Talk Therapy: Week 7 - Sunil

Though therapists have supervision (recall Paul's sessions with Gina), one thing they don't traditionally get to do is watch the "game tape" of a session. We've enlisted experts (read their bios and find their comments from prior weeks) to weigh in on select moments with Paul and his patients. What's said, implied, or deeply buried? Let's go to the videotape...

(The content in these discussions does not reflect the opinions of HBO.)

Joseph Shay, PhD

Are you feeling just a little angry? A little misled? A little betrayed? Or are you thinking, wow, what a brilliant way to conclude!

I vividly recall the final episode of 'The Sopranos' which ended with a black screen suggesting…exactly what? Viewers of that HBO series seemed to divide into those that saw this as brilliant and those that saw it as a cop out. This is America. Everybody gets a vote. (With Facebook and Twitter, the votes even arrive in real time.)

I am guessing, however, that the writers wanted us to feel a little angry, a little misled, a little betrayed. I'd like to try to explain how this happens while explaining a psychological process which, to my eye, has been of paramount importance for all three seasons of 'In Treatment.'

In season two, Paul recognizes that April, who cannot tolerate her anxiety and fear about having cancer, is trying to hand over that anxiety and fear to Paul. He likens this to April using him like a worry doll. Her worry is passed along to the doll, Paul, freeing her of it.

Also in season two, Gina gets infuriated by Paul and attacks him. A great therapist herself, in many respects, she also sees this worry doll aspect and says to Paul, "you got me to play the role you relish. You got me to be the punishing, rejecting parent, the failed authority figure that you can rail against. You get to be the innocent victim, doing your best, and I'm just like everyone else. I'm out to f**k you over." And thereby, Paul is free of the role of aggressor.

In our field we have a fancy name for this process (projective identification, which I have tried to rename as projective recruitment) which means, essentially, that an intrapsychic tension gets turned into an interpersonal conflict.

This may be a stretch but what if the writers felt this intrapsychic tension? I imagine them sitting in a room with the psychiatric advisor, Dr. Richardson, each struggling with whether it was fair to have the Sunil storyline end this way. But it's not fair to Paul to have him betrayed like this? But the audience will feel setup and betrayed. But the audience will be angry with us? Until someone said, you know, that's not so bad. Because then the audience will experience precisely what Paul is experiencing. Paul feels angry, misled, betrayed. The audience will have a visceral resonance with Paul, and hopefully will forgive Sunil for the subterfuge because of their sympathy with Sunil. (And hopefully, they will forgive us as well because they love this show.)

So, the internal tension which I am imagining must have existed within each writer is turned over to us. Having given us this ending, clearly they were comfortable with it. It is we viewers who are struggling with these confusing feelings of betrayal.

Having said that, do we think that the profound connection between Paul and Sunil is a real one or just an instrumental one meant to help Sunil accomplish his desire of retuning to India? Sunil says, "the most important thing, Paul, is that you have been a good friend to me." This angers Paul who rejoins, "I was meant to be your therapist, not your good friend." Would the therapy have progressed better had Paul not tried to be a friend? Would he have seen through Sunil's ruse? Would Paul have been able to help Sunil accept his trapped situation more had he maintained a more careful and distant boundary? Paul's boundary issues have been legendary through all three seasons. Is this another instance where they have landed him in trouble?

That's not how I see it.

Even with this conclusion, and apart from Paul's delay in warning someone about the potential danger that Sunil posed – and it is now clear that Sunil was going to keep upping the ante until Paul reacted – I remain impressed with Paul's treatment of Sunil. Paul was able to develop a relationship of caring and of understanding with Sunil which allowed Sunil to share his grief, the torment of his life, and the pain of his tragic relationship with Malini. He says to Paul, in this clip, that Paul has been a good friend to him. (Sunil isn't bound by our therapeutic niceties that suggest that if a patient calls a therapist a friend this must connote a failed boundary.) He describes having felt connected to Paul, calling it a "full connection," and he says that Paul has helped him with his loneliness, as well.

As all three of us have noted before, there has been the development of a powerful connection, an alliance, with Sunil, which has led ultimately to Sunil accomplishing his goal, albeit by deception. True, it's not very nice of Sunil to have used Paul in this way. True, it's not very nice of the writers to have used us in this way.

But being 'In Treatment' is not always very nice. Even when it works toward its goal.

Rachel Seidel, MD

At the end of the first meeting between Paul Weston and Sunil, Paul says, "Mr. Sanyal, I just want you to know that I would like to help you in any way that I can." Sunil, who has been almost silent, replies, "I wonder if you could write me a prescription that would allow me to return to India, where my wife would be alive."

This wondering of Sunil's, a longing presented with irony, is the groundwork upon which the plot line thickens into a suspense-filled psychological thriller, then finally twists and explodes with searing emotional intensity in week seven.

Clues are dropped along the way. By week five, Paul is questioning whether he is hearing the whole truth from Sunil, and at the end of week six, Sunil quizzically assures Paul that Paul will indeed help him one more time. Help him? We viewers and Paul are left puzzling, how? Only in week seven do we, along with Paul, feel the gotcha sting of realization that Sunil's initial wondering has turned first to wish, then to need, and finally that it has been brewed up as a dark mind-blowing potion, his own prescription for securing at least half of his wish: to return to the only place where he can imagine an authentic life, his homeland, Calcutta.

We have gotten to know many aspects of Sunil: Sunil, the depressed and alienated but poetic dreamer; Sunil the widower who has lost not only a wife of many years but, before her, a youthful love, Malini, under tragic circumstances; Sunil the delusionally jealous father-in-law; Sunil the dangerous cricket-bat wielding potential murderer; and—throughout the episodes—also Sunil the engaging psychoanalytic psychotherapy patient who is learning to express feelings, to analyze dreams, and seemingly to connect fully with his therapist, Paul, whom he has begun to trust and who, in return, is trusting him (as a therapist must) despite many smokescreens and unexplained omissions.

Over three years of programming, Paul has been the 'In Treatment' character who virtually embodied the question, "How far do I go?" (See Terry Gross' November 1, 2010 NPR interview with Dan Futterman and Anya Epstein for more on this.) Paul both enacted and also tried to analyze his need to cross lines with patients, to break the frame of treatment in various ways. In this final brilliant and disturbing episode of Sunil, the writers and actors bring us face-to-face (albeit through a jail's plate-glass window darkly) with yet another aspect of Sunil as seen by Paul: Sunil the single-minded vicious Dark Knight with a warped sense of humor, the mastermind Joker who, undeterred from his ultimate goal of returning to India no matter what it takes, crosses all the lines of fair play, reciprocity and honesty in therapy.

Sunil has, in some ways, out-Pauled Paul, has even become something of a therapist-provocateur to Paul: Sunil the Dark Knight unleashes anarchistic chaos in Paul's mind, forcing Paul deeper into his own struggles, questions and journey. At the end, the roles are reversed: We see a depressed and broken Paul opposite a shaken but still eloquent Sunil who expresses concern for Paul along with hope that Paul will free himself from his own great loneliness.

Is Sunil's concern and hope for Paul honest, ironic, a bit of both? Has Sunil, as Paul charges, betrayed him with a pack of lies, thereby nullifying the very idea of psychotherapy? Or has Sunil actually used therapy to remember and grieve for Malini, a step that was necessary in order for Sunil to even imagine a return to an authentic life in India? Do we imagine that Sunil, with no job or home, no family or friends, is returning to Calcutta to live, as he states, or rather do we imagine that he is going there to die on Malini's funeral pyre, so to speak, to not only stare down from the Howrah Bridge, but perhaps to jump off it as Malini once did and, thereby to rejoin her in the next life?

We do not know the answers to these questions. We are left to struggle with many ambiguities, many more questions, among them: What is the nature of honesty, of lies, in the context of psychotherapy? What are the limitations of psychotherapy?

Randy Paulsen, MD

I did not see this ending coming. I admit it. Sunil arranges for his own deportation in the midst of questioning by the police who were sent by his daughter-in-law, Julia, who had been alarmed by Paul who called her because his therapist, Adele, aroused his concern for the safety of a "woman and her children." It is a beautiful row of dominoes (some of which I'll leave out in case you are reading this before the last episode with Adele). The dominoes fall in a way that makes sense to the soul, like music. The central domino in this clip is Paul's shocked outrage at discovering that Sunil "used" him to escape from the impossible limbo in his son's house. "I meant to be your therapist, not your good friend!" and, "you deliberately lied to me… what an incredibly disturbing thing you have done."

Later, the episode moves beyond this dissonant mode. It returns to echo Sunil's phrase at the beginning, "the most important thing, Paul, is that you have been a good friend to me." As Sunil walks away at the end, with his slender left hand raised in a gesture of farewell to Paul, I found myself not angry, but in awe (the script, the acting) and in tears. An old teacher once told me that as things end, we tend to focus on what we didn't get, or on what we did – we feel cheated or grateful. Tears move us from the former to the latter.

Of the myriad impressions left by Sunil and Paul I'd like to pick 3 themes:

1. Issues of ownership and privacy in the territory of psychotherapy.

For the moment I'd like you to picture a Venn diagram – 2 circles that overlap in the middle forming a middle zone shaped like two parentheses. Paul could be the circle on the left and Sunil the one on the right. Their therapy is the middle zone. Their two independent spheres are hardly touching in Sunil's first session, which ends with him saying, "perhaps you could write me a prescription to return to Calcutta, and that Kamala would be alive." Each week the spheres move a bit more toward each other, creating a bigger area of overlap. Tea is served; dreams are interpreted. Paul begins to carry Sunil around in his mind; Sunil does the same. The private, non-overlapping areas are smaller, but they still exist. Sunil yells in Bengali, "you do not know what my life has been!" Paul asks, "do you understand what kind of position you have put me in?" Non-overlapping, private. Sunil says that when he was looming outside Julia's bedroom, he thought of calling Paul. Paul gets him to promise that next time this happens, he will call him. Overlapping, mid zone.

Paul is outraged because Sunil has taken ownership of their therapy. He has seen that Paul "might be able to help him in a bigger way." In Sunil's private view, the "bigger way" that therapy has opened is a way out and a return home. Paul is reeling, momentarily homeless. His ownership of the therapy has suffered a coup d'etat. "Do you treat every relationship you have in this self-serving way?" But Paul can be a good therapist. He survives the coup, and his own enraged reaction to it. He stays with it, he hangs in, he asks Sunil, "Where will you live?" And we can ask Paul, Don't all therapists, ultimately, want their patients to use them in a self-serving way - especially if that way is leading to liberation, aliveness, choice and responsibility?

2. The organic nature of trust, mendacity and love.

When an adolescent lies to his parents, in some fundamental way he is developing autonomy. Trust becomes relative, a realm of give and take, negotiation and feeling - no longer maintained by law, or Brahmin custom. We all become adolescent in therapy – e.g. Paul with Adele. So we do tell lies; we cannot always serve two masters. After being arrested, when he is seated behind the visitors' bulletproof window, Sunil is face to face with the task of winning back Paul's trust. Love has not gone away; trust has. "The one thing I hold sacred is trust!" After the shared sphere of their therapy, the overlapping mid zone, has been shattered, it is the love between these two men that sustains them while they pick up the pieces. The lie made room for the self; the reconciliation rebuilds the trust. Sunil needs the trust back just as much as he needed the lie. That trust is where further growth and truth can be found, back in the mid zone between them. Sunil says, "it is absolutely critical that you believe me, about Malini's pregnancy." The reality of a growing self stems from the mid zone, the re-established. How can I believe what I am becoming, if you, my companion, do not hear me, believe me?

3. Notwithstanding all this good therapy, both Sunil and Paul are still a little crazy.

When Paul says. "you may never see your grandchildren again, you're being deported," the flicker of surprise in Sunil's eyes tells me that he has not fully thought through all the consequences. I think Sunil did not actually plan the deportation until the police were in the house. When they asked for his papers, he "did not give them to them, because (he) chose not to give them to them." - a choice that therapy helped him make. I think that choice was an act of improvisation, not conscious planning. He was truly worried, himself, about going crazy, harming Julia, "the way (his) hand (kept) turning into a fist." The risk-taking between them was real. Otherwise there would have been no growth, no learning. This mid zone between Paul and Sunil has created a bridge that connects their lives; call it crazy, call it love, call it a lot of things, it is a durable Venn-shaped living thing that will not be broken or severed by deportation. It will yet serve purposes for them that we cannot foresee, even though it's great fun to try.

Thank you, Gabriel Byrne, Irrfan Khan, Adam Rapp and everyone for this journey.


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