Monday, May 04, 2009

In Treatment: Week five in review

Once again, I'm reviewing all five of this week's episodes of "In Treatment" at once, with general thoughts followed by brief takes on each patient. Spoilers coming up just as soon as I look at my watch...

For the first time in the brief history of "In Treatment," the series skips over a week in the lives of Paul and his patients(*), as he returns to work after taking time off to bury and grieve for his father.

(*) In case you didn't know, "In Treatment" itself takes next week off so HBO can debut a documentary series tied to The Alzheimer's Project, with the show coming back on May 17 for the final two weeks of the season. It's unfortunate that HBO couldn't have scheduled the season so that the break fell between weeks 4 & 5 instead of 5 & 6, so we could have experienced the gap right along with Paul's patients. Made too much sense to happen, I guess.

And when Paul comes back, he discovers just how much his patients -- at least, these four patients in crisis, as opposed to more mundane cases like the impotent law student whose session we glimpse at the start of the Oliver episode -- have come to depend on him. For them, he's more than a therapist: he's a surrogate husband, or father, or simply the only thing keeping them alive. He has become the most important figure in each of his patient's lives (maybe Walter less than the others, but he's also better at hiding/denying his true feelings), and when that relationship gets severed, even temporarily, they don't react well.

Paul returns to major developments in every case: Mia is pregnant, April is losing her hair and getting weak from the chemo (though this could at least be predicted), Bess has yet to return home to Oliver, and Walter is in the hospital with "food poisoning." Even the Gina episode comes with a couple of seismic shifts, as Paul tries to reconcile with Kate, and gets a settlement offer from Alex's father.

"This is me being caring. Is that okay?" -Mia
"You don't have to worry about my feelings." -Paul
"Does anybody?" -Mia
Mia just can't help herself, can she? She has to feel like the most special patient in Paul's practice, and so she's constantly taking advantage of her past history with him, and her firm's present association with him, to get access and information that the other patients don't have. And yet Hope Davis plays her with this tremendous vulnerability and self-awareness that makes it impossible not to like her even when she's being an entitled, intrusive pain. Just look at that lopsided grin she flashes Paul after springing the news of her pregnancy; she is so desperate for his approval, isn't she?

As Mia notes, this seems like kismet: all these years after Paul talked her into aborting the last pregnancy she had (or so she believes), she's come to him with an unexpected, last-chance (and, though it's not discussed here, no doubt high-risk) pregnancy. And even though she claims it's the thing she wanted to make her life complete, she realizes the picture isn't as full as she really, really wants.

For the first time since the premiere episode, Paul is off his game with Mia, so thrown by his father's death that he has a harder time concealing his emotions -- in this case, dismay over her casual attitude about not informing the presumed baby daddy -- in front of her, and even surreptitiously glancing at his inherited wristwatch when her monologue brings him to think about his dad.

And Mia, in turn, drops the remaining pretense about her desire for Paul. She may not want him sexually right now (though with that Irish accent and those baby blues, how could she resist?), but she wants him to be her partner in every other way, enlisting him to help her make every kind of child-rearing decision that would normally fall to the father, instead of just "a father." And he briefly lets her indulge that fantasy, admitting that the two of them as a couple seems like "it could solve all our problems." But all that does -- as Paul was no doubt expecting -- is to lead her to confront her true fears about the pregnancy, and her realization that it was Mia, and only Mia, who decided to get that abortion 20 years ago. And that realization, in turn, helps her make peace, for now, both with that old decision and her desire to see this pregnancy through.

At session's end, she asks Paul to be happy for her, but he can't be happy for anyone or anything right now, unfortunately.

"I thought you were going to take care of me." -April
Even more than Mia, April has built Paul up into the be-all, end-all of her existence. She fantasizes about his eyes, has these elaborate imaginary conversations with him about every topic in her day, and, just as Mia expects him to play adoptive father as well as therapist, April assumes he's going to be her physical as well as emotional caretaker during her cancer battle. And the betrayal on her face and in her voice when she realizes Paul has no plans to take her to the next chemo appointment make it clear why he waited so long to offer in the first place. It's not practical, nor fair (to either Paul or to April) to expect that of him, and if that's the only way she's going to go to chemo, that's a huge problem. I don't disagree with his decision last week -- someone needed to get her there, obviously, before she was too ill for it to matter -- but this is exactly what I'm sure he feared when he wasn't dragging her there in week two or three.

Great as the entire cast is, and great as they all are this week, this is Alison Pill's week to shine above all the others. The moment when April, panicked and betrayed by the idea that Paul doesn't want to take her to chemo, tries to get up too quickly and instead doubles over in both physical and emotional agony, ripped me to the core as I watched it. And she was just as brilliant, albeit in subtler fashion, in the episode's quieter moments, like April telling the charming story of how she became friends with Leah ("You can sing or you can hold your penis, but you cannot sing and hold your penis"), even as she doesn't understand, as Paul does, that this is a relationship she can and should be able to rely on in this situation.

Where Paul is guarded when discussing his father with Mia, and a bit irritated as usual at her overstepping the doctor/patient boundaries, he gives the knowledge freely to April. It's because he feels more of a connection with April, but also because he feels like she needs this level of honesty to make her trust him enough to save her life. She doesn't want to talk about the dream she had before her health scare, but in some ways that's the key to the whole session. It isn't just that April is afraid to trust anyone. It's that her life has been so difficult -- and with the possibility of caring for Daniel, she knows it may only get more difficult -- that the cancer may be providing her with an escape hatch. And it's everything Paul can do to keep her from trying to bail on life. In their last session, he was able to do it by going beyond the call of duty and physically taking her to the doctor. Unwilling or emotionally unable to do that this week, Paul instead sees that hard-won victory slipping through his fingers, and I felt just as alarmed when she left the office as I did when she claimed to have spoken with her mother at the end of the third episode.

"It's like rats abandoning a sinking ship." -Luke
As I've said before, Oliver doesn't have any real problems. I mean, he has external problems, not least of which is the bully(*) who drives him to run away from school and straight to Paul's office (the only place in the world where he feels safe). But all of his emotional issues are being caused by these external forces, and so I like that these last two episodes have spent more time on Paul getting to know the chief external forces -- first Bess, and now Luke.

(*) Another great moment of Paul failing to hide his emotions: check out the look of pure rage on his face when Oliver is telling him about the dog-doo locker prank. It's all in the set of his jaw, but it's there.

Where Bess -- who understandably, if not appropriately, seems determined to extend her Me Time vacation for a good long while -- seems largely oblivious to her behavior and how it affects Oliver, Luke at least is blessed with enough self-awareness to know how badly he's treating his son, if not the wisdom to figure out how to stop doing it.

The patients on "In Treatment" are all in some way supposed to reflect Paul's own problems. Oliver has stood in for Paul's children, whom he struggles to relate to half as well as someone like Oliver or, last year, Sophie. Luke, meanwhile turns out to be a stand-in for Paul himself: a bad dad who wishes he could be a better one, and the son of a distant and adulterous father who fears he's turned into his old man's exact double. When Paul tells him this doesn't have to be so -- "You don't have to become like him. You're not doomed to live your father's life. You have a choice." -- he nods at himself, as if he knows he needs to learn this lesson as badly as Luke.

This session is far from a cure-all, but the look that Luke and Paul exchange at the end suggests that it accomplished a lot more than last week's comparable Bess session. Luke may be an ass, but he'd rather not be, and if Paul can keep getting through to him, then maybe Oliver has a fighting chance.

"It's too late for me. We both know that." -Walter
If Walter is this year's Alex, then sooner or later he was going to attempt suicide. Is it a coincidence that he tried this after Paul canceled their last session, or has he let Paul become his only lifeline in the same way that April has?

Though the episode takes place in Walter's swank hospital room, it plays out like a traditional "In Treatment" episode, with the two men even moving over to the armchairs so they can sit opposite each other the way they do in therapy. And, as usual, Walter is combative as hell, emotionally slapping Paul across the face with the knowledge of Alex's death and the lawsuit (which makes Oliver this week's only patient to not know more than he should about Paul's personal life) and trying to bully his way out of having to admit that he wanted "a millionaire's death."

But he does admit it -- "I just wanted it to be over. That's all." -- claiming to be doing it for altruistic reasons, even as Paul points out how cruel it would be to his wife and daughter. And for a moment, Paul seems to be getting through to him, just as he's always almost there with April. But then Walter armors up again, and you can see he's resolved to end it, somehow, just as soon as Paul, and Natalie, and Connie, and the world, are looking the other way.

(I liked how Walter refers to Paul as "a young man" in the same week where April is discussing how old he is, and whether 50+ will always seem very old to her.)

Maybe the most interesting scene of the episode -- even though it doesn't feature the amazing John Mahoney -- is at the end, when Natalie tells Paul that Connie has been in rehab, and Paul realizes that Walter's carrying an even greater burden than he's let on. Because the patients can be, at best, unreliable narrators about their own lives, it's always interesting to meet other people who can cut through the half-truths and self-flattery and give Paul a clearer picture. I had always expected to get something like that in the first episode with Alex's father -- to find out that Alex had either exaggerated, or flat-out invented, half of the outlandish stories he told Paul -- but that never happened. Here, if Walter wouldn't tell Paul this huge detail, what else has he left out of the auto-biography?

"You already know that love's the only thing that has a chance against death." -Gina
His father's death -- and Gina's non-attendance at the funeral (which suggests she now views herself as Paul's therapist more than his friend) -- would likely already have Paul in a bad mood for this session. But then he makes things worse by mistaking the warmth Kate showed him in the aftermath of his father's death with a desire to get back together, humiliating himself by asking her to give him another shot when she's already moved on.

So he's irritated, and on edge, and still filled with self-loathing for refusing to see his dad sooner -- and for not realizing that he had this whole other life outside of being the bastard who walked out on Paul's mom and had an affair with a patient.

Gina says she doesn't want to hear about Paul's patients, which may be the right thing for her as his therapist, but which is kind of unfortunate for me as a viewer. Because if ever there was a week for Paul to talk about his patients -- to talk about how the obligations between a father and son are not unlike those between a doctor and his patient, how he had to temporarily leave his patients because of his father, and all the havoc that caused -- it's this one.

Gina tries to get him to see that it's possible to have mixed feelings about his dad, but he's too raw to see that at this point, and is almost eager to get out and have that uncomfortable meeting with Mr. Prince.

And speaking of which (and I always welcome a chance to watch Glynn Turman in this role), what should Paul do? Gina's been trying to tell him that he isn't responsible for Alex's death. Forget the legal and/or professional implications for a minute. How badly would this retard Paul's attempt to get past the guilt he feels about it? Or would he be able to write a confession he doesn't believe in, just to get this headache over and done with?

What did everybody else think?


The Gregarious Misanthrope said...

Paul is crazy if he writes that letter. First, it's simply not true, and I think it would harm rather than help Paul's state of mind to take responsibility for Alex's death. Part of him wants to believe that it's all his fault, and putting it in writing is just too much.

Second, the unspoken truth is that Mr. Prince is as responsible for Alex's death as Paul, if not moreso, and he's deflecting his own guilt by going after Paul. Why should he be let off the hook by Paul taking the blame? I hope that someday, something forces that man to see what he did to Alex and own his part in that tragedy. Paul accepting guilt makes it that much less likely to happen.

Third, there is no guarantee that Mr. Prince would not use that letter to end Paul's career, and his career is all that Paul has. Mr. Prince seems like a vengeful man without much capacity for self-reflection. There is no way I'd give him the satisfaction.

dez said...

It's because he feels more of a connection with Mia,I think you mean April?

How badly would this retard Paul's attempt to get past the guilt he feels about it? Or would he be able to write a confession he doesn't believe in, just to get this headache over and done with?
Apart from the legal/professional implications, this is the wrong thing for Paul to do. I think it would increase his guilt because he would wonder if he did mean the apology and feel responsible, and also be worried that he told a lie to make a lawsuit go away. It's lose-lose.

I can't believe the teachers & administrators at Oliver's school can't help him more. Sure, they can't single out the bully because they don't have proof, but they can surely educate the students in general about bullying and how the school won't tolerate it. It's ridiculous.

Besides the parallel daddy issues, there's a lot of transference going on this season. The patients and/or Paul have crossed boundaries, which, although not sexual, have become harmful to the patients' health, especially April. I don't blame Paul for crossing the boundary with April (someone had to), but the repercussions are immense and with only two eps to go, I wonder if we will get to see him course correct.

Another thing that came into more relief is the difference between Gina's and Paul's therapy styles. Gina is not afraid to be more direct in therapy and tell Paul what to talk about or even what to do, whereas Paul seems to allow his patients to get there on their own more. I wonder if that is Gina's normal style, or just what she knows will work with Paul because he's a therapist himself and knows the "tricks of the trade"?

Glynn Turman rocks. I sure as hell hope Paul doesn't take him up on that offer, though.

tort reform said...

As good as Paul has been as a therapist this season, you can still see how the seeds for many of these complications were sown gradually in the little things Paul did. Even though he said it pretty explicitly in session with Gina last week, it took this Sunday's session for me to truly realize just how much Paul's been responding to Mia's come-ons throughout the season. I'm reminded of Week 3, when Mia was discussing how she imagined the affair between Paul and Laura may have been like. That whole time Mia was trying to get a rise out of Paul, and he would try and redirect it into a discussion about what she was thinking and feeling. Looked at another way, he was basically inciting her to fantasize about him and talk dirty for him.

I agree wholeheartedly about the April sessions. As incredibly written as April is as a character, Alison Pill just takes it and sells it for even more. when Paul tells April that the reason he cancelled last week was the death of his father, you can see the switch go off in her, where she starts closing herself off, and tells herself to be strong for him and stop crying. It's like another replay of the trauma with her mother. And then when April deflects his question about who she will get to accompany her to her chemo session, you can see her testing Paul, placing herself next to that metaphorical open window, seeing if he'll notice if she falls. She even lingers in the waiting room as if he still might change his mind.

When April and Paul were discussing whether Paul looked the whole time they were installing the catheter in her chest, it reminded me of last season, when Sophie asked him to help her change out of her wet clothes because her cast prevented her from doing so on her own. I'm not sure there's anything meaningful to be gleaned from that. I just found it interesting.

I think the most significant moment in the Oliver episode was in his reaction to Luke when Luke tried to act sympathetic to him after the session. While Oliver readily asks Paul for ham, he rolls his eyes at his actual father when he offers to take him out for pizza. Oliver has learned not to expect a father who understands him, and doesn't trust it Luke presents himself as one. Oliver trusts Paul over his own father, and when he ran away from school, chose to Paul's office over either of his parents' homes.

I don't know if it has anything to do with the fact that Paul's own father issues factor in more with each successive patient, or whether it's more a function of time, but you can see Paul progressively improving over the course of the week—from Mia (where he was unkempt and distracted), to April (where Paul was still misreading cues), to Oliver, and then walter. Walter's comment about how both he and Paul have blood on their hands seemed important to me, as it both Alex and Alex Sr. also had blood on their hands.

As for the confession, I would be shocked but not too surprised if Paul did sign. We've seen a lot of people sacrificing their own peace ostensibly for the benefit of others. While as a therapist Paul must see that Mr. Prince is displacing some of his own guilt over Alex Jr. onto Paul, Paul's own sense of guilt may become an overriding factor, whereby he signs both to avoid a potential costly judgment and to give Mr. Prince that sense of justice.

Scholar of Turtles said...

Paul can't write the letter. He's not capable.


It goes back to the ongoing turtle symbolism.

Ask yourself this: is it a coincidence that a turtle CAN'T WRITE?

If the turtle is symbolic of Paul, and a turtle can't write...of course Paul can't write that letter. He has to just be Paul, just like how a turtle has to be a turtle. It can't be something it's not.

Gish said...


You've been so insightful until now. You only assume a turtle can't write because you have never come across one who could. I used to naively believe that turtles couldn't fly, until I saw Gamera. I make no more assumptions about turtles.

Gish said...

Anyone out there familiar with Allison Pill's previous work. Not to take anything away from her performance here, but every tic and mannerism of April reminds me of Kristen Bell. Am I the only one seeing that?

LA said...

Gish - Allison Pill reminds me of Lauren Ambrose with her readily available emotionality.

I've seen her in three things now; this, Milk, and The Book of Daniel. She's very talented, I'll be interested to watch her career.

Geoff Rose said...

I'd also recommend Pieces of April for more Allison Pill awesomeness.

That scene with the cringe of pain: she had the audience cringing with her. That's what the ol' drama teacher called, "an original moment." It's not a replicated action, but that spontaneous emotional level that grips people's attention.

And those really soft, quite parts of the show, that's where you see them the most.

Anonymous said...

From Jan:

I first saw Allison Pill several years ago in a made-for-middle-or-high-school video from a Canadian company called "Degas and the Dancer." She played the dancer who was the model for the famous statue, and she was all of about 13 at the time. It wasn't the greatest video, but I still remember her as she had some quality about her that made me remember her--and her name--even then. Since then I've seen her in "Milk" and "Pieces of April," and if you go to IMDb and look up her body of work, she's done quite a bit for someone as young as she is. She is amazing in this series.

Nicole said...

Some jurisdictions have "Apology Acts" where Paul would be able to write an apology and it would not be used as an admission of liability. So, it's legally plausible. But I just kept thinking that Alex's dad needs therapy more than anything, because a letter is not going to make him feel better. A lawsuit won't do that either, but unless he is going behind his lawyers' backs, they may have planted a seed in his mind that this lawsuit is not worth pursuing, both financially and emotionally. I don't think there would be enough for Paul to be found negligent, presuming we have seen the entire picture, and it is pretty difficult to establish that a medical practitioner has not met the appropriate standard of care.

The best thing for both parties would be for a mediation to take place, so that both parties could informally state their positions, and Alex's dad could vent a bit more emotionally in a quasi-judicial setting, which would help him take a step toward closure. Paul's insurers have already made a settlement offer, so Alex's dad could get some monetary compensation, although that won't actually make him feel any better.

I don't think Paul should write that letter. It won't make this go away, despite what Alex's father says.

Spectacular performances this week and Alison Pill better get an Emmy nom for her work in this.

erin said...

@Nicole: I'm with you that Alex Sr. wouldn't feel any better if he had that letter from Paul. In fact, he'd feel worse because that meant Paul had "gotten away with it." He can't forgive himself, Alex, or Paul, and the letter is the only thing that he thinks will work. It'd be fascinating if next season HE was one of Paul's patients, although I know that would realistically never happen. But man, what a miserable, angry, grieving man he is. I think Paul's right--women are much better at the grieving process than men are.

Really powerful week: I was also struck how unkempt he was for Mia, and how he seems a little off his game for her sessions than he does for anyone else.

I also thought it was interesting how direct he was with Luke in Oliver's session about "diagnosing" what was wrong with Luke. Usually he just lets them wander around until they get to the appropriate conclusion, but maybe his father dying made him realize sometimes he just has to put it out there.

Reason #542 I couldn't be a therapist: the unimaginable guilt i would feel if i had to skip a week for a parent's funeral and I came back to all my patients blaming me for the turn their lives took while I was away. His look of grief when April was crying was just...awful.

Hard to imagine how some of these will wrap up in 2 weeks...but it's never predictable!

Anonymous said...

Anyone else have this problem?
On my FIOS On Demand (in Northern NJ) the first three episodes that popped up for week six (No spoilers)
were Mia, Oliver, and Gina.
Don't know if this is an HBO glitch or a FIOS glitch and since I've been catching up from a couple weeks behind I didn't start watching the episodes as they went up until this week, so I don't know if this is part of a pattern.
Anyway, it'll be interesting to discuss these and I hope that the last April episodes maintain their amazing high standards.