The final curtain has fallen on The Sopranos. Hence it is an auspicious time to take stock. What did the series mean to us? The Sopranos is unparalleled in the annals of television. Called “the most compelling piece of popular culture ever” by critics, the series prompted many psychotherapists to subscribe to HBO solely to see Jennifer Melfi's latest therapy session with the mobster Tony Soprano. On Monday mornings, e-mails and water cooler chat often focused on the relative merits of Dr. Melfi's interpretations or the length of her skirt.
For once, psychoanalysts and psychotherapists could sink their teeth into a portrayal of psychoanalytic psychotherapy that in some respects was similar to real life therapy. Dr. Melfi was far from an ideal therapist. In fact, that's what we liked about her. She struggled in every session. She sought out her own therapy, where she talked about her countertransference with her celebrity “bad boy” patient. She hung in there when many therapists would have quit or moved to a different city. The writing was extraordinary in its psychological sophistication. In the early seasons, four of the show's five writers had been in psychotherapy themselves, and their “inside” perspective was impressive. Lorraine Bracco, the actress who played Dr. Melfi, said she told creator David Chase that she would play the role only if he promised her that the therapist would not be portrayed as a “drug-crazed psychotic killer sex addict.” Having found psychotherapy extraordinarily helpful in her own life, she did not want to be party to another instance of therapy bashing in prime time television.
The impact of the series on real life practice is difficult to measure. However, I received at least 18 or 20 e-mails from therapists who told me that a male patient had come to see them largely because of the depiction of therapy on The Sopranos. Numerous anecdotes were also circulated about patients bringing examples of psychotherapy from The Sopranos to their own sessions and asking their therapists why they were not more like Dr. Melfi. Some even felt that her interpretations provided insights that their own therapists had missed!
For the first three seasons, the psychotherapy, a heroic treatment at best and an ill-advised decision at worst, seemed to be taking hold. Despite extensive acting out, Tony began to reflect on what he was doing with his life. He chose not to “whack” a pedophile soccer coach after discussing it with Dr. Melfi. In the middle of a knock-down, drag-out fight with his mistress Gloria, he suddenly realized, “I've known you all my life!” In other words, she was an externalized version of the internal representation of his mother that haunted him. The audience had its expectations raised in the same way that mental health professionals who treat antisocial patients get caught up in excessive countertransference optimism. We thought there was a glimmer of hope for Tony Soprano. Maybe—just maybe—a bad man could be transformed into a good man with the help of a skilled psychotherapist.
In the early seasons, Chase showed us the sympathetic side of Tony. He might be capable of brutal murder, but he also loved his children and, to some extent, his wife; he was capable of loyalty both to his mob family and to his domestic family. Chase and his team of writers also appropriated the Quentin Tarantino trope of placing moral dilemmas in the mouths of sleazeballs. A man who is capable of feeling pangs of conscience fosters hope in the therapist, no matter how evil he is at his core.
Midway through the series, however, the wind shifted. Last May I interviewed Joe Pantoliano, who played the psychopathic Ralphie in the series. He suggested that shortly after Tony killed off his character, things took a darker turn. I agree. Tony became more despicable, less sympathetic, and started showing all the signs of a treatment failure in Dr. Melfi's consulting room. As Geoffrey O'Brien noted in his eloquent tribute in The New York Review of Books, “What began as the story of a potential healing became a description of the last stages of an incurable sickness.”
David Chase had repeatedly warned his audiences that Tony and his mob were not nice people. They were thugs. They were killers.
Glen O. Gabbard, M.D., is Brown Foundation Chair of Psychoanalysis, professor of psychiatry at the Baylor College of Medicine, training and supervising analyst at the Houston-Galveston Psychoanalytic Institute, and author of The Psychology of The Sopranos.
One of the most fascinating achievements of the show was that the writers somehow made us find these characters lovable.
In the last season, the sophistication of Dr. Melfi seemed to disappear. In prior seasons, she had been a complex character whose actions appeared to grow out of motivations we could understand. Suddenly, she appeared to be manipulated by the needs of the plot to the point where she behaved in ways that lacked credibility.
When she finally threw Tony out of her office, the writers linked this decision to her “discovering” an authoritative source on antisocial and criminal personalities that informed her of the possibility that sociopaths might misuse therapy and manipulate the therapist for their own interests. You don't say! In fact, this information is usually mastered in Psychiatry 101 and is well known by all seasoned therapists. Nevertheless, within the show's narrative, we were supposed to believe that Dr. Melfi was naively taken by surprise to learn that patients like Tony had other motives.
A eulogy would not be complete without some consideration of the final episode. The media buzz around the ending of the series was deafening. Would Tony be murdered in a blood-spurting, heartrending operatic finale? Would the writers kill off one of his children instead of Tony himself, leaving him to spend the rest of his life in inconsolable grief? Would Carmela finally get fed up and whack him at the kitchen table as he ate his gabagool? And which song would play over the final roll of the credits, a fitting capstone to the brilliant use of music throughout the series?
As usual, Chase chose to defy audience expectations and violate the conventions of television drama. No one in the family was killed. Instead, life went on as usual. The family met at a diner and ate onion rings. Chase sent his familiar message: In real life, there aren't operatic endings. Life goes on. The Sopranos is not The Godfather.
Many analytic colleagues were disappointed with the collapse of Tony's psychotherapy during the last several episodes. While Dr. Melfi's manner of ending the treatment may not have been entirely unethical, it was certainly an example of poor technique. Moreover, at the dinner party precipitating this unilateral termination, her own therapist, Eliot (Peter Bogdanovich), broke confidentiality by sharing the identity of Dr. Melfi's patient during dessert. Many of us felt betrayed by David Chase and the group of writers who had heretofore seemed to have respected the integrity of psychotherapy.
However, can we really expect a television drama to bear the oppressive weight of a documentary about psychoanalytic psychotherapy? Of course not. Years of watching cinematic and television depictions of psychotherapy have taught me that the needs of the genre and the demands of the plot will always trump a well-intentioned effort to portray psychotherapy at work as it really is. Television is fundamentally entertainment. The writers owe us nothing. Art owes no debt to reality. Dr Melfi and Tony Soprano are not real people. They are points of light on a television screen that we imbue with life each week. Into them we project our hopes and dreams about what psychotherapy is and what it could be.
We must take heart in the showbiz aphorism that there is no such thing as negative publicity. Having the nation buzzing about the therapy of Tony Soprano placed psychotherapy in the mainstream of popular culture. That's exactly where we want it to be.