Analyzing The Imagery Off the Couch

" NOT to dredge up old news, but you may recall that several weeks ago America's most lethal psychiatric patient, Tony Soprano, walked out on his shrink, Dr. Jennifer Melfi.

Yes, yes, we realize this was a television show. But we're not the only ones with trouble at times separating reality from illusion. Even the American Psychoanalytic Association can fuzz the line between the two. So smitten is it with Dr. Melfi that barely a year ago it gave a special award to the actress who plays her, Lorraine Bracco.

What, then, does it think about an honored colleague being treated so cavalierly by this lug?

It seems fair to ask, given that hundreds and hundreds of association members are in New York for the first time since that award. They are here for their winter gathering at the Waldorf-Astoria, a five-day affair that will stretch through the weekend.

(Note that of the association's roughly 3,500 members, 700 live in and around the city. Metro New York's share of the United States population is about 7.5 percent. Yet we have 20 percent of the shrinks. You be the judge of what this says about the state of our mental health.)

Back to Tony Soprano. Let's put the question to the shrinks in terms that everyone can understand: how does what he did to his therapist make them feel?

Not bad at all, they say. Who knows? He may yet come back.

More important, ''it's real life -- patients leave us all the time,'' said Dr. Leon Hoffman, a former chairman of the association's committee on public information. His successor in that position, Dr. Kerry J. Sulkowicz, added, ''Patients don't stay in treatment forever.''

These guys must have missed a lot of Woody Allen movies if they believe that.

In fairness, they have bigger concerns than Dr. Melfi's patient load. One is their own public image. It isn't good, they say, and in part they have themselves to blame.

''We've probably isolated ourselves too much from the rest of the mental-health community,'' Dr. Sulkowicz said. With the general public, he said, not enough has been done to ''articulate some of our ideas in plain language and to be useful to the world outside the consulting room.''

Dr. Newell Fischer, the association's president, is even more blunt about the problem. The image of psychoanalysts is ''dismal,'' he wrote in the organization's newsletter. They are viewed as ''aloof, uncaring, too intellectual and arrogant.''

Thank goodness, he threw in ''too intellectual'' with the other adjectives. Otherwise, we might have thought he was talking about journalists.

OF course, defining positive and negative when it comes to image is a tricky business.

The Melfi character was praised by Dr. Hoffman for having established ''professional boundaries'' with Tony. She doesn't hop into the sack with him, as the Barbra Streisand shrink does with Nick Nolte in the film ''The Prince of Tides.''

But they can be full of surprises, these psychoanalysts.

You would think they'd like warm and cuddly film shrinks like Judd Hirsch in ''Ordinary People'' or Robin Williams in ''Good Will Hunting.'' No way, Dr. Sulkowicz said. ''The characters create totally unreasonable expectations of what an analyst can do,'' he said. They give you the idea that ''once you get connected up with a long-forgotten memory, you're fixed.''

''While on the surface it sounds great,'' he said, ''this ultimately does a disservice.''

Want to hear Dr. Sulkowicz's idea of good shrink characters?

Hold onto your couches. He likes the chomping Hannibal Lecter in ''The Silence of the Lambs'' and the bumbling Billy Crystal in ''Analyze This.'' They may be outlandish, he said, but they ''touch on some fairly ubiquitous fears that patients have about being in therapy.'' One fear for patients is that they may be sharing their innermost thoughts with someone who is in as bad shape as they are.

It's almost enough to make you reach for a drink.

Some psychoanalysts at the Waldorf did just that yesterday, while listening to Toby Williams, a singer with a group called Cocktail Angst. She sang numbers with titles like ''Shrinker Man'' and ''I Can't Get Adjusted to the You Who Got Adjusted to Me.'' There was also a Rodgers and Hart song called ''To Keep My Love Alive.'' Sounds sweet, no? It's about a woman who marries one man after another, killing each before the romance can wear off.

With so many Freudians on hand, Ms. Williams steered clear of that Sinatra standard, ''You Make Me Feel So Jung.'' "

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NYC; Analyzing The Imagery Off the Couch By CLYDE HABERMAN
Published: January 24, 2003