In Treatment: Week five in review

Once again, I'm reviewing all five of this week's episodes of "In Treatment" at once, with general thoughts followed by brief takes on each patient. Spoilers coming up just as soon as I look at my watch...

For the first time in the brief history of "In Treatment," the series skips over a week in the lives of Paul and his patients(*), as he returns to work after taking time off to bury and grieve for his father.

(*) In case you didn't know, "In Treatment" itself takes next week off so HBO can debut a documentary series tied to The Alzheimer's Project, with the show coming back on May 17 for the final two weeks of the season. It's unfortunate that HBO couldn't have scheduled the season so that the break fell between weeks 4 & 5 instead of 5 & 6, so we could have experienced the gap right along with Paul's patients. Made too much sense to happen, I guess.

And when Paul comes back, he discovers just how much his patients -- at least, these four patients in crisis, as opposed to more mundane cases like the impotent law student whose session we glimpse at the start of the Oliver episode -- have come to depend on him. For them, he's more than a therapist: he's a surrogate husband, or father, or simply the only thing keeping them alive. He has become the most important figure in each of his patient's lives (maybe Walter less than the others, but he's also better at hiding/denying his true feelings), and when that relationship gets severed, even temporarily, they don't react well.

Paul returns to major developments in every case: Mia is pregnant, April is losing her hair and getting weak from the chemo (though this could at least be predicted), Bess has yet to return home to Oliver, and Walter is in the hospital with "food poisoning." Even the Gina episode comes with a couple of seismic shifts, as Paul tries to reconcile with Kate, and gets a settlement offer from Alex's father.

Mia

"This is me being caring. Is that okay?" -Mia
"You don't have to worry about my feelings." -Paul
"Does anybody?" -Mia

Mia just can't help herself, can she? She has to feel like the most special patient in Paul's practice, and so she's constantly taking advantage of her past history with him, and her firm's present association with him, to get access and information that the other patients don't have. And yet Hope Davis plays her with this tremendous vulnerability and self-awareness that makes it impossible not to like her even when she's being an entitled, intrusive pain. Just look at that lopsided grin she flashes Paul after springing the news of her pregnancy; she is so desperate for his approval, isn't she?

As Mia notes, this seems like kismet: all these years after Paul talked her into aborting the last pregnancy she had (or so she believes), she's come to him with an unexpected, last-chance (and, though it's not discussed here, no doubt high-risk) pregnancy. And even though she claims it's the thing she wanted to make her life complete, she realizes the picture isn't as full as she really, really wants.

For the first time since the premiere episode, Paul is off his game with Mia, so thrown by his father's death that he has a harder time concealing his emotions -- in this case, dismay over her casual attitude about not informing the presumed baby daddy -- in front of her, and even surreptitiously glancing at his inherited wristwatch when her monologue brings him to think about his dad.

And Mia, in turn, drops the remaining pretense about her desire for Paul. She may not want him sexually right now (though with that Irish accent and those baby blues, how could she resist?), but she wants him to be her partner in every other way, enlisting him to help her make every kind of child-rearing decision that would normally fall to the father, instead of just "a father." And he briefly lets her indulge that fantasy, admitting that the two of them as a couple seems like "it could solve all our problems." But all that does -- as Paul was no doubt expecting -- is to lead her to confront her true fears about the pregnancy, and her realization that it was Mia, and only Mia, who decided to get that abortion 20 years ago. And that realization, in turn, helps her make peace, for now, both with that old decision and her desire to see this pregnancy through.

At session's end, she asks Paul to be happy for her, but he can't be happy for anyone or anything right now, unfortunately.

April

"I thought you were going to take care of me." -April

Even more than Mia, April has built Paul up into the be-all, end-all of her existence. She fantasizes about his eyes, has these elaborate imaginary conversations with him about every topic in her day, and, just as Mia expects him to play adoptive father as well as therapist, April assumes he's going to be her physical as well as emotional caretaker during her cancer battle. And the betrayal on her face and in her voice when she realizes Paul has no plans to take her to the next chemo appointment make it clear why he waited so long to offer in the first place. It's not practical, nor fair (to either Paul or to April) to expect that of him, and if that's the only way she's going to go to chemo, that's a huge problem. I don't disagree with his decision last week -- someone needed to get her there, obviously, before she was too ill for it to matter -- but this is exactly what I'm sure he feared when he wasn't dragging her there in week two or three.

Great as the entire cast is, and great as they all are this week, this is Alison Pill's week to shine above all the others. The moment when April, panicked and betrayed by the idea that Paul doesn't want to take her to chemo, tries to get up too quickly and instead doubles over in both physical and emotional agony, ripped me to the core as I watched it. And she was just as brilliant, albeit in subtler fashion, in the episode's quieter moments, like April telling the charming story of how she became friends with Leah ("You can sing or you can hold your penis, but you cannot sing and hold your penis"), even as she doesn't understand, as Paul does, that this is a relationship she can and should be able to rely on in this situation.

Where Paul is guarded when discussing his father with Mia, and a bit irritated as usual at her overstepping the doctor/patient boundaries, he gives the knowledge freely to April. It's because he feels more of a connection with April, but also because he feels like she needs this level of honesty to make her trust him enough to save her life. She doesn't want to talk about the dream she had before her health scare, but in some ways that's the key to the whole session. It isn't just that April is afraid to trust anyone. It's that her life has been so difficult -- and with the possibility of caring for Daniel, she knows it may only get more difficult -- that the cancer may be providing her with an escape hatch. And it's everything Paul can do to keep her from trying to bail on life. In their last session, he was able to do it by going beyond the call of duty and physically taking her to the doctor. Unwilling or emotionally unable to do that this week, Paul instead sees that hard-won victory slipping through his fingers, and I felt just as alarmed when she left the office as I did when she claimed to have spoken with her mother at the end of the third episode.

Oliver

"It's like rats abandoning a sinking ship." -Luke

As I've said before, Oliver doesn't have any real problems. I mean, he has external problems, not least of which is the bully(*) who drives him to run away from school and straight to Paul's office (the only place in the world where he feels safe). But all of his emotional issues are being caused by these external forces, and so I like that these last two episodes have spent more time on Paul getting to know the chief external forces -- first Bess, and now Luke.

(*) Another great moment of Paul failing to hide his emotions: check out the look of pure rage on his face when Oliver is telling him about the dog-doo locker prank. It's all in the set of his jaw, but it's there.

Where Bess -- who understandably, if not appropriately, seems determined to extend her Me Time vacation for a good long while -- seems largely oblivious to her behavior and how it affects Oliver, Luke at least is blessed with enough self-awareness to know how badly he's treating his son, if not the wisdom to figure out how to stop doing it.

The patients on "In Treatment" are all in some way supposed to reflect Paul's own problems. Oliver has stood in for Paul's children, whom he struggles to relate to half as well as someone like Oliver or, last year, Sophie. Luke, meanwhile turns out to be a stand-in for Paul himself: a bad dad who wishes he could be a better one, and the son of a distant and adulterous father who fears he's turned into his old man's exact double. When Paul tells him this doesn't have to be so -- "You don't have to become like him. You're not doomed to live your father's life. You have a choice." -- he nods at himself, as if he knows he needs to learn this lesson as badly as Luke.

This session is far from a cure-all, but the look that Luke and Paul exchange at the end suggests that it accomplished a lot more than last week's comparable Bess session. Luke may be an ass, but he'd rather not be, and if Paul can keep getting through to him, then maybe Oliver has a fighting chance.

Walter

"It's too late for me. We both know that." -Walter

If Walter is this year's Alex, then sooner or later he was going to attempt suicide. Is it a coincidence that he tried this after Paul canceled their last session, or has he let Paul become his only lifeline in the same way that April has?

Though the episode takes place in Walter's swank hospital room, it plays out like a traditional "In Treatment" episode, with the two men even moving over to the armchairs so they can sit opposite each other the way they do in therapy. And, as usual, Walter is combative as hell, emotionally slapping Paul across the face with the knowledge of Alex's death and the lawsuit (which makes Oliver this week's only patient to not know more than he should about Paul's personal life) and trying to bully his way out of having to admit that he wanted "a millionaire's death."

But he does admit it -- "I just wanted it to be over. That's all." -- claiming to be doing it for altruistic reasons, even as Paul points out how cruel it would be to his wife and daughter. And for a moment, Paul seems to be getting through to him, just as he's always almost there with April. But then Walter armors up again, and you can see he's resolved to end it, somehow, just as soon as Paul, and Natalie, and Connie, and the world, are looking the other way.

(I liked how Walter refers to Paul as "a young man" in the same week where April is discussing how old he is, and whether 50+ will always seem very old to her.)

Maybe the most interesting scene of the episode -- even though it doesn't feature the amazing John Mahoney -- is at the end, when Natalie tells Paul that Connie has been in rehab, and Paul realizes that Walter's carrying an even greater burden than he's let on. Because the patients can be, at best, unreliable narrators about their own lives, it's always interesting to meet other people who can cut through the half-truths and self-flattery and give Paul a clearer picture. I had always expected to get something like that in the first episode with Alex's father -- to find out that Alex had either exaggerated, or flat-out invented, half of the outlandish stories he told Paul -- but that never happened. Here, if Walter wouldn't tell Paul this huge detail, what else has he left out of the auto-biography?

Gina

"You already know that love's the only thing that has a chance against death." -Gina

His father's death -- and Gina's non-attendance at the funeral (which suggests she now views herself as Paul's therapist more than his friend) -- would likely already have Paul in a bad mood for this session. But then he makes things worse by mistaking the warmth Kate showed him in the aftermath of his father's death with a desire to get back together, humiliating himself by asking her to give him another shot when she's already moved on.

So he's irritated, and on edge, and still filled with self-loathing for refusing to see his dad sooner -- and for not realizing that he had this whole other life outside of being the bastard who walked out on Paul's mom and had an affair with a patient.

Gina says she doesn't want to hear about Paul's patients, which may be the right thing for her as his therapist, but which is kind of unfortunate for me as a viewer. Because if ever there was a week for Paul to talk about his patients -- to talk about how the obligations between a father and son are not unlike those between a doctor and his patient, how he had to temporarily leave his patients because of his father, and all the havoc that caused -- it's this one.

Gina tries to get him to see that it's possible to have mixed feelings about his dad, but he's too raw to see that at this point, and is almost eager to get out and have that uncomfortable meeting with Mr. Prince.

And speaking of which (and I always welcome a chance to watch Glynn Turman in this role), what should Paul do? Gina's been trying to tell him that he isn't responsible for Alex's death. Forget the legal and/or professional implications for a minute. How badly would this retard Paul's attempt to get past the guilt he feels about it? Or would he be able to write a confession he doesn't believe in, just to get this headache over and done with?

What did everybody else think?