April 2008

Jason B. Jones


In Treatment

About a decade ago, when starting as a graduate student in Emory's Psychoanalytic Studies Program, I had a fierce, public argument with a good friend, Eddie Gamarra, about what the point of dream interpretation might be in psychoanalysis. We were arguing, in effect, over what mattered most: some original wish or dream-thought that could painstakingly be recovered (Eddie's view), or the fact of dream-censorship itself, which retroactively creates the wish out of the raw materials of the dream (my own view). This debate raises a complex question about whether analysis points you toward a truth about yourself, one that the analyst knows or infers and tries to help you find, or whether the analyst simply (!) helps us realize the complex ways that we enmesh ourselves in self-deception, in the hopes that such a recognition may help us take up a more sustainable attitude -- to exchange, as Freud said, hysterical misery for ordinary human unhappiness. Does analysis claim that there is a truth in your head, which might be excavated in order to disclose the real meaning about your life? Or does it claim that our minds are, more or less, set up to facilitate misrecognition, mistranslation, and other forms of petit and grand errors, and that it can simply be useful to track that process in action?

I have been thinking about this argument with Eddie a lot recently, usually while watching HBO's recently-concluded series, In Treatment, which received a lot of press -- largely on the strength of the brilliant Gabriel Byrne and the fact that the New York Times probably overrates the contemporary importance of psychoanalysts -- but not so many viewers. The show, an American import of a runaway Israeli hit, aired five nights a week, recording a therapist (Paul) as he meets with a single patient, and then on Fridays showing his meeting with his own therapist.

The show reminds me of Jean-Paul Sartre's "The Man with a Tape-Recorder," which is a transcript of a taped session with an analyst, sometimes rumored to be Lacan himself. In the session, in which the analysand aggressively rejects the analyst's customary control over the situation and insists on the "objective" transcript of the recorder, we hear an analysis come completely off the rails, as the analyst's wildly neurotic and defensive, and thus human, responses are like a series of disasters one after the next. In the conflict with this patient, the unnamed analyst either cannot recognize, or no longer cares, that he's playing into his patient's destructive games. (The essay is worth getting, not just for the drama of the conflict, but for the introductory essays by Sartre, Jean-Bertrand Pontalis, and Bernard Pingaud, in which Sartre defends his decision to publish the essay.)

In Treatment reveals a therapist careening out of control. On the one hand, he's aware enough that he seeks out therapy for himself; on the other, he seems genuinely to believe that he knows what's best for his patients, and that if he just explains their problems in an empathetic way, they'll come round. In the show, Paul boasts of his ability to see into his patients' heads, and to manipulate them, if he desires, into almost any emotional state. However, what the show points out, time and again, is the way he reacts emotionally to his patients' slightest provocations. The show's writers have set him up, in a way, by giving him patients tailor-made to evoke these reactions. Monday's patient is his love interest; Tuesday's is an erotic rival and threat to his masculinity; Wednesday's is a teenaged girl, a schoolmate of his daughter; and Thursday's patient is a couple in a fraying marriage. Paul's home life is even worse: He's wholly disconnected from his children, and his wife is having an affair.

The show's innovative format -- it aired for a half-hour every night from Monday to Friday, with Friday's episode featuring Paul and his own therapist -- works well to showcase both how Paul deceives himself about his own culpability, and how he picks up phrases and images from his patients without apparently recognizing their provenance. Paul regards himself as a bit of a Beautiful Soul, surrounded by bad faith and confusion but utterly innocent of these things himself. It's impossible to watch two episodes of the show without being disabused of that notion. Although the format is interesting, In Treatment is definitely a show that improves when you watch it in bunches. Watching it on screeners, for example, meant that the previous episodes were fresh in my memory, and so the verbal connections between them were easier to see.

As a consequence of the column, I kept an eye out for episodes involving dream interpretation. My expectations were pretty low: Listening to other people's dreams usually isn't very compelling, and the half-hour format meant that there'd be no time for serious interpretive work. And sometimes, indeed, we see (unnamed) patients recite dreams immediately after Paul has undergone some devastating experience. At those moments we're expected to sympathize with Paul -- how can he listen to these pointless dreams when he is suffering? Other times, however, patients recount dreams, or dream-like states, in vivid detail. A good example of this happens during Jake and Amy's session in week 4. Jake and Amy are in couple's therapy, initially because they can't decide whether to bring an unexpected pregnancy to term, but inevitably other issues arise. They have different class backgrounds, ambitions, attitudes toward parenting, and much else. He's paranoid and controlling, and she's a gifted, gleeful liar. (During this episode, Jake records Amy with his cell phone, in a nice homage to Sartre. Despite his usual aggressive role in sessions, Paul accepts this passively.) After a particularly vicious fight, Amy stalks out, and Jake tells Paul about a dream he's had, in which Amy is driving Jake's car, incredibly fast, even out of control. They don't have seat belts. She's out of lotion, and so they go to rob a store, because Jake has forgotten to buy it despite many reminders. This dream is offered up in the episode as commenting directly on Jake and Amy's relationship, which is indeed out of control. (As in the Hold Steady song: "She drove it / like she stole it. / She stole it fast, / With a multitude of casualties.") I understand, dramatically, why this might be the case. But considered analytically, it was shocking. In The Interpretation of Dreams, Freud comments directly on dreams that seem to make too much sense:

Dreams occur which, at a superficial view, may seem faultlessly logical and reasonable... Dreams which are of such a kind have been subjected to a far-reaching revision... which is akin to waking thought; they appear to have a meaning, but that meaning is as far removed as possible from their true significance. If we analyze them, we can convince ourselves that it is in these dreams that secondary revision has played about with the material most freely, and has retained the relations present in that material to the least extent. They are dreams which might be said to have been interpreted once, before submitting to waking interpretation.

The explicit relevance of Jake's dream, then, ought to have been a goad to further interpretation -- done by Jake, not Paul! -- rather than an opportunity for the therapist to display his prodigious sympathy.

But it's not clear to that the show's participants grasp these distinctions clearly. In an extended Charlie Rose interview about the show, for example, Byrne speaks admiringly (at about the 30 minute mark) of a therapist who "knows what his patient should do," and who complains of being bored at waiting for the patient to accept his point of view as correct. (If you click the link, don't miss Rose's panicked disavowal of the Oedipus complex at about 11:45.) He also describes the point of therapy as "to have our stories validated by someone else, even if we have to pay them to listen." For all that he invokes Freud in the interview, Byrne here points up the fundamental difference between therapy and analysis. Etymologically, analysis is associated with unraveling, loosening, or undoing -- not at all with "validating." Therapy, by contrast, promises healing. What made In Treatment so compelling for me was the way it took an almost analytic view of the therapeutic fantasy. I spent most of every episode covering my eyes, hoping that Paul wouldn't make a well-intentioned, but ham-fisted, interpretation, and then watching in amazement as the show followed up with the inevitable consequences of his empathy. The proverb about the road to hell being paved with good intentions is never truer than in analytic/therapeutic sessions, when transference lends unpredictable emotional force to the slightest gesture or word.

The fantasy of analysis, or of therapy, is that the therapist can tell you what to do about your problems. Three of Paul's clients -- Alex, Sophie, and the couple, Jake/Amy -- come to him with specific problems about which they'd like advice. And so when Paul interprets their behavior, they inevitably experience that as his attempt to guide them in some way. Paul is a responsible enough therapist that he correctly seeks to deflect responsibility for decisions back onto his patients, but, as I've suggested, he also revels in the idea that his interpretations are right. However, a famous analyst once wrote that an interpretation whose effects are understood is not a psychoanalytic interpretation. Nothing is more tempting to the therapist than the belief that he possesses special knowledge about his patients. In Treatment was at its best when it anatomizes the consequences of that belief.