For years, I have regarded the HBO series The Sopranos as a metaphor for the brutalities, injustices and blood sport ignored and tolerated in families, work settings, communities, and societies. In this, the fifth season, the show has become a warning: With a split-second decision, we can destroy all we have worked toward. Think Martha Stewart and Howard Dean. Also think Dr. Jennifer Melfi and all of us.

David Chase, creator of the series, depicts Tony Soprano as a brutal, conflicted Everyman. When cruelty and sadism permeate a child’s world, can that child grow up to be anything but a monster? Through Melfi, Tony’s therapist, Chase poses the question: Can the monster, the beast, be saved?

With Melfi as therapist the question is: Which will win, professionalism or passion? In past sessions Melfi is presented as one who faces the conflicts, loss and pain of the human condition but still maintains appropriate boundaries in her relationship with Tony. Until this season, her character has suggested that hope and ethics can triumph over loneliness and temptation.

But Melfi’s professionalism may be starting to wobble. As a therapist, I know why. You can’t work with patients in an intimate way, bear witness to their struggles, without feeling love for them. But that love should be expressed only as belief in their potential and abilities, as respect for their courage to face difficult personal truths. The patient can heal only if appropriate boundaries are not violated. Can Melfi do it?

Well, she has to. Tony, now separated from his wife, Carmela, sets out on a path to seduce Melfi. He kisses her, and although she doesn’t respond and finally moves away and protests, she never forcefully tells him: “I respect you and our work together too much to allow this to happen.” In a later scene, she digs an even deeper professional hole. As a defense against attraction, she tells him his values are beneath her own. Bad move. This outburst only feeds Tony’s self-loathing and rage.

Attraction can still be a sign that Tony can heal. Part of a child’s love for a parent, after all, is experienced sexually, a necessary prelude to growing up. But if anyone’s love for his mother was messed up, it’s Tony’s. Sex and violence have become one to him. His mafioso life has given rise to anxiety attacks, and his need for kindness and nurturing has brought him to therapy. How that is handled says everything about not only Tony’s future, but Melfi’s as well. She is just as vulnerable as Tony. He’s still a killer, after all. But even if she escapes physical danger, Melfi is not free. If she violates the standards of her profession, she will hate herself for the rest of her life.

Tony is a microcosm of the clash between inner and outer person in us all. And now, so is Melfi. As her fellow therapist, I hope she does the right thing. This is a show that teaches us much about the muffled cries of pain in both the ordinary and the extraordinary life. It’s also becoming a myth about the perils of therapy.