Wednesday, January 30, 2008

In Treatment: Episode Number 2.....the sub-blog


Today's patient (well, yesterday's patient, I'm playing catchup) is Alex, I assume the therapist will still be Paul. And you know, Paul is kind of hot.

No denim today. Paul's in slacks, though Alex the patient wears jeans and a leather jacket.

It's Alex's first session, it starts at the door with a handshake and first names. Alex asks if there are ground rules. He looks around, touches some books. Paul jests, "In my profession we say that the customer is always wrong... it's a therapist joke."

Alex has done research: he knows Paul is the best. "So, do you recognize me?" Alex always goes to the best. Paul does not recognize him.

Alex explains that he flew a navel mission which accidentally resulted in the deaths of civilian schoolchildren while they studied the Koran, it was all over CNN. Alex is a wanted man by Islamic fundamentalists.

"You're dying to ask how I can sleep at night. Very well thank you. I hit my target, I sleep like a baby." Alex is smooth, cavalier, steeped in denial if you ask me. (You didn't ask, but hey, it's my blog).

Alex talks about how his father handled his mother's death, an event he deems the most traumatic thing in his life. He imitates his father: 'It never ends, Alex, your mother left such a mess.' His father soon remarried. "A whole life together and not a single tear."

Alex talks about running, his way of getting R&R. He runs with a gay friend named Danny, they go for miles. They run farther than ClinkShrink. Alex pushed Danny, who wanted to stop, to go for 26 miles, a marathon pace. At 22 miles, Alex had a heart attack and "died" but was revived from his 'total clinical death' defying all odds. He talks about the end, "the tunnel." Alex tells Paul, "All that time I tried to figure out if I had a hard on." And from there he talks about how his 92 year-old grandfather died with an erection. Danny, the gay runner, is a doctor who resuscitated Alex. Paul wonders if this links to Alex being fearful of being a homosexual. No way.

Alex and Paul tussle a bit. Paul points out that Alex has been testing him since he walked in the door. "You have no patience," Alex tells the therapist.

So now Alex tells Paul his chief complaint: He talks about being 'frozen' for 48 hours in a body suit during his time 'dead.' Paul tells Alex he has a strong will to live. He's come back from the dead, "and if you don't supply the goods...." Paul says, "this is a systems failure that wasn't supposed to happen to you."

Alex says his whole life was perfect, he was born to excel, he is the creme de la creme, "I'm a top gun grad and that training is not for pussies."

Alex wants advise. He continues with his cryptic style. Alex decided to go back to the site where he dropped the bomb on the school. "I don't have a guilty conscious." Paul worries that Alex will not be safe if he returns to the school. "This isn't for me." Alex says of therapy.

Paul talks about how Alex perhaps needs someone to be his commanding officer. Paul is scheduled to leave TONIGHT to go to Baghdad.

"Don't you think there's a strong desire there to atone for your actions?" Paul asks. Something finally hits Alex, he wants a cup of coffee, he doesn't want to leave even though his time is up.

My husband says it's not enough, it's just a plot summary, it needs a Dinah-spin. He wants me to predict where the therapy is headed. What does my husband think I do for a living? I'm a shrink, not a fortune teller!

So I liked this episode better than Laura. It was less predictable. Alex is a narcissist, I think, he's also difficult, constantly challenging and trying to out-smart the doc. He wants advice, but he isn't there to listen, he's there to hear he's right, to get permission in a sense, and to ignore whatever it is he doesn't want to hear. Maybe he's just there to out-best the best.


NeoNurseChic said...

Didn't watch it tonight since I was watching House instead, but I DVR'd it, and I might watch it while I fall asleep tonight. How was it? Any better than last night?

You think Paul is hot? Hmmm...can't say he's my type! :-P

Take care,
Carrie :)

Anonymous said...

Ok, I think I might be hooked. I finished watching the rest of the week's epi's. It is a little over the top at points (REAL therapy sessions would bore the hell out of viewers, got to spice it up a bit), but I see some elements of truth in it. Some of the character struggles are pretty compelling... And I have to admit, there have been quite a few times where he resonates as a therapist with me.

mingalls said...

For anyone who wants to watch and doesn't have HBO (or TV at all...) In Treatment can be downloaded (for free!) as a podcast at the iTunes music store.

Happy viewing!

Rach said...

the only podcast I could download was Friday's!

So I have no idea about what happened with Laura or with Alex. Maybe I'll be watching them backwards!

NeoNurseChic said...

I watched it. I actually like Paul's character, and I think he is pretty realistic. It's the patients that seem unreal to me. They are very overdramatic, and almost comical in their presentations. Again, I found myself laughing at some of the stereotypes portrayed. I watched Wednesday's episode, too, as all the episodes are on HBO On Demand (and I think available for viewing on, and I felt the same way about it. I do like the show - I just find the patients to be a little over the top! We'll see how it plays out!

Take care,
Carrie :)

Rach said...

Carrie, I think you are right on. The patients (at least alex and laura) are over the top... Paul is very realistic, and I think they did a good job of casting him.
I'm halfway through Wednesday's episode. I'll finish the rest by this afternoon... which means I'll need to find something else to do until next week.

NeoNurseChic said...

OT but good psychiatrist news from me! My psychiatrist has accepted a new job at a big academic medical center in Philadelphia. Since last July, I've been driving almost an hour (and on the worst ride home it once took an hour and 45 minutes) to go see my psychiatrist at a location in New Jersey. This meant a good 3 hours out of my day for psychiatry appts, which nobody in my family liked that I was doing. Plus, bridge tolls, gas, etc etc... Well, I did like refilling the tank in Jersey, since the gas is so much cheaper there, but still - it's not good to need to fill up so often! ;)

So - I was very happy for him! It came at a funny time because I was just thinking the other day and wondering if the job he has now is the job he really wanted when he finished all his training. I've been working with him since residency, as most know, and I've followed him from when he was a resident at the same hospital where I work, to a fellow at another big academic institution, to his current attending position in NJ - and now back to the same place where he did his fellowship. Our arrangements can stay the same, including costs for now, which is a huge relief!

Starting in March, no more driving across 2 states to see my psychiatrist! Yippeeeee!! :)

Just thought I'd share my psychiatry-related news!

Take care,
Carrie :)

Daniel Carlat said...

I just discovered your site, and was so pleased with it that I immediately added it to my own blogroll (The Carlat Psychiatry Blog). I'm working on a counter-detailing presentation for some PCPs in New Hampshire (actually, Kevinmd's group)and I liked the recent posts on how to choose an antidepressant.