The joke that might be running through this is that despite his apparent sense of failure the psychiatrist has actually managed to get through to his patients and change their lives for the better.
In terms of the burns victim she ventures outside for the first time; the depression sufferer starts to come to terms with humility and the rape victim starts to see the doctor rather than just the rapist in her dreams.
Even the politician, who is embroiled in a sex scandal, is in a better position because from rock bottom he has the option to acknowledge his problems and try to rebuild his life.
The only person who is suffering is the psychiatrist who realises that his marriage is effectively defunct and his career has been ultimately quite a selfish activity.
What you pick up loud and clear from this is the mental illness is quite a selfish thing from the point of view that it is very difficult for family members to reach the sufferer and the patient spends a great deal of time concentrating on how they feel.
There are clear benefits from navel gazing if you can look up and make positive changes. But it becomes dangerous when you never look up.