Psychology of The Sopranos: Love, Death, Desire and Betrayal in America’s Favorite Gangster Family (Book Review)

Author:  Gabbard, Glen
Publisher: Basic Books, 2002
Reviewed By: Martin Manosevitz, Summer 2003, pp. 65-67

In this wonderful little book, Glen Gabbard presents a psychoanalytic perspective on the wildly successful HBO Series, The Sopranos. It is estimated that 11 million viewers tune into this story about a mob family. The center point of the series is the absurd, yet believable premise that a mob boss, suffering from panic attacks, is in psychoanalytic psychotherapy with an attractive Italian female psychiatrist. The book was not written to be a psychoanalytic text. Yet I believe it deserves attention from psychoanalysts. It is a book that some of our patients will read. Some of our patients are Soprano fans and thus will have ideas about therapy derived from the program that will be expressed one way or another in their treatment. For example, Tony talks to his psychoanalyst about his dreams and their meaning. Hopefully this will encourage our patients to attend to their dreams and bring them into therapy. Talking about dreams will be seen as appropriate in one’s therapy sessions!

Gabbard skillfully and deftly makes the case for a psychoanalytic approach to emotional problems. He tells us,

In this book I take a hard, but lighthearted, look at those dilemmas [the dilemmas of love, death, desire and betrayal] as they reveal themselves in the psyches of America’s favorite Mob family—and our own. I explore what The Sopranos teaches us about psychology and psychotherapy, and I offer my thoughts about why we are drawn to a series about the misadventures of a middle-aged thug. (p. xii)

Gabbard says “lighthearted.” He certainly delivers on this promise, and is assisted by the material provided by the creator, writers and producers of the series. For example when He discusses the well known Madonna-Whore vertical split that exits in some men, he writes “Tony’s vertical split allows him to lavish birthday gifts on Carmela [his wife] and profess his love for her while shtupping goombahs on the side” (p.138).

Again, when Tony and Carmela discuss parenting their daughter, Meadow, they poignantly realize how difficult it is to set appropriate and enforceable consequences on a teenager. Tony notes “ Let’s just not overplay our hand. ‘Cuz if she finds out we’re powerless, we’re fucked!” (p. 144). A feeling that many of us can relate to.

The complexities of father-son relationships are portrayed, again with some lighthearted humor. Tony wants his son, A.J., to be confirmed. A.J. states that God is dead and thus he is not getting confirmed. Tony tells his son that his mother is adamant that he be confirmed. A.J. scornfully asks “What does she know…” “Tony has the last word: “ She knows that even if God IS dead, you’re still gonna kiss his ass” (p. 152).

Gabbard is well known to the psychoanalytic community. He is a most distinguished analyst, writer, editor and lecturer. He currently is Professor of Psychiatry at Baylor College of Medicine in Houston Texas. He also is a Training and Supervising Analyst at the Houston/Galveston Psychoanalytic Institute. He has received numerous awards, but most notable and recent was the Sigourney Award for Outstanding Contributions to Psychoanalysis. Before moving to Houston, Gabbard was Bessie Walker Callaway Distinguished Professor of Psychoanalysis and Education in the Karl Menninger School of Psychiatry.

He has authored 17 books and published over 200 papers and chapters. Many of his books and papers are classics in the contemporary psychoanalytic literature. He is a popular international lecturer. He is recognized for his ability, demonstrated in his writing and lecturing, to present important ideas and clinical material in a most straightforward and clear manner. His theoretical position is inclusive and non-dogmatic. For the purpose of this book, it is important to note Gabbard’s interest in TV, film, and theatre. He has written about how psychiatry is portrayed in film in his book Psychiatry and the Cinema (with Krin Gabbard, second edition,) and in Psychoanalysis and Film. Only a person with Gabbard’s credentials plus his interest in psychiatry, literature, drama and the media could have written such a scholarly and sensitive book on The Soprano’s.

Who might read this book and why? Certainly the millions of devoted fans of the TV series. Viewers who want deeper insight into the psychology of America’s favorite mob family will enjoy the psychoanalytic perspective. However, the series also touches on some main themes of life that affect all of us as Gabbard notes in the title “ Love, Death, Desire, and Betrayal.” He says “ Death is the great leveler. Every viewer glued to the television set on Sunday evenings knows that death is the ultimate certainty. We all want to make an impact, leave a trace of some kind. We, too feel like grunts in the game of life” (p.17).

The fact that Tony’s psychotherapy is such a central aspect of the program certainly makes it a perfect vehicle to discuss the current psychotherapy scene.

The ubiquity of psychotherapy in The Sopranos offers a sophisticated rendering of fundamental human dilemmas rarely portrayed in any medium. Many therapists have reported increases in male patients as a result of The Sopranos. One can speculate that the windows on the unconscious mind that psychoanalytic approaches open up in the series may suggest a renewal of interest in the in-depth exploration of the individual psyche. Although the time-intensive techniques of this kind of treatment run against the grain of today’s more fashionable pill-popping, we still have a hunger to know ourselves. Critic Ellen Willis points out ‘Our culture’s flight from psychoanalysis is not permanent.’ The pendulum is swinging back, and the motion of that pendulum may have been influenced by a cable series about the relationship between a mobster and a therapist. (p. 21)

If the pendulum is swinging back (and I believe it is) then Gabbard presents to the reader a persuasive presentation to help rehabilitate the image of psychoanalysis. The lay reader can obtain an experience near idea of contemporary two-person psychoanalysis without dogma, jargon or ideology.

Let us look at one example of how Gabbard explains a fundamental concept in psychoanalysis: countertransference. The writers depict Dr. Melfi,

… as a professional and competent practitioner who is nevertheless troubled with conflicts of her own and with specific countertransference reactions to Tony. Countertransference—the therapist’s emotional reactions to the patient—is an expectable part of any therapy process and a tool to help understand the therapeutic interaction. Dr Melfi’s mistakes and her own emotional struggles with Tony lend further credibility to the series…. (p.7).

Besides the fans of The Sopranos, many psychoanalytic therapists (some of whom are devoted Soprano fans) who want to know what their patients are reading will be drawn to this book. Psychoanalysts may also want to see how a talented psychoanalytic writer presents major psychoanalytic concepts in a non-technical way. Gabbard, using the rich material from the series, discusses basic tenets of psychoanalysis such as the importance of developmental history, transference, countertransference, interpretation, Oedipal conflicts, vertical splits, dreams, free association etc. He does so in a matter of fact manner using plain language to help the reader see how such concepts are not archaic Freudian ideas, but alive and well in our lives and in psychoanalysis. For example regarding interpretation, Gabbard recounts Tony and Dr Jennifer Melfi talking and Tony “…recalls his hallucination of the baby suckling at the voluptuous mother’s breast. Jennifer points out that the baby was Tony, and the memory represented a wish to be nursed by a loving mother. This interpretation brings Tony to tears” (p.69).

Is the TV show is a realistic portrayal of therapy? There has been some significant debate about how realistic it is. The series creator, David Chase says that the therapy sessions portrayed in the series “…reflect his own experience with the woman therapist he saw.” (p. 8). While Gabbard notes “ To say that the therapy represented in The Sopranos is the most accurate and complex to ever appear on television or film is not the same as saying that it is identical to what transpires in the office of the typical female psychiatrist conducting psychoanalytic therapy with a Mafia don.” (p.8).

Gabbard is a member of the popular online Slate discussion group along with analysts Margaret Crastnopol, Phillip Ringstrom and Joel Whitebook. They have an online discussion of each episode. There is considerable difference of opinion among them and among other commentators on the series. Discussion of the program has appeared in Psychiatric News (the newspaper of the American Psychiatric Association). Much of the controversy surrounds questions of technique, in addition to the accuracy of therapy portrayal.

In December, 2001 the American Psychoanalytic Association presented the producers and writers an award for “… ‘ the artistic depiction of psychoanalysis and psychoanalytic psychotherapy.’ Lorraine Bracco received an award at the same event for creating ‘the most credible psychoanalyst ever to appear in the cinema or on television’” (p.6).

Readers may feel that they are sitting in on a clinical case conference or a seminar on psychoanalytic treatment. The patient is Tony and the clinical material is the three seasons of the TV show. Gabbard takes us through the usual topics one would cover in such a presentation. We learn of Tony’s chief complaint (panic attacks), family history, symptoms, relationships, treatment plan and rationale for it and prognosis and progress to date.

Tony arrives at Dr. Melfi’s office after a series of panic attacks. His internist refers him. He was given the names of three psychiatrists and chose Dr. Melfi. He reported to her the onset of the panic attacks occurred when ducks, which were in his swimming pool, flew away. Tony also reports that he feels “depressed’ as well as “dead and empty.”

In chapter one entitled “Bada Being and Nothingness” Gabbard invites the reader to think psychoanalytically. “The human condition involves psychological conflict, the inevitability of strife in intimate relationships, existential loneliness and crises of meaning.” (p.2-3) “…I explore human psychology as it unfolds in The Sopranos, not only in the context of psychotherapy but in the characters’ relationships, behavior and dreams that occur outside the consulting room.” (p.3).

In this first chapter, Gabbard sets the stage for thinking psychoanalytically. He introduces the idea of a “play space” and the “as if” quality of transference. In chapter two the question of differential diagnosis is raised as well as the question of mode of treatment. He champions the psychoanalytic perspective and educates the reader when he writes:

Tony Soprano has the good fortune to be referred to a psychoanalytically trained psychiatrist, who knows that the symptomatic tip of the iceberg may herald the presence of deeper layers of conflict and suffering that are not immediately apparent. Dr. Melfi recognizes that the anxiety Tony reports is a signal of profound distress. She also knows that the origins of that distress are largely outside Tony’s conscious awareness. A psychoanalytic therapist would assume that her patient’s defenses were failing for some reason and that the anxiety was a flare sent up from his unconscious. (p.25-26).

These quotes demonstrate how Gabbard gently introduces basic psychoanalytic ideas in an experience near way and in a style that lay readers can relate to. Other basic psychoanalytic concepts are introduced in this chapter as Gabbard discusses the nature of Tony’s problems. He also presents a thoughtful discussion of whether Tony suffers from an antisocial personality disorder or is a psychopath.

In the next two chapters Gabbard presents Tony’s therapy and addresses the question of whether Tony is treatable. In so doing Gabbard introduces the psychoanalytic model and many of its major concepts using the material of the TV series. He says,

Combined with Tony’s medication is twice-weekly psychoanalytic psychotherapy. The principles of this form of therapy are straightforward. The patient’s childhood experiences are crucial to the understanding of his adult concerns. The therapist encourages the patient to view his behavior as having complex meanings that are largely unconscious and therefore require time to understand. Emotional problems have multiple determinants rather than a single cause (p.46-47).

When he turns to the question of whether or not Tony is treatable, Gabbard writes:

Someone with as many antisocial traits as Tony is not realistically going to show dramatic changes in the first year of therapy. Much of the therapist’s task is to help the patient reflect on chronic patterns of behavior that are embedded in his character and that he thus takes for granted. These traits, which are so much a part of the person that they do not create distress, must be transformed so that they begin to make him uncomfortable. The therapist needs time to convince the patient that his habitual behavior is going to land him in some kind of emotional trouble. Hence in ordinary therapy we would not expect Tony to show great improvement in his insight or behavior, even though his panic attacks may have improved considerable with a combination of medication and psychotherapy. (p. 75-76).

This is a very nice explanation of symptom improvement versus character change! Gabbard goes on to state “ The ultimate value of psychoanalytic therapy is not to eradicate that past. Neither is it to liberate the patient from the past. The goal is to bring the implications of the past fully into the conscious awareness of the patient so there is an increased capacity to choose a different path when confronted with the familiar old crossroads.”(p.96).

In the next three chapters of the book (or the case conference- seminar) Gabbard thoughtfully presents the family dynamics and important features of Tony’s childhood and family relationships and how they influence his current functioning. His marriage relationship and his psychodynamics are also discussed.

In all, Gabbard has done a masterful job of educating viewers about the deeper meaning of what they are seeing on their TV screen. This is particularly true regarding the central role Tony and Dr. Melfi and their therapy have in the series. But Gabbard has done more than enrich the viewer’s experience of the Soprano series. He has done an inestimable job of introducing readers to contemporary psychoanalytic ideas in a way that will permit them to view psychoanalysis differently. Hopefully, this will be in a more open and receptive posture to psychoanalytic ideas of mental functioning, development and therapy. All analysts should be in debt to Gabbard for his contribution in getting psychoanalysis back in the public domain in a positive light.

Martin Manosevitz practices in Aspen Colorado and is Treasurer of the Division of Psychoanalysis, American Psychological Association.

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