The call of the couch: The depiction of psychotherapy in American films and television series

Not many shows return after a decade and manage to recapture that old urgency straight off the bat (David Lynch’s Twin Peaks is a notable exception). But HBO’s In Treatment did just that over the last couple of months with its fourth season, starring Uzo Aduba as Dr. Brooke Taylor. Between 2008 and 2010, Gabriel Byrne played Dr. Paul Weston, a successful Baltimore psychotherapist who tends to a variety of patients every season.

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Every episode covered one therapy session and every season juggles the stories of 5-6 patients on an average, including of Paul himself who intermittently engages his own former mentor, Dr. Gina Toll (Dianne Wiest). This same format is followed with a slight tweak in the fourth season — instead of a therapist, Dr. Taylor has a sponsor (she was addicted to alcohol once) named Rita (Liza Colón-Zayas), who’s more of a friend and mentor.

Courageous depictions

In Treatment was and is an immersive piece of storytelling with some fine performances — Irrfan Khan in the third season, for example. It’s also a reminder of the fact that therapy, whether in its individual or group avatars, has become a major theme in American film and television in the 21st century. The Marvel universe (always a good barometer for tropes), for example, has taken this very seriously of late. Trauma and grief therapy were a big part of its recent series The Falcon and the Winter Soldier. And, of course, the biggest Marvel film of them all, Avengers: Endgame, begins with a scene set at a grief support group being led by Captain America (Chris Evans) himself.

The Sopranos (1999-2007), one of the turning points of American television, took the lead in thoughtful, courageous depictions of therapy: the good, the bad and the downright scary — because the patient here was, of course, New Jersey mob boss Tony Soprano (James Gandolfini). The Sopranos ushered in the era of anti-heroes to TV, and Tony Soprano’s therapy sessions with Dr. Jennifer Melfi (Lorraine Bracco) were how the audiences initially humanised an unsympathetic, frequently violent protagonist. Dr. Melfi helps Tony with his recurring panic attacks, ironically, by reminding him of the key traits that make him such a ruthlessly effective gang leader: vision, foresight, and decisiveness. The bodies continue to pile up but Tony noticeably improves at first. “We have to repeat the familiar, even if it’s bad for us,” as Dr. Melfi tells him at one point.

Eventually, of course, Dr. Melfi distances herself from Tony’s actions, telling him she feels her therapy is enabling him and his violence.

The scepticism about therapy itself is a formal feature, almost, of these stories — In Treatment’s third season, for example, sees Dr. Weston doubting the very fundamentals of his practice. Similar sentiments have, more recently, been expressed for comedic effect in feel-good shows like Apple’s Ted Lasso and NBC/Netflix’s Brooklyn Nine-Nine.

Asking the right questions

In the second season of Ted Lasso (which began a couple of weeks ago), the titular protagonist, a good-natured American football coach, says he has a “Midwestern scepticism” towards therapy, when confronted with the prospect of a sports psychologist (Sarah Niles) working with his players. In the sixth season of Brooklyn Nine-Nine (the eighth and last season of which will start later this

Andy Samberg as Jake Peralta in a still from Brooklyn Nine-Nine
 
| Photo Credit: Special arrangement