HBO’s “In Treatment” – Is That What Therapy is Like?

How many of you have been watching the award-winning HBO Series, “In Treatment” with Gabriel Byrne, Dianne Wiest, and John Mahoney?  This HBO series is currently near the beginning of its second season, centered around how Dr. Paul Weston (Byrne) conducts therapy sessions with four different clients, and then his own individual therapy process with his own therapist, Dr. Gina Toll (Wiest).

In my opinion, the “In Treatment” series is more accurate about the layered complications of the therapy process than the brief bits of therapy shown in Showtime’s “United States of Tara”.  The snippets shown of Tara’s therapy were with an overwhelmed, under-trained, uneducated wimp of a therapist.  I suppose it is true that all too many therapists are overwhelmed and unprepared to deal with the healing process for trauma survivors with Dissociative Identity Disorder.  Hopefully a referral to a more specialized trauma therapist in season two of Tara will lead to deeper, more meaningful presentations of her therapy process.

With the “In Treatment” series, the clients present with relateable issues, and the therapists become real people – likeable, emotional, genuine, flaws and all.

“In Treatment” shows how therapy is different from person to person.  While staying the same, the room “changes” and feels different and unique to each client.  The therapists and their rooms are the same from session to session and client to client, and yet they become totally different places as each individual client comes in, exposing his or her own life, pain, feelings, energy, thoughts, and emotion.

It shows how the therapy process challenges therapists to be their best selves at all times, as impossible as that might be.

It shows how much people actually say about themselves when someone is listening closely to what is being said.  And it shows how much people do not listen to their own selves, and how they don’t hear the words that come out of their own mouths.

It shows how families speak to each other – or not.  And how helpful family members can be to each other – or not.  And how loving, kind, supportive, and caring family members can be to each other – or not.

It shows how people wrestle with their emotions, their feelings, their realities, and the denial of those realities.  It shows their emotional conflict, turmoil, grief, depression, anxiety, suicidal actions, passive suicidal feelings, anger, panic, fear, dismay, agony, self-harm motives, struggles with life and death.

It shows how the therapy process, while focused around the expression of words and feelings, can be enhanced by paying close attention to the communication from the physical body itself, which sometimes says more than clients can put into words.

It shows how therapists get invested in their clients, and how they build connections and bonds with their clients.  The caring can be a real thing.

It shows how important it is for clients to make their own life-decisions, how much people wrestle with their own life decisions, and how quickly therapists get blamed when these decisions do not work out as hoped.

It shows how tender and fragile people can be, even when they outwardly appear to be strong, powerful, and in control.

It shows the importance of being heard, understood, listened to, and recognized as a worthwhile person, first by others, and then by yourself.

These television shows can lead to a lot of personal thinking and reassessment about your own therapy process, your relationship with your therapist, and how your life is changing and progressing.  How do you relate to what you are seeing “In Treatment”?

* What is your therapy process like?
* How is your therapy impacting your life?
* Do you see your therapist as human as Dr. Weston presents in “In Treatment”?
* Do you blame your therapist when your life plans do not work out as hoped?
* Is your therapist as central to your life as presented in these series?
* Are you more attached to your therapist or to your therapy process?
* What would you do if you realized how human and flawed your therapist is?
* Do you expect your therapist to be something more than a real person?



Kathy Broady LCSW

15 comments on “HBO’s “In Treatment” – Is That What Therapy is Like?

  1. I’ve seen the first season on DVD, and I think it’s excellent, though it isn’t particularly relevant to my own personal experience of therapy. I have no emotional investment in or attachment to my therapist, which seems to make me a bit of an oddity amongst therapy clients; one feature of the show that has seemed particularly realistic to me, especially now that I’ve started reading therapy blogs, is the hugeness of the analyst in the clients’ lives. I’m not that way myself, but I recognize that it is very accurate for most people, and it’s a feature of analysis that usually isn’t presented when a therapy/client relationship is shown on TV/in film.

  2. I’ve only seen a few episodes. But i’ll tell you what my therapy is like. My therapist has changed offices three times in three years, so it feels sometimes unstable and i worry she will move again. I grew up in foster care so i hate moving so much, but my therapist does make her moving very convenient for me and i do really like her new office. So when i go in i hear the classical music playing on the Bose, and of course NPR and the white noise machines. I sit on the sofa, sometimes i go to the bathroom to check my face. sometimes i journal a but a quick internal meeting before she comes out to get me. Mostly i put my headphones on and listen to music as loud as i can. I am always an hour early because i worry about being late, so i sit there for an hour, sometimes playing my Nintendo DS, or reading a book, or eating lunch or whatever..but i just wait. I get very anxious while waiting. And then my therapist opens her door. I always pretend like i don’t see her or notice her because we like it when she says our name. We get up and walk into her office and she closes the door. We scan her whole office trying to make sure nothing has changed or nothing is new..Last week she had a new book case and she moved the plant to put the book case in the corner, it also had new books on it. She sits in the big brown chair across from me, and i sit on the sofa with my knees folded to my chest or indian style. i usually take off my shoes. I don’t usually talk, so she grabs markers and paper. Sometimes i go in and i can’t shut up. Sometimes i go in and i sit in the corner near the door and she sits with me. we all inside have different relationships wish our therapist i think. Some of us adore her, some of us love her, some don’t really care, and some of us hate her or resent her and pick fights with her…but consensus is that we really do love her and wish we could be around her all the time..i think i’ve said enough for now.
    okay well,

  3. I will probably come back later to answer those questions because they are provacative. I have a few questions if you Kathy or anyone else for that matter would answer I would really appreciate it. I have been thinking lately about exsposure and how vast it is and that people almost feel entitled to know things about others and feel affronted if people don’t answer. What I mean is the eplosion of blogs, online journals and vlogs. It seems you can find a blog dealing with just about anything, things that would have never been open for disccusion, like colonos ( ok, I don’t know how to spell that) but you know , things that were private. I even read a blog where a few months ago the writer was upset that nobody responded to entries but a sentence later said it was for their own release and they were not writing for an audience. Then later still demamnded to know who was reading and why. I think I have been thinking about this because May is Mental Health Awareness week, (whatever that means) in the US. Particularly my question in my roundabout way is, regarding dissociation and the whole spectrum, where do you place individuals who claim to be from another planet or life form and say they are multiple? What about those who say that their alters/parts (insert verbiage of choice) are real life incantations of fictional characters? Like Hans Solo or chararcters from Lord of the Rings? I am not kidding here, there are whole communities online, do a search for *soul-bonding* or *otherkin* and yet when people have responded in what is percieved as disbelif, they are berated for being judgemental or reminded of their own struggles with people not beleiveing them. There seems to be this *anything goes/ anything is possible/ real with dissociation*. And L*rd help the non-agreeer. Why is it not okay within the *multiple community* to just call B*llsHHt on some things that seem just delsuional. For me, no someone is not on the road to mental health if they believe that a character from someone completely outside of themselves can take up residence within. One other thing and then I promise I’m done! Why is it soo important that the general population understand DID? Personally I think it is more important they understand trauma and the effects *especially with vets returning home* other than the minutea of the DID. To even put it in an entertainment category is insulting to me. When they make a whole production about someone living with kidney disease and dialysis and throat cancer for entatinment value *see how abhorrant that is* then maybe I could be entertained. Not funny right?
    I used spell check this time!

  4. I have seen this show and was not very impressed with it at all. The whole sexual tension between the therapist and a pt really bothered me.I also saw an episode where a pt went into his bathroom and took some meds the T had in the cabinet?!! I find it strange that the T would let pts use his personal bathroom or that he would keep personal things in guest/pt bathroom. I see my T once a week. I am always on time and never miss an appt. I think of my T as human. I have never blamed him for things that went badly in my life. Of course i always take the blame for everything in my life whether or not it is my fault LOL. I would say at this point in my life i am more attached to my T than the “process”. I could not do the inner work needed with another T, it would take a very long time for me to trust that this person had my best interests at heart. I know my T is not perfect and he makes mistakes, he has made them with me.But we have gotton past that. It is because i see my T as a whole person that I can trust him. it has taken many years to say without a doubt that he would never hurt me, or lie to me or talk about me to anyone without my permisson. I know he is always always always on my side and looking out for my best interests. So for me part of the theraputic process was/is to be in a trusting healthy non sexual relationship. i never had friendships before i met him. i have friendships now because he has taught me how to open up even alittle bit to other people. It is however an artifical relationship. I can yell and scream and get angry and be hurt and be all kinds of weird. He is always calm, collected, kind never angry. He might be angry outside session with me but he never is angry with me. He is firm with his rules and has to set limits more than once with us over the years. But never in a hurtful manner. And we didn’t run away. we have seen three other Ts, so we understand how special the T we are now with is. And that is why we can say that i am more commited to him than the process. Although if he moved away we would still read and work towards improving ourself. We just would not go to another T.

  5. I haven’t seen the show so I can’t speak to that. But, my T is very important to me. We work online so the office is not important, though it was very important with my old T.

    betweenseconds, I can only answer for myself. I have parts who are not human and some who are fictional characters. I do not believe that anything from outside has “taken up residence” within me. I believe that these parts were created to be what we needed at the time. And sometimes that need can be embodied most effectively in a character we know, or an animal, etc. Part of therapy for ALL of us is learning to seperate our real memories from the things that were created to make us who we are. One of my parts for example originally believed that she was a British woman in her forties with memories based loosely on a story we once read. She chooses still to be british and in her forties (its what feels right to her) but some of her early therapy work was seperating out her real trauma memories from the “memories” that were actually just that story.
    I do think things are possible inside that aren’t possible outside. Maybe that makes me delusional. I don’t know.

  6. lots to comment on…
    i had never heard of in treatment until i read this blog. i looked it up and watched quite a few episodes. i don’t like the fact that all the patients seem to come in expecting things to be fixed by the therapist without getting into any details. i will say though that i am impressed that the therapist can pull it out of the patients as kindly as possible. i didn’t like the whole sexual thing being added in there but the therapist brought up boundaries which i think is important. i think i have a pretty good relationship with my t. i don’t expect her to fix things and i know she needs to hear the whole story. there’s proper boundaries and she works with each of my insiders at their level. i do see my therapist as very human and respect her for what she does. it really seems like a tough job to me. i don’t blame her for anything, but i have blamed previous t’s and pdocs in the past mainly for screwing us up more than we already were. example (one pdoc claimed to have trained with the best of the best in DID and then said we didn’t have DID and then doped us up on a bunch of meds). my previous t and my current t both have had my best interests at heart and i trust them and believe in the process. others inside don’t always trust and sometimes feel like the t is hurting rather than helping, but overall she does a pretty darn good job. i don’t expect my therapist to be anything but human. she is real and she has flaws and makes mistakes just like the rest of us.

    i have to also comment on what betweenseconds said as well. recently we have been faced with people who have ‘otherkin’ or parts that play parts from actual movies and tv shows and have people internally that are supposedly actually from other planets with a spaceship that comes to take them away to their home planet on occasion and even has a whole other language. it’s really frustrating. i really try to have an open mind, but sometimes things can be a little hard. i totally understand other DIDer’s that have insiders who know different languages or have insiders that are not human, but some stuff seems to be going over the top with the whole other real planet with a space ship and all and then also characters who are real from other movies and tv shows. seems like that person has more than just a DID issue it seems, but fear bringing it up for fear of retaliation or them feeling not believed. sorry if this was way off track. just could really relate. i want people to believe me so i try to believe everyone else too.


  7. gobbies –
    i may be speaking out of turn, but i just wanted to say that you certainly don’t seem to be the type of person that i am at least talking about in my comment. i can totally see how an insider can pick up some things loosely from a story and use them for their own for the sake of surviving what they are going through. that makes sense to me. when i talked about fictional characters i was meaning someone who used word for word what an actor/actress/writer was saying. i don’t know something just feels strange and you are certainly not over the top or delusional in my eyes. maybe that’s how i have to view these people. that this is just their escape. i don’t know. something doesn’t settle well though. sorry to bring this up again. just wanted to clarify for gobbies. sorry we are off track. we’ll be quiet now.


  8. I didnt realize the 2nd season had started. I was quite distressed by the whole sexual tension thing with the patient from the first season. I had a therapist I had truly adored suddenly cross the line, after I had shared about my inability to have boundaries with teachers from my past.

    I had really liked this series till this came into it.

    I just found it really distressing how much he obsessed about this patient, and in what ways.

    I dont know if I could cope with watching more of his sexual struggles with himself over patients.

  9. I watched a few shows…..seemed awful confrontational….
    The T seemd a bot of a know it all…As for questions…\

    * What is your therapy process like?


    * How is your therapy impacting your life?

    Wrecking and Its hard and expensive. But i think I am doing better than i would w/o it. It gives me hope. I feel less alone.

    * Do you see your therapist as human as Dr. Weston presents in “In Treatment”?

    Oh ya, I love her humaness, makes me feel better bout ,myself.

    * Do you blame your therapist when your life plans do not work out as hoped?


    * Is your therapist as central to your life as presented in these series?

    Sigh…..she’s a much bigger part than I would EVER like to admit…..

    * Are you more attached to your therapist or to your therapy process?

    I am working to NOT be attached….but FWIW, I expect the human connection is extreemly important….

    * What would you do if you realized how human and flawed your therapist is?

    LOL, be happy, as long as its not messing up my therapy!

    * Do you expect your therapist to be something more than a real person?

    welll, I kinda wish…LOL, but alas, she is human, and it shows…which ultimately makes me happy, cuz then i don’t goto feel inferior!

    Yes….I AM the client fro H-E-dble toothpick! ROFL!!!

    So, as fpr the show, I may not watch more.
    My T is OK so far.
    I certainly hope people can be aware of t relationships and that they CAN go wrong, or get stuck etc.
    That T’s should have consult groups and go to them.
    Eyes wide open…

  10. Nightowl,
    You’ve pointed out some of the more disturbing dramatic moments in the show. Of course a real t would not (better not!!!!) keep medicine in the bathroom cabinet. That whole bathroom situation was weird to me too. I didn’t like way they had him drawn towards the one “Laura” character — it didn’t make a lot of sense to me. This second season, I’m hoping the psychologist guy has his act together more than he did during the first season. He was a mess in season one, that’s for sure, lol.

    It sounds like you have a very trustworthy therapist of your own. It’s hard to find a person you feel so safe with, so good for you. Well done.

    If you see more of season two of “In Treatment”, let me know what you think!

  11. Hi BetweenSeconds,
    Thanks for your comment, Stephanye.
    I don’t particularly understand why anyone has a blog that they don’t want anyone to read or comment on either. Isn’t that the point of having a blog?? Writing for private purposes can happen in so many other places — places that are truly private. So … why don’t they write there? I do understand that some people need to write on a password-protected place in order to keep their writing private from people in their home. But, those places can still be private, and not viewable to the world. So… seems to me if someone is writing in public, they should expect a viewing / commenting public as well. But people can be weird, lol… so who knows!🙂

    I have to agree with you on the supposed real life copies of fictional characters idea, and I don’t really go for the “from another planet” idea either. I actually think some of those kinds of sites are set up on purpose to discredit genuine survivors of trauma. The perpetrator population puts a lot of effort into discrediting therapists / treating professionals, and in my opinion, they could just as likely be attempting to discredit trauma survivors as well. Those really bizarre explanations for multiplicity seem to be there as a way to discredit the fact that genuine and severe trauma and abuse creates multiplicity.

    That’s how I define them. And no, I really don’t give that stuff any credibility.

  12. Great insights.

    I especially appreciated what you said about how the room stays the same but appears very differently in the sessions with each of the different patients!

  13. One more comment – in reply to those who have mentioned the more unsettling moments of the show (Dr. Weston’s boundary confusion with his patient, Laura. And him keeping medicaiton in the patient-used restroom, etc.).

    I too, felt very unnerved and annoyed by these aspects of the series during season one. Unfortunately, I think part of the “package” here is – in addition to some realistic elements – the necessary addition of drama and entertainment that the general public can relate to. There would not be as much of a dramatic and intriguing “story” for the common layperson, were it not for some of these boundary-crossing story elements.

    This is an ongoing issue (in my opinion) when it comes to therapy portayals on TV and the big screen. In some cases, boundary violations are what provide the humor to a therapy scene (in comedies). In the case of In Treatment, they provide some of the more emotional and dramatic moments for the viewers. The downside can be that this gives a skewed perspective to the general public (or can) regarding true professional therapy boundaries.

    Then again, it’s TV and created as entertainment. It’s not a therapist-training documentary. I struggle with this all the time – as a lover of drama and comedy on TV (and in films) I also greatly dislike public misperception of the enormous value of therapy, psychologists, social workers, psychoanalyists, psychiatrists and other clinicians.

  14. Hi Dr. Philm,
    Thanks for your comment and welcome to the Discussing Dissociation blog.

    For me as a therapist, even though I am often sitting in the same room with different people while they go thru’ their therapy, healing process, it is really so very different from person to person. And whether the room is my office, or online in an IM session or a phone session, it’s still different from person to person. The therapy process with that person is as unique as the person that is there with me. It’s never the same from person to person.

    I was impressed that the HBO “In Treatment” producers were able to show these differences in the ways that they filmed the different episodes with Dr. Weston’s different clients. I found myself actually looking to see if they were in the same room, when obviously, of course they were, but I still had to look and see.

    Very cool.


  15. Dr. Philm,
    Re: your “one more comment” — very well said. Thank you for that.

    I’m curious — have you seen any of the “United States of Tara” episodes? Are you familiar with multiplicity and dissociation? I’d be interested in hearing what your thoughts are about that Showtime Series.

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