Therapists Upset Over "Sopranos"

Second-To-Last Episode Sees Serious Breach Of Ethics In Tony's Therapy

(AP)  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.

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Photos: "The Sopranos" Final Season

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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 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.

"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.

That is, until this last episode, when she ... dumped him.

"We're making progress," Tony protested, genuinely shocked. "It's been seven years!" But Melfi had reluctantly read a study, brought to her attention by Kupferberg, claiming that therapy doesn't actually help sociopaths — it further enables their bad behavior by sharpening their manipulative skills. Demoralized, guilt-ridden and almost speechless with hostility, Melfi literally showed Tony the door.

A tidbit that had some therapists buzzing this week: it turns out the study is a real one — albeit hardly new — from authors Samuel Yochelson and Stanton Samenow, psychiatrists specializing in the criminal mind. But the way the fictional Melfi shoved aside her patient was anything but real, therapists said.

"You don't just drop a patient like a hot potato, even if you conclude they aren't responding to therapy," Annibali protested. "She should have taken several months to do it."

For Richards, the development just didn't ring true. After seven years, "only NOW she figures this out? My sense is that there was some narrative purpose for (series creator David) Chase to end this relationship."

As in the fact that there's only an hour left to the entire story? That Tony's life is crashing down around him, and one by one, by death or rejection or his own murderous hand, he appears destined to lose everyone close to him?

Maybe. But Annibali said he'd heard that Bracco may be appearing in the final episode next Sunday. Which means there may still be time to reverse her professional missteps.

"My hope," Annibali said, "is that she and Tony will get together again."

But for one certified expert on both therapy and "The Sopranos," that wouldn't make sense, dramatically speaking. About halfway through the show's run, Tony's therapy started failing, said Dr. Glen Gabbard, professor at the Baylor College of Medicine in Houston and author of "The Psychology of The Sopranos."

Perhaps it was because Chase himself went through years of therapy, and has publicly expressed ambivalence about its usefulness. In any case, at the busy psychiatry clinic where Gabbard works, the talk this week is about how Melfi should have ended things with Tony years ago.

"The therapy had to end," Gabbard said. "It was getting more and more futile.

"He's just not getting any better."

[ronsieg1]

Therapists (even psychiatrists) can be avid Soprano fans too. If you were a fan whose profession (in the person of Dr Melfi) had been portrayed "realistically" for 6 seasons--and then this major character Melfi seems suddenly to come un-hinged, wouldn't it seriously disturb you? Or don't therapists have the right to publicly complain?

[neobrian-2009]

All I know is,after the final episode,HBO is over at my house. I`ll cancel it that night. I need the money for gas.I truly hate to see it end too.

[scarletphd]

Geico.com...

SO EASY A THERAPIST COULD DO IT!!!!

[scarletphd]

IT'S
JUST
A
FU(KING
TV
SHOW
YOU
HYPER
FREAKED
OUT
MORON!!!!!!!!!

[johnshaft4]

"Physician, heal thyself."

[ajaxrose1]

OMG! IT'S JUST TV SHOW!!! For crying outloud, maybe these "therapists" need to get some therapy themselves if they're having this much trouble distinguishing fantasy from reality! SHEESH!

[ssporleder]

It is sad and funny...these therapists live in the fantasy world they are trying to get their patients out of.

[rip_pockets1]

The end to therapy had to happen so Tony could avoid the ambush. The hit squad would have gotten him had Dr. Melfi kept treating him. Its fiction, get over it therapists!

[jennmarie620]

This article reminds me of the little old senile ladies who talk about their "stories" and the people in them as if they were real, live, breathing members of their families!

Jeez! This is a TELEVISION SHOW! Get over it! It's fictional!

Yes, there may been aspects of the story where it helped bring to light therapy or some good points about possibly seeking counseling for some viewers - but come on! It's FICTIONAL! This is purely for entertainment value. If therapists truly want to be seen for what they believe they are, perhaps the changes should come from INSIDE the office and not from a d*mn television show!

GET LIVES!

[kommoncents-2009]

Unbelievable that all these therapists have nothing better to do than be distressed about a fictional TV show. Why do people think something that happens on TV or in a movie is supposed to reflect reality literally? It's not people!! Wake up and get some common sense! Fiction by it's very definition pushes the boundaries of true life to it's limits, other wise it wouldn't be that interesting now would it?

[jacksteen1]

It seems to me that the Sopranos ending is coming too fast. I think Chase and the other writers decided to end it all rapidly, leaving some parts of their endgame lacking in credulity.

AJ would not really have fallen apart like this over the Latina bimbo.

Bobbie Bacala's death in the toy store was a copout. He should have been allowed to defend himself for all the crapola he took from Uncle Junior and Tony thruout the show. He went out by assassins. Cheap.

I really hope a miserable, drawn-out death awaits that snake Boss Phil Leotardo. He deserves to have both his eyes gouged out.

Sure hope they thought out HIS death carefully!

[mayaderen-2009]

Odd - the real-life 'therapists' are upset by a fictional television episode and the viewers know it's only FAKE! Time for a reality check in therapy land! Sheesh!

[lawandorder6]

God, get a life, lik ewas said, it is FICTION. If you don't have any thing better yo do than talk about a fiction TV show at the office. I would say you need to STAY HOME.

[ssporleder]

Dear God...people...it is a TELEVISION SHOW not based on real people, so it is FICTION.