The incisive back-and-forths. The immaculate casting. That earworm of a theme song. In Treatment is back after a 10-year hiatus, and the HBO psychotherapy drama has not lost a step.
Since its inaugural season, In Treatment has followed the same effective formula. In the first few episodes of its weekly cycle, the lead psychologist sees patients for standard hour-length sessions, compressed to 25 minutes for the sake of television. On the last day of the sequence, the good doctor visits his or her own shrink and experiences a profound role reversal. Among the benefits of this design is its acknowledgment of something that every talk-therapy recipient has likely intuited at one point or another. Behind the mask of professional composure, psychologists are just as screwed up as the rest of us.
Filling the starring role in the show’s first three seasons was the brilliant stage and screen actor Gabriel Byrne, whose Dr. Paul Weston exemplified this mercurial dynamic. Treating his headstrong patients (played by Mia Wasikowska, John Mahoney, Irrfan Khan, and many other memorable performers), Byrne’s Paul was a figure of such wisdom and goodwill that one struggled to recall his personal anguish. On the couch for his own sessions, however, Paul became a raving misanthrope of such fire and fury that co-star Dianne Wiest (and later Amy Ryan) must have left the set with singed eyebrows.
Though Byrne has been replaced in the series’s latest run by Orange Is the New Black’s Uzo Aduba, the structure originally borrowed from the show’s Israeli forerunner BeTipul continues to hold. In each week’s opening episode, Aduba’s Dr. Brooke Lawrence treats Eladio (Anthony Ramos), a home health aide who lives with his wealthy employers. On subsequent days, Brooke sees the disgraced tech executive Colin (John Benjamin Hickey) and the distraught, overmanaged teen Laila (Quintessa Swindell). In the new season’s single, modest departure from the norm, the “therapist” whom Brooke consults at the end of this rotation is no doctor at all but her AA sponsor, Rita (Liza Colon-Zayas). Nevertheless, the pattern’s force is largely undiminished. Having observed Brooke the unflappable expert, audiences witness Brooke the duplicitous alcoholic and gain fresh insight in the bargain.
Much of the pleasure of In Treatment lies in the slow evolution of each patient’s particular distress. They, and we, can’t say precisely what’s wrong until a good deal of work has been done. In Eladio’s case, for instance, a despondency that initially presents as mere sleeplessness turns out to be an unarticulated but deeply felt sense of economic and racial unease. For Laila, a claim of sex addiction gives way to trickier questions concerning love, trauma, and identity. (Following the lead of the actress who plays her, Laila seems poised to come out as “nonbinary” before her arc concludes.) If these capsule summaries make In Treatment sound like yet another exercise in doctrinaire leftism, their impression is misleading. Few contemporary dramas handle race, class, and sexuality with more honesty and grace. Almost none are as intelligently written and cast.
Though the series’s fair-mindedness is evident in each of its season-four stories, this is never more the case than in those episodes dedicated to Colin, who has recently emerged from federal prison after a four-year stint for fraud. Without question, Hickey’s performance as a great man much reduced is among the finest in the show’s history, and Zack Whedon’s trenchant dialogue has a scorpion’s stinging tail. What is most surprising about Colin’s subplot, however, is the series’s willingness to entertain his decidedly unfashionable grievances. Having “obliterated [his] entire existence” with a “misplaced decimal point,” the former CEO can’t separate his new pariah status from the general collapse of white men in the culture’s esteem. And he has a point. But for the presence of a burgeoning “anti-racism” movement, Colin might have reentered polite society with minimal delay. Instead, political developments have transformed him into just another “privileged white guy” and made his redemption next to impossible. “My actions aren’t neutral,” he confesses to Brooke in a wrathful moment, “but guess what? No one’s looking at my actions. They’re looking at my face.”
That In Treatment is able to let so unpopular a notion linger rather than dismissing it outright is a function of the show’s commitment to psychotherapeutic realism. Brooke can’t simply interrupt a session to insist that Colin be more woke. Among the consequences of this built-in limitation are scenes that feel remarkably free of ideological agendas. Brooke must and does push back against Colin’s excuse-making and self-pity, but Eladio and Laila get the same medicine despite their standard-issue liberal politics.
If the series’s newest season has a weakness, it is the ever-so-slight decline in its quality when Brooke moves from chair to couch at the end of each week. Though Aduba, a three-time Emmy award-winner, is undeniably skilled, she struggles to make Brooke’s flaws quite as interesting as that character’s considerable strengths. In part, this is due to the relative straightforwardness of what ails the show’s protagonist: Were she to stop drinking, her life would improve dramatically. It is also the case, however, that Aduba relies a bit too heavily on forlorn gazes when playing Brooke in “patient” mode. This deficiency should not be overstated — the actress is a worthy successor to Byrne — but it is noticeable.
Less easily describable is why In Treatment remains so addictive despite its inherent staginess and utter lack of action. My own working theory is that the program’s political lightness of touch is only part of the story, as are the generally excellent performances and scripts. The final factor has to do with the compelling mixture of candor and self-deception with which the show’s characters confront their trials and victories. One doesn’t have to be a trained psychoanalyst to recognize the truth in that combination. One merely needs to be human.
Graham Hillard teaches English and creative writing at Trevecca Nazarene University.
