Saturday, January 26, 2008

Psychotherapy on Television


I'm not sure if this is a good thing or not, but it almost makes me wish I had cable/HBO. I'm really curious to see how they do this, whether they get it "right," or if they are just sensationalizing the voyeuristic urge in their viewers.

From the New York Times Magazine:

This Monday night, with the debut of the HBO series “In Treatment,” viewers will get a chance to sit in on the therapeutic endeavor like silent, third presences. The series originated in Israel, where it attracted a huge audience; one of Israel’s leading newspapers described it as “the closest thing to literature to be found nowadays on television.” The show will air for nine weeks in half-hour episodes, five days a week. The patients (an adolescent, a woman, a man and a couple) are each accorded their own night, as they fumble, weep and wrestle their way — “Believe me, you’d be shocked to know the person that’s sitting here,” one patient declares — through their experiences with a therapist, Paul Weston (played by Gabriel Byrne). In the fifth session, Weston explores his own fantasies and obsessions with his former therapist (Dianne Wiest).

“In Treatment,” unlike other shows about therapists, like “Huff” and “Frasier,” takes the therapeutic transaction — where, as Weston asserts, “the customer is always wrong” — seriously and makes for mesmerizing watching. Weston is a realistic, likable but imperfect character, and his patients speak to our foiled dreams and resilient longings, even when their problems seem overdrawn or their behavior improbable. (Tuesday night’s patient, a Navy pilot who is resistant to the process and yet drawn in, sets up his own espresso machine in Weston’s office after deeming the therapist’s coffee “attempted murder.”)

Of course, it remains to be seen whether audiences will be persuaded of therapy’s relevance to their own lives, especially at a time when the tweaking of serotonin and dopamine levels is considered more effective than examining the wrong turns of the psyche. Psychotherapy, much like the conjurings of the imagination, has always required a degree of blind faith — what Samuel Coleridge characterized as a “willing suspension of disbelief.” In a country that declares happiness to be a constitutional right, it is unclear whether therapy — a process that mostly offers a means of arranging rather than altering experience — provides enough bang for the buck.


Daphne Merkin, who authored this review, seems to have a rather skewed idea of what "talk therapy" is about and how it functions. Her overview of therapy tends to see it as a somewhat pointless exercise in narcissism on the part of the client.

The individual narratives may vary, but they always feature a presenting problem or set of problems that crouch behind the chair or couch, ready to pounce or, as it may be, edge their way into the room: an unloving mother; indifferent father; unlikable friends; cruel spouse; stalled ambition; inability to form an intimate relationship. It is all grist for the mill, for the insulated setting, for the imperceptible and often painful drama that characterizes the therapeutic encounter. On one side is a professional trained in the art of paying close attention; on the other is someone trained in the arts of repression and denial. The two sit across from each other, week after week, talking, pausing, examining the inflections between pauses, gathering information, adducing motivations, all in the name of a tenuous but daunting goal. That goal is nothing less than a new way of inhabiting the self, a release from entrenched patterns into a place where old wounds don’t reign.

I added the emphasis at the end of this quote because that is, despite all the other qualifiers Merkin offers, the real point of therapy -- and it's not an antagonistic relationship, but rather a co-creation.

More and more, talk therapy is coming to the realization that the human being -- no matter how damaged and lost -- has within him or herself the ability and the desire to be whole and complete, to inhabit the healthier sense of self.

Granted, some forms of pathology -- schizophrenia, borderline, psychoses of various sorts -- need more than talk therapy to regain some balance. But even with the near-total reliance on chemical interventions in modern psychology, researchers are coming to understand that both approaches are needed. There seems to be a synergistic result when talk therapy is combined with psychopharmacology.

As to whether or not this new TV show will do anything to make therapy more understandable and/or desirable to those who watch the show -- that remains to be seen. If it's handled well, I think it could do a great service to the fading art of therapy (although there are too many of us who see its value for it to ever totally be replaced by the medical model).

However, this is television -- and I am afraid the show will be more about sensationalizing the therapy space than actually presenting the painful and ecstatic reality of what can transpire between a good therapist and a willing client.


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