Living a prosperous life with all the trappings of success comes with a price. The ill-gotten gains are symbols of a ticking time bomb fueling a high level of anxiety knowing all of it can be taken away including precious freedom in a heartbeat. 

Tony sadly admits to his therapist, “What kind of a person can I be when my own mother wants me dead?”
Dr. Melfi helps reveal another persona, that of a little boy who desperately seeks approval, which manifests itself as a need for respect. 

Tony complains, "You ask me how I'm feeling, and now you're going torture me with it."

When he feels needy, a side of his personality emerges as a brutal
sociopathic killer.

impulse control fueled by Incidental triggers provoke outbursts of violence which create an adrenaline rush warding off depression.

He gains his “little boy” need of approval through the respect those around him project.

Knowing that a
stigma of weakness exists for those seeking psychological help, a secret he protects at any cost.

Tony’s secret was revealed to his crime associates by his own mother.

He blames her for his disorders but she is relentless in her efforts to control him through guilt.

His mother justifies her actions as an act of revenge for Tony putting her in a managed care facility.

Her plan to have him killed includes enlisting her dead husband's brother, Tony’s rival for control of the crime family to execute her deadly scheme.

"Anything seen on TV is, in a subtle and sinister sense, thereby endorsed." 

- Dick Cavett, TV Host

Strict religious codes of an Italian family justify turning a blind eye to their own feelings of betrayal and guilt because the church forbids divorce. When the patriarch of the crime family, Tony, admits suffering from depression and panic attacks and seeks talk-therapy he puts both his home and crime families in jeopardy as they fear exposure due to a breach in confidentiality.

A relationship between a female therapist, Dr. Melfi and her gangster client Tony breaks a generational pattern of lack of trust allowing him to disclose his deepest fears. 

Counter transference occurs, as the therapist and client grow closer with unspoken implications of unethical sexual boundaries being crossed.

Tony struggles to maintain balance between the personashe is destined to live.

One mask gives the world the impression of having it all by being a loving father and devoted husband.

Another personal is that of the head of

a crime enterprise and another persona as a serial philander. He is walking around with a short fuse ready to attack to maintain control of all those around him.

 The Psychology of Impulse Control 
The Sopranos
is the story of a dysfunctional crime family boss who struggles to maintain control while hiding his emotional weaknesses

of reoccurring panic attacks.

Tony Soprano’s emotionally scarred mother Livia, who grew up in poverty escapes through marriage. While suffering from borderline and narcissistic personality disorders she maintains her balance by taking her psychic inadequacies out on her family including on her husband, son Tony and his sister thus repeating the cycle of emotional poverty over generations.

A family secret looms like a dark cloud over the generations of the Soprano family as infidelity and brutal crimes elevate the self-esteem of its male members causing the female members to live lives of quite desperation under the defense mechanism of denial.