Why Dr Melfi Stopped Seeing Tony

The more important part of The Sopranos ending

Jacky Tang
5 min readNov 25, 2022
Photo by Heather Wilde on Unsplash

Dr Melfi has always stuck to her guns with Tony, believing she can understand him and help him change. She always kept her doors open to Tony despite his unsolicited advances and her potential danger. Even when she was told about that paper, she resisted. She didn’t want to believe her practice was being used, she was being used, to justify Tony’s behavior and even possibly encourage it. At first, it seems like the answer is straightforward. Dr Melfi reads the paper and realizes that she is wrong. Tony cannot change. There is nothing good about him after all. So she ends things with him.

But that would be cutting The Sopranos short.

I only watched the show in this year (2022) after learning that it was the stepping stone for Breaking Bad, one of my all time favorite shows. As soon as I watched a few episodes, I understood why it was such a big deal. Sure there’s the great acting, funny and tense writing, and memorable characters and moments. However, the real soul of the show is in its deeper layers and themes weaving from season to season.

At the heart of it, The Sopranos was about all about people that wrestle between who they truly are inside and who their world shapes them to be. Chris wanted to be a film maker. Paulie a good son. Carmela a good Catholic. And Tony a caring provider. The mob life, however, required them to be an entirely different persons, to hold the line and set the example, to follow their family code with a heavy hand. Each character, whether they were mobsters or not, were all heavily affected in their own way by the presence of the family and its extreme actions.

Dr Melfi was different.

The original premise and pilot of the show was a mob boss that goes to therapy. These sessions between Dr Melfi and Tony was very much at the core of the show. So much so that even other characters like Janice, Meadow, AJ, Carmela, and even Dr Melfi herself would have their own therapy sessions. Chris would go to rehab. All the characters were either working in the family or relatives of the made men. Dr Melfi was the only one outside. She only knew about the family through storied from Tony himself or from news on TV or shared by her outer circle. So, to answer why she ended treatment with Tony we have to ask, what relationship she has with the Sopranos? How does the family affect her? It gives her power.

The only person that could get Tony to change, was Dr Melfi.

She was the one who showed him it was ok for others to know he was in therapy. She was the one who helped him realize the women he saw was controlling and sadistic like his mother. She refused his romantic advances demonstrating he can’t always take what he wants. She was there to give guidance when people in his life attempted or committed suicide. She encouraged him to put embrace his understanding with Vito’s homosexuality, making Tony go against his culture and actually try to protect him.

Dr Melfi was the only one who knew and understood the most about Tony, the only one that believed in him. And that gave her power. She had admitted that she was simultaneously thrilled, conflicted, and fascinated by having Tony as a patient. Like all things in The Sopranos it was always nuanced. But it was clear that, though she feared him at times, she knew, and maybe even reveled, that she had power over him. She had power over this supposedly powerful man. He would cry in his office and go into panic talking about his deepest fears, and only she would know. Dr Melfi has known about Tony’s power ever since she was raped in the beginning. While she overcame the temptation to use him for revenge, she knew very well that Tony had that ability, that he held that power, and she could have used it. Over the years they spent together, Dr Melfi became emboldened and empowered by her relationship with this notorious client. That is until the paper.

While reading those words and thinking back through their sessions, she couldn’t stomach the fact that Tony was the one with the power all along. She likely also felt a healthy mix of professional and moral heartache, thinking she couldn’t make him better after all this time. Worse yet, she was enabling him. It was no longer exciting and fascinating. It became unbearably deflating believing she was being used all along, that she never had any power to begin with. Even Tony would tell her that this was morally wrong before leaving that office for the last time. It was no longer about her practice, her moral code to help, her belief and attraction to him. It was about his and her standing in their relationship.

If every character was struggling between who they want to be and who their world makes them become, Dr Melfi is at her core a good therapist yet even she got sucked into the world of the Soprano family. She got corrupted by wanting to know, wanting to be involved, and wanting the power to change a powerful man in a powerful family. The show began by forming this relationship, building the theme of mental health and healing, and ended with her giving up on that idea. The world wins. She could not get Tony to change himself. It was Tony that was changing her. Dr Melfi couldn’t escape the pull of the Soprano family, a blackhole drawing in and destroying anything that gets too close.

As much as people still talk about the cut to black, what truly defined the ending wasn’t whether or not Tony lived or died (which he probably did). It was the elegant bookends of a dangerous man who loved ducks and had a panic attack, and the smart sexy psychiatrist who always put her patients first giving up on the man. In the end, that sudden, still blackness is all there is.



Jacky Tang

A software-psychology guy breaking down the way we think as individuals and collectives