In Treatment is centred on a psychotherapist called Dr Paul Weston (acted sublimely by Gabriel Byrne). Paul is a good listener, empathetic, and intelligent enough to understand what people are really saying and why they are saying it. However, the traits needed for a good psychotherapist also seem to make the job very difficult for the practitioner. Paul feels too much, and gets attached to patients too readily; the show tracks this pattern and Paul’s response to it. By immersing himself in the minds of others, Paul struggles to maintain the distance necessary for him to use his therapeutic tools to work objectively with the problems he encounters. In contrast, due to giving himself fully to patients he has nothing left for his private life and becomes distant from those who love him.
Each episode focuses on the relationship between Paul and a patient or Paul and his therapist (mostly Gina). In the past Gina was Paul’s mentor and therapist. In the early stages of the show we discover they have not been in touch due to a fall-out over Gina blocking Paul’s entrance into a key role within the psychotherapist community. In a difficult time Paul reconnects with Gina and re-enters therapy. This dynamic exposes the fundamental issue with psychotherapy: the therapist begins to define a patient, but they see the patient through their own distorted lens. In this situation it is easy for the patient to lose sense of what is really true, which can create more confusion and distress; moreover, patients are supposed to leave empowered, but they can actually become psychologically enslaved to the view psychologists have of them or use the psychotherapist's view as an excuse for counterproductive behaviour.
The other issue explored in In Treatment is whether a therapist can develop true romantic feelings for their patient and/or the patient for their therapist. Since Freud the majority of experts have thought that any instance of romantic love between patient/psychotherapist involves the transference of feelings for another person; moreover, it is all to easy to fall in love with someone whose job it is to sit there and listen to your problems and empathise with them. We discover that Paul has historically held the contrasting view that patient-therapist relationships are OK, but at the same time is fearful of the reality of this and uses his marriage as a safety net to prevent him from giving into his desires. This argument plays out with Gina, who Paul desperately tries to convince that entering a relationship with a patient is fine; throughout this we sense that Paul is actually trying to convince himself, to either release himself from Gina’s view or justify his weakness.
At the core of this show is whether conflicted or confused people can help other people. This is a core criticism of psychology and religion. If the therapist or the priest has their own issues and imperfections can they be trusted to act outside their weaknesses out of a true concern for others? How do we really know if someone has our best interests at heart, or is leading us to a better place rather than into a different confusion? The conclusion In Treatment makes about this issue is nuanced, and up for interpretation; as a viewer you will be left with enough space to reach a final verdict for yourself.