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Friday - Paul & Gina

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Paul

A psychoanalyst in his 50s who conducts his practice from a home office, Paul has two boys and a girl with his wife Kate, and his career has led him to a respected and successful place. But Paul is beginning to feel his tolerance wane behind the easygoing front he displays for his patients; even worse, his gut reactions are beginning to seep through the cracks. After four particularly trying days of therapy, Paul decides he needs the counsel of a retired therapist, Gina.

Gina

Gina served as Paul's professional supervisor years ago. Since then, she has lost her husband, turned 60, retired as a therapist and started writing a novel. Yet when Paul unexpectedly calls her to discuss the growing issues with his practice, Gina allows him to return, renewing a complicated relationship between them.

Last Post Apr 17, 2008 9:02 PM by: sciwriter

sciwriter

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Re: Friday - Paul & Gina

Apr 17, 2008 9:02 PM

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I think that Paul should have been sensitive to Kate?s feelings of abandonment, and stopped rejecting her. Kate should have aggressively addressed this issue with Paul. Why does Kate have a separate bedroom? My wife (#1 for 39 years) and I have never had separate bedrooms.

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Re: Friday - Paul & Gina

Apr 16, 2008 10:23 AM

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Nightwind

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Re: Friday - Paul & Gina

Apr 14, 2008 11:09 AM

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> As a psychologist, who is also a graduate of a
> psychoanalytic training institute, I began watching
> In Treatment with a mixture of curiosity and
> trepidation. I was skeptical that the practice of
> psychotherapy could translate into satisfying drama
> (as entertainment), and even more skeptical that a
> member of my profession would be portrayed in a
> realistic light, let alone a positive light.
>

Welcome to the boards, Humanist! I'm thrilled that you're here and I'm sure your post will get a lot of responses from us stragglers who are awaiting news on a 2nd season! I'm going to try to respond to your message point by point, so bear with me.

> On the first count, my skepticism was completely
> dispelled. IT proved to be engrossing and compelling,
> mainly due to exceptional acting, direction, and
> camera work. I became addicted and involved, and
> marveled at the exceptional performances that brought
> these characters to life. Was this a totally
> realistic depiction of psychotherapy? Not really.
> Although it did capture the essence of some types of
> interactions which can transpire in a therapist?s
> s office, and showed how therapists might behave. Was
> it good drama? Most definitely. But part of what made
> it such good drama was that it parted from the
> typical reality and predictable course of
> psychotherapy. It veered off course.

I think every new show has its moments. I was wondering what professionals thought about the dramatic version. I'm not a therapist, but have been a patient in several types of therapies. I've responded best to my clinical therapist who gave me "tools" and homework assignments that I still use to this day - especially breathing techniques to calm myself instead of popping a Klonipin. I'm glad you stuck with it though b/c this show is about the therapist's dilemma. Obviously he's burned out and needs a break, but in our society, that's frowned upon, especially for males who are supposed to fit into this set of expectations that we thrust on them. I think Paul's having an "identity" crisis and is experiencing some kind of role exit or at least he's questioning his effectiveness as a human being, by asking "Is this all there is?" "Am I attractive enough for someone like Laura?" (seemingly discounting her behavioral issues and the erotic transference). So, I hope if there's a 2nd season, we see his issues addressed and some kind of catharsis is reached.
>
> Humans are complex and fascinating creatures,. The
> process of trying to understand others, and
> ourselves, and why we move toward and away from each
> other, what we fear, and what we long for, is
> universal and fundamental. We can connect to this in
> a dramatic framework, as IT proved so well.
> Psychotherapists live in this world all the time. It
> is an unusual line of work, and one that is conducted
> in such privacy that there is always some mystery
> about it, and about the practitioners who provide
> such treatment.

Is there a board that oversees other than the APA or AMA individual therapists within each state? IOW, are there chapters or how does that work? I'm curious. Gina said there's no body or organization who oversees individual therapists - who "freelance" (sorry -not the appropriate word) or aren't affiliated with an institute or hospital. Is that true? Where do you go when you have issues that need addressing (apologies if this is too personal).
>
> When I viewed the first two episodes of IT I was
> extremely upset by all the mistakes this therapist
> was making. In my mind, I felt like I was supervising
> a very inexperienced, and not very insightful,
> therapist who had very poor judgment. As a
> psychologist, I felt angered by this portrayal and
> had little desire to see more. I did not watch the
> remaining episodes that week. But curiosity, and the
> fine acting I had seen, drew me back on the weekend
> and, after I viewed the remaining three episodes,
> particularly the session with Gina, everything fell
> into place. This man knew he had problems and that
> they were affecting his work with patients. He knew
> he was floundering, and he was seeking help. He was,
> finally, doing the right thing. I breathed a loud
> sigh of relief. I was now able to become more
> professionally detached and simply view this as an
> absorbing drama with a central character who happened
> to be a flawed, burned-out, highly conflicted
> psychologist, who was obviously at a crisis point in
> his professional and personal life. He wasn?t a
> generic shrink, or a model shrink, but he certainly
> was a definite, and interesting, character in a
> drama, and I was able to get drawn into the reality
> of his life and his work. In other words, I was
> hooked..
>
You're not the only psychologist who has said this on this board. There are others who are quick to note that IT doesn't accurately portray the process. However, it captures the essence of what goes on in therapy.

> However, there was no way under the sun that I wanted
> to see this therapist wind up in bed with his
> patient, nor even in a passionate embrace with her.
> During the episode where Paul first tells Laura he
> has feelings for her, my stomach was in knots and I
> feared the worst. And a psychologist cannot just say,
> ?Well, you?re no longer my patient? and then move to
> initiate a sexual relationship with that person. That
> is unethical conduct, and it is not defensible. In
> that regard, Gina was initially right to immediately
> reinforce this sanction in a very firm manner. She
> knew Paul to be a basically decent, concerned
> therapist, and she had to help him try to regain his
> control before he moved beyond a boundary that could
> harm both himself and his patient in very profound
> ways. The dramatic tension of whether Paul could
> maintain control was sustained until the final
> episode, and, while I believe he still went way too
> far over the line with Laura, he did not wind up
> crossing that final, inviolate boundary.
>

I never wanted to see Paul cross that boundary with Laura. Laura hasn't really changed all that much - I am questioning her desire for change. She's transferred her sexual obsession (which she uses to gain affection) on to Paul, and if I were in that position, I'd definitely give the patient some kind of tools or have him or her focus their attention on *why* they feel the need to get self-gratification from somewhere outside of themselves. Happiness and gratification are internal things that are gained by going within ourselves - not by using other people. I'm not saying that other people don't influence us - they do, but we cannot rely on others to "fix" our problems. Our problems can be dealt with by an inward exploration of our behavior patterns, likes dislikes and looking at the reasons for our particular behavior.

> Certainly, for psychologists watching this program,
> it was not about wanting to see a doctor-patient
> romance blossom, or to see Gabriel Byrne in a hot sex
> scene. It was much more likely about not wanting to
> see a therapist (even a fictional one) behave in a
> highly unethical manner which abuses a patient. For a
> psychologist to enter into a sexual relationship with
> a patient is akin to violating the incest taboo. I
> cannot state it any more strongly. Apart from the
> American Psychological Association code of ethics,
> all state licensing boards define such behavior as
> unethical, and it constitutes grounds for removing a
> psychologist?s license. Colleagues do not look the
> other way when they learn of such behaviors.
> Psychologists want such practitioners sanctioned, and
> we want them removed from practice. We want
> consumers/patients protected, and we want the
> integrity of our professional image protected.
> Licenses are suspended and removed all of the time
> when ethical transgressions occur. Psychology, to
> it?s credit, has always strived to be a self policing
> professional, and one committed to very high ethical
> standards of conduct.

In the therapy sessions I've been in, my doctors/therapists have kept a professional distance while being amiable - there's a fine line. I've never been "hugged" or told I was 'loved' by a professional. I probably would have run for the hills if they did that. I like Gina's approach and her character closely reflected the 'traditional' role that therapists play in patients lives. However, with that said, I must note that Gina overstepped some boundaries as well with Paul. But that had to happen because it's fiction - and fiction calls for a different set of rules than non-fiction.
>
> Obviously, a drama does not have to be a promotion
> for psychologists, showing them only on their best
> behavior and making perfectly timed, brilliantly
> y formulated, life altering insights and
> interpretations with all of their patients all of the
> time. That would not be very realistic. Most of us
> might strive for that, but we know we do not function
> at that level all of the time, nor can anyone else.
> But, most of us also do not fall in love with
> patients, seriously consider having sex with them,
> physically attack a patient during a session, or have
> someone in our family dress and undress a patient and
> then offer them our daughter?s clothing to wear
> during a session . These sorts of behaviors were all
> so grossly inappropriate and unprofessional I am
> amazed that anyone would draw the conclusion that we
> were watching a good therapist at work. Clearly we
> are seeing a man, at a particular point in his life,
> where he has lost all sense of boundaries with his
> patients as a result of his own personal problems. As
> drama this makes for great viewing., but if Dr.
> Weston were a real psychologist, and someone referred
> you to him, I?d advise you to head for the hills. If
> I were Dr Weston?s good friend, I would insist that
> he take a break from his work and go back into
> personal therapy for himself and regularly see a
> supervisor to discuss his work with patients.
>

Your description of what a therapist's job is, kind of reminded me about this poet I saw on a PBS program. He said that poets are people who enjoy standing in thunderstorms hoping to get struck by lightening. Those moments when you can feel your effectiveness as a therapist are probably not as 'close together' as they were with Paul's breakthrough with Sophie, or the death of Alex. In those instances the drama was heightened, the tension taut for storyline purposes. The writers only had to write *plausible* situations - not reinvent the wheel or stick to true life therapy sessions. I've said many times that IT is holding a mirror on social issues reflecting back to us some significant problems people are facing in their relationships these days; infidelity of the heart v. infidelity in the flesh - which produces more harm or hurt? Both to some degree. But IT asks specific questions without necessarily answering them which is an important function of fiction or literature.
>
> The ploy of showing Paul in sessions with another
> therapist was a brilliant dramatic tactic in terms of
> character revelation. We did get to see a very
> different side of Paul, and we also get to see
> another therapist at work. Gina, who I think is
> s basically a better therapist than Paul, first
> offers him help as a supervisor/friend, but then gets
> drawn into analyzing him as well as doing marital
> therapy with Paul and his wife. On top of that, she
> has to sit there and take considerable abuse from
> Paul, although she is much better at drawing a line
> at that sort of thing than Paul is with his own
> patients. I must say that Gina had my complete
> sympathy. It is as though the poor woman stepped
> into quicksand when she agreed to help this very
> difficult man. Even she loses sight of the role she
> is being asked to play with him and struggles with
> some confusion about what he needs and wants from
> her. I suppose that the writers wanted to limit the
> number of characters and wanted only one with whom
> Paul could reveal himself on these weekly final
> sessions, but, in reality, no real
> therapist/supervisor could wear all of the hats that
> poor Gina is asked to wear. It?s almost impossible
> for her to get a good grip on anything that Paul
> presents to her. Friends don?t respond like
> supervisors, supervisors don?t respond like
> therapists, and supervisor/therapists wouldn?t
> undertake marital therapy, but Gina is dragged out of
> retirement and asked to juggle all of these balls in
> the air.
>

This is what is so fascinating about IT. The contrast or irony (if you will) of Paul the therapist and how he's different from Paul the husband, father, man, etc. He's at a crisis in his life that he's not capable of 'fixing' - not until he accepts the role his father played in his youth and the anger he feels toward his dad. IT underscores or illuminates subtle issues that we all carry with us in our day-to-day lives. And most of the time, we're not aware of how important those aspects are in forming the relationships we have in our lives. Our past makes us who we are today.

> Gina, who appears to be very empathic and
> understanding of Paul?s genuine distress, clearly
> seems to have gotten sucked into more than she
> probably bargained for at the outset. And,
> truthfully, I think she finally had had enough when
> she told Paul to go to Laura. Trying to analyze
> Paul?s ?love? for Laura hadn?t worked because his
> resistance was too strong. The fate of Paul?s
> marriage seemed to be largely in his wife?s hands
> now, and too many different things were going on at
> once in the marital sessions with Gina, that didn?t
> really include Kate, for marital therapy to have
> worked there. Simply telling Paul, as the good
> supervisor Gina did, that an extra-office
> relationship with Laura was ethically completely off
> limits, for almost eternity, hadn?t diminished the
> power or intrusive effect of Paul?s fantasies and
> desires regarding Laura, nor did it even cause Paul
> to realistically reflect on why the relationship
> wouldn?t work or was just plan wrong.
>
I think if this were real life, Gina wouldn't have been my choice of therapists for Paul & Kate b/c of Paul's working relationship with Gina. Kate's a social worker, and while she understands some aspects of psychoanalysis, the bond between Gina and Paul was too strong and I'm sure Kate may have felt like an outsider at times. That's not the ideal atmosphere to reconcile people with their problems.

> I think Gina finally chose to side with Paul?s
> fantasy when she urged him to go to Laura because she
> felt out of options in dealing with him. The
> boundaries of whether she was his friend or his
> supervisor or his analyst were very blurred, leaving
> her with no clear future direction, but also
> unwilling to just abandon this obviously very
> troubled colleague, who she had known for so long,
> and who she apparently deeply hurt in the past.
> Perhaps Gina retired precisely because she wanted to
> avoid this sort of emotional stress in her life in
> the wake of her husband?s death. Obviously, Paul?s
> problems weren?t something that could easily be
> worked out in a few sessions, he was fighting her
> every step of the way, and maybe Gina had finally
> had enough., Maybe she felt that the only thing left,
> that she could do, was to tell Paul what he wanted to
> hear, that his feelings might really be love and he
> should find out. She might have done this to force
> him to confront reality, but also to relieve her own
> frustrations, and break the stalemate, because their
> interactions had simply become an emotional drain on
> her. Their sessions were really not resolving much in
> terms of Paul?s problems with either his patients or
> his wife. So, Gina, in, effect, freed Paul to act, by
> simply accepting his feelings and reflecting them
> back to him. As drama, this apparent turnabout by
> Gina was stunning, and it set up great tension for
> what might happen next. I could not wait for that
> final episode.
>
Gina, in my opinion, lost 'control' (if Paul gave her any) of the sessions right from the beginning because of Paul's anger. He directed his distress and rage and projected it on to Gina - which was a self-defense mechanism for him. He has to acknowledge first that he has a problem with reconciliation of his past - his anger over his father's abandonment. If he can at the very least acknowledge he *may* have a problem with it, that's the first step towards acceptance. It's a long road from acknowledgment to acceptance, but I think Paul's going to get himself in a situation (he's headed there now, anyway), where he has to address it or be condemned to live out his days feeding that anger.

Gina essentially told Paul to do something he was seeking permission to do right from the beginning. Paul was looking for validation, and subconsciously, I think he was hoping Gina wouldn't permit him to test the waters with Laura. But for storyline purposes, we saw Paul try to address his feelings for Laura, but as we all know (a dramatic irony in a way), Paul's feelings for Laura aren't about love, they're about lust - a lust for a return to his youth -- that part of life he feels was denied him. That's the bottom line with Paul. He's feeling his age - which is common for some people who go through a mid-life crisis. But once one gets beyond the crisis, age almost becomes insignificant AFTER one accepts their issues or problems. At least that's been true for me. I don't pay that much attention to my actual age and live as though I was a 30-something person. Age is a construct, not necessarily something we must internalize as we grow older. At least that's how I view it.

> But, while Gina told Paul to deal with his Laura
> fixation on the level of reality, by going to Laura
> and finding out what sort of relationship actually
> existed, and could exist, I do not think she was
> really telling him to just hop into bed with Laura.
> Gina, who seemed to be a pretty smart cookie, and
> fairly astute analyst, knew that, if push came to
> shove, Paul?s ego and super-ego would most likely
> kick in, sound his internal alarms full blast, and
> he?d regain control of himself before things went
> that far. And I suppose that?s exactly what happened
> and provoked the anxiety attack that stopped him. His
> anxiety did prevent him from losing final control of
> his reason and being swallowed up by his impulses.
> Anxiety can be a very helpful emotion--it keeps us
> away from extreme danger, and it keeps our
> unacceptable and destructive impulses in check. It
> also helps us to protect our vulnerabilities and the
> parts of ourselves we hold most dear. Had Paul gone
> any further with Laura, he would have been swallowed
> up in his own internal chaos. We need rules, and
> taboos, to maintain some sense of order and
> stability.

I think Gina realized that Paul's problem wasn''t about "laura" early on - Paul was in a personal struggle with himself. And it was inevitable - b/c he was seeking some kind of authoritative permission to pursue Laura which is why he turned to Gina. Her cold analytical scalpel (as he put it) was what he wanted her to use to cut that disillusionment out of him so that he wouldn't have to process the anger by himself. He subconsciously knows that gina's a more effective therapist than he is, which is one reason he chose her out of the 50 others he could have chosen. Subconsciously, he's like a teenager who's pushing the authoratative boundaries of their parents. It may have been a conscious decision as well. While he was hurt that his wife had an affair, his reaction was less than 'shocked' - I think he kind of "expected it" - he knew at some point in her life Kate would outgrow her 'need' for him. But he wasn't ready for it when it happened. I think Paul expects events to happen on his own terms on his own subconscious time schedule. For Paul he's losing control and when we lose control we try to hold on tighter to those things we're losing. It's just part of being human. What I find interesting is he's aware of these issues but cannot face them. It's as though he can't "cure" himself or is unwilling to take the necessary route to get himself out of the crisis mode.

I'm a firm believer that we hold on to certain problems because they serve us in some way. I've had a weight problem all of my life and 15 years ago I lost over 125 pounds. But I had to go through a whole crisis because the weight served a purpose for me. It kept me from "feeling" anger that I'd been repressing. I come from a family that doesn't raise their voices when angered, - we discuss things instead of argue - or debate in a rational way. I didn't know how to control my anger so I stuffed it down with food. That food helped me control the anger. Once I understood this and got to the point where I was ready to address it, the weight started coming off with some small changes to my diet. I'm not at an *ideal* weight, but I'm comfortable in my own skin and give myself permission to feel anger when it's appropriate. This is what Paul needs to do with his anger or disillusionment.

>
> Gina had also told Paul earlier that if he moved
> toward Laura she would run from him, and, after the
> session in which Paul admitted to Laura that he had
> feelings for her, we do see her running. She didn?t
> want to linger and talk with him at Alex?s funeral.
> She didn?t want to answer his phone calls. I think
> she took pity on him when she finally answered the
> phone and told him to come over, and I definitely
> think she was motivated by compassion for him, when
> she went into her bedroom. I do not think she wanted
> a sexual relationship, or any relationship, with him
> at that moment. She felt sorry for him, and might
> have had rather joyless sex with him at that moment,
> but only because she would have felt pressured by his
> needs. She did care for him, but she was also
> confused by him, he was still her therapist in her
> mind, he was not free (in any sense) to have a
> lasting relationship with her, and she knew he really
> didn?t understand his own feelings well, or the
> effect his behavior was having on her. She knew this
> wasn't right for either one of them and that he?d
> probably bolt from her bedroom, or her life, leaving
> them both feeling unsettled and upset. That is what
> probably happened., although we will never know
> exactly what transpired after the blackout, because
> we have only Paul?s version, and we know that he
> distorts things. But, even that final ambiguity,
> seemed appropriate and satisfying as a finale for the
> series. What is truth and what is illusion? Isn?t
> that what the Laura-Paul ?love? was all about? Was
> it ?true love? or just the illusion generated by
> transference and counter transference? Is Paul?s
> version of what happened the truth? Does he even know
> what he really feels for Laura or what she represents
> for him?
&gt

Good question - I don't think Paul's at that point where he can answer or even know what the "truth" is for him. That's something he needs to redefine for himself as well as changing his view of the various roles he plays. Role exit is a common occurrence in our lives but one that's little understood. I've read some books on it and found how important it is in our transitions through life. Creating new expectations and goals for ourselves during times of great change. I told my nephew one day, that the only stable thing one can count on in life is "change" - he sat quiet for a moment and said, "Man, you're deep!" LOL "It's so true - change is the only thing we can truly rely on." As soon as someone understands this, they can adjust their expectations and goals.

> Paul and Laura, as a romantic couple, was not a
> relationship that was meant to be, not yet at any
> rate. Perhaps, if time passes, a year or two down the
> line, they might meet at a museum, go for coffee, and
> begin to get to know each other differently, in a
> more equal relationship, rather than as doctor and
> patient. Then, who knows what might happen? The
> romantics out there who wanted this couple to come
> together and ignite some sexual sparks, might finally
> get to see their wish come true. Even I would cheer
> them on at that point. But, right now, I?m glad that
> Dr Weston pulled himself back from the abyss, that he
> didn?t abuse his patient by having sex with her, and
> that he did not turn out to be a deeply unethical
> therapist,. I even hope that part of his anxiety in
> that bedroom was generated by some realization of
> what he was doing to Laura, even if he was not
> conscious of that at the time. I would prefer to see
> him as a basically good guy, with morals and ethics,
> rather than as a selfish cad who knew how to
> manipulate this woman who was his patient.

I agree with this. I'm glad he didn't jump in bed with Laura or even pursue a relationship with her. I think Paul needs to focus on himself for the time being and try to salvage whatever's left of his relationshp with Kate. I'm not suggesting they remain married - that' remains to be seen - I am suggesting that Paul take some time away from his work where he can reflect on his goals.
>
> But, despite all of Dr Weston?s flaws and errors in
> judgment, it has been nice to see a program that has
> excited people about the process of psychotherapy. We
> live in a time when people are encouraged to pop a
> pill to deal with anxiety or depression or anger, and
> for just about anything else that ails them. But
> medication, which can have some value, does not, in
> and of itself, solve our interpersonal problems,
> resolve our conflicts, help us to make better
> choices, or to lead more satisfying lives.
> Psychotherapy can, and does, help people with those
> sorts of things. And I am glad that we were able to
> see glimmers of that even in the midst of all of Dr
> Weston?s chaos and mistakes. I hope that the positive
> aspects of what was shown will motivate more people
> to seek treatment. And presenting characters with so
> much complexity, ambiguity, and internal conflict,
> should certainly help everyone to understand what we
> psychologists enjoy so much about our work, as
> challenging and demanding as it can be at times.
>
> I am sorry to have been so long-winded with this
> post. I have enjoyed reading all of these threads
> almost as much as I enjoyed watching IT. I thought I
> would finally chime in and post before this place
> became entirely deserted, but I didn?t realize how
> much I had to say or how long it would go on. If
> you?ve bothered to read this far, I wholeheartedly
> thank you for your patience.
>
> I hope that we can all find more programming as
> deeply absorbing, and as well done, as IT to excite
> our passions and enrich the hours we spend watching
> TV. It certainly doesn?t come along often, but when
> it does, I?m ready to pounce.

I loved your message, Humanist and look forward to reading more of your insights. your thoughts are very compelling! Thanks for posting a message that resonated with me!

--
Nightwind

"You know, I'm just taking it one day at a time. And the good Lord willing, I will continue to live up to the uncompromising standards which Johnnie Drama has set for me. Yes, it's true, I'm a slave to excellence." jonniedrama

Humanist

Posts: 1

Registered: 4/8/08

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Re: Friday - Paul & Gina

Apr 14, 2008 5:55 AM

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As a psychologist, who is also a graduate of a psychoanalytic training institute, I began watching In Treatment with a mixture of curiosity and trepidation. I was skeptical that the practice of psychotherapy could translate into satisfying drama (as entertainment), and even more skeptical that a member of my profession would be portrayed in a realistic light, let alone a positive light.

On the first count, my skepticism was completely dispelled. IT proved to be engrossing and compelling, mainly due to exceptional acting, direction, and camera work. I became addicted and involved, and marveled at the exceptional performances that brought these characters to life. Was this a totally realistic depiction of psychotherapy? Not really. Although it did capture the essence of some types of interactions which can transpire in a therapist?s office, and showed how therapists might behave. Was it good drama? Most definitely. But part of what made it such good drama was that it parted from the typical reality and predictable course of psychotherapy. It veered off course.

Humans are complex and fascinating creatures,. The process of trying to understand others, and ourselves, and why we move toward and away from each other, what we fear, and what we long for, is universal and fundamental. We can connect to this in a dramatic framework, as IT proved so well. Psychotherapists live in this world all the time. It is an unusual line of work, and one that is conducted in such privacy that there is always some mystery about it, and about the practitioners who provide such treatment.

When I viewed the first two episodes of IT I was extremely upset by all the mistakes this therapist was making. In my mind, I felt like I was supervising a very inexperienced, and not very insightful, therapist who had very poor judgment. As a psychologist, I felt angered by this portrayal and had little desire to see more. I did not watch the remaining episodes that week. But curiosity, and the fine acting I had seen, drew me back on the weekend and, after I viewed the remaining three episodes, particularly the session with Gina, everything fell into place. This man knew he had problems and that they were affecting his work with patients. He knew he was floundering, and he was seeking help. He was, finally, doing the right thing. I breathed a loud sigh of relief. I was now able to become more professionally detached and simply view this as an absorbing drama with a central character who happened to be a flawed, burned-out, highly conflicted psychologist, who was obviously at a crisis point in his professional and personal life. He wasn?t a generic shrink, or a model shrink, but he certainly was a definite, and interesting, character in a drama, and I was able to get drawn into the reality of his life and his work. In other words, I was hooked..

However, there was no way under the sun that I wanted to see this therapist wind up in bed with his patient, nor even in a passionate embrace with her. During the episode where Paul first tells Laura he has feelings for her, my stomach was in knots and I feared the worst. And a psychologist cannot just say, ?Well, you?re no longer my patient? and then move to initiate a sexual relationship with that person. That is unethical conduct, and it is not defensible. In that regard, Gina was initially right to immediately reinforce this sanction in a very firm manner. She knew Paul to be a basically decent, concerned therapist, and she had to help him try to regain his control before he moved beyond a boundary that could harm both himself and his patient in very profound ways. The dramatic tension of whether Paul could maintain control was sustained until the final episode, and, while I believe he still went way too far over the line with Laura, he did not wind up crossing that final, inviolate boundary.

Certainly, for psychologists watching this program, it was not about wanting to see a doctor-patient romance blossom, or to see Gabriel Byrne in a hot sex scene. It was much more likely about not wanting to see a therapist (even a fictional one) behave in a highly unethical manner which abuses a patient. For a psychologist to enter into a sexual relationship with a patient is akin to violating the incest taboo. I cannot state it any more strongly. Apart from the American Psychological Association code of ethics, all state licensing boards define such behavior as unethical, and it constitutes grounds for removing a psychologist?s license. Colleagues do not look the other way when they learn of such behaviors. Psychologists want such practitioners sanctioned, and we want them removed from practice. We want consumers/patients protected, and we want the integrity of our professional image protected. Licenses are suspended and removed all of the time when ethical transgressions occur. Psychology, to it?s credit, has always strived to be a self policing professional, and one committed to very high ethical standards of conduct.

Obviously, a drama does not have to be a promotion for psychologists, showing them only on their best behavior and making perfectly timed, brilliantly formulated, life altering insights and interpretations with all of their patients all of the time. That would not be very realistic. Most of us might strive for that, but we know we do not function at that level all of the time, nor can anyone else. But, most of us also do not fall in love with patients, seriously consider having sex with them, physically attack a patient during a session, or have someone in our family dress and undress a patient and then offer them our daughter?s clothing to wear during a session . These sorts of behaviors were all so grossly inappropriate and unprofessional I am amazed that anyone would draw the conclusion that we were watching a good therapist at work. Clearly we are seeing a man, at a particular point in his life, where he has lost all sense of boundaries with his patients as a result of his own personal problems. As drama this makes for great viewing., but if Dr. Weston were a real psychologist, and someone referred you to him, I?d advise you to head for the hills. If I were Dr Weston?s good friend, I would insist that he take a break from his work and go back into personal therapy for himself and regularly see a supervisor to discuss his work with patients.

The ploy of showing Paul in sessions with another therapist was a brilliant dramatic tactic in terms of character revelation. We did get to see a very different side of Paul, and we also get to see another therapist at work. Gina, who I think is basically a better therapist than Paul, first offers him help as a supervisor/friend, but then gets drawn into analyzing him as well as doing marital therapy with Paul and his wife. On top of that, she has to sit there and take considerable abuse from Paul, although she is much better at drawing a line at that sort of thing than Paul is with his own patients. I must say that Gina had my complete sympathy. It is as though the poor woman stepped into quicksand when she agreed to help this very difficult man. Even she loses sight of the role she is being asked to play with him and struggles with some confusion about what he needs and wants from her. I suppose that the writers wanted to limit the number of characters and wanted only one with whom Paul could reveal himself on these weekly final sessions, but, in reality, no real therapist/supervisor could wear all of the hats that poor Gina is asked to wear. It?s almost impossible for her to get a good grip on anything that Paul presents to her. Friends don?t respond like supervisors, supervisors don?t respond like therapists, and supervisor/therapists wouldn?t undertake marital therapy, but Gina is dragged out of retirement and asked to juggle all of these balls in the air.

Gina, who appears to be very empathic and understanding of Paul?s genuine distress, clearly seems to have gotten sucked into more than she probably bargained for at the outset. And, truthfully, I think she finally had had enough when she told Paul to go to Laura. Trying to analyze Paul?s ?love? for Laura hadn?t worked because his resistance was too strong. The fate of Paul?s marriage seemed to be largely in his wife?s hands now, and too many different things were going on at once in the marital sessions with Gina, that didn?t really include Kate, for marital therapy to have worked there. Simply telling Paul, as the good supervisor Gina did, that an extra-office relationship with Laura was ethically completely off limits, for almost eternity, hadn?t diminished the power or intrusive effect of Paul?s fantasies and desires regarding Laura, nor did it even cause Paul to realistically reflect on why the relationship wouldn?t work or was just plan wrong.

I think Gina finally chose to side with Paul?s fantasy when she urged him to go to Laura because she felt out of options in dealing with him. The boundaries of whether she was his friend or his supervisor or his analyst were very blurred, leaving her with no clear future direction, but also unwilling to just abandon this obviously very troubled colleague, who she had known for so long, and who she apparently deeply hurt in the past. Perhaps Gina retired precisely because she wanted to avoid this sort of emotional stress in her life in the wake of her husband?s death. Obviously, Paul?s problems weren?t something that could easily be worked out in a few sessions, he was fighting her every step of the way, and maybe Gina had finally had enough., Maybe she felt that the only thing left, that she could do, was to tell Paul what he wanted to hear, that his feelings might really be love and he should find out. She might have done this to force him to confront reality, but also to relieve her own frustrations, and break the stalemate, because their interactions had simply become an emotional drain on her. Their sessions were really not resolving much in terms of Paul?s problems with either his patients or his wife. So, Gina, in, effect, freed Paul to act, by simply accepting his feelings and reflecting them back to him. As drama, this apparent turnabout by Gina was stunning, and it set up great tension for what might happen next. I could not wait for that final episode.

But, while Gina told Paul to deal with his Laura fixation on the level of reality, by going to Laura and finding out what sort of relationship actually existed, and could exist, I do not think she was really telling him to just hop into bed with Laura. Gina, who seemed to be a pretty smart cookie, and fairly astute analyst, knew that, if push came to shove, Paul?s ego and super-ego would most likely kick in, sound his internal alarms full blast, and he?d regain control of himself before things went that far. And I suppose that?s exactly what happened and provoked the anxiety attack that stopped him. His anxiety did prevent him from losing final control of his reason and being swallowed up by his impulses. Anxiety can be a very helpful emotion--it keeps us away from extreme danger, and it keeps our unacceptable and destructive impulses in check. It also helps us to protect our vulnerabilities and the parts of ourselves we hold most dear. Had Paul gone any further with Laura, he would have been swallowed up in his own internal chaos. We need rules, and taboos, to maintain some sense of order and stability.

Gina had also told Paul earlier that if he moved toward Laura she would run from him, and, after the session in which Paul admitted to Laura that he had feelings for her, we do see her running. She didn?t want to linger and talk with him at Alex?s funeral. She didn?t want to answer his phone calls. I think she took pity on him when she finally answered the phone and told him to come over, and I definitely think she was motivated by compassion for him, when she went into her bedroom. I do not think she wanted a sexual relationship, or any relationship, with him at that moment. She felt sorry for him, and might have had rather joyless sex with him at that moment, but only because she would have felt pressured by his needs. She did care for him, but she was also confused by him, he was still her therapist in her mind, he was not free (in any sense) to have a lasting relationship with her, and she knew he really didn?t understand his own feelings well, or the effect his behavior was having on her. She knew this wasn't right for either one of them and that he?d probably bolt from her bedroom, or her life, leaving them both feeling unsettled and upset. That is what probably happened., although we will never know exactly what transpired after the blackout, because we have only Paul?s version, and we know that he distorts things. But, even that final ambiguity, seemed appropriate and satisfying as a finale for the series. What is truth and what is illusion? Isn?t that what the Laura-Paul ?love? was all about? Was it ?true love? or just the illusion generated by transference and counter transference? Is Paul?s version of what happened the truth? Does he even know what he really feels for Laura or what she represents for him?

Paul and Laura, as a romantic couple, was not a relationship that was meant to be, not yet at any rate. Perhaps, if time passes, a year or two down the line, they might meet at a museum, go for coffee, and begin to get to know each other differently, in a more equal relationship, rather than as doctor and patient. Then, who knows what might happen? The romantics out there who wanted this couple to come together and ignite some sexual sparks, might finally get to see their wish come true. Even I would cheer them on at that point. But, right now, I?m glad that Dr Weston pulled himself back from the abyss, that he didn?t abuse his patient by having sex with her, and that he did not turn out to be a deeply unethical therapist,. I even hope that part of his anxiety in that bedroom was generated by some realization of what he was doing to Laura, even if he was not conscious of that at the time. I would prefer to see him as a basically good guy, with morals and ethics, rather than as a selfish cad who knew how to manipulate this woman who was his patient.

But, despite all of Dr Weston?s flaws and errors in judgment, it has been nice to see a program that has excited people about the process of psychotherapy. We live in a time when people are encouraged to pop a pill to deal with anxiety or depression or anger, and for just about anything else that ails them. But medication, which can have some value, does not, in and of itself, solve our interpersonal problems, resolve our conflicts, help us to make better choices, or to lead more satisfying lives. Psychotherapy can, and does, help people with those sorts of things. And I am glad that we were able to see glimmers of that even in the midst of all of Dr Weston?s chaos and mistakes. I hope that the positive aspects of what was shown will motivate more people to seek treatment. And presenting characters with so much complexity, ambiguity, and internal conflict, should certainly help everyone to understand what we psychologists enjoy so much about our work, as challenging and demanding as it can be at times.

I am sorry to have been so long-winded with this post. I have enjoyed reading all of these threads almost as much as I enjoyed watching IT. I thought I would finally chime in and post before this place became entirely deserted, but I didn?t realize how much I had to say or how long it would go on. If you?ve bothered to read this far, I wholeheartedly thank you for your patience.

I hope that we can all find more programming as deeply absorbing, and as well done, as IT to excite our passions and enrich the hours we spend watching TV. It certainly doesn?t come along often, but when it does, I?m ready to pounce.

sciwriter

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Re: Friday - Paul & Gina

Apr 13, 2008 8:38 PM

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I agree that Paul?s mojo can satisfy the sexual fantasies of women, but not to satisfy their need for safety.

What criteria should be used to evaluate Paul?s performance now that the first season of ?in treatment? has ended. I am not aware of any objective criteria that can be used to evaluate the performance of a psychoanalyst. I would use the general criterion: The patient?s behavior improved. IMO insight is just an academic exercise unless behavior has improved. Let?s review the current behavior of Paul?s five patients:

Laura still continues to move from one sex partner to another for the satisfaction of trapping, then rejecting the sucker. She hasn?t reportedly continued the dangerous practice of picking up men in a bar and commit a sex act in the bar?s bathroom. That?s a sign of improvement.

Alex had anxiety and heart disease, and died when he had vertigo and his plane crashed. Although Paul warned Alex not to fly, he should have been stronger in trying to convince, and should have called US Air Force MD?s to recommend that Paul should be grounded.

Sophie?s suicide attempt in Paul?s office was intended to provoke a rescue by Paul, but she may have died if her body absorbed the overdose of med too rapidly. Paul?s therapy, if effective, would have prevented. However, Paul succeeded in getting Sophie and her father to communicate with each other which should help prevent future suicide attempts by Sophie. Kudos for Paul.

Jake now understands that Amy married him only for sexual gratification and was using sex to manipulate him. He didn?t get angry or jealous when Amy announced to Jake and Paul that she had sex with her boss.

Amy now has no husband as Jake agreed to the divorce. She also has no job as she was fired when her boss?s wife found out about the sex incident. Since Jeff has apparently satisfied Amy sexually, why did she have sex with her boss? Did Amy plan to use sex to manipulate her boss? Why did she announce this in Paul?s office? Was she trying to antagonize Paul, as Paul didn?t like her?
Paul didn?t help Amy accomplish much.

sciwriter

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Re: Friday - Paul & Gina

Apr 13, 2008 2:04 PM

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Corrected post:

Read about psychotherapists and their own family problems
http://www.zurinstitute.com/therapistsfamilies.html
They need a response team of specialists in psychotherapy, e.g., alienation, emotional abandonment, suicide prevention, etc.
IMO work (labour) itself is alienation because for efficiency and other
reasons, workers devote excessive time and effort to the ?machine? rather than their own intimate connections, e.g., families.

sciwriter

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Re: Friday - Paul & Gina

Apr 13, 2008 12:08 PM

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Read about psychotherapists and their own family problems
http://www.zurinstitute.com/therapistsfamilies.html
They need a response team of specialists in psychotherapy, e.g., alienation, emotional abandonment, suicide prevention, etc.
IMO work (labour) is alienation because for efficiency, they devote excessive time and effort to the ?machine? rather than their own personal activities and responsibilities, e.g., families.

sciwriter

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Re: Friday - Paul & Gina

Apr 11, 2008 6:56 PM

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In the real world., severe, prolonged stress, such as that from four challenging patients who have been often resisting and sometimes violent and from wife: Kate?s straying, could trigger serious illness, including diabetes, heart attack or stroke. I propose that Paul, have a stress control support team including the following

Paul?s spouse or relationship partner who would discuss his problems and arrange for & join him in periodic extracurricular activities outside the home such as dinners, entertainment and vacations. Personally I think he needs a new spouse or partner as Kate may have qualified in the past but doesn?t qualify now.

Physicians who would suggest ways that Paul would tailor psychotherapy in line with any medical problems that his patients may have, e.g., insisting that a patient with cardiac disease maintain normal weight, and avoid smoking & coffee. He would also suggest medical specialists that Paul?s patients may need.

Gina would continue to be the friendly, neighborhood psychotherapist for Paul..

Young psychoanalysts who would describe new methods of psychotherapy with Paul.

Physical therapist who would assure that Paul gets adequate exercise.

babeeblues

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Re: Friday - Paul & Gina

Apr 9, 2008 4:40 AM

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> If you mean there was never any real threat
> that Paul would consummate it, maybe so.

Also, I hardly blame Kate for not realizing this. After all, it wasn't clear to Paul; it's debatable I believe at most whether Gina realized it; I didn't realize it.

Up, that is, until Alex's funeral. Even then, I wasn't entirely sure what to expect, but it wasn't until that point that I regarded it highly unlikely Paul and Laura wouldn't make a stab at a relationship outside therapy. Or that the stab Paul made, if one regards it as at least a stab, would be so stunted and pathetic. (Or from Gina's perspective, in what I saw as a reversal, a reversion from her lecture at the end of week 8, a triumph of Paul's better instincts.)

--
Edited by babeeblues at 04/09/2008 1:48 AM PDT

babeeblues

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Re: Friday - Paul & Gina

Apr 9, 2008 4:34 AM

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I agree that Paul's very much a fantasist, but I hardly regard his bond with Laura as merely a fantasy. If you mean there was never any real threat that Paul would consummate it, maybe so. But that doesn't mean, as he acknowledged unequivocally to Kate, that he wasn't dying to, or that he hadn't fallen deeply for Laura.

Laura's and Kate's accounts both mesh that Paul and Laura were intensely involved -- albeit in a charged, limited context -- for a year; from the beginning of her therapy. Yes, it does seem that Paul's not equipped, prepared, at least with Laura now, but it seems to me not with anyone, ever, to really interact very passionately, to be very engaged with anyone outside the confines of therapy.

sciwriter

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Re: Friday - Paul & Gina

Apr 8, 2008 12:30 PM

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Babeeblues, please delete my duplicate post below. Thanks.

sciwriter

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Re: Friday - Paul & Gina

Apr 8, 2008 12:29 PM

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I posted this on another forum, and I thank it?s also relevant here.

I think Paul should try psychosynthesis on himself and patients.

Ten years ago in addition to working for a pharmaceutical companyI worked with Dr. John Cullen, psychologist, as a consultant writer & editor of online articles related to
psychosynthesis which was originated mainly by Drs. Roberto Assagioli & Carl Jung:
http://www.aap-psychosynthesis.org/resources/articles/symbols_of_transpersonal.pdf

Simply stated practitioners of psychosynthesis try to teach patients to be their own psychotherapist, integrate their positive subpersonalities, e.g. creative photographer, into a cohesive whole, eliminate their negative subpersonalities, e.g., saboteur, and live in the future rather than be seduced by the past or present. This allows patients to achieve their full psychic potential and either have transcendental (peak) experiences if they didn?t have any previously or have better ones if they did:
http://two.not2.org/psychosynthesis/exer/ppe.htm

Based on application

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