Paul, Week 1

Psychotherapy is fundamentally a relationship between two people, much like the relationship a patient might have with a close friend. The reason the patient has to go to a professional rather than to a personal friend relates mainly to the psychological backwardness of our society. Were our society more advanced, friends would be more understanding at an intimate level, more supportive, and more ready to offer helpful advice. In a truly advanced society, there would be little need for psychotherapists.

In the therapeutic relationship, the patient attempts to gain the self-understanding he or she needs to begin living in a new way. One path toward this self-understanding involves dramatic reenactments that usually relate to hurtful childhood experiences even though the subject matter being discussed may focus on contemporary situations. In these emotional reenactments, the patient may be acting as he or she did as a child in hope that the therapist would not react with traumatizing behavior, as one or more parents regularly did. Or the patient may take on the role of the traumatizing parent in hope that the therapist would not be traumatized as the patient once was, thereby providing the patient with the hope that the therapist will prove helpful in mastering the trauma. These dramatic reenactments bring a level of complication to intimate relationships that untrained people do not expect or understand. As a result, friends may react in unhelpful ways by either traumatizing the person anew or by being traumatized by what the patient did. Trained professionals are taught to react in helpful ways no matter the provocation to act otherwise.

Gina, Paul's former therapist, knew that Paul could not do anything to please his mother and that she remained critical of him to the last. There is therefore no excuse for Gina to criticize him continually even when the criticisms had some merit. There is no therapeutic gain to be had from criticism in Paul's case. Gina not only criticized Paul within therapy, she criticized him to others so as to deny him an important appointment, and often took his wife's side during couples therapy. It might be said that Paul as a trained therapist should have known better than to seek Gina's help, but many therapists are attracted to psychology because of their own psychological problems and, like Paul, have failed to resolve significant issues even after becoming therapists.

There is an old saying that women marry their fathers and men marry their mothers. The same psychological tendency comes into play when choosing close friends of the opposite sex. So it should not come as a surprise that Paul's wife, Kate, spent at least as much time criticizing Paul as Gina did. Paul accepted Adele on recommendation without knowing much about her. It will be interesting to see whether the element of serendipity in choosing her exposes Paul to a form of femininity that challenges his pathogenic beliefs about how women see him and what they expect from him. The initial impression of her is that she is extremely professional.

Paul believes he is experiencing symptoms of Parkinson's disease, but Adele seems to suspect that the symptoms may be neurotic in origin. Adele has no real justification for this suspicion. Rather she is merely following the tendency of psychotherapists to continue exploring neurotic origins until symptoms are definitively shown have a physical basis. Paul complains of a recurring nightmare that is waking him up each night and claims to know everything there is to know about its meaning. Adele counters by asking, in effect, if you know so much consciously, why do you continue having the dream? Adele's question arises from the widely held view that rapid-eye movement (REM) dreams are meant to affect waking behavior in terms of providing either conscious insights or a basis for motives that operate while we are awake. A way of thinking about this is to see the messages REM dreams contain as operating much like post-hypnotic suggestions while we are awake. Paul believes the message is, "Wake up to the fact that you have Parkinson's." Adele believes that can't be right. The dream had the effect of giving Paul insomnia, which led to his seeking therapy, so maybe the dream meant to induce Paul to do so. It will be interesting to see whether the nightmare goes away when Paul seeks therapy for itself without any ulterior motives.

Category:

Entertainment

Tags:

• In Treatment
• Paul
• Adele
• insomnia
• nightmare

[orange17475]

For me I think after watching all 3 seasons when I went back and started to watch season 1 again, I had a whole other perspective on how poor Gina's reactions and comments were during this supposed 'therapy'. She so often seemed to fall back on judgements of him using the knowledge she had of him from the many other dimensions of their relationship. Sorry to post 3 times but I really love the show and love chatting about it :-)

[ControlMastery]

@orange17475 I did the same thing. At first I was high on Gina, but my opinion of her diminished over time.

[BigSisterNY]

Wow! How did I miss all the negative judging you claim that Gina did? I sure caught Paul's accusations thereof. But I thought he was seeing/hearing things that weren't there. Can you give us some examples?

[ControlMastery]

@BigSisterNY Gina's criticisms mostly come into play with respect to Paul's handling of Laura. I'm not saying that the criticisms weren't warranted. My problem with her actions is that leveling big guns of criticism at a patient is not therapy, particularly when the patient was constantly belittled by his mother. "One of the best therapists on the East Coast" should have taken a better recourse. In truth, Gina never acted as Paul's therapist; she remained his supervisor to the end.

[ControlMastery]

@BigSisterNY I accept your judgment. I recall that I was a fan of Gina's at first and only turned against her near the end.

[starrfist]

It is amazing and a little scary to me that an analyst can be so clueless about his own life. I hope that's not me in twenty years. (Not that I'm a therapist :) I just want to have more insight in my middle age than Paul seems to have.

PS: I love your written commentary in the description, but miss your edited videos with voiceover!

[ControlMastery]

@starrfist You must merely miss the opportunity to chuckle at me stumbling through my commentaries. We all have blind spots, even therapists. A therapist can help a person with a particular issue even when troubled by the issue in his own life by sensing what is going on and encouraging the patient to take life steps the therapist is reluctant to take. An unresolved issue might cause a therapist to act negatively too when it induces to therapist to urge being ruled by unresolved fears.

[daisymay1020001]

Adele is absolutely beautiful.

[orange17475]

I think things are complicated even further by Paul's admitance that he came to Gina for the very reason of knowing what she would think about the situation with Laura and that he had to test himself to withstandGina's critisism before he could realistically contemplate something more developing between him and Laura.

[orange17475]

Very interesting to read your comments about this episode and about Gina. I totally agree with how Gina was constantly critisising Paul. Not only in reference to how he felt about Laura but then also regularly implying that he was 'just like his father'. That his father left his mother and ran off woth a patient and compared that to Paul's situation.

[BigSisterNY]

@ControlMastery Thanks for your reply, CoMast. I guess I have a blind spot. I've gone back to some of the Gina sessions and see her assessing, evaluating, and drawing parallels but I have not seen a whole lot of judging. Hence I see more of Gina's role as therapist than you do, who see her exclusively as a supervisor to Paul. You and I agree that criticism of a patient is not therapy. How about judging? And are you judging Gina? Now I can't tell. Ha! Thanks to HBO for this "mind food."