For some years HBO has been producing the best TV drama in the English language. Quintessentially American themes and settings are central in Boardwalk Empire, John Adams, The Sopranos, The Wire and Treme (and there’s a noticeable spanning of historical periods there, too), while the fluctuating fortunes of American service personnel in harrowing foreign conflicts are the basis of Band of Brothers and Generation Kill – where the action again spans two different periods of recent history.
In Treatment is set in the contemporary USA, but it’s an adaptation by Rodrigo Garcia of an Israeli TV series Be Tipul created by Hagai Levi, who became one of HBO’s executive producers for the programme, along with Garcia, Steve Levinson and Mark Wahlberg. The themes are therefore universal: what makes human beings behave the way we do, and how do we cope when our lives unravel?
So far I’ve only watched season 1 (there were three, which aired between 2008-2010). An unusual feature when In Treatment originally aired on TV was that each nightly episode showed one patient’s session with Dr Paul Weston (played by the Irish actor Gabriel Byrne, thankfully using his native accent, thus flouting the HBO tradition of employing actors from the British Isles to play American-accented characters), a psychotherapist in his early 50s practising successfully in Maryland, and there were five episodes per week, one per patient. Unlike soap operas, where multiple storylines intertwine and develop separately in each episode, this enabled the writers and directors to concentrate on one storyline per night, and really probe deeply into the life of the patient and their dilemmas, while also developing Paul’s increasingly complicated reactions to the problems presented by his patients, and his growing inability to remain emotionally detached.
The pattern in Series 1 was that the four different patients featured Monday-Thursday for eight weeks, then in week nine, for various reasons, only two stories remained. The fifth episode each week featured Paul’s own sessions with his former therapist, Gina (Dianne Wiest), in which he attempted to wrestle with his own conflicts arising from his interaction with his patients, and, in later episodes, accompanied by his wife Kate (Michelle Forbes), as his ailing marriage came under scrutiny . There were thus 43 half-hour episodes in the series.
Some of the patient stories were more engaging than others – but isn’t this true of real life? The outstanding story for me was that of the teenage gymnast and Olympic hopeful, Sophie (superbly played by Mia Wasikowska, who went on to play the eponymous ingenue heroine in Tim Burton’s 2010-11 Alice in Wonderland – a very different role from Sophie), who seems to have a death-wish resulting from the unbearable emotional pressures she experienced in childhood – her father was a photographer who specialised in female nudes and personal promiscuity; she idealizes him and deprecates her long-suffering, fraught and loyal mother. As the weekly sessions develop under Paul’s gentle, caring gaze, and he gains Sophie’s trust and affection, subtly enabling her to see the cruelty and weakness of her selfish father, Sophie slowly discovers the truth of her parents’ natures, and learns how intolerable it was to have had the burden of a shared secret placed upon her by her philandering dad.
The other most successful patient story for me was that of the Navy pilot hero, Alex (Blair Underwood), who on a bombing mission in Iraq accidentally caused the deaths of children. Brashly confident, even arrogant on the surface, Alex feels guilt and remorse underneath; this inner conflict resulted in his suffering a heart attack. Although Alex believes he’s recovered physically, Paul faces the weighty problem of trying to convince him that his problems have not been resolved during their weeks of treatment, while Alex is determined to cajole Paul into giving him a clean bill of mental health so that he can return to combat duty.
Where the set-up became a little stagey and less convincing, I think, was in the most emotionally tangled storyline: a beautiful doctor in her late 20s, Laura (Melissa George) presents herself as someone who believes the only way she can induce men to relate to her is through sex. Worse, she declares that she has fallen in love with Paul. By the end of Series 1 Paul has had to confront his own feelings for Laura, and the possibility that he drove his wife Kate into an affair with another man. Paul’s weekly sessions with Gina become the most compelling in the series. They show a different side of Paul’s character: he’s in denial, angry, vulnerable, and takes out his frustration on the always patient Gina. There’s history between the two of them, and this back-story gradually emerges over the episodes. It will clearly develop further and become clearer in Series 2 and 3.
The final storyline involves a passionate but fractious young married couple, Jake and Amy (Josh Charles and Embeth Davidtz), who have come to see Paul initially to resolve a clash of views about whether Amy should abort the child with which she is pregnant, but subsequently to deal with more complicated issues arising from their constant fighting. Amy’s supercilious patronizing of her husband incenses him, yet she hates it when he starts treating her with more sensitivity. Paul faces a difficult task in trying to prevent these two tearing each other, and their marriage, to pieces.
It has probably become apparent by now that the storylines aren’t selected in a random way: they all comment on and infiltrate into each other in the viewer’s mind (and Paul’s, and ultimately into the lives of his increasingly imperilled family). As the ninth week finishes there are still unresolved issues and crises which in some cases are almost unbearably tense and emotionally draining for the participants and the viewer.
And that’s what makes this series such compelling viewing. The situation is audaciously undramatic: most of each episode is set almost entirely in Paul’s consulting room. We gradually become familiar with the objects with which he has filled it, and understand their symbolic significance: the numerous model sailboats, the perpetually swirling tube of blue liquid (a desktop toy) usually glimpsed in the background as his patients unwillingly, fearfully tap into the swirling emotions that have brought them to this room. There is intense drama here, and it’s mostly conveyed through facial expressions and the struggles of the characters to suppress as well as explore emotional states, as well as through the inevitably lengthy dialogues between Paul and his patients. We see and feel their pain, yet this is done without prurience or making us feel we’re intruding. This is us up there on the couch. All of us.
Byrne’s performance is what holds the whole thing together. He dares to act quietly (until he’s in his sessions with Gina; then he’s transformed.) Although the therapist’s role by definition requires a character who listens and watches, refrains from dramatic interventions or snap decisions, resists provocation from vulnerable patients who often lash out (or try to seduce), Byrne succeeds with masterful subtlety in convincing us that here is a man who is deeply caring and professional, committed to trying to help these people, and yet also deeply flawed. His eyes show all this, and the way he holds his hands or tilts his head and regards the person opposite him, his face a mask of neutrality but with deep compassion and love shining through (but with Gina his less professional self is revealed – with her he shows that he lacks insight into himself.) As the weeks pass by we are drip-fed tiny drops of information about his own emotionally traumatic past, his own conflicts, doubts and weaknesses.
The show has been criticised for exaggerating the ways in which the Byrne character enables the boundaries between therapist and patients to become blurred. But come on, this is a TV series; no fatal flaw, no drama. If Duncan had died peacefully in his bed we’d have no Macbeth.
I found In Therapy had weaknesses, but it’s still one of HBO’s most successful artistic and dramatic productions, because of its self-imposed constraint and restraint. That takes nerve, but it works. This show proves that we don’t need vampires or guns to create nerve-shredding tension and deeply moving insights into the human psyche, to show the ways it causes us to hurt each other in mystifyingly painful ways, how resilient we can be when those who love and help us refuse to give up on us, but also how fragile we are and prone to destructive self-hate and misguided, toxic guilt. And it’s not always our parents’ fault, Dr Freud.
Can’t wait to watch series 2 and 3.
A version of this review appeared on Sunday, Aug. 4, 2013 at Blogcritics