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Chicago Tribune
Chicago Tribune
Nina Metz

‘The Patient’ review: When therapy goes very wrong. Like, true crime wrong

Say you’re a therapist. And say your patient tells you, “I have a compulsion to kill people.” And say that information is conveyed after you’ve been kidnapped to some unknown basement location and chained to a bed. “The Patient” looks at what happens when the power dynamic between therapist and patient becomes completely upended.

Steve Carell plays Dr. Alan Strauss, a bearded and becardiganed widower. Domhnall Gleeson is his patient, a lanky guy named Sam Fortner, who is full of roiling thoughts and unpredictable energy. Too nervous to share the true nature of his problems in Alan’s office, Sam decides that abducting his therapist and having sessions on his turf, and at his convenience, is an idea that will work.

Does this sound like an idea that will work?

I’m not giving anything away. The premise is revealed in the show’s trailer and the details unfold quickly in the first episode, because the series isn’t concerned with whether the kidnapping will happen, but what transpires after the fact, in that deceptively average-looking residential basement.

An FX production created by Joel Fields and Joe Weisberg (the duo behind “The Americans”), the 10-episode series for Hulu really only has enough story for a movie. But the problems here go beyond a padded running time.

Alan is understandably terrified and outraged when he realizes he’s now this young man’s hostage. “I know that it’s not exactly a good idea, I do realize that,” Sam tells him. “But I’m out of options. And I really think if we can just talk, this’ll be OK.” Pause. “OK-ish.” He sounds almost upbeat. Lucid. Practical. Not overtly threatening, considering the circumstance.

Alan: “I have to help you see that this is wrong. Scaring me like this is wrong. You have to see that. I know you can see that.”

Sam: “I do, I do. I know. But — " he gathers his thoughts. “I wasn’t getting anywhere in therapy. You said so yourself, right? And I think that I know why. I couldn’t really tell you the truth in your office. But here — here, I can.”

Sam wants help, but only on his terms. And he’s failed to think through how this might plausibly end: If Alan succeeds (and that’s a big if) then what? The outcomes are limited.

There’s enough in the early going to keep you locked in, especially when Alan gets over his initial shock and anger and resigns himself to guiding Sam through therapy, or rather “therapy,” at the foot of the bed he’s been provided in that clean but dimly-lit rec room. At least the space has a large slide-glass door letting in natural light and the tantalizing reassurance that a world outside this trap exists.

As a narrative device, the intimacy of therapy can be riveting. The nonfiction Showtime series “Couples Therapy” is a prime example, but scripted scenes can be entrancing as well. Just people in a room trying to talk. That’s harder than we often realize, with the push-pull of vulnerability and guarded emotions. The uncertain rhythms and lurches. Someone simply telling their story and another someone helping them put that story in a different context.

That’s not exactly what plays out here. Alan tries to come up with a framework and coping strategies for Sam, but their sessions are often truncated, either because Sam loses patience, or Fields and Weisberg lose patience. We get surprisingly little insight into Sam’s thought process or even why he wants to stop killing. He doesn’t seem to feel guilt or remorse, so what’s this all about?

He’s an awkward person who experienced abuse as a child. How this led to homicidal urges isn’t explored beyond a rote explanation — Sam is taking his rage out on everyone but the person who hurt him — but we get little sense of how someone crosses the Rubicon of not murdering people to suddenly being a person who does, over and over again.

Maybe that’s because nobody really knows. But if you’re making a show about this very behavior, it’s not unreasonable to hope writers might speculate a little. Isn’t that why we’re watching? Or is “The Patient” more concerned with building dread and showing us just how ghoulish a circumstance like this can get?

As time goes on, Alan begins dissociating and the series becomes a study in what might go through a person’s mind when experiencing this kind of psychological trauma. Alan imagines himself in a concentration camp and the scenes are shot in black and white, as if his brain can only conceive of this historical terror through his memory of photographic images. I’m not sure what references to the Holocaust are meant to convey. Sam’s interest in him is specific and individualized and not rooted in antisemitism. The mental torture Sam inflicts on his therapist stems from his self-involved needs and if Alan is frightened and miserable, well, that’s just an unfortunate byproduct of the process — that’s how Sam sees it.

Maybe these moments are about Alan’s subconscious grasping for anything that will get him through this crisis, and he’s contemplating how those who survived unimaginable horrors in Nazi concentration camps actually did it. Alan’s feelings about his connection to Judaism become a running theme throughout the series as he contemplates, in flashbacks, what went so wrong in his own life when his son embraced orthodoxy and shunned the family. Alan also imagines himself in the present, in sessions with his own therapist (David Alan Grier) who has risen from the dead for this hallucination. Together, they assess his options as the screws tighten.

Carell brings all kinds of depth to this man’s mental anguish, improvising his way through extraordinarily tense therapy sessions that need to work, while Gleeson is legitimately terrifying when the character’s numbed facade falls away. The performances are strong. The story is not. It’s a psychological thriller that feels like a high-end riff on true crime. The show’s creators seem to be saying: If you’re obsessed with these grisly stories, here’s what that might look like from the inside.

It’s a punishing watch.



1.5 stars (out of 4)

Rating: TV-MA

How to watch: Hulu


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