Getting It Right: In HBO's in Treatment, Art Imitates Therapy

By Layton, Molly | Psychotherapy Networker, July/August 2008 | Go to article overview

Getting It Right: In HBO's in Treatment, Art Imitates Therapy


Layton, Molly, Psychotherapy Networker


Getting It Right In HBO's In Treatment, Art Imitates Therapy

By Molly Layton

I was into the sixth week, at five shows a week, of watching In Treatment, the HBO fictional series about a psychotherapist in the Washington, D.C., area, when one Monday morning in my own office I found myself--how to say this?--sitting in my chair like the therapist, Paul (played by a craggy, lean-faced Gabriel Byrne, Irish accent and all). Or maybe it was his supervisor, Gina (Dianne Wiest, looking both relaxed and regal). Something had happened to my posture: I'd straightened up, become more organized around the midline of the body. I guessed there was some imitative mirror-neuron thing at work, as if all those hours of watching other therapists, albeit fictional ones, had made me more aware of my own sitting. "Well, we don't often get to see ourselves quite so clearly," a friend explained.

I'd been talking with other therapists, following the blogs about the show, taking in the opinionated, antsy reactions: this intervention was wrong, that part was false, a therapist shouldn't do this or that, as if the show were a training tape from the American Psychological Association. As for myself, I watched it not with an eye to whether the series got the details of psychotherapy right, but whether it got being a therapist right.

In Treatment was originally the wildly popular Israeli series Betipul, and except for a few changes and some significant Americanizations, the HBO series matches it word for word. The idea was to follow the therapist (played in the Israeli series by the rumpled, masculine Assi Dayan, the son of Moshe Dayan) through week after week of therapy sessions. When we tune in on a Monday, we see Monday's patient; on Tuesday, the regular Tuesday patient; and so on, until the fifth day of the week, when Paul sits at last in his supervisor Gina's office, talking over the week's problems.

With 43 shows in all, In Treatment is an unprecedented immersion in the ebb and flow of ongoing therapy. In addition to the cases themselves, we're privy to how Paul thinks about these patients via his supervision sessions with Gina, where he is often as angry, confused, and self-deluding as he is perceptive and responsible. You know, just like . . . a psychotherapist.

In the first week, Paul has to intervene with a couple when the husband, Jake, verbally attacks his wife, Amy, because she's been considering an abortion without consulting him. Look, Paul says, it's not just about this decision you have to make. He points out Jake's belligerence and Amy's sneering evasion. Then he asks, Isn't this all really about your relationship?

Our relationship?! Jake shouts, Are you serious?! How do you sleep at night? We came here for advice about this pregnancy! He yells some more, and then stomps out.

I felt a jolt of recognition. Sure, that's how a couple sometimes deals with their own disheartening sensations: they turn on the therapist; they accuse the therapist of letting them down. Every couples therapist knows what I'm talking about. Well, I thought, the writers got that right.

Next evening, Paul meets with Gina, now retired and trying to write fiction. These two have been estranged for more than nine years, since the time he left her supervision in a huff at how she'd interfered with his work. Their falling-out hardened when Paul failed to show up at her husband's funeral. The memory of that act obviously still hurts her. You must have been really angry at me, she observes, not to have attended David's funeral.

I was watching the program with a group of therapist friends who'd gathered to see a week's worth of episodes. All of us were old hands at supervising other therapists. Some of us had met long ago behind the one-way mirrors of the Philadelphia Child Guidance Clinic, and now we sat entranced in front of a wide-screen television set. Hmmm, the group was wondering, why has Paul come back to this confusing relationship with Gina? …

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