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Updated: Jul 10, 2023

Author: Nidhi
Editor: Jasmeen Kaur, Arnab Ghosh

“In Treatment” - is a show that shows the life of a psychologist and what happens in therapy in a weekly format. Based on the Israeli television serial BeTipul, "In Treatment" is a 2008 American drama television series (4 seasons) for HBO that was produced and developed by Rodrigo Garcia. Season 1 depicts the life of psychotherapist Paul Weston, who also receives therapy from his former supervisor "Gina" in between conducting sessions for his clients.

From a story and direction perspective, the show weaves multiple levels of intricate emotion and drama, providing for enough variety and fluidity to let each episode stand out from the others. The series becomes more intriguing as each episode goes by, in part due to some excellent and sensitive acting by Gabriel Byrne as the aforementioned psychoanalyst and by several of his patients and in part by the exploration of concepts of psychology through the lens of the sessions.

Every Monday for a half-hour, Melissa George, playing Laura, an anaesthesiologist, tries to seduce Paul. As the series progresses, Laura openly declares her love for Paul, complicating their relationship and the dynamics of their therapeutic journey. One of the central themes explored in these sessions is the ethical responsibility of psychologists to maintain a professional relationship with their clients. Paul, as a therapist, faces the challenge of navigating Laura's romantic advances while upholding the boundaries of their therapeutic alliance. It highlights the importance of maintaining professional integrity and adhering to the ethical principles of the therapeutic profession. Additionally, the show delves into the psychoanalytic phenomenon known as transference. Transference occurs when an individual redirects their feelings, desires, or unresolved conflicts from one person onto another, often the therapist in a therapeutic setting. In this case, Laura's attraction to Paul represents a form of transference, as she transfers her romantic feelings and desires onto him during their therapy sessions. Transference is a significant concept in psychoanalysis, as it provides insights into the client's past experiences, relationships, and unresolved conflicts. It allows therapists to gain a deeper understanding of their clients' emotional and psychological dynamics, helping them address underlying issues and provide appropriate guidance and support. Laura's transference towards Paul adds complexity to their therapy sessions. It challenges Paul's ability to navigate the boundaries of their therapeutic relationship and address the underlying issues driving Laura's transference. It also presents an opportunity for both characters to explore Laura's traumatic childhood and strained relationships, shedding light on the origins of her emotional struggles and providing a pathway for healing and growth.

On Tuesdays, Alex played by Blair Underwood, a Navy pilot who prefers to be numb instead of feeling guilty about his airstrikes in Iraq, takes his sessions and throughout their therapeutic journey, Alex's struggles and emotional conflicts are brought to the forefront. One of the central themes in Alex's therapy is his preference for emotional numbness as a way to avoid confronting his guilt. Rather than facing his feelings head-on, he resorts to anger and verbal abuse towards Paul. This defensive behaviour is a common manifestation of individuals who find it challenging to cope with overwhelming emotions. By lashing out, Alex creates a protective barrier that shields him from confronting the guilt and pain associated with his actions. During the course of therapy, Alex develops a brief relationship with Laura (another patient), which adds another layer of complexity to his emotional landscape. Despite his difficulties in communicating his inner conflicts, the relationship with Laura serves as a temporary respite from his guilt. However, it is essential to note that relationships formed as a way to escape or distract oneself from emotional distress often do not provide long-term solutions to unresolved trauma. The sessions with Alex tend to revolve heavily around the idea that our relationship with our parents influences and shapes our future behaviour and patterns. This focus on parental influence is grounded in psychoanalytic theories that emphasize the significance of early experiences and attachment dynamics in shaping an individual's psychological development. By exploring Alex's relationship with his father, Paul aims to uncover underlying patterns and unresolved issues that may contribute to Alex's struggles with guilt and emotional numbness.

On Wednesdays, Mia Wasikowska plays Sophie, a 16-year-old gymnast who is tormented by both her personal relationship with a coach who is older than her father and her two broken arms. Paul explores Sophie's adolescent sexual relationship with her much older gymnastics coach, Cy, and its repercussions on her, as well as her mixed sentiments about her separated parents and her father's isolation from her, in order to extract and break down her ambivalence about life. The therapy sessions with Sophie in the series highlight the delicate balance between addressing a client's needs and maintaining ethical boundaries. Sophie's initial motive for entering therapy, seeking a written statement to prove her accident was not a suicide attempt, reveals her resistance to the therapeutic process. This resistance can stem from a fear of being judged or a reluctance to confront deep-rooted issues.

As therapy progresses, Sophie's testing of Paul and her attempt to take her own life within the session with sleeping pills demonstrate the extent of her distress and her need for validation and understanding. These actions also underscore the intensity of her emotional turmoil and the complexity of her trauma .In response to Sophie's challenging behaviour, Paul exemplifies the qualities of a skilled and compassionate therapist. Despite the severity of the situation, Paul maintains his calm and endeavours to gain Sophie's trust. Building rapport and earning a client's trust is crucial in therapy, as it provides a foundation for open and honest communication. Paul's steadfastness in the face of Sophie's actions reflects his commitment to the therapeutic process and his dedication to helping her navigate her struggles.

By delving into Sophie's ambivalence, addressing her relationships with her coach and parents, and navigating the boundaries of the therapeutic space, Paul aims to facilitate Sophie's journey towards self-discovery, resilience, and a healthier outlook on life.

On Thursdays, Josh Charles plays Jake, a song writing husband with a different goal, and Embeth Davidtz plays Amy, a career woman inclined to terminate her troublesome pregnancy. The depiction of Jake and Amy's therapy sessions in the series raises important considerations about couples therapy and the potential outcomes it can have on a relationship. It highlights the notion that couples therapy is not a guaranteed solution to save a troubled marriage and may sometimes lead to divorce. However, it is essential to understand that therapy does not inherently cause divorce but rather provides a space for couples to explore their issues, evaluate their values and needs, and make informed decisions about their relationship.In the case of Jake and Amy, their therapy journey showcases differing perspectives on the impact of therapy on their marriage. Jake believes that therapy was helpful, indicating that it allowed him to gain insights, improve communication, and work towards resolving their issues. On the other hand, Amy feels that therapy harmed their marriage, suggesting that the process may have brought to light irreconcilable differences or revealed underlying problems that were difficult to address. It is important to recognize that couples therapy aims to facilitate open and honest communication, foster understanding, and provide tools for conflict resolution. While therapy can be a transformative experience for some couples, it is not a guarantee that every relationship will be repaired or sustained. In certain cases, therapy can uncover fundamental differences in values, incompatible goals, or patterns of behavior that are difficult to reconcile, leading to the realization that divorce may be the best course of action for both individuals' long-term happiness and well-being. It is crucial to approach couples therapy with realistic expectations and an understanding that the goal is not solely to prevent divorce at all costs. The objective is to create a healthier and more fulfilling relationship, whether that involves staying together or parting ways amicably. Therapy provides a supportive environment for couples to explore their options, identify their needs, and make informed decisions about the future of their relationship.

Every Friday, Paul sees his own therapist, Dianne Wiest, who plays Dr. Gina Toll, a former mentor who later violated his confidence by expressing her reservations in a letter of recommendation for Paul but who still understands how to get under Paul's skin. The portrayal of Paul's therapy sessions with Dr. Gina Toll in the series highlights several important aspects of the therapeutic relationship and the role of therapists in their personal lives. The depiction emphasizes that therapists, like any other individuals, are not exempt from their own personal challenges and struggles. It serves as a reminder that therapists are also human beings with their own complexities and vulnerabilities. Throughout the season, Paul and Gina engage in heated arguments, reflecting their shared past and differing perspectives. This dynamic showcases the inherent tension and disagreements that can arise between therapist and client, particularly when there is a history and a complex relationship involved. It underscores the fact that therapy is not always smooth sailing, and conflicts and differences of opinion can arise, even between therapist and client.

Furthermore, the series depicts Dr. Gina Toll's violation of Paul's confidence by expressing reservations in a letter of recommendation for him. This portrayal acknowledges that therapists, despite their professional responsibilities, are not infallible and may make mistakes or act in ways that are ethically questionable. It highlights the importance of ethical guidelines and professional boundaries in therapy, as well as the significance of trust and confidentiality between therapist and client.

Towards the conclusion of the season, Paul recognizes the value of Dr. Gina Toll's input and decides to continue therapy with her. This development underscores the notion that therapy can be a transformative process that requires time, effort, and a willingness to confront difficult emotions and confrontations. The portrayal of Paul and Gina's therapy sessions also suggests the importance of therapists seeking their own supervision or personal therapy. It implies that therapists, despite their professional expertise, may benefit from guidance and support in navigating their own challenges and dilemmas.

Like every other TV programme, "In Treatment" has its ups and downs, which are widely discussed. One such discussion happened at APA's annual convention in collaboration with Robert Simmermon, PhD, a private psychologist in Atlanta, to talk on the show's impact on psychology. While some psychologists expressed their worries, many of them accepted the programme and even used it as a teaching tool.

One positive effect of the show is that it has helped reduce the stigma associated with therapy. Patients have discussed the show with their therapists, and some individuals have been inspired to consider seeking therapy themselves. By portraying therapy as a valuable and meaningful process, "In Treatment" has played a role in normalizing the idea of seeking professional help for mental health issues.

The show primarily focuses on "talk therapy," where the therapeutic work is centered around conversations between the therapist and the client. While some psychologists appreciate this depiction, others have pointed out that it lacks the inclusion of other therapeutic techniques or interventions, such as breathing exercises or homework assignments. These interventions are indeed valuable and can be essential for facilitating change and personal growth in therapy.

The series also sheds light on the challenges that psychologists themselves face. Paul's own therapy sessions and his struggle with emotional entanglement with a patient who has feelings for him reflect the real-world complexities and ethical dilemmas that psychologists may encounter in their professional lives. This portrayal humanizes therapists, showing that they too have their own personal issues and vulnerabilities.

Personally, the series focussed more on psychodynamic approach to therapy and there were almost no concrete interventions such as breathing work, homework evaluation etc which are equally important part of therapy and for change to take place.

While the show has its strengths and limitations, its impact on psychology and the discussions it has generated highlight the importance of representation and dialogue around mental health and therapy. It has sparked conversations among professionals and patients, contributing to a greater understanding and acceptance of therapy as a valuable tool for personal growth and well-being.

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