Four psychoanalysts comment on the therapy scenes in this Sunday’s Sopranos:

“My other thought about Dr.
Krakower is that his technique of ignoring Carmela’s defenses
and confronting her right down to her marrow served multiple
functions, not the least of which was ridding himself of a patient
that he didn’t really want to see. As analysts, we always have to
reflect upon the meaning of starting a treatment with telling a
patient how she must live her life and also laying out that they can
expect no help from us for anything short of following through on
our expectation. I’m not saying that we analysts don’t ever
confront; of course we do, but usually only after we have
established a relationship in which a patient feels known and
understood. In my own career and in all of the supervision I have
done with other analysts, when someone does what Dr. K. did,
they are really interested in taking care of themselves. I don’t think
that this is bad; obviously it indicates that this would be an
abysmal therapeutic match, even though it is a great dramatic one.”

“He was certainly a stark contrast to the “moral
relativism” of psychiatry that Jennifer’s husband complains about.
Peggy also raises questions about why Jennifer would pick him as
the analyst to whom she refers Carmela. Since he was her
teacher, she must have known that he would take the kind of
hard-line, moralistic approach that we saw. Could she have even
guessed that he would tell her to leave Tony? If so, was Jennifer
unconsciously disposing of her rival? Was this a
countertransference enactment in that sense? All of you noted the
problem with telling Carmela what to do after one session. It
reminds me of the cartoon about managed care that features
one-session therapy: The therapist says to the patient, “Whatever
you’re doing, stop it!” Dr. Krakower knows that dispensing this
kind of advice is not going to work because he knows that
Carmela has complicated reasons for staying involved with Tony.
Despite his lamenting that psychiatry has become a kind of
victimology, his message to Carmela seems to be that she is a
victim of Tony and the only solution is to remove herself from the
victimizer.” Slate