Thursday, February 28, 2008

HBO In Treatment: Sophie is Bullied Out of Her Suicidality

Sophie comes to a session with her mom after overdosing on her shrink's sleeping pills. She is non-stop hostile to mom, insulting, rude, angry. Paul gets to decide if she can go back to the gym and Olympic gymnast training (with the coach she's slept with), and Mom is not happy when Paul says she can go back. Mom storms off, leaving Paul to follow a distraught and angry Sophie around his office and to sit down on the couch next to her. He tells her that her suicide attempt was her way of "testing" him to see if he really loved her, and he barely passed the test-- he talks about how he has to find something he loves in every patient. Sophie is uneasy with this, and she talks about her dad, the only person in the world who really loves her, and she lies to Paul saying her dad visited her in the hospital. This we learn when a tearful mom pops back in to say Sophie can't go back to the gym, and Sophie insists that if she can't train, she'll kill herself. Paul tells her he can't treat her with the threat of suicide hanging over, that she can never come back to therapy if...if what? he doesn't say, I guess if she's suicidal, and Sophie promises not to kill herself while she's in therapy.

So the only reasonable person here is the tearful, dramatic, "surgically enhanced" mother.

We're left to wonder what issues has with his daughter Rosie (the one who sleeps with drug addicts, per stalker patient Alex) and how he's playing them out with Sophie.

The list of what Paul's done "wrong:"

--1) He hasn't reported the pedophile gymnastics coach, though he has thought about it.
--2) He's gotten Sophie out of the hospital immediately after a suicide attempt, rather then leave her there where she can be kept safe and carefully evaluated for a mood disorder. And he's painted the hospital as a bad place to be rescued from for someone who may well need to be there at some point.
--3) He's allowed himself to be the decision maker about sending someone back to gymnastics. At least he should fully hear the mom's reasons for not wanting to send her.
--4) He's telling a sexually abused 16 year old that he 'loves' her as he follows her way too closely around his office. And he tells her he trusts her after she's overdosed in his bathroom--- now why would he trust her? And she lies about her father visiting her in the hospital, why believe she's truthful about anything else?
--5) The kid's now on her 3rd serious suicide attempt in a short period of time (2 car accidents, one overdose) and he's just shut down the option for her to tell him when she's suicidal. "You can't come back to therapy, ever" --I could see telling someone this if they perhaps have another Attempt (and definitely, no therapy ever if you succeed at killing yourself!), but he says he can't operate under the
threat of suicide. In other words, if you're thinking about it, keep it to yourself. It just doesn't cut it for psychiatric care.
--6) Paul tells Sophie why she tried to commit suicide in his office-- a theory he's now committed to (much the way Gina comes up with theories about his behavior), without even asking Sophie "why?" He's made a lot of assumptions and closed his eyes to other possibilities for her behavior.
--7) Paul is too invested in being liked by his patients and this blinds him from acting in their best interest.

Somebody remind me that it's just a TV show.