Because psychotherapists rarely see each other work with patients, however, there is no firm consensus about what constitutes a good session with a particular person. Hence, they may have dramatically different opinions on depictions of psychotherapy in a television series. One reason, though, that the psychotherapy in The Sopranos is so fascinating is that the writers make no attempt to idealize Dr. Melfi as an oracular source of truth. They have wisely chosen to show her 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 and are especially engaging to viewers on both sides of the couch.
The Sopranos also departs from the positive cinematic depiction of psychotherapists. In a brief golden age of psychotherapy and psychoanalysis in the cinema between 1957 and 1963, idealized portrayals of dramatic healing misrepresented psychotherapy as badly as the negative portrayals. Think of Simon Oakland's brilliant psychodynamic formulation of Norman Bates in Psycho (1960) or Lee J. Cobb's magnificent cure of Joanne Woodward in The Three Faces of Eve (1957). In the former, the psychiatrist explains all of Norman's psychopathology and even the location of the missing money after a couple of forensic interviews. In the latter, the therapist integrates the disparate aspects of his patient's multiple personality by hypnotizing her and encouraging her to recall a single traumatic memory from her childhood. With The Sopranos, it is refreshing to see a therapist who is neither devalued as contemptible and incompetent nor raised to a transcendent level of expertise.
Even though The Sopranos is about many other aspects of Tony Soprano's life, the psychotherapeutic relationship between Tony and Dr. Melfi is at its heart. Creator David Chase noted that the therapy session was the germ of his idea for the series. Everything grew from that central image. He has acknowledged in an interview that the sessions with Dr. Melfi reflect his own experience with the woman therapist he saw. He also said he was helped by three or four male therapists before he found her. He insisted on a high degree of realism: "It was very important to me to let the silences play that really happen in a psychiatrist's office."