My analysis of the initial interview using the example of an episode from the film "Patients." Season 1, Episode 2.
ALEX
Alex entered confidently, not removing his dark sunglasses, demonstrating his dominant position and as if holding onto a sense of intrigue. He immediately began touching books, rearranging objects, behaving as if he were the master of the house.
The first frustrating situation forced him to transform his anxiety into control, as if thinking, "If I control the situation, I won’t be afraid," or perhaps this anxiety transformed into action: to avoid feeling anxious, he *must* do something!
Alex immediately asks about the rules, which also indicates his desire to compete.
Therapist’s position: The therapist also wants to maintain his dominant position and allows himself to make a subtle joke: "The patient is always wrong!" Then he adds, "That’s a professional joke."
Alex is briefly thrown off balance but quickly recovers and strikes back:
- Do you recognize me?
T: Should I?
- Yes, you’re the best! — and this sounds more like a claim and irony.
Alex continues to explain to the therapist that he truly sought the best of the best for himself and gathered personal information and reviews about the therapist before their meeting.
- I always turn to the best!
T: Is that important to you?
Yes.
Before us unfolds a scene where the protagonist wants to be recognized and not destroyed by it. As if he’s saying, "It’s me! Recognize me! You *must*! Who else if not you? But allow me to live if you understand who stands before you."
From the sidelines, we see how Alex strives to be evaluated as better than others, and only someone equal to him can do that. He seems to be searching for an equal player in the game but tries to keep the ball in his court. At the same time, he is afraid: what if this person is truly the best? What then? Will he be able to endure defeat? Can he handle the other’s helplessness? Will he remain by their side without judgment or criticism?
The rest of the scene seems to confirm this: Alex talks about an important event that occurred during his last combat mission. Alex is a fighter pilot who carries out dangerous and lethal orders. The therapist learns that Alex is a killer of 16 Muslim children. Again, the patient expects some special reaction from the therapist to this information, as if the therapist should now say, "Oh, I recognize you!" But this doesn’t happen because the therapist remains calm and ignores Alex’s desire to be recognized. Then the patient exaggerates, explaining that there was a leak of information and now a large reward is placed on his head: a place in paradise and 40 virgins!
The therapist listens carefully, but the patient still doesn’t get the expected reaction. Then Alex begins to attack the therapist, his speech quickens, his voice rises. He talks about this event as if he’s proud of it, as if it’s his well-executed work because he’s a professional. And while Alex carries out such dangerous missions, the therapist calmly earns money by talking.
Perhaps here we can speak of the therapist’s countertransference, as a sense of guilt is clearly evident. So, perhaps the therapist asked about the number of children killed. Instead, Alex, now calm, justifies himself, saying it’s just work, he sleeps well, and he always has a lot of work.
T: What kind of work?
A: All kinds of different work!
At this moment, Alex recalls his father, who, after his mother’s death, was always busy doing something. Alex waited for his father to break down, but the father only said that his mother had left a mess.
(I’ll allow myself to remind you that in the first scene, Alex also suppressed his anxiety by doing something with books and objects.)
At this point, the therapist makes an intervention for the first time, pointing out that Alex compares his mother’s death to his last mission.
How does Alex react? He resists. He says it’s not true. His mother’s death was a very painful event, while the mission was routine.
But after this intervention, the conversation changes, as if Alex can now tell more. As if he no longer needs to challenge the therapist. He even takes off his leather jacket and pours himself some water. His posture changes. He relaxes and leans toward the therapist.
Alex talks about how he and his gay friend like to run 10-15 km. One time, he decided to run 35 km, and it ended in a heart attack. He literally died. His heart stopped for several seconds. He had a 2.7% chance of survival. And he survived. But instead of joy, the patient immediately says he’s ready to disappoint the listener. The therapist obediently follows the patient, giving him the opportunity to speak.
A: I didn’t see the light at the end of the tunnel. I didn’t make it through the tunnel. But everyone only asked me about it. My father, my wife, everyone!
T: Are you sad that you disappointed your loved ones?
A: No, I had other thoughts.
T: And what was on your mind?
A: Whether I have an erection?
My grandmother used to talk about the "erection of the dead" when my grandfather died.
T: And what does an erection mean to you?
A: It would mean I was dead.
T confronts: But I thought you were afraid of having an erection in front of your gay friend.
This sounds like a challenge, something that casts a shadow on such a brave male pilot. Something that makes him vulnerable and unmanly.
Alex is flustered:
- Do you think I’m afraid of homosexuals?
T: Not necessarily, but I want to clarify.
A: There was no erection, relax.
Here we see how the patient holds the situation in his hands, and even when cornered, he can stop and redirect the conversation.
A: But I remember everything until I lost consciousness. "Losing consciousness" is a strange phrase!
T: Why is it strange?
A: My father measured everything in terms of losses and gains. That’s his style.
T: And is this loss of consciousness somehow connected to your father’s manner? Am I right?
Here, the therapist tries to steer the patient toward Alex’s relationship with his father, offering this interpretation. But Alex isn’t ready yet. It’s too soon.
A: Stop. Let’s not rush into discussing parent-child relationships.
T: Too soon?
A: I know it’s too soon!
The therapist feels anger and irritation (perhaps this is countertransference), so the following dialogue takes place:
T: Are you testing me?
A: Yes. I have to test you. I’m paying you.
T: You started testing me the moment you crossed the threshold. It’s important to you that I meet certain criteria.
A: And what’s wrong with that? You’re a stranger. I won’t open up until I understand I can trust you. I’m paying you good money. And it takes me an hour and a half to get here.
These remarks seem to accuse the therapist. As if it’s his fault for Alex’s inconveniences. The therapist is clearly angry and nervous, as he starts fidgeting with his fingers.
T: How will you know if I’m good enough for you?
A: I’ll know by your opinion.
T: About what?
Alex begins to describe how he was frozen in a chamber for 48 hours. The therapist tries to bring him back to the previous question, but Alex stops him again, saying that the therapist is impatient and should listen to him instead. He drags out the conversation with irrelevant details, as if deliberately showing who is in control and who is dependent. Eventually, the therapist gives in and follows the client.
T: Tell me about those 48 hours.
A: I felt fatigue, deadly fatigue and exhaustion, but I also felt relief when I returned to the real world.
T: Did that depend on you?
A: What’s the point?
T: I’m talking about your desire to live. And you tried so hard, but others were disappointed.
A: Yes. After all, I never spent a single day in the hospital.
T: Then perhaps you’re not angry at those who asked about the tunnel, but at yourself and your body, which betrayed you. It shouldn’t have happened to someone like you!
Alex then recalls his older brother’s words, who had a theory that God rewards talented athletes fully: they are both beautiful and successful. That’s evolution.
T: What about football?
A: That’s not my game!
It’s strange why the therapist asks about this sport. During my interview, I also got the impression that these two are playing football))) Someone passes the ball, someone doesn’t give it up and runs toward the goal line.
A: You’re talking to a person whose life has always been perfect. It’s not our choice — life itself has determined that we must be the best.
T: And what does that mean?
A: It means that you’re born understanding that you’re talented because you can’t just become an ace pilot. It’s not for the weak!
T confronts: So if you don’t achieve your maximum, you’re dissatisfied?
A: No, that’s not it.
A pause. The topic changes. Perhaps this topic has hit a resistance point for the patient.
A: I want to know your opinion: I decided to go there. But my friend said I should see a psychologist first.
T: Is it dangerous?
A: No. My wife didn’t even recognize me in that photo. I came to you for a consultation.
T: So you came so I’d tell you that returning to the bombing site is a good idea?
A: Yes.
T: Do you want me to be responsible for this decision?
A: No, don’t think I’m shirking responsibility.
Here, the therapist allows himself to interpret this dialogue:
T: But "life itself" has determined that you must be a pilot. Perhaps this approach suits you because it relieves you of responsibility. The decision is made by the commander; you only follow orders.
And immediately, Alex counters the therapist, belittling his words about payment:
A: Stop. Are you saying you want me to see you as my commander? Fine. Are you ready to be my commander for $150 an hour?
T: I’m afraid I’m not qualified enough for that. Maybe you should be your own commander?
A: Oh no. And you still consider yourself the best.
T: I’m not the best. Perhaps, Alex, you are the best, but I’m not.
The therapist dodges the blow. He allows himself to be weak while remaining calm. He shows that it’s possible — to not be the best.
The therapist asks one more question and moves on to the final interpretation of the problem.
T: When you ran 35 km, how long did it take?
A: 3 hours.
T: Doesn’t it seem strange to you that right after the mission, you take a vacation and, against your friend’s advice, push yourself to the limit? And this heart attack of yours is like a desire to punish yourself for what you’ve done.
Alex asks for coffee.
T: Our time is up.
A: But I haven’t discussed everything.
T: I’d be happy to see you again.
Alex stands up and carelessly throws money on the table.
A: Won’t you wish me luck?
T: Yes. Good luck, Alex.
In the final scene of the interview, the patient seeks attention and care from the therapist. Perhaps this is a projection onto his father. The disappointment that the therapist ended the session without listening as much as Alex needed, and as a reaction — the humiliating act of throwing money on the therapist’s table. All that a narcissistically wounded patient can do is choose an ideal therapist and devalue him. But for Alex, this isn’t just a therapist; it’s more likely a projection of his father. And then the unresolved Oedipal conflict comes to the surface. He fears his father’s anger but at the same time wants to destroy him. The fear of castration even manifests in the scene with the heart attack: an erection would have meant death.
