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Salon
Salon
Lifestyle
Melanie McFarland

The Patient star on a killer in therapy

Domhnall Gleeson as Sam Fortner and Steve Carell as Alan Strauss in "The Patient" (Suzanne Tenner/FX)

From the opening episode of "The Patient," the new limited series from Joel Fields and Joe Weisberg ("The Americans"), Domhnall Gleeson and Steve Carell play out every mental health professional's nightmare. 

Carell's psychotherapist Alan Strauss is a good doctor and a principled man whose clients don't realize he's struggling to maintain his equilibrium in the wake of his wife's recent death. Certainly Gleeson's Sam doesn't care much about that, given the homicidal urges he's stifling.

There's more to Sam than merely the part of him that's stuck on kill-kill-kill, understand. He loves superb food and Kenny Chesney, for example. His problem is with people who offend him in some way.

To Alan's great misfortune, he proves effective in helping Sam, and as a result, Sam kidnaps Alan and chains him to a bed in a basement. That way, Alan will be available to Sam on demand.

As Sam's urges intensify, Alan grows more desperate to maintain his sanity while preventing Sam from killing someone else – including his own therapist.  But Sam makes this exceedingly difficult, as Gleeson pointed out in a recent interview with Salon, for reasons other than the dishonesty of expecting effective therapy from someone who's being held against his will.

"The Patient" arrives at a time in which mental heath concerns have been mainstreamed, necessitated by the pandemic and the escalating global stressors that preceded and accompanied it. Seeking therapy is considered to be a responsible act, and perversely this informs Sam's drastic actions. And like so many of us, he doesn't take his therapist's mental well-being into account.

"I think it's obviously part of what interested the writers of the show: the weight on the therapist and the expectation and the demands of the patient," Gleeson observed. "Part of Sam's problem is that he's saying to Alan, 'It's your job to fix me. This is your job, this is what you do.' The work that is to be done is to be done by Sam."

Gleeson's most widely recognized roles may be his short-tempered imperial officer from Episodes VII, VIII and IX of "Star Wars" and Bill Weasley from later "Harry Potter" films, but he's played a version of this physical scenario before in Alex Garland's "Ex Machina," in which he mainly shared scenes in small rooms with Alicia Vikander and Oscar Isaac. But his character in that film, Caleb, is sane.

Sam maddeningly lingers on the border between unassuming quiet and murderous rage, and that performance produces a sustained tension that carries the drama. We talked to the actor about what inspired that performance and what "The Patient" may be telling us about our view of talk therapy.

This interview has been edited for length and clarity.

Domhnall Gleeson as Sam Fortner in "The Patient" (Suzanne Tenner/FX)

Your situation in "The Patient" is reminiscent of what your character in "Ex Machina" dealt with, in terms of being in an enclosed space and interacting with a limited number of people. Only in this story, the space is even more limited. Did you draw up on any of that experience as you were creating this role?

No, I never really thought about it. Well, that's not true. A couple times it did come up, when we talked about just the notion of like, 'Oh, my God, these are really long scenes. Have you ever done this many long scenes in a row before, with one other actor?' They're these really intense, not interrogations, but you know, manipulation and control, all that stuff going on. And "Ex Machina" was the only one that I had to compare it to.

"There's a whole aspect of his personality which has naught to do with serial killing."

But in terms of how it informed me, I'm not sure that it did. You have to know your lines inside out. They were similarly very, very well written and structured. So those long scenes really need to have an ebb and flow in the writing. And you need to stick to that, for it to sing. And on both jobs, I was working with pretty stunning actors. You know, Alicia was the one who I had a lot of longer scenes with in "Ex Machina," those sit-down-across-from-somebody scenes. And Steve on this – Oscar as well, obviously. But yeah.  Working with great actors is the key to keeping those things alive.

And then of course, the characters you play in each have total opposite personalities.  Did you base Sam on anyone from real life? And I don't mean, like, one of your friends.

Yeah, it would be so great if I said, "I based him on, like, my best friend growing up!" and you're like, "Oh, God!"

No, I didn't base him on anybody in particular. Really what I was looking for were the similarities with myself, I suppose. Because there's a whole aspect of his personality which has naught to do with serial killing. Even if you just roll back from that slightly, about how he feels about himself, about how he feels about his place in the world, about the things that frustrate him, and how he reacts under those situations. Where you look to is to try and find a bridge across to somebody who is quite different from you, but not based on anybody.

I played a serial killer before in one scene, and in a film, and I found that really upsetting and difficult to do. But that was presenting the worst of that character from the beginning. Whereas I think in this one, there's more time to get to know other aspects of him.

So did that make this feel worse or better?

That's interesting. I don't really know what it was, but I really enjoyed it. I really enjoyed the experience of finding the place where it felt like we were being responsible about how we're presenting somebody like this. Not mythologizing a serial killer because there's been a lot of that, and it's just boring and not good for anybody, and presenting him as a messed-up person who feels that his own situation is pathetic and beneath him, and is acting out as a result.

What I find most interesting about the series, and about your character, is that he obviously has a refined palate, and an expertise that comes out in the way that, although he has Steve Carell's character Alan as his captive, he's bringing him some of the finest food in town.

I think a lot of that is about control as well, you know. It's control of one's self-image, but it's also that he finds it difficult to curb his impulses generally. So if he likes a band, he's just going to listen to that one band all the time, and go and see that one person play all the time. If he's like that with food, he's going to know all the right ways to pronounce everything. He's going to look down on the people who don't. He's going to obsess over it. And, you know, I think a lot of that is relatable. I think everybody thinks that they are a good person who's struggling, you know. He feels like he has done his best. And he feels like it's somebody else's fault that he's like this. And I think we've probably all felt that way too, rightly or wrongly.

Steve Carell as Alan Strauss in "The Patient" (Suzanne Tenner/FX)

I'm asking this question of you based on the fact that you are from Ireland: Do you think that what you just described is a universal quality? Or do you think that it's more of an American tendency? The reason I ask that is because our culture has a longstanding aversion to therapy.  Even Sam at some point was saying, "Everything's about mothers." I wonder if that's just a very American-specific type of myopia.

I haven't thought about it in those terms. You know, and I don't know if it's a real quote, but is it Freud that said the Irish were the only people incapable of psychoanalysis? That the Irish people are somehow impervious to it.

But what you're talking about, in terms of the culture surrounding you and how that influences the way that you feel about yourself, I think that's very, very true of Sam. And both when it comes to therapy, but also where he thinks about his position in things.

You know, he has a failed marriage behind him. He is living at home. He probably doesn't have much money, he doesn't feel respected by the world. He feels like he's due more respect, and yet he hasn't done anything to earn it. I think that what you're promised on TV, or what you're promised you deserve in advertising, does not line up with how much things cost and what is realistic for everybody to have. And I think the disparity between those two things can make a lot of people very angry. And they blame the world.

This leads into another question I'm sure you've probably gotten, and I don't mean this to be prying: What is your relationship with therapy? Have you had any experience it? Are you a believer in it?

Yeah, I'm not really sure how to talk about that. I think anybody I know who's ever talked about going to therapy or is considering it, the only thing I can say is Jesus Christ, you should absolutely do that. Because everybody I know who's done it has benefited hugely from it. And there is still a stigma attached to it on some level, that you must be not well.

"The notion of being fixed is different than the notion of getting better."

I heard somebody reasonably saying if somebody goes to the gym to make sure that they don't lose the run of themselves physically, people consider that really healthy. The notion of doing it for your mind . . . should be exactly the same. It's basically just upkeep and being responsible.

"The Patient" is arriving at this time where I think therapy has been discussed very openly in a way that I don't think I've seen in a very long time. This is because of the pandemic, because of political turmoil, all of those things. And it arrives at a time where on one hand, it's championing therapy in its own strange way.  But it's also demonstrating the limitations of what we expect from therapy. That's why I asked that question, because I am curious to know what your thoughts are on what the show is saying about the relationship that Sam and Alan share, in terms of therapist and patient. What do you think that it's telling the audience?

I think the question that interests me, and I think it might be the same question is, how much are you willing to work to get better? The notion of being fixed is different than the notion of getting better. And the notion of doing the hard work of looking at yourself truly and clearly, and understanding your own problems, as well as the things that are good about you. That is, I think, the most interesting thing.

This series is a funny way of looking at it, because actually, the relationship that Alan has with his therapist, is much more true of what it can do and what it is and how it's best used. I love that relationship with David Alan Grier. I think he's wonderful. And I think he and Steve absolutely sing in those parts together. That is real therapy.

What Sam has entered into is a misunderstanding of what therapy is, because as Alan points out at various points, if the therapist is locked up and is in danger, and all of the control resides with the patient, that's not therapy.

What are you hoping that people will take away from watching "The Patient"?

I think it'll be impossible not to be impressed by Steve's performance.  I loved it. As it develops, it gets deeper. You find more about where Alan was at before this began, you find more about what he is struggling with in his head, and that aspect of things is what I just find so interesting and so well done. And it  really made me think about a lot of things in it, like about loss and suffering and grief and things that I wasn't expecting to be dealing with when I started reading the series. I hope that's what people are left with at the end of it. But I also hope they have a great time watching it and I hope they get a few laughs out of it too, because I thought it was really funny actually.

Do you wonder whether Kenny Chesney is going to watch?

I don't know. I have no idea whether he would. Yeah, I have no idea how he will feel about it. But I will say you know, the Beatles wrote "Helter Skelter" and it's not their fault that some imbecile used it incorrectly. So similarly, I think Kenny Chesney remains without blame in the whole situation of things. So if he watches it, I hope he enjoys it.

The first two episodes of "The Patient" premiere Tuesday, Aug. 30 on Hulu, with new episodes streaming weekly. Watch a trailer via YouTube.

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