In Treatment: Week six in review

For the next-to-last time this season, I'm going to be looking at all five episodes of "In Treatment" at once, offering a brief overview of the week and then going patient-by-patient. Spoilers coming up just as soon as I'm placed on hold...

"It's not about you, Paul. They're human beings. They're struggling with profound problems. If only you could find courage to sit with the fact that what we do is hard, and sometimes it makes you feel like an idiot. It's a humbling profession, and if you lack anything as a therapist, it's humility." -Gina

Because "In Treatment" is a scripted drama and not a documentary, Paul's makes more progress, and faster progress, than a real therapist would. While he really only "cured" one of last season's patients (Sophie), he consistently achieved breakthroughs with them over the course of that season. (Mr. Prince would argue that Paul was too successful with Alex, which is why his son is dead and not flying jets.) And here, in this shorter season, Paul has done remarkable work with a group of patients who often fight him kicking and screaming every step of the way.

But as Gina says in the line I quoted above, therapy is often a lot trickier than that. The process doesn't always work, the patients don't always want to let it work, and sometimes outside circumstances conspire to prevent Paul from accomplishing much of anything at all.

And so it feels right, and moving, to see a week in which Paul repeatedly, and painfully, smacked up against the limits of his profession, encountered one scenario after another where his training seemed to be of little use. By the end of the week, it was no surprise he was ranting to Gina about his desire to chuck it all and become "a life coach."

Also, while we may be at the it-goes-without-saying point on the genius of these performances, holy cow was everyone amazing this week. A few specific points on that as we go patient-by-patient...

Mia

"Why did she give up? Okay, she was sick for a year. But after that, why didn't she fight harder to be my mother? How come nobody sticks by me?" -Mia

As Paul says to Gina, what can he really do for Mia? The things that Mia wants -- children, and a husband to raise them with -- are almost beyond her now. There's still a chance she could find the right man, and they could adopt, etc., etc., but it'll be a struggle all the way. But at the same time, as Gina notes, the only way Mia even has a chance for that to happen is if Paul can help her learn to let love and affection into her life, to not be so guarded.

Now, when Amy had her miscarriage in Paul's office last season, I didn't like that choice (even though I'm guessing it came from the Israeli version), as I thought the more interesting choice would be for Jake and Amy to realize that a baby didn't come close to curing all the ills of their marriage. But here, I was okay with Mia's condition turning out to be a false positive (does anyone still use the term "hysterical pregnancy"?), because far more than Amy, so much of Mia's unhappiness is genuinely tied up in this lack of a child. Having one wouldn't solve all her problems, either, but it would solve enough of them that, in "In Treatment" terms, it wouldn't give Paul enough to work with to make for good TV.

And while helping her cope with the realization that her fantasy of being a mom was just that, and might always be, Paul also started to make significant progress on helping her deal with the underlying issues that have likely kept her from succeeding in previous relationships. He still hasn't gotten Mia to drop her idealized view of her daddy, but he did at least get her to start re-examining her belief that her mother is to blame for all her problems.

All the patients are, in some ways, a reflection on Paul, and here we got to see him apply a lesson he'd learned from Gina about the unreliability of childhood memory -- of editing your own mental autobiography and learning to believe the altered details -- and show Mia how maybe, just maybe, her mother wanted to reach out to her, but her father made that impossible.

Two great acting moments to highlight here: first Hope Davis as Mia sitting on the couch and debating whether to follow Paul into his office, as if crossing that threshold would make the therapy session real, as opposed to this impromptu waiting room chat she could pretend was just two friends chatting; and then Gabriel Byrne as Paul learning that this was no miscarriage at all and understanding the depths of Mia's pain.

April

"I don't believe in anything anymore. I don't believe in love, or my mother, or my body, or you. Because of all this stupid therapy, I don't even believe in myself anymore. I literally have no idea why I should get out of bed in the morning." -April

Wow.

One of the limitations of the series' format is the difficulty in showing an event like Paul at the hospital with April, calling her mother in. It could have been done, but it would have had to be clumsily shoehorned into someone else's episode. So instead, we learn about it after the fact, as the episode opens with Paul and April as physically far apart in the TV frame as possible, her arms crossed, her attitude sullen and chilly. At first, I assumed she was still mad at him for not wanting to take her to chemo anymore, but instead it was this whole other story, with Paul making a choice to violate the one cardinal request April had made of him.

And I understand why he did it -- just as, I think, April finally did by the end of the session, even though she didn't want to admit it. But her level of anger with him, and his frustration with her, led to some amazingly raw acting from both Byrne and Alison Pill. (Pill also had some hilarious black comic moments, like her delivery of "I don't understand: are you for this woman or against her?" She's at the can-do-no-wrong stage for me.)

What we're seeing here, as we saw last week, and as we'll see in the Oliver episode, is that, while Paul's desire to play savior with his patients is admirable, it also creates problems that a more professionally-distanced therapist like Gina simply wouldn't have. April has come to think of Paul as much more than her therapist, and she feels flat-out betrayed by him. No matter how much she might objectively understand why Paul did what he did, it still hurts too much for her to deal with.

And then comes that moment at the end, when she physically can't get herself up off the couch, and has to ask for help from this man whose help she's not sure she wants anymore. Mortifying, devastating, and brilliantly-played.

Oliver

"You can't help me." -Oliver

And this one hurt -- badly.

With Mia or April or even Walter, Paul at least has the hope that he can do something for them emotionally, even if he can't solve their bigger problem (Mia's loneliness, April's cancer, Walter's career). Here, he has completely and utterly failed to do anything to help Oliver -- not through any fault of his own, but just because Bess and Luke are such selfish, messed-up, oblivious twits that they have created a situation -- where Bess takes Oliver away from the city altogether so she can take this new job -- that no therapist could fix. Paul can rail against them, can cross all kinds of professional lines with them, can flat-out yell, "You have got to figure out a way to look after your son!," but there's no getting through to them. As Oliver realizes, neither of them wants him, and he's stuck with the one who doesn't want him less than the other one.

And the hell of it is, Oliver has grown to like and trust Paul so much that, like April, he can't see him as a doctor anymore, but a father figure. And so of course he pleads with Paul to stay with him, and there's nothing Paul can tell him -- that it's ethically unkosher (I think it is, anyway), or that once Oliver went from being his patient to being his foster son, Paul would likely become just as distant with him as he's been with his own kids -- to ease the pain of being rejected by another parental figure, and especially by the one parental figure who actually seems to like him.

There was a finality to that scene on the playground (beautifully shot by director Paris Barclay) that has me feeling, sadly, like this is the last we'll see of Oliver. Last year, we saw a few episodes towards the end without certain patients, and I could see us getting a "Wednesday" episode in the final week that has nothing to do with Oliver at all. (Maybe Paul's court hearing?)

But dammit, it stinks that it had to come to this for the kid.

Walter

"I'm not supposed to malfunction, Paul. That's for other people." -Walter

Wow, and then double wow.

The closing sequence, with Walter doubled over and bawling and wrapping his arms around Paul's leg like a little boy clutching his daddy, was among the most affecting scenes of this incredible week. In fact, I loved it so much, I asked "In Treatment" showrunner Warren Leight (who's been writing most of the Walter episodes of late) about its origins, since he'd alluded to it when I interviewed him before the season. Here's what he had to say:

The truth is, I had been hoping for Walter to breakdown in front of Paul for a few episodes: week four, right after he'd been fired, and week five, in the hospital after his suicide attempt. What was fascinating to me was Mahoney's first take on those two episodes. His Walter stumbled, but he didn't breakdown. And even stayed confrontational. So, after week four, I wrote week five, set it in the hospital, and waited for a breakdown which never came (the Israeli week five was a one on one session between Paul and Walter's daughter discussing her spiritual quest in India, and her lesbianism, I believe. There was no suicide attempt).

After week five, I thought, Walter's defenses are crumbling, but they are all he has, and he won't go down without a fight. So I wrote week six with that in mind. When I got to the last line from Paul, about how the other Walter is the one who wants to live, I thought, 'OK, this will work.' And it did. We had a long talk on the set about the false self and the true self, and how often people split off from themselves to please others or to survive. This seemed to resonate with both actors.

The grabbing of Paul's leg was a spontaneous gesture on Mahoney's part. After the first take, Gabriel came up to me and Paris and said, basically, "How am I supposed to sit in the chair when the man is falling apart in front of me?" He asked if he could go over to Walter, we said yes, and we all decided not to tell John that would be happening. John reacted in the moment, and I think it's one of their strongest moments. Week seven then had to be rethought, to acknowledge, or deny, what had happened in week six.

John would've gone there earlier if we'd asked, but I trusted his instincts. It would take someone like Walter a very long time and a huge amount of pressure before he'd drop his defenses. Older men don't come to therapy easily.

Am I the only one who finds it really cool that the writer of the episode was trying just as hard to get Mahoney to open up as Paul was trying with Walter? In the end, it all played out perfectly, so I'm glad Mahoney had the instincts he did; Walter crying pre-suicide attempt, or even right after, wouldn't have had nearly as much power as it did after this long wait.

Other than Walter's breakdown, the most interesting part of the episode to me was the comment by Walter's shrink from the hospital, about how Paul maybe opened a Pandora's Box he shouldn't have with Walter. That's what he arguably did with Alex, and what I was worried about in the early episodes of this season. I think the "other Walter" does deserve to come out after all this time, but I can't help but wonder if the Walter who came to Paul as a patient will be better off this way.

Gina

"I really think that you're acting like an a--hole. I really think that you're a therapist who has remarkably little insight into your own behavior. You are so self-absorbed. You are so entitled. You come in here and you spout the same old bulls--t!" -Gina

Triple wow.

What's usually so wonderful about Dianne Wiest's performance as Gina is the extreme control she displays in front of Paul -- both how she manipulates him where she wants him to go, but how she keeps her own emotions buttoned up tight. While Paul is obviously more demonstrative with Gina than he is with his patients, it's more of a matter of degree; it's not stunning that the guy who occasionally loses his patience with the likes of Luke and Bess might explode even more when outside the confines of his role as a therapist. So to see Gina finally, after two seasons of goading from Paul, lose it and unload on him... amazing. I usually take meticulous, near-transcribed notes of these episodes, but when we got to Gina's outburst, I put the computer down, except to jot down an occasional line or two, because I didn't want to miss a second of this when I might be otherwise distracted by making sure my notes were correct.

After all of Paul's failures during the week, Gina argues pretty convincingly for the value of what they do, and hopefully we won't see him asking for the letter back next week. But things got really, fascinatingly, ugly there for a little while, didn't they?

Finally, I want to say that I've written all of the above without watching the final week's worth of episodes. I hope to get to those in the next few days, depending on my Upfront Week schedule, and to maybe talk to Warren Leight for a season post-mortem interview. I don't know what the future is for the show, or for these patients, but it feels like there's too much left to deal with in each case for the show to wrap up anybody's story the way that season one did, in one way or another, with all of its patients. I'd like to think this year leaves things a little more ambiguously, whether or not there's going to be a third season, and whether or not any or all of these four characters would be a part of it.

What did everybody else think?