When Good Therapists Make Bad Referrals

The Sopranos: Season 4 Analyzed; Week 2

When Good Therapists Make Bad Referrals

The Sopranos: Season 4 Analyzed; Week 2

When Good Therapists Make Bad Referrals
Talking television.
Sept. 23 2002 5:33 PM

The Sopranos: Season 4 Analyzed; Week 2

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Dear Peggy, Glen, and Phil,

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What drew all of us shrinks to Dr. Melfi was her realness. As Glen points out in his book, before TheSopranos virtually all the depictions of therapists in movies and on TV alternated between two extremes, demonized psychopaths and sex maniacs like Michael Caine in Dressed to Kill, or idealized flawless saviors like Judd Hirsch in Ordinary People. You couldn't find a complicated and nuanced portrayal of a therapist anywhere in the media.

Then along came Jennifer, who looked like the authentic thing—warts and all. Indeed, the members of our profession have been so grateful that they have been tripping over each other in an effort to present David Chase, Lorraine Bracco, and the writers of TheSopranos with awards. (This fact itself has caused some controversy in the field.) And when colleagues asked the creators of TheSopranos why they have offered such a sympathetic picture of a therapist, most of them replied that they were all grateful for the help they'd received in their own treatment. This isn't something you hear too often!

This is not to say that Dr. Melfi doesn't have her technical shortcomings. At one time or another, we have all winced at her interventions. Some have seemed mistimed or ill-conceived, and others struck us as too wordy or didactic. But in general, she's been on the right track: slowly and dependably working to help Tony discover and take responsibility for his inner world.

And we've all been impressed by another fact. Despite her own personal difficulties and pathology—which the writers haven't hesitated to show—Jennifer has, by and large, maintained her professional stance. Indeed, she has recovered from several dicey transference-countertransference crises. It is important that the public know that to be effective, a therapist doesn't have to be perfect, just "good enough."

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Enter Dr. Wendy Kobler (who reminds one of Brenda's mother in Six Feet Under). She is exactly the sort of caricature of a contemporary shrink that we were worried would appear in the first place. She's into everything that's trendy in the mental health world: anti-depressants, trauma, and repressed sexual memories. She's full of her self-importance, letting it be known that she's connected with the University of Barcelona. Her chumminess—that is, her unearned presumption of closeness with Meadow—is particularly offensive. Totally devoid of therapeutic skepticism and humility, she postures as if she has all the answers. Kobler immediately tells Meadow what to do about Columbia and Europe, despite the fact she hardly knows her. Perhaps most strikingly, in contrast to Melfi, Kobler goes right for the jugular and confronts Meadow about Tony's Mafia affiliation in the first hour.

What is the purpose of introducing this cliché-ridden parody of a psychotherapist at this point? And it is a particularly critical point, indeed. For unlike Tony, Meadow—a member of the next generation—stands a chance of extricating herself from her family's bloody legacy. To do this, however, would probably require the help of a good, uncorrupted, and dependable therapist. It will be interesting to see how the perceptive and straight-talking Meadow reacts to Dr. Wendy.

Perhaps Kobler is introduced as a foil for Melfi—to highlight how good Jennifer actually is. But if this is the case, we are left with a nagging question. What was it about Jennifer that caused her to make such an awful referral?

Joel

Glen O. Gabbard, M.D., is a professor of psychiatry at Baylor College of Medicine and author of The Psychology of The Sopranos, inspired by this discussion. Philip A. Ringstrom, Ph.D., Psy.D., is a senior faculty member at the Institute of Contemporary Psychoanalysis in Los Angeles. Joel Whitebook, Ph.D., 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 the William Alanson White Institute in New York. All are practicing therapists as well.