After hearing about the death of actor James Gandolfini, I decided to fire up HBO Go and watch the pilot episode of The Sopranos, the revolutionary 1999-2007 series that defined Gandolfini’s career. As any fan of the show can easily imagine, I ended up watching several episodes. The last time I had seen the opening hours of The Sopranos, I was a teenager. I recall identifying with Tony Soprano’s son, Anthony, Jr., as he came to understand that he was the child of a powerful and notorious mobster. I had wondered how I might cope with such a heavy and complicated realization. Today, I am one week away from beginning my predoctoral internship, the final step in the long road toward becoming a Ph.D. of clinical psychology. Not surprisingly, this time around I find myself identifying with Dr. Jennifer Melfi. I wonder how I might cope with being Tony Soprano’s therapist.
Much has already been written on Dr. Melfi — perhaps the most well-known fictional psychotherapist alongside In Treatment’s Dr. Paul Weston (and perhaps Hannibal Lecter) — by professionals of psychology, psychiatry, and psychoanalysis. She has been alternately praised for representing therapy well and decried for representing it poorly. In re-watching the early sessions between Tony and Dr. Melfi, I am quite struck by how the flaws within their therapy are not structural — that is, they do not stem from bad writing or a lack of research by the show’s producers — they are human. Dr. Melfi is not a perfect therapist… but who is? She shows fearlessness and compassion in helping Tony unpack the dense emotions he projects onto the ducks who live in his pool in the first episode. She is curious rather than defensive when Tony repeatedly brings her into the session — through her diploma, her last name, the painting in her lobby. Perhaps most importantly, she continues to see Tony even after he storms out of her office multiple times, and openly discusses with Tony his doubts about treatment.
Dr. Melfi also struggles, an experience any trainee such as myself knows all too well. She pushes her agenda on Tony at times, and often he is not yet ready to hear what she has to say, distorting the original message — for instance, when Dr. Melfi tells Tony that she knows elderly people who are “inspired and inspiring,” Tony ends up aggressively shouting this sentiment to his mother a few scenes later. Dr. Melfi also cannot contain her own emotional distress following a disturbing encounter with a crooked detective (secretly sent by Tony to spy on her), and subsequently over-discloses in session. Failure to stay with the patient and failure to contain are familiar challenges, and I was impressed with how The Sopranos treated these clinical phenomena with sophistication and respect.
I highly recommend watching or re-watching The Sopranos to all, but especially to those readers who, like me, have embarked on clinical careers since last having watched it. The relationship between Tony Soprano and Dr. Melfi offers a uniquely honest portrait of a complex and often fraught psychotherapy treatment. It is both satisfying and a bit terrifying to see as I prepare to move forward in my own career — and that’s probably the point.