Alan Strauss is an ideal therapist, kind, attentive, levelheaded. Gene is a problem patient who lies (his real name is Sam) and refuses to take off his sunglasses during sessions. When Alan regretfully says that things aren’t working because Gene won’t open up, Sam takes the logical next step: He kidnaps Alan, takes him to a place where Sam can open up — Sam’s nicely finished basement — and chains Alan to a hook in the floor so that they can finish the therapy. Oh, and the first thing Sam gets off his chest is that he’s a serial killer.
That’s the setup of the 10-episode mini-series “The Patient,” produced by FX for Hulu, where it premieres on Tuesday. It’s a premise that would usually play out as either morbid, shock-value horror or mordant, over-the-top comedy. But the show was created by the writing and producing team of Joel Fields and Joe Weisberg, in their first collaboration since the great family spy thriller “The Americans” (also from FX).
So “The Patient” is more distinctive and complex than a synopsis suggests, and it’s often highly entertaining in its modulated, cagey way. Fields and Weisberg, who wrote the entire series, don’t find an entirely satisfying way to resolve their comically stylized meditation on the possibilities and limitations of therapy — six hours may have been three or four more than the story needed — but they’re still expert craftsmen, and the short episodes fly by.
Steve Carell, who plays Alan, has said that “The Patient” is “certainly not a comedy.” But it certainly is a comedy, of the driest, most pinpoint variety, and that’s one key to its success — as we’re introduced to Alan’s and Sam’s tortured back stories, the current of dark humor keeps the show from descending into soap opera. At the same time, the carefully maintained tone of hushed melancholy tempers the macabre extremes of the horror plot, with its occasional flashes of violence. (The plot of “The Patient” calls to mind “Misery” or therapy dramas like “In Treatment,” but a closer analogue to its tricky tonal balance would be FX’s Australian hit-man dramedy “Mr. Inbetween.”)
Another key is Carell, whose mild edginess, or edgy mildness, fits Alan as comfortably as the cowl-necked cardigan he’s kidnapped in. He gives Alan a rationality and compassion that ground the story, allowing us to absorb its more outré or unlikely elements without fretting over them. But he also gives him a submerged anger and spikiness that play well against Domhnall Gleeson’s more frontal, theatrical performance as the bollixed-up Sam.
Gleeson is engaging enough to make us buy into the unlikely notion of the self-aware serial killer trying earnestly to cure himself. Sam, who works as a municipal health inspector, lives with his mother and blames his troubles on his abusive father, could be read as an incel in a white-male-rage scenario, but the story doesn’t bear that out. He’s more like an eager grad student finally getting his favorite professor all to himself.
Fields and Weisberg set up a network of connections between Alan and Sam, and the story is inevitably about Alan’s needing to analyze himself in order to figure out what to do with Sam. Alan is the kind father figure Sam never had; Sam, who forces Alan to talk to him, is an analogue for Alan’s son (Andrew Leeds), who won’t talk to him because of a falling-out over religion. Sam’s mother (Linda Emond) and Alan’s dead wife (Laura Niemi) also figure in the family and religious dynamics. Being in captivity, and pondering whether he should try to escape, leads Alan to nightmares about Auschwitz. The show’s title doesn’t apply only to Sam.
Those relationships provide the show with a framework, but its heart is in its black-mirror depiction of the process of therapy, to which Fields and Weisberg bring both obvious affection and corrosive wit. “The Patient” raises to the highest possible level the stakes on the central question of whether analysis actually works, and the plot has a double-helix structure: Alan has to employ every trick in his arsenal to keep Sam happy and thereby stay alive; but he is also, through desperation, curiosity and professional pride, conducting an actual course of analysis.
What he keeps running up against, of course, is the fact that his patient is a sociopathic killer. Alan gives Sam good feedback — involve other people in the therapy; think about who it is you really want to kill — but it keeps having disastrous consequences. Meanwhile, Fields and Weisberg supply comic grace notes, like the comfortable chair Sam goes to some trouble to obtain for the therapy sessions, and the takeout meals he brings to Alan, like offerings, from the restaurants he inspects. The running joke: How different is a psychoanalyst’s normal day from being chained in a room with a crazy person?
A lot of this could be played for broader, more obvious farce, and you might wish it had been; the show’s reserved, minimalist approach won’t work for everyone. And while Fields and Weisberg don’t sell out the ending — what they’ve come up with is credible, within the off-kilter parameters they’ve established, and moving — it feels a little small and pat, with a tidy message. You may not feel that you got full value for your time, but that’s always the danger with therapy.