sessions, viewed in 30-minute segments as opposed to the standard therapy “hour.” Psychologist Ryan Howes, self-confessed lover/hater of the series, listed his pros and cons in a Psychology Today article titled  “In Treatment Ambivalence.”

Excerpts from a sampling of Howes’s cons:

    • …Paul often begins sparring with new patients before they take off their coat…
    • Paul attended a psychoanalytic institute, but his therapeutic approach doesn’t always appear psychodynamic. It’s more like Rogerian reflection and withholding, which results in the frustrated patient demanding advice, followed by Paul’s defensive reaction and howitzer-like interpretation.
    • In each episode you’ll hear several variations of an accusatory: “so you’re telling me…” or “you think I’m saying…” or “what’s that supposed to mean?” followed by an infuriating misinterpretation. Wait a minute, I’ve got an idea: Introducing The In Treatment Drinking Game: take a shot every time someone makes an assumption, questions the validity of therapy and/or storms out of the session early.

A sampling of pros:

    • The writers may not have Ph.D.’s, but they get a lot right about therapy….
    • It reveals the “layers of the onion” in therapy incredibly well. The patients enter therapy with an immediate and obvious complaint. As the weeks unfold, you see how the problem has roots that extend deeper and deeper.
    • I’ve heard unsubstantiated rumors that complaints are made to licensing boards about Paul’s behaviors. If this is true, I love this….

At the start of the second season Jeremy Clyman, Psy.D, wrote in Psychology Today, “At last the field of clinical psychology has a show free of melodrama and full of the detail and depth necessary to realistically represent the therapeutic process. Predictably enough, patients all across the country are discussing the show in therapy and therapists are discussing it with each other.”

Because Be’Tipul only had two seasons, the third In Treatment season was created from scratch. Furthermore, it involved Paul having a different therapist (Amy Ryan). A fitting summary from Nancy Doyle Palmer, HuffPost:

Ryan plays Adele, Paul’s end-of-the week analyst and foil, who at first glance seemed perhaps too young and fresh-faced for the task — but quickly took on him, his patients’ issues of the week and his 30 year plus roster of mommy/mentor/tortured Irish issues. She’s pitch perfect in a completely new way and knows just how to handle him…

While demonstrating the finest qualities of a therapist Monday through Thursday – deeply caring, observant, benevolent and wise – Paul comes to Adele (as he did to Weist’s Gina) often in a rage – harsh, condescending, duplicitous and game-playing – basically giving credence to the fact that doctors are the worst patients ever and shrinks, well…

Jun 30

“Gypsy”: Role Model for Unethical Therapists

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Coming to Netflix today is Lisa Rubin‘s Gypsy, a widely panned series starring Naomi Watts as a therapist—a vastly unethical therapist.

Rubin offers this official film description: “Gypsy is a ten-part psychological thriller that follows Jean Halloway (Naomi Watts), a Manhattan therapist with a seemingly picturesque life who begins to develop intimate and illicit relationships with the people in her patients’ lives. As the borders of Jean’s professional life and personal fantasies become blurred, she descends into a world where the forces of desire and reality are disastrously at odds.”

Psychological thriller? Most critics seriously question how well Gypsy fills that particular bill.

Further plot details from Jen Chaney, Vulture:

Happily married (Billy Crudup plays Michael, her handsome lawyer-husband) with a daughter, a nice home, and a New York City office yanked straight out of a Z Gallerie catalogue, Jean ticks most of the boxes on the ‘she has it all’ checklist. She does have some issues, though, including a strained relationship with her mother (Blythe Danner), difficulty coming to terms with her non-gender-conforming daughter, and a low-simmering jealousy of the relationship between Michael and his assistant. To cope, Jean does what Gypsy the series does: spend minimal time genuinely exploring these matters in order to channel energy into unethically infiltrating the social and family circles of her patients.

Selected Reviews: Comparisons and Conclusions

Dan Fienberg, Hollywood Reporter: “Watts doesn’t play Jean as victim or villain and Gypsy doesn’t judge Jean, though many viewers are probably going to think it should. Professionally, the things she’s doing are wrong and the show’s only real tension comes from playing the same, ‘Is she about to get caught in her latest lie?’ beats over and over without offering an alternative perspective, allowing us to root for the cruelly manipulated patients.”

Jen Chaney, Vulture: “It’s like In Treatment with more weird, stalker-y behavior, except when it’s delving into Jean’s conflicts with fellow moms in her chichi Connecticut suburb. Then it’s like a far inferior version of Big Little Lies.”

Maureen Ryan, Variety:

It’s hard not to compare this show to ‘In Treatment,’ the HBO series about a therapist which had the good sense to keep its episodes to under 30 minutes. Not only did that series do a better job of turning most clients into three-dimensional people, it distilled the intensity of sessions into efficient, effective installments.
What transpires in Jean’s office, however, usually lacks insight and spontaneity, and her patients — who nurture obsessions with people who don’t return their interest — are a pallid, moderately annoying bunch. Jean’s eyes often glaze over with boredom, and it’s easy to see why.

Inkoo Kang, Village Voice: “The show is a confluence of interesting ideas: female midlife crises, competitive mothering, the parenting of a very young trans child, the invisibility of female sociopathy, mental-health professionals’ frustration at their own helplessness, and, especially, the vicarious thrills therapists (might) experience when they hear about the life-derailing pleasures that got their patients into trouble. But each scene wastes every opportunity to reach for something fresh or original.”

Brian Tallerico, rogerebert.com:

…a depressingly bad show for the talent it wastes on horrendous dialogue, unbelievable characters, and the kind of soapy plotting you’re more likely to see on a Lifetime TV movie than prestige drama…
Worst of all, none of it rings true…If I was the show’s therapist, I’d suggest it stop taking itself so damn seriously. Pick up the pace and give us something to care about. Get to the point and stop dancing around your issues. Because no one wants to dance this slowly.

Aug 23

The World Capital of Psychotherapy May Be Argentina

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Is Argentina the world capital of psychotherapy? According to the New York Times:

The number of practicing psychologists in Argentina has been surging, to 196 per 100,000 people last year, according to a study by Modesto Alonso, a psychologist and researcher, from 145 per 100,000 in 2008.

That compares with about 27 psychologists per 100,000 people in the United States, according to the American Psychological Association.

And that’s just the psychologists, only one of several disciplines in which psychotherapists practice. In other words, what about clinical social workers, psychiatrists, mental health counselors, etc.?

Another (now unlinkable) source gives a broader breakdown. Stating that “Argentines are officially the most analyzed people in the world,” the report says there are 15 therapists for every 1000 residents.

Psychoanalysis has apparently found much popularity ever since Freud’s ideas emigrated there in the early 20th century. However, the other end of the spectrum—cognitive-behavioral therapy and other of the shorter-term approaches—is also represented in Argentina.

Apparently high fees don’t necessarily pose a big issue. From the NY Times article: “Andrés Raskovsky, president of the Argentine Psychoanalytic Association, recently asserted that psychoanalysis had little risk of extinction in Argentina since seeing a psychologist twice a week is still viewed as being affordable for much of the population.” When people can’t afford it, sliding scale fees and other types of arrangements are often offered; also, public insurance covers it for some.

One analyst interviewed about the wide acceptance and use of therapy in Argentina says that it’s basically about their people liking to talk—as well as liking having someone to listen.

Could it really be that simple? Probably not.

Maybe Argentinians are more in need of therapy than other folks? Unlikely. In one article last year (update 2018: source no longer available), two therapists who were both originally from the U.S. but now practice in Argentina observe that people have essentially the same types of problems there as anywhere. As stated by one, Steven Nissenbaum: “It doesn’t make a difference what the culture is – people are people. Problems include life transitions, relationships, family, health or addictions.”

Therapy is also big in their popular culture, with the TV show In Treatment, starring Gabriel Byrne as a shrink, currently being quite popular. In addition, on the “Broadway of Buenos Aires” you can now find a staging of “Freud’s Last Session,” last year’s winner of New York’s Off Broadway Alliance award. It’s about the conversations that take place when the seriously ailing Freud invites writer C.S. Lewis to his home in London.

Michael Tanenbaum describes the play for The Argentina Independent:

As the two men carry on their debate – Lewis equating psychoanalysis with intellectual religion and Freud swatting away God as an infantile fantasy – the conversation and circumstances take multiple turns in subject, intensity, and competitive edge, bringing the men together at a historically fateful moment…

God, love, sex, and the meaning of life may be suitable tag words for this play, but overwhelmingly it is a display of the walls we build up and break down in dialogue with ourselves and others.

Another hit play “Toc Toc,” about six characters with obsessive-compulsive disorder who meet in their psychiatrist’s waiting room, is also currently playing.

World capital of psychotherapy? Certainly in the running.