Elliot Did Nothing Wrong

Elliot did nothing wrong. He is hated not because he deserves it, but because he is an obstacle to Dr. Melfi's sessions with Tony Soprano. An unwanted nagging reminder that her treatment of a violent mob boss is an unhealthy compulsion that is hurting her personally and professionally.

At the end of the first season Dr. Melfi was forced to go into hiding because mob hitmen wanted to kill her. She almost died. And the the disruption to her practice may have contributed to the death of one of her patients.

Dr. Melfi starts drinking between sessions on the days that she sees Tony Soprano. She and her son are kicked out of a restaurant when she drunkenly confronts a woman smoking a cigarette. Her drinking problem is only in one episode. Maybe she nipped it in the bud, but even if it only lasted two weeks, it was enough to cause serious harm to her practice and her family.

Dr. Melfi is under no ethical obligation to treat Tony Soprano. Her family does not want her to treat a dangerous mobster, her therapist does not want her to treat a dangerous mobster, and in the immediate aftermath of going on the run from hitmen the harms of treating Tony Soprano were so overwhelming that she rejects him as a patient. She does it for the thrill of it. More precisely, she has a compulsive desire to treat a mob boss not despite the danger involved but because of it.

At the end of the series, Elliot shares in a session that a recent study found that not only is talk therapy useless with criminals, it actually helps them become better con-men. They sharpen their skills on their therapists, and the re-conviction rates for criminals in therapy is higher than those who have no therapy at all. Dr. Melfi has no reaction at first. But later at a dinner party the study is brought up again by a colleague. She deflects: "studies turn around every few years." Then she accuses Elliot of putting her coworker up to this, causing confusion and embarrassment. It's not until Elliot revels the identity of her patient does she finally read the study and see the light. The scene cuts between clips of the study: The criminal ... uses insight ... to justify heinous acts.

After everything she went through this is finally what gets her to stop treating Tony Soprano.

Many fans will decry Elliot as "unprofessional" here. I'm not a therapist, I have no idea what the real world consequences for Elliot's actions are, but considering the circumstances I doubt it would be anything more than a reprimand. Our sympathy should be firstly with Elliot. Tony Soprano is no ordinary patient, he is a dangerous criminal who has thrown his friend and colleagues life into chaos. Elliot may have been unprofessional, but Dr. Melfi was the first to act unprofessionally at the dinner, making accusations about Elliot that would be difficult to understand without the knowledge that she was treating a mob boss.

Why the opposition to Elliot? He could be unnecessarily smug about things, but that's not it. It's the same reason that Skyler White was hated by some breaking bad fans: even though we can rationally know that Dr. Melfi should not treat Tony Soprano, we want it to happen anyways because as the viewer we participate in the vicarious thrill of treating a mobster. His very presence is an impediment to the plot of the show, an obstacle that creates a dissonance that Dr. Melfi needs to overcome.