The New York Times-20080127-How Its Couched

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How Its Couched

Full Text (848  words)[Author Affiliation] Daphne Merkin is a contributing writer for the magazine.

Whether we cast a suspicious eye on the whole enterprise or have taken the plunge ourselves (perhaps even as we continue to feel suspicious), we've all wondered: What goes on behind the closed doors of psychotherapy? Is it a crucial and unique relationship that contains within it the kernel of personal transformation? Or is it a form of self-indulgence, a way of forcing someone to listen -- if only because you've paid him or her -- as you repetitively pour out the emotional subtext of your life?

The individual narratives may vary, but they always feature a presenting problem or set of problems that crouch behind the chair or couch, ready to pounce or, as it may be, edge their way into the room: an unloving mother; indifferent father; unlikable friends; cruel spouse; stalled ambition; inability to form an intimate relationship. It is all grist for the mill, for the insulated setting, for the imperceptible and often painful drama that characterizes the therapeutic encounter. On one side is a professional trained in the art of paying close attention; on the other is someone trained in the arts of repression and denial. The two sit across from each other, week after week, talking, pausing, examining the inflections between pauses, gathering information, adducing motivations, all in the name of a tenuous but daunting goal. That goal is nothing less than a new way of inhabiting the self, a release from entrenched patterns into a place where old wounds don't reign.

For some, therapy has become an expensive necessity; for others, who would not think of entering the cloister of a therapist's office no matter the level of psychological distress, therapy is nothing more than costly malarky, a means of not getting on with the business of life. (Freud's contemporary, Karl Kraus, an early and confirmed skeptic, denounced psychoanalysis as the illness for which it purported to be the cure.) For yet others, who were once seduced and then disenchanted, like the writer Frederick Crews, therapy is the enemy, a con game demanding constant exposure.

This Monday night, with the debut of the HBO series In Treatment, viewers will get a chance to sit in on the therapeutic endeavor like silent, third presences. The series originated in Israel, where it attracted a huge audience; one of Israel's leading newspapers described it as the closest thing to literature to be found nowadays on television. The show will air for nine weeks in half-hour episodes, five days a week. The patients (an adolescent, a woman, a man and a couple) are each accorded their own night, as they fumble, weep and wrestle their way -- Believe me, you'd be shocked to know the person that's sitting here, one patient declares -- through their experiences with a therapist, Paul Weston (played by Gabriel Byrne). In the fifth session, Weston explores his own fantasies and obsessions with his former therapist (Dianne Wiest).

In Treatment, unlike other shows about therapists, like Huff and Frasier, takes the therapeutic transaction -- where, as Weston asserts, the customer is always wrong -- seriously and makes for mesmerizing watching. Weston is a realistic, likable but imperfect character, and his patients speak to our foiled dreams and resilient longings, even when their problems seem overdrawn or their behavior improbable. (Tuesday night's patient, a Navy pilot who is resistant to the process and yet drawn in, sets up his own espresso machine in Weston's office after deeming the therapist's coffee attempted murder.)

Of course, it remains to be seen whether audiences will be persuaded of therapy's relevance to their own lives, especially at a time when the tweaking of serotonin and dopamine levels is considered more effective than examining the wrong turns of the psyche. Psychotherapy, much like the conjurings of the imagination, has always required a degree of blind faith -- what Samuel Coleridge characterized as a willing suspension of disbelief. In a country that declares happiness to be a constitutional right, it is unclear whether therapy -- a process that mostly offers a means of arranging rather than altering experience -- provides enough bang for the buck.

Perhaps in order to make up for the intensely verbal and largely inactive nature of therapy, In Treatment provides its own share of melodrama, including a girl who overdoses on sleeping pills that just happen to be resting on a shelf in Weston's office bathroom and Weston's growing erotic countertransference with a beautiful young doctor who insists their sessions are nothing but a disguised love affair. Still, the underlying intrigue is of a subtle kind, focusing on the way each of us -- including Weston -- frames and distorts our narratives. The viewer may or may not be pulled in, perhaps experiencing a bit of transference of his or her own, as the show ups the stakes week by week. What is certain is that In Treatment will help us to make up our own minds about the talking cure by answering the question: What's it all about, Sigmund?

[Illustration]PHOTO (PHOTOGRAPH BY RENE BURRI)