Monday, February 11, 2008

In Treatment: Episode 11....the sub-blog


Mike Huckabee was on Meet The Press discussing how he cooked squirrel in a popcorn popper in his college dorm. That is so weird.

Okay, back to our show here:
Paul is sleeping on the couch in his office, fully dressed, rudely awakened by the alarm. His idea or Kate's?

Laura is 25 minutes late, she asks for water (also a common theme on this show, no wonder they all have to go to the bathroom). She's come in a cab and she watched a dog get hit by cars, repeatedly. "I had to get him to a vet. You would have pulled over?" Paul responds, "I wouldn't have pulled over, I'd have assumed he was dead and there was nothing I could do."

He points out that she would have been late, dead dog or not, "I would have appreciated a call." She accuses him of being "anti-me."

"What do you think your being late is trying to say to me? Maybe you think I'm not doing my job?" "Are you angry with me? Maybe we need to talk about what good this therapy is doing you." She talks about her distress at the end of the last session. "You're trying to make me angry. I can't win here." She curses him out. "You don't have to love me in return."

"Now I see why they laugh at shrinks and their ridiculous interpretation." She talks about her helplessness as the patient, about having an idiotic theory thrust on her.

"Maybe I'm not helping you at all," Paul says.

They talk about Laura's upcoming marriage, how she hasn't told her father, though her husband-to-be has blasted his whole e-addressbook. He returns her to the issue of her being late.

"You want to kick me out of therapy." He says absolutely not, but then says they should think about winding down. "You don't want me to treat you as a psychologist (he really garbles this, did he say ologist or iatrist?)....I'm the one who says No, who humiliates you. Therapy should not be a source of constant humiliation for you."

"Am I the first patient to be in love with you, Paul? Maybe you can't treat me because you're in love with me Paul?" She's breached the boundaries. He ends the session despite her pleas for more time and Laura storms off while Paul tries to hand her the bill. Laura bumps into Alex, who has arrived for his session a day early. They flirt on the street and they drive off together.

Oh my, so we've got early patients, late patients, popping squirrels and dead dogs. Patients in love with shrinks ramming unwelcome theories at them, and an uncomfortable doc who wants the patient to leave.

Okay, so I still don't know What Paul is. Laura made a reference to med school, so I thought a psychiatrist, but there's never any mention of meds. Of course, with all that water, one might think everyone has dry mouth from their medications. One of our commenters has said he's a psychoanalyst, but I don't think so, his patients come weekly, not daily, and he doesn't have an analytic set up with a chair behind an analytic couch (these are rather specific couches).
Paul and Laura have a discussion that epitomizes the type of power struggle our commenters often worry about. Another episode where no one feels heard. You know, the whole point of psychotherapy (or at least one major point of psychotherapy) is to feel heard. These people are getting it all wrong, and I don't blame Laura for feeling cornered. Seems like Paul takes turns with his patients being painted against the wall.

Why can't Paul be honest? It's hard to have a patient declare that they're in love with you, the boundaries are a mess, he's feeling uncomfortable and he CAN'T have a relationship with her, it's simply unethical and he would lose his license. So he went to see an old supervisor, to get another opinion of how to handle a situation that's uncomfortable for him and that is obviously uncomfortable and painful for her. The supervisor wondered if they shouldn't consider transferring her care and he feels that now that that option's been brought up, they should look at it. Laura would be mad, she'd feel betrayed, but at least it's honest, it gives the sense of consultation and propriety, and instead he's pushing Laura away, treating her unfairly, being unnecessarily cold.

And a final thought here-- Sarebear asked if anyone here worries about being sued (I think it was Sarebear)--between making tea and having one's wife dress one's patient in their daughter's dry clothes. Really, there's nothing to be sued for here--- there are only a few boundaries that are set in stone (don't sleep with your patient and don't kill them, for starters). A patient could lodge a complaint that her therapist made her tea, but why? And since he makes tea for everyone, and the question is milk or sugar, not Red or White, there isn't a boundary violation. And giving an injured wet and cold young patient dry clothes, well, it's hard to find harm here. The boundary issues become salient if a patient ends feeling injured, and then the doctor's behavior gets scrutinized. If Laura feels jilted, and she sues Paul, then things like whether he extended the time of the sessions, what he gave her to drink, whether they'd ever met outside of the office, then and only then is it an act that has relevance. Even if a patient and a therapist were to go out for a meal, yes this is a boundary violation, but in the absence of something more, a patient can't sue a doctor simply for going out to eat a meal. It's just a suspect thing to do, and becomes a part of the case against the doctor, if the patient then alleges they had sex.
ClinkShrink, I hear, shares her squirrels with her inmates.