Dinah, ClinkShrink, & Roy produce Shrink Rap: a blog by Psychiatrists for Psychiatrists, interested bystanders are also welcome. A place to talk; no one has to listen.
Friday, March 07, 2008
HBO In Treatment....The Rest of Week 6
The Sophie Episodes are my favorite. The Jake/Amy ones are insufferable as are the Alex ones, though Alex is earlier in the week. It feels like these people spend an awful lot of time talking about the sessions themselves and going at it with the therapist. For what it's worth, in real life-- at least in my real life-- patients are a lot less focused on me and a lot more interested in telling me about their lives outside of the office. Oh, and my patients are much nicer than Paul's. So there are my thoughts.
Sophie orders a pizza to be sent to the session-- how cute is that? Deep dish: you go, girl! They end up talking about weight and eating and control and we get to question if Sophie has anorexia like her dad's Italian model girlfriend thought. Then we hear about good old Dad, Sophie's favorite person in the world, who doesn't know about how she OD'd on her shrink's sleeping meds in his office bathroom (gotta love that bathroom). Paul pushes Sophie on why she's keeping this from her father and he shows her that he's found a book with photos by Sophie's dad-- photos of naked women. Sophie gets mad, she tells Paul to "Eat Shit, Paul" and she's ready to storm out. Then she comes back and she screams at him that she's supposed to control the conversation, basically tells him not to push her too hard. He comes back with more shrinky analysis pushing at her how she needs to look at her relationship with Dad. Sophie weeps, Paul assures her that there are safe places besides on her gymnast's balance beam, and says his office is one of those safe places.
Ha! Talk about bad therapy. This is a kid he pushed her buttons and she overdosed in his bathroom. She's told him loudly and clearly that she needs to keep it where she feels safe, float it on the surface. She comes undone when he pushes her, and I thought that when she sat back down, he'd make an effort to put her back together, to smooth things over, and yet, while she somehow doesn't lose it with him (at least doesn't keep yelling at him), he keeps up his plug to go deeper, to look at the painful stuff. We're supposed to believe he gets his message across because he's now chosen the right words, but if you ask me, he's standing next to the fire with an open vat of gasoline. A patient this fragile needs to control the session, she doesn't need a lot of annoying interpretations or to be pushed to look at things she doesn't want to look at . She tries to kill herself when this happens. We're on session 5, we've had a pizza, we've had an overdose, we've told Mom to f--k off, and now he's shoving naked photos her dad took in her face??? Oy. Assess her symptoms (including the possibility of an eating disorder), make sure she's literally safe, report the damn gymnastics coach who slept with her, treat her Major Depression with medications, and talk about school, how it's going at home (if she wants), what she likes on her pizza, and maybe chat about a movie. How many suicide attempts does it take before the shrink figures out that his office isn't a "safe place" if he pushes her to the the brink? Okay, you get my point. See any good movies this week, Sophie?
Amy shows up alone, no Jake this week. She feels rejected when Paul is a little late and asks her to wait outside for a few minutes. She tells about it. We then hear that she's back together with her controlling husband, and that Jake is now disgustingly tender, she likes it rough. Bad sex with hubby and a fling is set in motion with her boss tonight. She always forgives herself. Oh, and she was a fat and tormented child, dad died when she was 13, her sister was a mean little thing who had to have the red dress. Paul clearly doesn't approve of sex with the boss. Amy goes to the famed bathroom where she blackberries her husband just to hear his voice. And what does that mean?
Is there something to say?
Paul's psychotherapy supervision has turned in to couples therapy. His lovely arachnid wife, Kate, joins the session. Gina kisses Paul and there's a spot of tea waiting. They worry about their daughter. They bicker about Paul's sexy patient Laura. Paul tells Kate what Gina is saying, cuts off Gina, jumps to conclusions. Gina comes up with theories of Kate's role in Paul's life-- they she started the marriage as a dependent "patient" who was never his equal (to be clear here, Kate was never Paul's patient, she just liked that he listened to her, apparently that puts one in a patient role even in a romance). Paul harshly accuses Gina of "jumping to conclusions" and of rushing the therapy by making interpretations that should wait for months if not years. Funny, didn' t I just say he did something similar with his patient Sophie? Kate weeps and storms off. Apparently you can't have psychotherapy without beverages, a few choice obscenities, and someone storming off.
You know, spell check doesn't like "shrinky" or "oy".
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does anybody know in wich city the Paul's office is located?
What I do know for sure until now is that there is a street or avenue called "Madison" because Laura mention it in one of her sessions. First I thought it was in New York, but according to the the episode s01e13, when Paul is talking to Sophie, it's clear isn't in New York.
I don't know the United States so well, once I'm not american and I had never been in there.
So, if anybody know where the the Paul's office is located (in the show, so to speak), please, tell me, I really want to know. Thanks! :)
It's in the suburbs of Washington DC (this is said at one point) and Paul's prescription bottle had a 301 area code on it (the ones Sophie overdosed on) so it's in Maryland, in a suburban community. I'm still betting on Chevy Chase, Bethesda, or Rockville.
There was a mistake though: Paul's bottle also said Baltimore on it, but the area code was not the Baltimore area code.
You keep saying how unrealistic this show is, but I saw one talk therapist for a year where therapy was the main subject of the sessions and there would regularly be a few choice obscenities and someone storming off. (No beverages though.) I hated it. This is precisely the one that had me crying for a day before the session. I felt so very dysfunctional, and thought that the fact that I couldn't cope with a very basic talk therapy was proof that I had something to learn by sticking with it. The therapist kept telling me that therapy was supposed to hurt and would promise that the unhappiness of one session would provide lots of excellent material for the next session, though the promise was never kept. After a year my beloved finally made me stop going because it was making me too miserable, and my mood, general functioning and primary relationships immediately improved - to the point that I didn't feel the need of any therapy at all, even good therapy.
Just saying that this show, while terrible, does not sound that unrealistic to me at all. Maybe not representative - I did see another therapist with a similar (though not as extreme) dynamic for a couple of years, and I got worse during the course of my time with her too, but other therapists I have seen were not like that - so maybe not representative, but certainly not unrealistic.
I never said it was unrealistic. Some of the real-life stories I've heard out do TV. What I said was that this is BAD therapy. I stand by that.
Sorry, misunderstood. Yup, bad therapy.
I've had 7 different therapists, some I only saw for a brief while because I thought they were bad therapists (some just weren't a good fit), but never have I seen incompetence like this guy. Any therapist even remotely starting to resemble Paul and what he's done would clearly be in ethical violations.
Today's NYT Magazine piece provides and interesting take on In Treatment ... http://www.nytimes.com/2008/03/09/magazine/09wwln-medium-t.html?scp=2&sq=In+Treatment+&st=nyt
so maybe something is being lost in translation.....?
that link again...
Over here we take our shoes off when we go to someone else's house, or at least we offer to. We consider it rude to track mud and snow into the house. Over there, where Be'Tipul originated, we leave our shoes on. We don't get snow, well this year they did in some parts, but that is not the point. It is considered gross to take off shoes and expose others to smelly feet. And as for all the drinking that happens on the show, if it is a direct translation, then it comes from the Middle Eastern tradition of offering everyone something to drink. Hey, it's hot, but more importantly, the cultural stuff that flowed from Abe's tent and continues to this day no matter what religion, in those parts.
And the boundaries that are breached equal the walls that are erected and breached and resented and that are there in a physical and emotional level whether they are discussed or not. This is not going to translate so well to a foreign audience and all we take out from it what we see at face value which is really bad therapy. It would be bad therapy anywhere B'Aretz there would be some message underlying it all. It would represent something which it does not to a foreign audience and that is why there are just some jokes you are better off not telling, and leaving off with a "you had to be there."
You know, Dinah, that even though this may be more of a chore for you now, that you are showing what's bad about what he's doing "In Treatment" for those who may come across your blog, and thus perhaps countering some of the misperceptions this show can and does create in the public about therapy.
Especially since a whole new wave of new viewers, for the first three weeks of free episodes, are just getting them, via Tivo Unbox on Amazon. There was an offer for them free. Anyway, so a whole new slew of victims, I mean, viewers.
I wanted to comment on the overdosing in the bathroom incident. I did a similar thing. My therapist had been trreating me for 7 months. I had been hospitalized 4 times during that time AND started to self injire (which she promptly told me she wouldn't continue seeing me if I did again). After another month of getting through my suicidality, I finally decided that I could trust her. Maybe. I came to her office for my regular mon. session and she informed me that I had "stolen" her clock, a computer mouse and a pair of scissors (Presumably to SI with). I had a key to her office, was the first one there on Mon morning and she accused me with no proof (because I didn't do it, there was no proof). Anyway, I had such abandonment issues (my Dx was DID and PTSD) and at that moment her accusations just pushed me off the cliff. I OD'd that day. She called me at the hospital and said she was done with me...she would not continue because I had tried to kill myself. She said I emotionally blackmailed her and made her have sadistic thoughts. I was released from the hospital after 3 days of an evaluation and 2 weeks later went to her office and OD'd again. She found me. Which is apparently what I wanted. She did not call 911. She called my husband and told him to come get me or she was calling the police because I was nonresponsive. He told her to call 911 because I had prob. OD'd...AGAIN.
Spring forward 6 moer months and I am in HEALTHY therapy with no SIing. I enrolled in college, got a job, and am getting back to how I was "Pre-Stephanie."
Was it totally her fauilt? I had never been hosp. for psych reasons proior to her and never attempted suicide and am not suicidal now. Her constant threats and lastly her accusation, pushed me off a cliff I was dangling on. Had she gone a different direction, perhaps it would have never happened. She was supposedly a "DID-specialist" to boot.
The last time I spoke with her she told me I wasn't worth her time.
I'm working on my Masters in psychology now.
That was a different anon. I graduated years ago and.. I kept my day job.
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