Steve Carell and Domhnall Gleeson give killer performances in tense psychotherapy series ‘The Patient’

A serial killer locks his therapist in his basement, forcing him to answer the question of whether his psychopathic tendencies can truly be cured.

Steve Carell as Alan Strauss. Credit: Suzanne Tenner / FX

A man wakes up chained and confused in an unfamiliar room with no way out. It’s a premise seen in dozens of horror movies, but The Patient has a killer twist on a classic trope. The man being held captive is Dr Alan Strauss (Steve Carell), a well-regarded therapist and lovable family man. His captor is one of his patients, Sam Fortner (Domnhall Gleeson), a troubled young man hiding serial killer tendencies.

Unable to guarantee confidentiality in the outside world, Sam captures Alan and locks him in his basement. He won’t free him until Alan can answer an age-old question: can Sam’s serial killer nature be cured? Is he capable of being helped?

When audiences meet Alan, he is quietly grieving the loss of his wife, Beth (Laura Niemi), and attempting to mend the distance between him and his estranged son, Ezra (Andrew Leeds). He is a paradox, a therapist adept at healing others but struggling to fix his personal trauma.

When Alan encounters Sam (who at first uses the codename Gene), he seems to be a run-of-the-mill patient grappling with the feelings about his violent father. His quirks, like his refusal to remove his sunglasses inside, protect him from letting Alan see too far into his troubled soul. When Alan points out that he is frustrated with Sam for not fully opening up, Sam responds by giving Alan far more truth than he bargained for.

Now, with Alan far away from the public, Sam is ready to be real with him. He has an uncontrollable desire to kill people, and he wants to stop. Alan initially doesn’t want to help Sam, and he refuses to work with him while he’s being kept a prisoner. So, Sam raises the stakes: he will hurt someone else, unless Alan can help him find a way to stop himself.

Steve Carell as Alan Strauss and Domhnall Gleeson as Sam Fortner. Credit: Suzanne Tenner / FX

The Patient is a complex character study of not just one but two men. Sam may be the serial killer confessing his sins in the patient’s chair, but the series spends just as much time exploring Alan’s past mistakes as well, uncovering a man whose beloved family was also his undoing. Each episode unveils another piece of the puzzle to each character, revealing which of Sam’s compulsive lies are true, and which of Alan’s past learnings can help him with his present case.

For a series set mainly in one room, featuring conversations between mostly the same two men, audiences should still expect the unexpected from The Patient. How many ways can Alan try to escape his basement prison, and will he be successful under the watchful eye of his homicidal warden? Is Alan truly alone in this house with a serial killer? And what would happen if Sam were to bring one of his targets home? Each episode of the series barrels toward the next, making it difficult, if not impossible, not to hit play on another chapter.

The Patient is built around the complex dynamic between Alan and Sam, which would not be successful without two actors at the top of their game. Carell, an actor known widely for his roles in comedies like The Office and Little Miss Sunshine, has proven his skill at more serious dramas in recent years, earning himself an Oscar nomination for Foxcatcher in 2014.

Meanwhile, Gleeson (ironically, the star of the new The Office spin-off, The Paper), has featured in everything from major franchises like Harry Potter and Star Wars, to romantic dramas like Brooklyn and Anna Karenina. Both actors impressed in The Patient and were rewarded with lead and supporting actor nominations at major Hollywood ceremonies when the series was first released in the US in 2022. They make an undeniable pair in The Patient, bringing to life a compelling power struggle with flawless performances.

Domhnall Gleeson as the complex serial killer. Credit: FX

The Patient’s intense back-and-forth two-handers and deceptive characters are hallmarks of the creators, Joel Fields and Joe Weisberg, who are famous for shepherding the hit Emmy-winning spy drama The Americans. Series like In Treatment or Mindhunter are strong references for The Patient, as Alan and Sam embark on a series of conversations that attempt to get to the heart of the serial killer psychology.

The patient and therapist dynamic may seem familiar, but The Patient twists this trope into something far more unsettling. With every tense exchange between Alan and Sam, the series blurs the line between therapy and survival, forcing us to question whether a killer can truly be cured or if the process will consume the therapist himself.

The Patient is streaming at SBS On Demand.