Therapy models

I've promised psychological blogs so I should wrtite one occasionally.

I was asked recently to present some tapes or videos dealing with the practice of psychotherpy to my school psychology colleages. I have several old tapes by Wolpe, Beck, Lazarus, Rogers and others dealing with the application of their own particular theoretical model. They are not bad tapes and it is likely that many psychologists, like me, used them at one time or another as models for their own efforts. On this occasion I chose to use a popular HBO progrsm, In Treatment. It is beginning its third year. The first year episodes are now available as DVDs.

My wife and I have become hooked on this series. The therapist, played by Irish actor Gabriel Byrne, is superb. Paul, the therapist, is psychoanalytically oriented therapist, as his his mentor whom he sees regularly. While this might not sit well with many cognitively and behaviorally oriented therapists, the series is real, highly empotional, and extremely well written and acted. Paul looks for determinants of his patients' problems in their parents and usually finds credible determining factors. His female patients tend to fall in love with him. He sometimes has problems with limit setting and frequently questions his own competence and the value of psychotherspy in general. He falls in love with a patient while going through his own divorce. In a recent episode he verbally attacks his therapist and mentor, accusing her of being uncaring and hiding behind her technique.

My audience, none of whom had ever seen the series, were enthralled and wanted more. One might argue that what I was presenting was artifical--merely acting, while my professional tapes were real and empirically based. Artificial or not the In Treatment episodes are extremly relevant and provide many areas for discussion. I sometimes question one or two of Paul's interventions but mostly find myself feeling envious of him. I think he is a better therapist than me and I rarely think that or say it. Furhtermore, I never really believed that the professional tapes are completely honest. The editors have been selective in what is presented. Futhermore, I find them devoid of feeling, (except for Rogers). They rarely deal with the therapist-patient relationship and its impact upon outcomes. I don't know if In Treatment is written by real live therapists but whoever writes it is highly sophisticated. The situations are extreme and a little contrived. (Two patients meet outside his office and wind up having an affair; he is threatened with lawsuit by the father of one of his patients who may have committed suicide; a cancer victim refuses to go for chemo). Nevertheless, the series is powerful should be required viewing for clinicians and those aspiring to do therapy. Kudos to HBO.