Reflections on "The Patient" on Hulu, created by Joel Weisberg and Joel Fields

*Major Series Spoilers!*

I’ve just finished watching the new Hulu series, “The Patient”, staring Steve Carell and Domhnall Gleeson, and like so many others, am feeling gutted by the ending and the ultimate failure of the therapist, Alan (Steve Carell), to find a way to save his own life. It was heartbreaking to be given a moment of release in the form of Alan’s reunion with family at his son’s shabbat dinner, only to be thrust back into the violence of Alan’s death. The show’s ending was the natural conclusion of an impossible situation. The writers were certainly skilled enough to give their audience a great deal to think about with regard to the narrative, including many aspects of character and action to ponder. I will be turning the events of the series over in my mind for some time to come. However, the focus of this post is on the experience of being ‘ therapist’ and the show’s creators’ masterful depiction of certain aspects of what it means to be a therapist.

Unfortunately, Alan was doomed from the moment he received the call on his answering machine from a new patient (Sam, posing as Gene) reaching out for help. In fact, Alan may have been doomed far earlier than that, at the point in which he entered his profession with a strong conviction that therapy can help people change and become the people they truly wish to be. There’s a very interesting interaction in episode 1, during which Sam (then Gene) shares Alan’s frustration that their experience together may be superficial, glancing off the surface of engagement rather than creating depth of connection. Alan points out that he feels Sam (Gene) is not opening up enough. Sam replies with obvious emotional pain, “I’m trying, I’m re[ally].., I’m trying”. Alan responds, as so many therapists would in a similar situation, with genuine empathy over Sam’s struggle. With all sincerity and conviction Alan replies, “In my experience, anyone who has come this far, who has made the choice to come to therapy, and keep hammering at the hard things, they can be helped.” This statement sealed Alan’s fate. It created hope in Sam, a hope that in spite of his devastating secret and his awareness that there was something terribly, terribly wrong with him, he could change. Alan’s belief in the power of change, along with his skill as a therapist, set a series of events in motion that would ultimately lead to his death.

This moment lead me to consider the dangerous (painful!) work of therapy that we, as therapists and clients, enter into hour by hour in the confines of the private space that is the therapy session. “The Patient” concretizes this experience in an explicit, very action-oriented manner, but the truth is that clients seeking fundamental change are always entering the fraught territory of the psyche and bringing us along with them. Hopeful, as we’re hopeful, but engaging in a process with an uncertain conclusion that necessarily requires accessing parts of self that have been hidden for very good reason and oftentimes, for a long while.

At times, there is a very real experience of life and death struggle within the confines of the session time. On the side of life is the life of the self, the experience of being truly free to live without the traps and devastation of the past, as Sam tries to move beyond the reality of himself as killer into his life as person capable of meaningful, deep connection with others. On the side of death is the entrenched experience of self, maintaining its iron grasp and causing a devastating block to the freedom of being who one truly is. For Sam, the death side of the struggle represented the absolute corruption of the promise of the free self, wrought by his continued killing of fellow human beings.

As therapists, we seek the technical prowess, intelligence, wisdom and sometimes luck(!) to be able to share this journey with our clients, experiencing the darkest recesses of their selves with them, moving through the emotional and/or physical devastation of the past, through a shared darkness and toward a new state of well-being. We use hope and our belief in the possibility of change to provide us with fortitude on this journey and fortunately, generally find our way to reach the other side in safety. Occasionally, we aren’t able to complete this journey together. Perhaps poor therapeutic fit, interruptions in the therapy itself, missteps in technical application, or intra-psychic devastation that is too great to be sufficiently healed may prevent that completion. Luckily, the stakes are not generally as high for us as they were for Alan and Sam and we are left free to move on, to other therapists or for therapists, themselves, to moments of reflection and learning and then other clients. Remaining hopeful and ready to begin the work again.