Fink! Still at Large: Shrinking 'The Sopranos'. (Opinion)

By Fink, Paul J.; Hoban, David | Clinical Psychiatry News, January 2002 | Go to article overview
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Fink! Still at Large: Shrinking 'The Sopranos'. (Opinion)


Fink, Paul J., Hoban, David, Clinical Psychiatry News


The New York Times credits "The Sopranos" with being a kind of endorsement for psychotherapy at a time when psychotherapy is struggling to regain ground lost to psychopharmacology and biologic psychiatry. The Times cites psychiatrists as major fans of the series. What does their infatuation with "The Sopranos" really say about psychiatrists?

As many as 75% of psychiatrists do not watch "The Sopranos," if you can believe the results of a highly unscientific poll conducted by CLINICAL PSYCHIATRY NEWS.

Countering the assertion that the hit television series enjoys an "almost cultish devotion" among the nation's psychiatrists, only 5 of 20 psychiatrists we polled have actually watched the show.

"The Sopranos" producer David Chase has never employed a psychotherapist to consult with the show's writers, this newspaper was told by the studio. This didn't bother the psychiatrists we interviewed: "Somebody on that show has had psychotherapy," said University of Illinois, Chicago, psychiatrist Carl Bell, and they do "a fairly decent job" of depicting it.

Private practitioner Dr. Ahmad Almai, who teaches at Yale, said that although he usually enjoys the show, it took him 2 weeks to recover from watching the blud-geoning death of a mobster's girlfriend.

As an anxiety specialist, Dr. Almai also questioned the show's depiction of Tony Soprano's panic attacks. People with panic disorder, he argued, "frequently become reclusive, somewhat shy characters, not antisocial sociopaths who run crime families.

Boston psychiatrist Patricia Norman gave the show's therapist, Dr. Melfi's, approach with the mobster favorable marks but faulted her short skirts. "Therapists make an effort not to dress provocatively" she said.

One respondent who claims never to have missed an episode is Dr. Norman Rosenthal, clinical professor of psychiatry at Georgetown Medical School and former senior researcher in psychiatry and psychobiology at the National Institutes of Mental Health. "'The Sopranos' is the classic depiction of the son of a borderline woman who is volatile, self-preoccupied, complaining, abusive, and, in the end, colluding in a plan to murder her son," he said. "That was 'The Sopranos at its best. If it stopped there, it would have been a brilliant, classical, self-contained gem.

But the show errs in Dr. Melfi's exploration of the origins of Tony's panic attacks, he added. She associates the attacks with Tony's feeling of abandonment at the ducks' departure from his swimming pool, as well as with an early childhood memory of his father's brutality toward the neighbor. hood butcher.

"This is an old Freudian notion untenable in light of modern psychiatry It makes better viewing to think he's having his panic attacks because of the ducks than because his nor-epinephrine system is misguided," Dr. Rosenthal said.

Dr. Fink's Response

"The Sopranos" is an excellent show, It has received high ratings, but not because it depicts the excellent work of a psychiatrist with a Mafia boss with panic disorder, It is a drama that bears no resemblance to how real life psychiatry is practiced.

I think psychiatrists enjoy the show because it is a good commercial-free story about the Mafia. In that sense, psychiatrists are no different than anyone else; they can find escape in a story about crime and punishment as well as brutality, murder, and betrayal. Although Tony's mother is an evil, despicable woman, her characterization is not relevant to the psychological situation in which he finds himself.

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