Here's What Real Life Psychotherapists Think of Tony Soprano's Shrink

But what do real life psychotherapists think about how she handled treating a mob boss?

Well, Glen O. Gabbard, a psychiatrist and clinical professor at Baylor College of Medicine in Houston, Texas, wrote a book called The Psychology of The Sopranos and says Dr Melfi is actually pretty damn good at treating Tony.

Gabbard described Tony as probably "the most difficult patient" you could treat. He's diagnosed with APD (antisocial personality disorder), making him pretty much devoid of empathy, guilt or any sense of responsibility.

There is no cure for this condition – just treatment options.

Of course, the constant elephant in the room was that, despite his self-proclaimed role in waste management, everybody in New Jersey (including Dr Melfi) knew he was a mob boss. So, everything she said in that room would have been laced with a slight sense of dread.

This issue was further complicated by the fact she would have been legally obliged to report anything that might put people at risk of harm.

With such limitations on the kind of open and honest conversations therapists are expected to have with their patients, Gabbard says, any sort of improvement would be considered an "extraordinary success".

The fact that Tony does see some sort of improvement then. His panic attacks become less frequent – and as early as season 1 episode 9, he proudly informs Carmella "I didn't hurt nobody" when he returns home drunk.

Dr Melfi also helps him understand his fractious relationship with his mother and how that impacts the way he is attracted to women who remind him of her.

As Gabbard says, Melfi allowed Tony to "grow in self-understanding" and get a "better sense of who he was". And isn't that kind of basis of psychoanalysis?

But she also shows him that not everybody will give in to his will. Whether it's losing his rag or trying to seduce her, Tony always fails to manipulate Dr Melfi in the way that he has always had such power over what people do and say around him.

Her calmness in such a scenario is something to be applauded. But she also acknowledges that treating Tony does affect her. And she deals with this in her own therapy sessions.

This is a positive professional step that allows her to continue treating him and helping him overcome at least some of the hurdles he faces.

But perhaps the biggest reason Dr Melfi gets a thumbs up from Gabbard is simply that she agrees to see him in the first place. Given all the risks associated with such a patient, most psychotherapists, it seems, would run a mile.