Rewatching the Sopranos S1 E13 "I Dream of Jeanne Cusamano"

I am waiting (38 minutes so far) on the phone, on hold with SSA and decided to do what I always do when I'm bored, which is to read my old blogs.  I haven't written anything recently because I've been drowning in school stuff, and when I'm not doing that I'm catching up on everyone else's needs that have gone neglected while I was doing school stuff. Summer has been slightly less demanding so I can read and watch tv again. 

I spent 56 minutes on hold waiting to talk to these idiots for someone to tell me I can't make an appointment for what I need and have to WALK IN. 

FML.

Family Events: Livia shows up at Tony's house not oriented in reality and yells at Meadow and a police officer. After she is transferred to the nursing unit at Green Grove for Alzheimer's care, she upsets visitor Artie Bucco by suggesting Tony was the one who set fire to the old Vesuvio. Artie shows up at Satriale's and threatens Tony with a rifle. Tony manages to talk him down; Artie responds by bashing his rifle apart and driving off.

Tony goes to confront Livia at Green Grove where he is informed she has had a stroke. As Livia is wheeled away in a gurney she smiles as Tony threatens her. Tony takes the family to Vesuvio in the middle of a terrible storm and toasts them, telling them to remember the little moments that were good. 

Mafia Events: Junior gives permission for Tony's crew to whack Jimmy; Christopher lures Jimmy to a hotel where Silvio kills him. His body is later recovered outside a dumpster with a rat stuffed in his mouth. Tony later meets with the feds where they play him recordings of Livia and Junior discussing Livia's anger at being forced to live at Green Grove, Tony's depression and psychiatric treatment, and Tony's crew using Green Grove for cover. Tony informs his crew that Junior and Mikey were the ones who arranged to have him killed. Tony kills Junior's assassin; Silvio helps him take care of the body. Paulie and Christopher come upon Mikey during his morning run, chase him through the forest, and kill him. Junior, Larry-Boy Barise, Joe Sasso, and 13 others get arrested for federal racketeering. Under examination with a federal agent, Junior refuses to cut a deal to save himself, scoffing at the idea that Tony is the actual boss of the family. 

Tony comes clean to his crew about seeing a psychiatrist, Silvio and Paulie are supportive, Christopher appears confused and upset about it. Later Paulie admits to Silvio that he can't get past Tony choosing a woman psychiatrist.

Mental Health Events: Melfi challenges Tony's reluctance to consider Livia's responsibility for the attack on his life, referencing the sudden memory loss and his subconscious creation of Isabella. Tony is incredulous."What are you saying, that my own mother tried to have me whacked for putting her in a nursing home?" Melfi explains that usually patients are encouraged to make their own breakthroughs in therapy, but that she is willing to help him through to some conclusions because his life is in danger. As Tony becomes increasingly physically agitated, Melfi goes on to suggest that Livia may have borderline personality disorder, reading diagnostic criteria from the DSM 4. Tony reacts by charging Melfi, flipping the glass top off the coffee table, shattering it, and threatening her. He shows up to his next session, admits Melfi was right about his mother, and tells her she needs to leave town. 

Religious Events:

Father Phil happens upon Carmela and Rosalie Aprile at Vesuvio; Carmela is disturbed to discover that Rosalie has given him Jackie's expensive watch. Later Carmela shows up at church with dinner for Father Phil and sees him eating with Rosalie so she dumps her own pasta into the garbage. Carmela is bothered by Father Phil's familiarity in showing up at her home and using her video store account, eventually confronting him for his hypocrisy when he questions Tony's faith and actions. Carmela suggests that instead of criticizing Tony, he look at his own manipulation. 

Father Phil also seems to be making a play to encourage Artie Bucco to report Tony's possible involvement with the restaurant fire and appears to be disappointed when Artie declines to take his advice. 

Significant Ideology

They took a little bit of a liberty in stretching out the borderline personality disorder (BPD) diagnostic criteria, probably to fit the version of Livia they'd already spent so much time laying out, but saying flat out that sufferers of BPD aren't able to form interpersonal relationships at all and that their internal phobias are all that matter to them is very negative and in many cases, off the mark. For Livia, (who Melfi is not treating so she has really no business diagnosing), these descriptions sound accurate, at least at first, but to qualify for BPD one needs at least five out of nine criteria, and Livia has formed and continues to form interpersonal relationships outside her immediate family, and her internal phobias (driving, being abandoned) aren't really phobias but relevant concerns as she recently had a car accident, injuring a friend, and was literally placed in a nursing home! If anything, Livia might qualify for histrionic personality disorder, dependent personality disorder, or maybe even an unspecified one before borderline, but whatever. She might not even be out of the ballpark for antisocial personality disorder, considering how easily she arranged her own son's assassination and her strange smile at Tony after her "stroke," but that's a kind of a reach. 

Whatever diagnosis ends up fitting best, Livia's mental health continues to be an important factor in this story. That said, any practitioner should have been able to clearly read Tony's escalating body language and anxiety cues as these descriptions were applied to Livia, thus avoiding the table flip and physical threat. Tony's inability to consider this information cognitively (your mother arranged to have you killed and is now faking dementia to get out of it) and uncontrolled physical anger suggests that despite several months of therapy, he cannot process unpleasant information through his executive functioning, only by reacting with his body. Coupling this (Tony still has so much work to do) with the scene of him in Melfi's abandoned office after she has left is a very serious situation. He is literally in the dark without her.

Some of the most emotional moments in this episode come in reactions: 

Agent Harris's reaction to his boss dangling the tape of Livia and Junior in front of Tony---he knows what's on the recordings and he knows what hearing them will do to Tony . . . (suggesting Harris, while still committed to doing his job as a federal agent, has grown to like Tony, or at the least, empathizes with him learning his mother and uncle have conspired against him).

Tony's reaction to hearing what he hears on the tape, hurt, anger, then immediate regrouped control as he nods to the fed that he wants to hear more . . .  He just finished losing control with Melfi and perhaps felt bad about it afterward but manages to keep his cool with the feds. In a way, Melfi's warning prepared Tony. Having that information prompt such a violent response with her proves that it bothered him, likely because he found it plausible, painful as it is. Melfi being a woman might be a factor; her proximity to Carmela and Livia or women in general would have been accepted as trustworthy---who knows an Italian woman better than another Italian woman?---but also perhaps emasculating. Tony can't escape the news Melfi gives him by any sort of strategic business or mafia means so he rages, physically and threatens her; when the feds confirm Melfi's theory, he has no choice but to play it cool and plan his retaliation, faced with the realization that Melfi saw it coming and was taking a risk in telling him the truth. His showing up at her office afterward suggests he might be looking for absolution.

Carmela's response to hearing the news about Livia: "I could kill her . . . with THESE HANDS!" and later, "This wasn't you. It was HER." Yet putting on a completely believable pleasant act when Livia and Junior come for dinner. Tony may be the one in therapy but Carmela seems to be learning a lot about boundaries (Father Phil), emotional regulation, and strategizing. 

When Tony explains to Carmela that cunnilingus and psychiatry brought them to this, he connected the issues with Junior and the mafia at large to what Silvio earlier said to the crew about needing therapy. "It'd be better to admit to ourselves that these are painful, stressful times." He looks around to see no one willing to agree with him and then says, "But it'll never fucking happen." These men are in a business that requires them to commit many unpleasant, upsetting acts but does not allow them to have or express feelings about their actions. Tony's case is unique among the crew: he seems to have made peace with the lifestyle but does not understand why his mother treats him as she does.