Isaiah Kriegman / blog /

The Sopranos Says No to Therapy

People tell me all the time that I ought to see a therapist. Not that I need to see one but that everyone does. I used to be very open to the idea but now I just say no. People are incredulous, so I thought I’d write up how The Sopranos gets me. Spoilers ahead, this is for people who have seen it. But if you haven’t and want to read on, the gist is that Tony the mob boss is stressed out and has fainting panic attacks so he starts seeing a shrink.

Ironically, my family is in it deep. Both of my parents work in the field: my father is an evolutionary psychologist with a therapy practice and my mother is a psychiatrist for state health services. My mom also credits psychotherapy with making her the woman she is today. Many of my family members swear by therapy and my brother even made a hit TV show by sticking cameras in a therapist’s office.

You might assume that a show about the main character seeing a therapist has nice things to say about therapy but I think it makes the following good points against it:

It’s just talking

My dad says that talking aloud and being listened to is the primary benefit of therapy. Actually, the thing listening doesn’t even need to be a human: we had a rudimentary therapy AI in the 60’s that users became attached to. So therapy is mostly just paying someone to listen. Fair enough, if you like that then I don’t begrudge that. But it makes me feel like a sucker. Tony brings up occasionally with Dr. Melfi that she’s the only one he can really talk to; he unfortunately doesn’t have any actual friends who aren’t liabilities or snakes. Carmela sees this in Paulie’s eyes when he delivers money to her while Tony is in the hospital. She smiles back at him as he’s leaving, thinking that Tony’s associates genuinely care for him. But she only sees a scowl, showing that it’s all just an act to mask their selfish frustration.

Don’t you think it would be better for Tony to have some real friends who genuinely care for him? I think that would go further than therapy.

It doesn’t work (it’s not supposed to)

I saw an amazing tweet on this recently, it went something like this:

I once talked to a therapist at a party. She told me how much she loved her work and helping patients deal with their issues and trauma. I asked her if she had ever cured a patient to the point where they no longer needed therapy. She stared back at me like I had asked the question in another language.

The cynical take on therapists is they just want to make a buck. But I think the more likely explanation is that they enjoy feeling important. It must feel good to be a therapist today with so many people insisting that paying you hundreds an hour to TALK is essential for happiness.¹ Towards the end of the show, Tony tells Dr. Melfi that he’s done and asks what he has to show for all this therapy. It’s a good question.

On the flip side, the patient can also be uninterested in a cure. Tony also called the therapy “masturbatory,” and had obviously used therapy to deal with the trauma of his evil enterprise throughout the show. Other therapists in the show pointed out the futility of the whole exercise. In a great scene, one therapist tells Carmela bluntly that this is the bed she made. She says of Tony “My priest said I should try and work with him and help him to be a better man.” The therapist cuts through all the phoniness of modern therapy and Carla’s excuse-making at once by simply saying “How’s that going?”

Your problems are (probably) pretty simple

All this therapy that’s designed to not work distracts from the actual solutions to patients’ problems. In that same scene, our cynical therapist also says

Many patients want to be excused for their current predicament because of events that occurred in their childhood. That’s what psychiatry has become in America.

He tells Carmela “He’s cheating on you? Well, do you want to stay with a cheater or do you want to leave?” That’s the only relevant question to be asked, there’s no other point to the therapy.

The impracticality of therapy becomes more apparent when you consider the glaring abusrdity of Tony’s unaddressed issues. He’s having panic attacks because he runs an evil enterprise where he often has to murder good people and close friends. Tony’s son is a spoiled brat because Tony spoils him with mob wealth. These are actually very practical problems with very straightforward solutions. It reminds me of a joke: a man goes to see the doctor and says that he gets a stabbing pain in his eye every time he takes a sip of coffee. The doctor says “Take the spoon outta the cup!” Tony may be committed to never taking the spoon out of the cup. Very well, the therapy might help him smooth over his chronic eye stabbing. But that’s the message of the five season story of Tony’s suffering: the problem isn’t getting fixed with therapy.

I once started therapy to work on my fear of talking to women after reading some advice that men can benefit from studying their insecurities. I sat down and explained to the therapist that I was afraid of talking to women. But as soon as I finished I thought to myself “Why the hell am I in this therapist’s office instead of trying to meet women?” I started pushing myself to talk to girls at bars and parties and very quickly felt much more secure. I never went back to therapy.

Not all therapy is wrong

This isn’t to say that therapy has no role at all. I can imagine some practical use cases, like with trauma victims. And the show does portray Tony having breakthroughs with psychoanalysis, even if they don’t materially benefit him in the end. But in the end he doesn’t get the cure that he seeks. Most of us aren’t dealing with trauma. Most of us have very normal and practical issues, like procrastination. The medicalization of depression is detrimental to the resolution of those issues. The only way out is though. Treating normal issues with therapy is detrimental to ourselves while mostly benefitting therapists.

I like therapists and many of the people I love most in the world are therapists. But it’s a fraught profession that often serves the role of a paid pair of ears. I don’t want to come off as a hater. I mean to champion the incredible potential of addressing our issues with practical instead of therapuetic means. I had no clue that I could have the conversations I’ve had with women since I started putting myself out there. Tony as an anti-hero begs us to see this point. Viewers fall in love with Tony and want the best for him. But, we’re also shown him failing again and again. Therapy alone was not the answer for Tony. He was missing a key ingredient.

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