IN TREATMENT
HBO
THE NATIONAL POST

When I first heard about In Treatment, I assumed it was going to be a reality series. My mistake, and a foolish one: It would be ethically impossible for a real psychiatric session to be filmed for public consumption. (Now go ahead and tell me that someone, somewhere has done it.) But if it is going to have any credibility, a fictional show about psychoanalysis or psychotherapy should adhere to stringent naturalistic standards. It should probably be improvised. Certainly it should not sound written.

In Treatment does sound written, in a glib if high-minded way, like a 1950s Hollywood melodrama directed by Ingmar Bergman. Based on, but not slavishly tied to, a successful Israeli series, it airs five nights a week.

Monday to Thursday, Paul, a rumpled, middle-aged therapist of Irish extraction (to put it another way, he's played by Gabriel Byrne), acts as inquisitor and sounding board for three individual patients and one couple.

On the fifth day, the shrink himself gets shrunk, consulting with a senior therapist called Gina on how his week has been. Generally, it has been terrible.

A minor reason for this may be that some of his patients are tedious, to us and probably to him. They include Alex, a young veteran of the Iraq war who tries for favoured-patient status by buying Paul an espresso machine, and a couple wondering whether or not to abort their second child.

Another patient is dull for viewers but disturbingly fascinating to him: she's Laura, a narcissistic anesthesiologist who may be the least convincing medical professional in TV history, and certainly the one you would least trust to put you under. She delivers unbearably pat monologues about her state of mind, tells Paul that she's in love with him and berates him for not responding.

She also tells him about the sex she's having with Alex, whom - in the soapiest of soap opera developments - she encountered outside Paul's office one day when he got his appointment time wrong. (If it were really true to its own pretensions, this show wouldn't step beyond the consulting room.)

Like many in his profession, Paul works from home. (A nice place, somewhere in the New York hinterlands.) This becomes a problem for him, since his physical proximity to work emphasizes his psychological distance from his family; at least that's how his wife resentfully sees it.

She has an affair, which she tells him about, and he winds up sleeping on his own couch. That couch sees a lot of drama, much of it way beyond the normal call of psychiatric duty. It gets bloodied when Paul's pregnant patient has a miscarriage right on the premises (one problem solved, you might think, but the couple come back for more).

It's the site of gymnastics, including backflips, performed by Paul's youngest and most interesting patient, a 16-year old athlete with parental and relationship problems. She broke both her arms in an accident but is obviously recovering, at least physically. She's seeing Paul for "evaluation" rather than therapy, so maybe it's permissible for him to put his arm around her when she's in distress. But it looks like crossing a line.

That's undoubtedly how Gina, his own therapist, would see it. She's a martinet on doctor-patient etiquette.

The show has some things going for it. One is Mia Wasikowska's performance as Sophie, a model of teenage bewilderment and teenage disdain. I'm not sure that her scenes are better-written than the others, but her freshness and spontaneity certainly make them seem so.

Byrne himself is fine, a patient and unwearying listener when on the job; very weary indeed and far from patient when he's the patient. So his scenes with Dianne Wiest's excellent Gina, whom he likes but distrusts (or maybe trusts but dislikes), have a special charge.

Paul's confessions to Gina (and his rows with his wife, who's given a good, brittle performance by Michelle Forbes) have something of that. Paul's bathroom seems to see even more action than his couch - so far it's hosted one suicide attempt and any amount of vomiting - and it's interesting to see how much of the turmoil in his life he reveals, how much he conceals or how much he exaggerates.

But this makes In Treatment a more conventional show than it promised to be, or was promoted as being. Its focus is not the therapy, but the therapist. As his patients keep complaining, it's all about him.