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Hunting for good therapy.

Here's a trivia question for you: Who's the only actor to ever receive an Oscar for playing a psychotherapist? If you said Robin Williams, you're right. He was awarded Best Supporting Actor honors in 1998 for his role in "Good Will Hunting" as Sean Maguire, a psychotherapist who teaches clinical psychology at a second-tier Boston college. As a favor to an old friend, a math professor at MIT, Maguire agrees to treat the impossibly defensive math genius and world-class smart-ass, Will Hunting.

Hunting (Matt Damon), aged 20, works as a janitor in the math building at MIT. He surreptitiously solves nearly impossible math problems left up on blackboards to challenge students in an advanced class taught by Fields Medal-winning professor Gerald Lambeau (Stellan Skarsgard). Prof. Lambeau finally catches Hunting in the act one day and tries unsuccessfully to engage the young man.

Hunting for Trouble

Hunting has had a rough life: Orphaned early, he passed through several foster homes where he was badly abused physically. In adolescence he has accumulated an impressive arrest record for multiple assaults, grand theft auto, and impersonating a police officer, among other raps. He has stayed out of jail by defending himself in court, where he displays a withering command of pertinent case law (he has an eidetic memory). His janitor's job was arranged by his probation officer.

Hunting grew up in the rough and tumble Irish area of south Boston known as Southy. For fun, he cruises with his buddies (who include characters played by the Affleck brothers, Ben and Casey), drinking beer, hitting on girls, and picking fights. One night at a bar in Cambridge he meets Skylar (Minnie Driver), a trust-fund child who attends Harvard and will soon head for medical school in California. They click. But soon, after a street brawl with his buddies, Will is once again arrested and given a 6-month jail sentence by a judge who brushes aside Hunting's jailhouse lawyer defense.

Prof. Lambeau intercedes, convincing the judge to suspend the sentence if Hunting will agree to take part in a math tutorial and psychotherapy. As the tutorial moves along, it becomes clear that Hunting is a once-in-a-generation genius of Einsteinian dimension who can solve problems better than anyone on the MIT faculty, including Lambeau. But as a therapy patient, he's the worst case in memory. Lambeau shops Will to five therapists he knows (one cameo is played by George Plimpton), but Will on every occasion presents himself as outrageous, insolent, and untreatable. Finally Lambeau turns to his old chum from school days, Maguire, who agrees to see Hunting, and the film's real adventures begin.

Maverick Psychotherapy

The adventures I refer to occur in the process of psychotherapy encounters between Maguire and Hunting. Make no mistake, Maguire is not a traditional therapist. He may understand and use psychodynamics, but he eschews the indirect methods of psychoanalysis in his work. He's one of the newer wave of therapists who believe in more active engagement with their patients, the sort of "encounter" or existential approach that has been in vogue for years in the treatment of people with substance abuse problems, among other conditions.

Maguire's conduct can cross conventional ethical boundaries. The key instance occurs in the very first session, when Will tries to deflect attention away from his own problems by presumptuously suggesting that Maguire had probably been unlucky in choosing the wrong woman to love. As it happens, Maguire is still deeply mired in unresolved grief after the death of his beloved wife from cancer several years earlier. He flares angrily at Hunting, grabs him by the throat, and tells him that if he ever again disrespects his wife, "I will end you." This is transgressive, unacceptable behavior for a therapist by any standard. But dramatically it works, it helps hook Hunting's interest and brings him back for a second session.

At the second meeting, Maguire tells Will that for all his smugness and book learning, he is just a "cocky, scared shitless kid" who has "never dared to love anyone more than yourself ... I can't learn anything from you I can't read in some f--king book, unless you talk about yourself. So it's your move." An awfully daring confrontation, we would all agree. An impasse follows, when Hunting refuses to reveal anything about himself and Maguire waits silently for this to change. Whole sessions pass in silence. Yet Will keeps showing up for appointments (in part he knows he must, of course, to avoid jail), and finally he does begin to talk.

There are scenes from several more sessions at various times over the next few months. Maguire often didactically expresses his views of Will's central problems and issues, especially his fears of intimacy and other direct experience of the world. He also permits Will to question him about his own life experiences, and shares personal information quite freely. There are several wonderful exchanges. Near the end, Will notices one day that Maguire has been reviewing his (Hunting's) old social case file, including photos of wounds inflicted on Will by foster fathers. Maguire then says, over and over, to Will, "It's not your fault ... It's not your fault ... It's not your fault ..." They end in a mutual hug as Will breaks down in tears. This feels like real stuff.

Will Faces Huge Choices

Interspersed with therapy scenes are others depicting the deepening of Will's romance with Skylar. She loves him and wants him to go to California with her. He gets scared and balks. She goes west alone. Prof. Lambeau pushes Will to accept a career in math. Will's closest buddy Chuck-ie (Ben Affleck's character), in one moving scene, also urges Will to go on in math and emancipate himself from their mutual dead-end life. Maguire champions Will's right not to pursue math if he chooses, which frustrates Prof. Lambeau. (Another seeming ethical transgression here is that Maguire and Lambeau meet regularly to discuss Will's progress in therapy. Has Will consented to this? It isn't clear that he's even aware of these discussions.)

In Will's final meeting with Maguire (the court had ordered therapy only until Will's 21st birthday, which has now occurred), we learn that Maguire is going to take a leave of absence and travel, do some writing, move on with his life. He tells Will that he's "... gonna put my money back on the table and see what cards I get." Meaning that he feels ready to open himself once more to the possibility of loving someone new again. At the end, Will also makes a choice: between Skylar and a math career, between his heart and his head.

Is This Good Therapy?

Glen and Krin Gabbard, in the 2nd edition of their classic book, "Psychiatry and the Cinema" (Arlington, Va.: American Psychiatric Publishing Inc., 1999), call the treatment depicted in "Good Will Hunting" "... pure Hollywood fiction." They disparage Will's "cure" as based too much on identification with the therapist (Maguire and Hunting do share much in common: They're both Irish, both from Southy, and both were physically abused as kids). The Gabbards further criticize the apparent "confusion of roles," in the therapy relationship; i.e., Maguire sometimes seems to be the patient insofar as he talks so much about himself and his marriage, and his encounters with Will clearly appear to aid his movement out of the quagmire of his grief toward personal renewal. Nevertheless, I think the Gabbards' stance is too harsh and overly generalized.

Granted, the egregious instance in the first session, when Maguire physically threatens Will, surely is "Hollywood fiction." But overall, I suggest that only a direct, self-disclosing treatment approach is likely to engage a young man with Hunting's history and psychopathology, an approach advocated for many patients by Irvin Yalom in his recent book, "The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients" (New York, HarperCollins, 2002). Particularly with individuals like Hunting, who have personality disorders marked by acting out, arrogance, and the inability to trust others, traditional therapy often fails while the newer, more vigorously engaging methods may work.

Most of what Maguire does in the sessions, far from being Hollywood fiction, can be seen anywhere in the country in the confrontive "tough love" therapies of addictions and prison- or parole-based treatment programs. Maguire is not only tough, he is honest, warm, empathetic, reliable, persistent, caring--attributes one hopes for in any therapist. With regard to identification as a basis for cure, Jerome Frank showed years ago that most successful analysands tend to describe their gains in terms of their analysts' particular "school."

As for the issue of Maguire experiencing change as a consequence of his work with Will, this too is probably more common and less pathologic than the Gabbards imply. One might say that if a therapist is truly open to a patient, not overly fortified by his or her own defenses and doctrines, then the therapeutic enterprise in theory should always hold the possibility of change in both parties. What is the working out of the therapist's countertransference problems if not a change of this nature?

The acting is superb all around in this film, especially the turns of Williams, Damon, and Ben Affleck. The photography, music and Gus Van Sant's direction are excellent. The screenplay, written jointly by long time friends Damon and Ben Affleck, is brilliant. Few films focus on the therapy relationship as a central drama or subtext of the story, and fewer still portray therapy with such moving, heartfelt effect as is realized here. "Good Will Hunting" thus joins "The Three Faces of Eve," "I Never Promised You a Rose Garden," and "Ordinary People" among the very best such films ever made.

DR. ATKINSON is a professor of psychiatry at Oregon Health and Science University, Portland. For more reviews, visit his Web sites at www.AtkinsonOnFilm.com and www.Psychflix.com. Share your thoughts with Dr. Atkinson by writing him at cpnews@elsevier.com.

BY ROLAND ATKINSON, M.D.
COPYRIGHT 2005 International Medical News Group
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Title Annotation:psychotherapy
Author:Atkinson, Roland
Publication:Clinical Psychiatry News
Geographic Code:1USA
Date:Sep 1, 2005
Words:1665
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