Thursday, June 07, 2007

Therapists scratch heads over latest 'Sopranos' move

NEW YORK -- Therapists, we've long known, are among the biggest fans of "The Sopranos."
So pleased were they with the credible therapy scenes between Tony Soprano, pop culture's most famous mobster/patient, and the appealing Dr. Jennifer Melfi, played by Lorraine Bracco, that the American Psychoanalytical Association once gave the show and Bracco an award.

But professionally speaking, they could only scratch their heads at the latest developments on HBO's hit drama, which aired its penultimate episode last weekend.

Just as Tony Soprano's life seemed to be imploding with dangerous speed -- in short, just when he needed some really good therapy -- Melfi and her own therapist made some highly questionable moves.

Not only therapists were distressed. Some patients were actually furious when they showed up for appointments this week, said one New York psychoanalyst.

"You wouldn't believe the outrage I am hearing," said Dr. Arnold Richards, who'd missed the episode, but was filled in by his patients. He was talking Mind-boggling," pronounced Richards. "I do not recall ever being told the name of a patient in treatment."

Colleagues agreed. "That dinner party was just very upsetting to me," said Dr. Joseph Annibali, a psychiatrist and psychoanalyst in McLean, Va. "What he did was outrageous. He's never had control of himself, and this just fits in with that."

Why did Kupferberg commit such a sin? He didn't think Melfi should be treating Tony, whom he considered a manipulative psychopath. Be that as it may, his disclosure was "a very egregious ethical violation," said Dr. Jan Van Schaik, chair of the Ethics Committee at the Wisconsin Psychoanalytic Institute.

"A patient needs to know that what gets said in the doctor's office stays there," said Van Schaik, who's never witnessed such a violation. "I've been at gatherings where people talk about patients in a more disguised form. Even that can be inappropriate. A good therapist should do the best they can to protect the anonymity of patients."

It's a shame, Van Schaik added, because "prior to Sunday's episode, 'The Sopranos' was the best portrayal in the popular media of a therapist-patient relationship." Annibali agreed: "We're so used to seeing therapists presented as incompetent hacks. Or as people who are more disturbed than their patients!"

What's been nice about Melfi, the Virginia therapist explained, is that she's a complex and caring figure -- she's not ideal, but she tries to help Tony even as she struggles with the idea of treating him.about a serious ethical lapse by Elliot Kupferberg, played by Peter Bogdanovich, at a dinner party full of therapists. Across the crowded table, the character callously revealed -- over Melfi's protests -- the identity of her star patient.

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