Dr. Melfi as Spectator to the Therapeutic Process
The First Five Weeks of Season 3 of The Sopranos
Dr. Melfi as Spectator to the Therapeutic Process
Talking television.
March 27 2001 9:55 PM

The First Five Weeks of Season 3 of The Sopranos


Dear Phil, Joel, and Glen,


I'm getting in on the interchange late this week and can't hope to do justice to the richness of the ideas already in the air, so I'll just give you my own initial take on this episode's therapy component. Sometimes patients outdo the therapist in their "therapizing," which is what happened last Sunday night. Carmela and Tony badly needed to have their chronic, signature "fight" with a capital "F" in the hearing of a third (professional) ear, and they did! They had to take over the work in part because Jennifer had indeed "sealed over"--that is, resurrected and fortified her defenses against her own longings for relatedness with Tony--and this impeded her ability to become responsive to the couple as a new entity in the treatment. OK, she may also have been jealous of Carmela's freedom to sling epithets and interpretations while keeping Tony as her man. So, there are plenty of personal reasons why Jennifer blew the session so badly on her end. But, a technical reason could be that she was trained in and couldn't creatively expand on what we call a "one-person," "there-and-then," insight-oriented approach to therapy. This approach, modeled on a classical Freudian view, involves "digging into" a patient's past history as the primary source of her or his current symptoms. A "one-person" model, while often extremely useful when working with individuals, has serious trouble being elasticized to suit a couple. Here's where a "two-person" approach would come in. This perspective, which I'd say is the most broadly used now by good psychoanalytic therapists of most persuasions, would invite in the spouse of an individual patient not to press for information about the patient's past lives and loves, but to watch (and, to some degree, "participate in") the relatedness that exists between the two now. In other words, the relationship itself becomes the "patient" in a good couple's session. Jennifer couldn't manage that, but Tony and Carmela knew implicitly what they needed to do. They presented themselves loud and clear to each other in the session, demonstrated the most chronic and destructive dynamics (as well as Carmela's efforts to "cure" Tony with her seat-of-the-pants methods), and then had the classic after-session quarterbacking, partly defensive and partly constructive. I look forward to seeing if they can teach Jennifer how it's done!

This spring, Slate will ask Dr. Melfi's real-life counterparts to examine developments on The Sopranos. Glen O. Gabbard, M.D., is a professor of psychoanalysis at the Menninger Clinic and co-author ofPsychiatry and the Cinema. Philip A. Ringstrom, Ph.D., Psy.D., is an analyst at the Institute of Contemporary Psychoanalysis in Los Angeles and a full-time practitioner. Joel Whitebook, a practicing analyst in New York, is on the faculty of the Columbia Center for Psychoanalytic Training and Research. Margaret Crastnopol, Ph.D., is on the faculty of the Northwest Center for Psychoanalysis and a practicing psychologist/psychoanalyst in Seattle. Click here to comment on Sunday night's episode.

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