Excellent, award winning and memorable HBO drama series are almost too numerous to count.  The network has a knack for putting out well-written programs with novel concepts – the only formula seems to be quality.  Among the lesser known and certainly less appreciated dramas they released during the last ten years is In Treatment, a show with a both a unique concept and an unusual format.

Based on an Israeli television series BeTipul, it revolves around psychologist Dr. Paul Weston, portrayed by Gabriel Byrne, and his practice.  Each episode, under 30 minutes in length, is structured as an individual session at an appointed time.  The program was broadcast five days a week, with every day dedicated to a recurring patient or patients.  Friday marks a change of pace, with Paul seeing his supervisor and old friend Gina (Diane Wiest) for his own therapy sessions.  The 43 episode first season covers 9 consecutive weeks in total.

In Treatment is a dramatized but nonetheless fairly realistic look at the therapeutic process, and a variety of psychological issues are explored across his regular clients.  The work happening in his office is often difficult, disturbing and challenging for both parties.  Meanwhile, Paul’s personal space is fraught with its own conflicts and emotional entanglements, some of which have resulted from his professional life intruding on his home life.  At times he questions how much help he is being to his patients, and what toll his deep commitment to caring for them is costing him.

Most of the “action” throughout In Treatment is taking place in the room, or adjacent to it, probably a symbolic representation of Paul’s complete absorption with what he does for a living.  Though nominally set in Baltimore, you get a sense this premise could work anywhere, and the people in each session are merely a cross section of a typical psychologist’s week.  What helps sell this is the brilliant writing and the amazing performances that come from each and every cast member.

Melissa George is hypnotic as Laura, Paul’s long-term Monday morning patient with erotic fixation issues.  Her professed love for Paul appears at first glance to be a stock case of transference in a counselling setting, but a deeper relationship is in fact on offer.  Tuesday’s focus is Alex (Blair Underwood), a fighter pilot grounded after struggling to deal with the emotional consequence of killing innocents on a bombing mission in Iraq.  His relentless perfectionism, owing to his upbringing, and a strong desire for control see that he resists Paul at every turn.

On Wednesdays Paul sees Sophie (Mia Wasikowska), a gifted gymnast who struggles with abandonment issues and a tendency to blame herself for the failures of the relationships of adults and caregivers in her life.  Her distress may have pushed her to a suicide attempt and there is concern she might make another.  Jake and Amy (Josh Charles and Embeth Davidtz), their complicated marriage in considerable strife, attend couples counselling with Paul on Thursdays.  Seemingly polar opposites, their disagreements over trust, children and life priorities have them wondering if they have any future together beyond causing each other harm.

Friday’s sessions, in addition to primarily being personal therapy for Paul himself (something he has returned to after years without any contact with Gina) serve as somewhat of a recap for the viewer, as he frequently discusses current patients in a supervisory context.  Progress, or his frustrations with lack of progress in his job are an ongoing subject, in particular his complicated relationship with Laura.  Paul’s history with Gina and their shared circles of friends and professional acquaintances are a source of tension and conflict between the two.

Gabriel Byrne’s performance as Dr. Paul Weston is enthralling, and centrally important to the success and believability of In Treatment.  One never doubts how much he cares for his patients, even when he doubts his own abilities.  Diane Wiest manages to portray both the perfect foil for Paul and a sympathetic ear with equally convincing measure.  Michelle Forbes, as Paul’s long-suffering (if not blameless) wife is notable in a recurring supporting role, every bit as strong in character as her husband.  I had personally not encountered Mia Wasikowska prior to her appearance as Sophie and will not soon forget the brilliant depth of her work here.  The relationship between Sophie and Dr. Weston is heart-warming and in my opinion, the  highlight for Season One.

It would be very difficult to mention much specific about Seasons Two or Three of In Treatment without getting into rather serious spoilers.  Suffice to say both involve a new cast of patients on each weekday and a change of locale.  Both are significantly shorter in terms of episode count, though the quality of writing and acting never falters.  In spite of a good critical reaction and several significant awards and nominations, In Treatment never found a particularly large or loyal audience; it remains tragically overlooked to this day.  In recommending it, I must admit that it feels cut short and ends in an unresolved manner that not everyone will be able to get past.  If you can overlook the nature of its conclusion and want to give it a try, box sets aren’t hard to find on eBay or Amazon and HBO streaming services also carry it in multiple countries.  There are definitely worse ways to spend your time on the couch.