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What FX’s ‘The Patient’ Has To Say About Therapy, Violence, And The Masculinity Crisis

Their drama is the drama of today’s men. Sam doesn’t need therapy, but an actual loving relationship.


Hollywood has a tendency to glamorize psychotic serial killers. They are often portrayed as charismatic, intelligent men who happen to have a thirst for murder — the TV series “Dexter” is a good example of this. In reality, psycho-killers tend to be miserable losers with below-average IQs.

For all its flaws (and there are a few of them), “The Patient” starring Steve Carrell and Domhall Gleeson captures this truth quite well. Gleeson plays a disturbed young man Sam who kidnaps his therapist Dr. Strauss (played by Carrell) and holds him captive in the basement of his mother’s house in the hopes that Strauss will help him overcome his habit of murdering random people.

At first, this setup has the makings of a good psychological thriller. And in the first few episodes, this is true. However, this tension dissolves as the show’s progression slows down to a snail’s pace, filled with several flashback scenes developing themes and characters while doing nothing to advance the plot.

For all that, however, the themes and characters featured in “The Patient” are poignant and well done. Much of the series presents a biting critique of therapy, which proves ineffective in treating Sam’s mental illness. Half of what Strauss practices amounts to mind games intended to cultivate empathy in a hurry. The other half is Strauss explaining the continual need for therapy and how Sam is improving — even when every possible sign demonstrates the opposite.

Ironically, both Sam and his mother have faith in Strauss though much of this faith is based in desperation, as neither of them wants to confront the truth about their situation. Sam clearly wants someone or something to blame, when it’s his own stupidity and nihilism that causes him to murder, and his mother simply wants to absolve her own complicity by pushing her son off on the best therapist she knows.

In similar fashion, Strauss begins as a confident psychiatrist but eventually comes to realize the shallowness of his profession and his limited perception of the world. His captivity causes him to revisit his assumptions that he previously never questioned.

What eventually becomes apparent is that Sam doesn’t need therapy, but an actual loving relationship. This is the other major theme of the show, as Sam blunders into violence because there’s no reality check. He is estranged from his father and has little connection with his enabling mother. He has no friends, and his ex-wife divorced him years ago. Because there’s no one around to tell him otherwise, he forms delusions about people and acts on those delusions.

This alienation is a big problem with men in the show and the modern world in general. Growing up without a supportive father figure, men will develop antisocial tendencies and potentially become violent. Such is obviously the case with Sam, but also with Strauss’s own son Ezra who breaks with his liberal Jewish parents to join a hyper-orthodox Jewish community.

This conflict between Strauss and his son brings up the third major theme of the show which is the role of religion in a man’s moral and social development. As one might expect, Sam grows up in a secular household and has no moral compass beyond what feels good or bad. Curiously, he is more intrigued by Strauss’s Jewish faith than his professional opinions. While he’s already forgone at this point, his interest suggests that Sam needs religion as much as he needs a friend.

In the case of Strauss and his son Ezra, the Jewish faith is important for both men, but Ezra grows up to deplore his parents’ form of Judaism, which dispenses with tradition and focuses more on having fun than developing spiritual discipline. This situation easily applies to other religions, which have their own version of the same challenge: older believers who prefer an inclusive, more festive form of worship resisting younger believers eager to bring back the old ways and restore some seriousness and beauty to the faith. The show seems to condemn the latter group, portraying Ezra as a sanctimonious prig at the beginning of the series, but this portrayal becomes more complex and even sympathetic as the series continues. 

Despite having problems with slow pacing and a tendency to drift into thematic tangents that are more interesting than essential, “The Patient” is altogether a good show. It is realistic, complex, provocative, and well-produced. Carrell and Gleeson put in amazing performances, successfully shouldering the intense psychological burden placed on their characters with nothing but their lines and a one-room setting to work with. Their drama is the drama of today’s men, and while it’s not exactly a happy story, it is an important one that all audiences can learn from.

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