The truth about therapy

In the age of Netflix, used as we are to shows made with bingeing audiences in mind and episodes that stretch anywhere between 40 minutes and one hour, it is a bit disconcerting at first to watch older television with its strict 30-minute cut-off.

The brevity—not just in terms of episode length but of the storytelling itself—takes some getting used to, and this is heightened for a highly structured, taut show like In Treatment, in which the action of each episode largely takes place within one room and consists of two people talking. But soon, you start noticing and appreciating how the show makes each second, each movement, each sigh and twitch of the eyebrow, count; when it zooms into the speaker’s face and when it pans to show the rest of the room. It’s like watching great theatre.

In Treatment, which in its first three seasons features the 50-something Dr Paul Weston (Gabriel Byrne) as its star therapist and, in its recently concluded fourth season, the 40-something Dr Brooke Taylor (Uzo Aduba), is a show about therapy—the people in therapy, the process of therapy, and even the therapist in therapy. Its structure is formal and practically unshakeable without being gimmicky—each episode begins with the therapist preparing for the upcoming session, and through each season, we follow three or four patients who show up on specific days of the week and at a predetermined time to meet with the therapist. There are variations—in one, the therapist may conduct the session in a hospital room, and in another, she may do so via Zoom in a clearly post-pandemic scenario, but overall, the setting is predictable, lending a delicious intensity to the conversations that go on within the room.

The staggered manner of the meetings—which is absolutely how it would happen in real life—lends its own drama and even low-key suspense to the show. After each meeting, you’re left waiting to pick up that patient’s story, but you get to do so only after four more episodes. Every fifth episode, the therapist sees their own therapist, and we finally see them drop the studied neutral mask and become real, confused, contentious, confrontational human beings. Sometimes, these are the best episodes of the week.

You may think that this kind of regimented structure would prevent the viewer from becoming truly invested in the characters, especially the breakout ones in each season—a suicidal teenage gymnast in season 1, a brilliant architecture student who finds out she has cancer in season 2, and a middle-aged Bengali man who feels trapped in his son and American daughter-in-law’s New York home, played brilliantly by Irrfan Khan, in season 3—but the development of the story is calibrated so precisely through the season that this doesn’t happen at any point.

Therapy is not just a framing device on the show—In Treatment takes the process of therapy itself very seriously. Through the conversations between client (in the past decade, the words ‘patient’ and ‘treatment’ have been dropped from modern parlance, and the fourth season reflects this) and counselor, we get an intimate view of this process, along with its challenges and faultlines. The therapists on the show often struggle with the constraints of therapy—at one point, Paul Weston wonders whether he was able to help Sophie, the young gymnast, because he was good at his job or because he was more approachable, more human with her than with his other clients—and rail against its artificiality.

In no story arc of all four seasons is this constraint more visible than in the Irrfan Khan episodes of season 3, co-written by Jhumpa Lahiri, where Weston is confronted by a smart, erudite, grieving man to whom therapy is so alien as a cultural construct that he refuses, again and again, to respect its boundaries—ultimately using it in an entirely unexpected and spectacular way.

Khan is brilliant in these episodes, making even Byrne, the veteran protagonist of three seasons, appear fumbly and gauche at times. But that’s not the only reason to watch In Treatment — it is a brilliant, impeccably restrained show that feels both challenging and refreshing in these times of too-much-information TV.