The more I think about it, the more I think that the basic theme of this episode of The Sopranos and of the entire series is loss—which complements Glen's and Peggy's ideas about Tony's doom. After all, Tony has apparently lost hope in therapy as an agent of happiness. Like The Godfather, The Sopranos traces the erosion of "the old ways" (as if they themselves hadn't appeared to those who practiced them as the erosion of even older ways), but in TheSopranos Christopher gives no promise of growing into a Michael Corleone, so Tony seems even more alone. The real tragic power of this show, it seems to me, is that in its sometimes Shakespearean way—all those parallel plots!—and in a very dark mirror, it reflects the distance between all our hopes and our realities.
I want to ask Glen and Peggy and Joel (if he's available) whether their patients ever talk about this show and what they say, if so. As for me, I'm just a skinny fuckin' editor/writer/analysand from New York.