Extract from an article in issue 3, May 26, 2008 of The Jerusalem Report. To subscribe to The Jerusalem Report click here. A realistic depiction of the therapist-patient relationship may help explain the dizzying success of the HBO TV program "In Treatment" as well as the Israeli series on which it is based It has none of the visual staples of the TV medium - no car chases, exotic locations or comedy of any kind. It takes place in a single room and most of the action consists of two people talking to each other. And what they talk about does not make for lighthearted escapism. And yet, "In Treatment," the American version of an Israeli series about a troubled psychotherapist and his patients, has been a hit in terms of both viewer ratings - 2.5 million per episode - and critical comment. No one is more surprised by the success of the HBO series than Hagai Levi, the creator of the Israeli series, "B'Tipul," on which it is based. But he was also surprised by its popularity in Israel: "When I put together the pilot for 'B'Tipul,' I thought I was doing a small niche program for cable TV that would only interest people in my milieu, a little bit of highbrow fare for my friends," recalls Levi. Even after "B'Tipul" became one of the most widely-discussed programs in Israel, Levi doubted that it would attract international interest. "I thought maybe a station in Europe would go for it; the U.S. never occurred to me." But after HBO producers saw a few episodes of "B'Tipul" in late 2006, they were sold on the idea. "I thought it was the best thing I had seen on TV since 'I Claudius,'" says Rodrigo Garcia, a director of "The Sopranos" and other hit U.S. TV series, who became an executive producer and writer-director of "In Treatment." And since the 9-week series began airing five nights a week last January, U.S. reviews have exceeded the praise that "B'Tipul" earned in Israel, where the daily Yediot Aharonot described the series as having "the most suberb, refined dialogues ever to be seen on an Israeli screen." The Chicago Sun-Times described the series as "exhilarating," the Los Angeles Times said it achieved "theatrical transcendence" and the Wall Street Journal wrote that "its capacity to maintain an unyielding grip on your attention becomes similarly evident fast, as does one's strong sense that that grip isn't going to weaken anytime soon." The series has a five-night-a-week modular format: The therapist sees patients for four nights, and on the fifth evening he goes to his own therapist. The patients are a young woman doctor infatuated with the therapist, an arrogant fighter pilot who's fending off the guilt of a bombing mission gone wrong, a teen gymnast who may or may have not attempted suicide, and a couple at odds about having another child. When HBO started to work on the American series, the producers chose to stick closely to the Israeli text. "It was simply a masterpiece of writing that shows an understanding of the process of therapy and a deep sense of the character of the therapist who is a good therapist but a flawed human being," executive producer Rodrigo Garcia told The Report in a phone interview from New York. Garcia, who is the son of Nobel prize-winning novelist Gabriel Garcia Marquez , adds: "In the end I would say that the American version was ninety percent the same as the Israeli one." HBO worked closely with Levi, who served as a co-executive producer. As the series progressed, the American writers also began to imitate the Israeli production strategy of rewriting scripts according to the dynamics that developed among the actors who, in addition to the 57-year-old Irish-born Gabriel Byrne ("Usual Suspects") as psychotherapist Paul Westwood, includes stars such as two-time Oscar winner Dianne Wiest as his mentor, Embeth Davidtz ("Schindler's List") and Josh Charles ("Sports Night") as the embattled couple, Melissa George ("30 Days of Night") as the young doctor, and Blair Underwood ("L.A. Law") as the pilot. "We began to add more of our perspective and our interpretation of the characters," says Garcia. Picking the cast was also a top priority for the Israeli version. "There are very few actors that you can watch with interest for half an hour and that have a magnetic pull that makes you want to watch more and more of them," says Levi. For the first season he came up with top stars, including a world-weary, weather-beaten Asi Dayan ("Life According to Agfa," "Mr. Baum") as the therapist, the grande dame of Israeli stage and screen Gila Almagor (who has starred in more than 40 movies) as the therapist-mentor, Lior Ashkenazi ("Walk on Water," "Late Marriage") as the pilot, and Ayelet Zurer (who has appeared in several U.S. films, including "Munich" and "Vantage Point") as Na'ama, the woman doctor. "Having a role in the series was a real gift for the actors," says Zurer, who feels that the series gave the actors a rare opportunity to develop a character in such depth, but also posed a challenge. "Some of the takes were 20 minutes long and you had nowhere to run away. But it was amazing how many emotions could arise between two people," she told The Report in a phone interview from her Los Angeles home. Zurer notes that the way the writers revised the scripts from one week to the next also added to the edge of the actors' performances. "I knew the general direction of the script, but in a way I actually didn't want to know where it was going because what Na'ama said on the day she came for treatment was the truth of what she was feeling on that day," says Zurer, suggesting that this allowed her to fully concentrate on being in the moment of each episode "It didn't matter what would happen next." After Levi directed two pilot segments for "B'Tipul" using his own money, it took him nearly two years to convince an Israeli cable channel to take a chance on it. As the series went into script development, Levi recruited therapist Roni Baht, a clinical psychologist and lecturer at Tel Aviv University, as a professional adviser to the series. "At the start of the project, Hagai seemed to have in mind a drama that is driven by the personality of a therapist who is confrontational and a little bit provocative," recalls Baht. "My suggestion was to create situations based on the psychological principle of transference, which would focus the drama on the moments when the past shapes the present. The most significant moments are not when the patient tells the therapist about getting mad at someone like his father in the past, but when the patient actually gets mad at the therapist in the room," explains Baht. Like Baht in his own practice, the therapist in the series is strongly influenced by the relational psychology approach, which differs from the classical Freudian model. "In the traditional model, the therapist is supposed to be a blank screen onto which the patient projects his or her history. The therapist remains neutral and ends up telling you who you are and doesn't bring his or her personality into the interaction," explains Baht. Relational psychology (or relational psychoanalysis) is a more democratic approach in which the therapist is on the same level as the client and recognizes that he brings his or her own feelings to the situation. "It's not that I, the therapist, know the real story; it's more like you and I are going to work on it together," says Baht. "It's a post-modernist approach in which there is no truth, we simply build a narrative together." Baht notes that the relational approach is gaining ground in Israel because it suits the national character. "Israelis tend to be culturally non-hierarchic. People tend to call doctors by their first name and even in the army, the gap between officers and regular soldiers is not that wide. Relational psychology has been more warmly embraced here than in countries like France or England," he notes. Baht's main role in the series was to give the writers feedback on their ideas but often he, too, suggested ideas. "I used to be a jazz musician and in meetings with them I often felt like we were improvising by free association," he recalls. It was Baht who introduced the writers to a controversial scientific paper called "Love in the Afternoon." In the article, author Jody Davies, an American therapist, describes a session with a patient who asks her if she was flirting with him. She responds by acknowledging that he was right. The author contends that her admission to him (of what psychoanalysts would call erotic countertransference) turned out to be an integral part of the therapy. This article became the inspiration for the conflict created when the young woman doctor in the series professes to be in love with the therapist. Vulnerable in part because of his own marital crisis, the therapist finds himself grappling with his feelings towards her. The dialogue between the two of them is often quite ambiguous, such as in a scene when the therapist sits beside her on the couch and says, "Do you want something to happen between us?" and it is not clear if he is trying to seduce her or simply asking about what is going on with her. Extract from an article in issue 3, May 26, 2008 of The Jerusalem Report. To subscribe to The Jerusalem Report click here.