I think it should be understood, that therapy is not always the cliff-hanger that these episodes are. But, if you made a show that was truly realistic to what occurs in therapy, no one would watch it. So I feel the writers/producers of "In Treatment" made the smart move in focusing on the aspects of therapy (psychoanalysis, to be precise) that are most riveting; these tend to be issues of transference and counter-transference. The Friday supervisions/treatments that Paul receives provide vital clues to keep an eye out for in the subsequent sessions that he has in the following week. In the most recent episode (2-5-08), Paul is seen to be projecting onto Alex his own feelings towards his marriage by telling alex that he's probably known these marital concerns were at a "boiling point" for some time. This is a small example of the attention to detail that the writers/producers have paid to the realities of therapy; and if they did this without a psych consult, all the more credit to them.
Lets not forget that this is a television show. It can't be a perfect portrayal of the reality of the therapeutic environment. Lets ALSO remember that therapists are not perfect people. They can be idiots who foolishly leave medicine in their office bathroom cabinets; they can project their own issues into a session; and they can clog their toilets up, resulting in an argument with a client over boundaries (Laura, week2). Paul is being portrayed as an adept psychoanalyst with issues of self-worth that were probably never thoroughly analyzed during his training. When the narcissistic thrill of being a gifted therapist wears off, everything starts to make its way to the surface.
Kudos to HBO on a well-done series.
