Analytic Insights

Jill Sirota, LCSW
“In Treatment”: Reflection on the HBO Series
Presented at the SIPP Mid-Winter Brunch, January 9, 2011
Jill Sirota, LCSW
SIPP Advanced Candidate

The HBO “In Treatment” Series has entertained us with many compelling patients and dynamics over its three seasons, and one of this season’s characters, Sunil, is no exception. We meet Sunil, a middle-aged, recently widowed, retired mathematics professor from Calcutta when he is brought to treatment with Dr. Paul Weston by his son, Arun, and daughter-in-law, Julia. Disheveled and disengaged, Sunil does not want to be there. As the first session unfolds, however, Paul facilitates an alliance and elicits information about his life, his feelings about his displacement to America, and his increasingly difficult adjustment to his son’s American home.

Through the seven ever more intense sessions with Paul, we witness Sunil’s apparent inability to own his feelings, instead relying on projection and reaction formation. He expresses that his late wife would not approve of his daughter-in-law’s parenting values, but will not articulate his own disapproval. Sunil indicates his belief that his son must be unhappy with his marriage while denying any dissatisfaction with his own arranged marriage. “For us, it was fine,” he says. When Paul acknowledges Julia’s attractiveness, Sunil listens but avoids answering Paul’s question as to his own opinion of Julia’s beauty. Sunil seems baffled and irritated when Paul suggests he might experience excitement or intrigue along with repulsion at the immodest display by American women on the reality television program, “Survivor”. Sunil conveys a similar unconscious experience of thrill, though he consciously claims only disgust, in his description of watching Julia exercise. Such passion, we learn, has been repressed in Sunil for thirty-two years, since his brief love affair with Molini, his girlfriend from undergraduate school. However, living now with his son and daughter-in-law may be unearthing many of Sunil’s repressed feelings, and it is unclear whether or not he can cope. Julia embodies the cultural differences he detests and cannot accept in America, as well as she represents his lost love, forsaken passion and choices he did not make in his life. These unconscious conflicting feelings of loss, jealousy, anger, longing and excitement, appear to lead to dangerous thoughts and fantasies about Julia. Sunil believes that Julia is having an affair outside her marriage to Arun, and when Paul attempts to expose another projection, suggesting that Sunil may feel personally betrayed, we are disturbed to see Sunil laugh uncontrollably in response.

In the final session, along with Paul, we are handed a dramatic twist. Sunil reveals, while sitting in the detention center from which he will be deported back to India, that his intentions in coming to therapy were not pure. He admits to Paul that he had hoped Paul would act on his duty to warn Julia of his potential to harm her. Sunil anticipated that Julia would then contact the police, and, in turn, he could refuse to show the authorities his proper immigration papers. This plan to get himself deported--his wish to return to Calcutta--became his ulterior motive in seeking therapy. He says to a deceived and betrayed Paul, “You have given me the greatest gift…to live my life how I choose.” He explains that he would rather be penniless on the streets of Calcutta than be dependent and purposeless in his son’s home in America. While we empathize with the displaced Sunil and the tragic losses he has endured, we wonder if this deception is truly his only way home. We also must empathize with the position in which Paul is placed by Sunil’s actions; as therapists, we know the uneasiness of wondering about a patient’s stability or safety. Does Sunil have no concern for his impact on Paul?

As Paul struggles to absorb and make sense of Sunil’s confession, we observe his anger, confusion, and sense of betrayal. Indeed, he openly discloses all these feelings to Sunil, who, in turn, blames Paul: “Is it possible to be both [friend and therapist] at once? You gave the impression that it was.” He reminds Paul, that from the beginning, it was Paul who allowed the boundaries to be broken. Paul brought out the ashtray and allowed Sunil to smoke. He shared tea with Sunil in the session. He chose to acquiesce to Sunil’s demands for personal information and disclosed the status of his marriage and his feelings for his ex-wife. Finally, Sunil reflects to Paul his awareness of their similar struggle with loneliness, which Paul may not consciously have intended to disclose.

Certainly Paul’s own psychology and life struggles contribute to his vulnerability to Sunil’s manipulation. We are aware from other episodes that Paul suffers with personal questions about the efficacy of his work and his life’s purpose. Perhaps a sense of professional failure, too, motivates his departure from the frame, in order to feel competent at developing a therapeutic alliance, at any cost. Further, Paul clearly identifies with Sunil on a number of levels: the loss of his wife, displacement from his homeland, the loss of a loved one years ago to suicide, living a life without passion, personal loneliness and ambivalence about intimacy, and perhaps one of the most compelling issues, the struggle to remain connected to one’s son amidst a major family transition. The writers of “In Treatment” cleverly develop a common dynamic among the two men. Several episodes in the Sunil series begin with Paul’s attempt to reach his young son, Max, via his art, homework, caring for him when ill, even advocating for his son’s choice of schools with his ex-wife. From Paul’s own therapy session with his new analyst, Adele, we know he is distressed by Max’s separation. Max begins to bond with a new stepfather, just as Arun embraced a new culture. Paul knows Sunil’s pain and sense of rejection at this life transition only too well. Indeed, in different episodes, and in their respective situations, each utters the phrase “I am his father” in frustration and grief at feeling his role minimized, and even dismissed.

In an early episode, we see Paul looking at his son’s discarded drawing of an eagle rising above an urban setting, which he then places in his pocket. On one level, the drawing might serve as a metaphor for both Paul and Sunil’s experience of feeling trapped in their uninspired life. We are aware from other episodes that Paul contends with the loss of his father to Parkinson’s at the same time he fears losing his son to a new stepfather. Paul’s need to father and be fathered, still, seems to foster the paternal transference-countertransference. For instance, Paul demonstrates an overly-paternal concern for Sunil’s ability to navigate the Brooklyn streets home, without getting lost or fearing being bullied on the subway, in spite of Sunil’s rejection of his help.

And, even as Paul must come to terms with Sunil’s confession of deception in the treatment, and his charge that Paul allowed the therapy to cross the lines into friendship, Paul, in a sort of transferential role reversal, allows Sunil to father him. Sunil tells him he is a good therapist and a good man; arguably reassurance he might wish for from his father at a time when he seems to have lost his way, personally and professionally. The final poignant scene depicts Sunil singing to Paul a traditional Indian song about saying goodbye to a friend, which Sunil previously shared was the song he and his wife used to sing to their son at bedtime during his childhood.

As I watched Sunil’s Week Seven and the final plot twist, I was stunned and dismayed. And then, I had the same urgent questions Paul did. Which parts of Sunil’s story were real, and what was fabricated as part of his scheme? Was the dream real? his relationship to Molini,? the hostility and violent fantasies towards Julia? I found myself hoping that most of what Sunil discussed in therapy was real. I recognized that like Paul, I had developed my own attachment to Sunil, and I wanted to continue to like him. Surely, Sunil could have found another means to return home that would not, in the process, have so alarmed his daughter-in-law, grandchildren, and therapist. His true intentions remain unknown, yet his actions clearly hurt significant others. However, I was relieved to witness Sunil’s empathic fathering of Paul in the final scene, singing his gentle farewell lullaby. I was left with compassion for what I saw as a tragic figure, who had lived the life his culture and family expected, and once displaced, became lost, possibly undone, without those boundaries to define him. If we assume that the potential aggression towards Julia was real, we might wonder how unraveled Sunil actually was becoming, without those external limits of his culture. Was Sunil afraid of a complete loss of control if he remained so unrestrained? Perhaps the abandon of American culture coupled with the freeing of many of his unconscious feelings proved too threatening a combination for him, compelling Sunil to take desperate measures to restore his sense of self and well-being in returning home. He could not securely venture into the unknowns of his internal psychological landscape while having to navigate a foreign external world, as well. Of course, we cannot draw definite conclusions, because “In Treatment” is a work of fiction. Like Paul, we are left with having to sit with the not knowing, a reality we deal with as the very nature of the inexact science that is our work.