“This psychiatry shit. Apparently what you’re feelin’ is not what you’re feelin’ and what you’re not feelin’ is your real agenda.” – Tony Soprano. RIP

I feel that I owe a small debt to the Sopranos for career marketing, because a common question strangers ask each other is, “What do you do?” When I respond, “I’m a therapist.” The next question is usually, “What kind?” To which I often find myself saying, “A talk therapist, you know, like on the Sopranos.” And, almost everyone I meet has watched the Sopranos and knows that Tony went to therapy.

Television mimics real life, making some things appear easier or harder than most of our actual experiences. Tony’s television therapy experience was polished to include brilliant interpretations in every session, which actually doesn’t always happen. But Tony’s resistance to therapy: his disagreements with Dr. Melfi, his anger at her interpretations, his threatening to leave therapy, and his unwillingness to give credit to the therapy vs the medications—those are all normal challenges people can have in response to therapy.

The remarkable, laudable trait about Tony is that he stayed in therapy, even when he was unhappy with it. Or, at least he returned to Dr. Melfi during his difficult periods to try and understand himself and his confusing world. Perhaps it’s the fact that he tried to wrestle some with his interior life that allowed me to have a soft spot for Tony, who otherwise would be just another sociopathic, power-hungry mafia boss/murderer.

As far as the above quote, and what’s obvious or not in therapy, part of the therapists job is to track content, patterns and signs/symbols. Often times all the content in the therapy session is related, even if it feels like it’s not. At the end of a session, perhaps the patient disagrees with the therapist’s interpretations. But also, perhaps it will register in the patient’s subconscious, spawning later discussion or different thinking. Therapy is generally not an immediate gratification process, another concept with which Tony struggled.

The world will miss James Gandolfini, by all accounts an intense, multi-faceted, challenging, surprising human being.

* I am not a psychiatrist—I am a psychotherapist.

** One of my former neighbors claims Gandolfini rushed him and his dog to the ER after witnessing a doggie hit and run. Animal lovers get lots of credit at our house.