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.
Sunday, April 19, 2009
In Treatment: Season 2, Week 3: Mia then April
Paul is late and apologizes. Mia grills Paul, was he with his girlfriend? Is this how your Maryland office looked? What happened to all those patients, did Paul abandon them too? Paul deflects her questions and she bristles. "Aren't you glad I'm back?" Mia asks questions about his lawsuit. Who is Laura? "She said you became friends after the therapy, you broke the rules for her....I think you had an affair with her."
This session is every therapist's nightmare. Paul gets angry: "You opened a legal document that was not meant for you...and you brought it into session."
Mia taunts Paul. She's goading him, and I have the sense she's jealous, she wishes Paul would sleep with her. "If you were going to get involved with a patient...you picked her." Mia imagines Paul with Laura and he looks wistful as he listens to her fantasize about Paul's relationship with his old patient.
Mia knows she's difficult: "I'm like a knife in your neck, it feels good when it's gone." Actually, I kind of agree, I'm ready for her to leave. Paul plays the tape she gave him as a parting gift 20 years ago: see, he still has it, he saved it, he does indeed care!
So I've been trying to write about personality disorders for our book-to-be. It's hard. Mia is difficult, a precise diagnosis is unclear, but perhaps something in the borderline, histrionic, dependent realm, "I push everyone away, I'm demanding and I'm needy...." Paul does a good job of addressing her fears and desires.
At the door, Mia asks Paul if he slept with Laura. He hesitates. And then he tells her he didn't sleep with Laura. Should he have answered this extremely personal question about his sexual life with another patient? Yes (especially since the answer is "no, I did not"). Laura is asking two things: Did you choose her over me? And, Am I safe With You? Any way you dice it, it's better for the honest answer to be No, to put these issues to rest, and to move on with the psychotherapy.
April's been up all night and she's a wreck. She's tired and fragile and she wants to go to sleep for just a minute. She looks like she could sleep for hours and Paul wakes her by shaking her gently. She smashes her class project and the violence of it is such a stark contrast to the peacefulness of her sleep.
April has thoughts that get stuck in her head. She gets offended when Paul calls her thoughts obsessive, and he realizes how hard she tries to feel her autistic brother's feelings. April talks about her parents dancing and how they didn't notice that she'd fallen out the window. We hear a little about the family dynamics, about how April can't tell her mother she has cancer, and Paul asks her to call her mother now, but April doesn't tell her. Should he have offered to call April's mother for her?
Posted by Dinah on Sunday, April 19, 2009
Labels: In Treatment
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This article was in our weekend paper; thought you might like to read it so have provided the online link above.
its fun reading about intreatment on your blog!!
i rarely get to see all of them...but its good not to lose touch entirely by reading your blog!
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