However, while Lamb’s novel may reflect this truth, it also provides a decidedly inaccurate portrayal of modern psychiatry and psychiatrists. Indeed, the blurring of roles between patients and therapists has been a popular theme in books and cinema for some time. This trend predates managed care and the changes in our practice environment by many years. An excellent example is Conroy’s Prince of Tides(1), published in 1986 (quite early in the managed care era in American psychiatry). In this novel, in which a psychotherapeutic relationship is also central, numerous boundaries between patient and therapist become blurred. Their relationship evolves into a sexual one. The clear message is that the relationship’s intimacy, both emotional and sexual, is what heals the patient. Gabbard and Gabbard (2) documented numerous other examples from the world of cinema. The truth reflected in these examples, including I Know This Much Is True, may be the age-old fantasy of the patient who wishes to break through the confines of the therapeutic alliance and enjoin the therapist in a "real" relationship.