Monday, November 02, 2009

In Treatment

I just heard a 14-year-old Pakistani boy on the radio. His entire family had been killed by a bomb. It made me think of In Treatment. I know people who are addicted to this TV series which consists solely of (fictional) psychotherapy sessions conducted by Dr Paul Weston (Gabriel Byrne). We see successive sessions involving the same patients. Only one of these - the young gymnast - seems to me to be ill by any imaginable definition. The rest are just screwed up within normal parameters. They turn up just to talk. This makes it hard to see what good Weston is doing. How would he/they know they'd been cured? And why expend so much time and intellect on people who seem to be functioning as well as anybody else? I am not addicted to In Treatment, but I keep watching in a state of sick fascination.
That Pakistani boy will probably need therapy but he won't get it. Weston costs $150 an hour. This point is, I know, pretty dodgy. The boy may suffer Sudden Hearing Loss and he probably won't get much help with that either. I am as spoilt as Dr Weston's patients. Except that I was definably ill. To be confused, angry, mildly paranoid, delusional or depressed is not to be ill, it is to be conscious. To treat these states as illness is to believe in some other, ideal mental state in which they vanish. Unconsciousness would seem to be the only such state. This is delusional and absurdly self-indulgent. I suspect this is why I found the perpetually psycho-analysed Woody Allen so objectionable.
I'm not being fair to therapists, of course. In Treatment is just a TV show and, doubtless, my suspicions of the process probably say something nasty about me (Adam Phillips, a brilliant man, once nearly trapped me with that one but I veered swiftly away). Furthermore, the idea of psychotherapy is fascinating. I see it as medicalised Henry James. He, also, would be no help to that boy.

23 comments:

  1. Nowadays, I think one of the biggest causes of visits to the Doc' is loneliness. And to be honest with you it could well be the primary cause to most illness.
    On my rare visits to the Doc, it seems that young mothers are the majority always, no matter what time of day or year. They cannot all be there for "real" ailments. But dear God that must be one of the lonely jobs on this planet.

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  2. I think you are dead right about all of this except that I am sure therapists do perform a dead useful and sometimes crtical service.

    What I am saying is that the content of your post points to us living in a highly confused time, and therefore good therapists will have an important place.

    That said, I have found an enormous amount of silliness around it. Those with good self-analytical faculties hardly have a need for a therapist, the point of 'em being to restore self-analysis and regulation.

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  3. In my early twenties I lodged in Notting Hill with an elderly Russian lady, doing my best to pick up the lingo. One evening I met an acquaintance of hers, from one of the Muslim Soviet states. I liked him so we got chatting and I asked how he came to be in Britain. The story went something like this.

    Forced against his will to serve in Stalin's army on the front-line against the Germans. Overrun and captured. Because circumcised taken for a Jew and put somewhere like Auschwitz (don't recall which hellish name). Survived the death marches at the end, liberated by the Western Allies. Sent back to Uncle Joe under Operation Keelhaul, victim of the dirty deal at Yalta. On the sealed train eastwards people were slitting their wrists to the extent (he said) that those outside could see blood pouring from the carriages. Another concentration camp, as a traitor to the great Soviet utopia. Each day trucks arrived and took away his peers 'for repatriation'. He sees a guard from his home region and asks what gives. "They are all poisoned - you need to escape." Does so, and manages to make it back to the West.

    Whatever faults I had at that age (and they were many) I listened and I looked. I realised how badly this man needed someone to tell this to, forty years later. Despite all he had gone through, he was (also) another lonely old emigre in London. No expertise was required. I just needed to be there. That evidently helped.

    This meeting profoundly influenced the rest of my life, though not nearly enough.

    Expertise is good, as the Medical Foundation for the Care of Victims of Torture shows. But that was all begun by a non-expert, someone they called the 'good listener'.

    Perspective regained is of course one of the benefits to the listener. No $150 an hour could do you anything like as much good.

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  4. So do people keep going to therapists because:

    a) it doesn't work and they're never cured (ie. the same reason people keep going to chiropractors), or

    b) because it does work in that it makes them feel better and they enjoy it (ie. the same reason people keep going to yoga classes)

    ?

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  5. Brit, people go to yoga because they think being tortured with a foreign method is somehow better than the native variety. If the time taken to Yogue oneself was profitably used to hoof around the nearest park, I believe it would be better for health and wallet.

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  6. "I am not addicted to In Treatment, but I keep watching in a state of sick fascination."

    Hm, I thought that's more or less what constitutes addiction?

    And - about therapists: If a therapist can prevent a divorce or a conflict between or within individuals from escalating, isn't that benefit enough?

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  7. What that young lad needs is another family to take him in, love him and cherish him. Same as always.

    Some people do need a bit of help - call it what you will. The people who don't understand this are the people who don't need any. A perennial divide, I'd imagine. The difficulty is that we have only a rather vague, shifting idea of what constitutes "OK" and what "mentally unwell". Until we know more, a lot more, better to err on the side of caution, perhaps.

    Chris said: "Those with good self-analytical faculties hardly have a need for a therapist." Some would argue to the contrary. It's the intelligent folks who think they can think their way out of a mental bind and who are often most resistant to the notion that with some problems this cannot be done. A different approach is required. You can call it "therapy" if you want.

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  8. I watched In Treatment's first season, and it struck me as a terrible show. Or, perhaps, an OK show, but which terribly depicted what therapy is. The worst possibility for me is if it accurately depicts what therapy is for most Americans. For me, therapy is a space and a tool for cultivating self-awareness. In the West, we need psychology to help us uproot attachments lingering from childhood traumas and bad habits we internalized from our often afflicted parents, friends, teachers, societies. To resign frustration, unsatisfiedness, and other afflictive emotions to consciousness is, in my opinion, not only a fallacy, but a great injustice to so many world traditions which say we can achieve a greater sense of happiness -- not separate from, but within this world, this consciousness. The key is awareness. We suffer only because we remain ignorant of the nature of things. There's no escape here, and that's not what therapy is about. It's about remembering how beautiful life it-- remembering what is down underneath the muck of conditioning... (At least, this is what therapy CAN be...)

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  9. Mark, I appreciate all you say but I assume the "people who don't understand", who "don't need any" help themselves, don't include Bryan, because he says he thinks one of the people on In Treatment is genuinely ill. I've never watched that programme and I can't imagine that I would ever do so. But on three occasions I've been enormously helped by talking things through with others with more or less qualifications as therapists. (In fact the most effective time was in a group, with two 'experts' and three others seeking help. That combination - including all praying for all - was truly awesome.)

    I trust Bryan's judgment enough to assume he's roughly right about who needs specialist help in this case. The question of how we relate perceived needs for therapy in the West to the gigantic needs elsewhere was the real point. No easy answers, but it reminded me that even in our imperfect and non-specialist state we can sometimes make a contribution.

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  13. There are many types of therapy and In Treatment is displaying one type. Generalising I would say some Americans use thier therapists as a paid confidante and in this busy world if they can afford it I see no harm. To make a show that airs some specific 'problems' and works through them with the 'patients' may even provide free therapy for the occasional viewer. Even those with great insight to themselves can be blind at times and another intelligent (qualified or not) viewpoint can be enlightening. To see the picture they need to be a great listener and Gabriel Byrne does this superbly!

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  20. Yes, much of the comments seem to ring true. The interactions between the patient 'Sophie' and her therapist were the most gripping as we witnessed a person truly in crisis and capable of hurting herself. She was mesmerizing, and he at times understandably not in control of her power to inflict harm onto herself. The show is truly great and the doors are wide open to address the problems of our times. The audience is finally ready to sit in the chair and engage by listening and observing.

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