‘In Treatment’ Review: Season 4 Struggles to Reboot HBO’s Therapy Drama, Even as Uzo Aduba Shines

Therapy can be exhausting. Having any kind of emotional conversation can be exhausting. These days, being so out of practice, any conversation at all can be exhausting — even when you’re just listening.

The original seasons of HBO’s “In Treatment” turn talk therapy into profound theater. Dr. Paul Weston (played by Gabriel Byrne) meets with patients, and the audience at home gets to watch each session. The show’s brilliant design allows viewers to do what Paul can’t: pick and choose which patients to follow — including Paul himself, who holds weekly sessions with a therapist of his own. It can feel like you’re working alongside the doctor, until the end of the week, when you have see him in a new light. HBO originally aired episodes every weeknight, with each day of the week devoted to the same patient, before shifting to block releases on Sundays and Mondays.

What may appear to be one of the simplest TV setups imaginable is actually incredibly complex. Every component has to work perfectly: The direction has to break up the simple shot-reverse-shot framings in order to hold viewers’ attention; the writing has to create a a believable back-and-forth while establishing tension and suspense rooted in what’s said (and what’s held back); the acting — which is top-tier in early seasons — has to be natural yet commanding, unique yet relatable, and constantly reactive. Putting together these aspects (and more) four-to-five times per week, one half-hour at a time, is an immense challenge, even back when head writer Rodrigo Garcia was sticking close to Hagai Levi’s scripts from the original Israeli series, “BeTipul.”

All of this is to say that if a few minor elements are off in a series like “In Treatment,” the whole show can wither — and not everything in Season 4 clicks.

Much has changed in the 10 years “In Treatment” has been off the air. Season 4 introduces new showrunners Jennifer Schuur (“Big Love,” “My Brilliant Friend”) and Joshua Allen (“Empire”) along with a new lead: Dr. Brooke Taylor, played by three-time Emmy winner Uzo Aduba. Dr. Taylor resides in Los Angeles, not New York, nestled within a gorgeous, well-manicured home in the Baldwin Hills neighborhood that provides her patients a shimmering view of the downtown skyline. Still, she’s only holding sessions there because her Santa Monica office is part of a medical building facing restricted access during the pandemic; yes, COVID-19 is a part of Season 4, though its most noticeable impact (beside guests awkwardly claiming they’re vaccinated) is that she sees one patient virtually.

That would be Eladio, played by “Hamilton” and “In the Heights” star Anthony Ramos. The home health aide for a wealthy family’s adult son, Eladio starts seeing Dr. Taylor for insomnia. He’s worried his lack of sleep will impact his work, and the family, in turn, is worried enough to pay for his pricey sessions. Also seeing Dr. Taylor at no cost to him is Colin (Tony winner John Benjamin Hickey), a recent parolee whose freedom depends on a therapist’s guarantee he’s no harm to himself or others. Though sent away for committing fraud from his high-salaried tech job, Colin exhibited enough volatile behavior in prison to get the court worried this white collar criminal is more than just a thief. Lastly, there’s Laila (“Euphoria’s” Quintessa Swindell), a teen brought in by her grandmother after she “chooses” to be gay. Her introduction is a bit confusing, seeing that Dr. Taylor makes it clear she won’t support any type of “conversion therapy,” but soon Laila gets past her glib attacks on the good doctor and divulges trauma in need of counsel.

Each of these performers does fine work. Ramos is a star no matter the project or his allotted time; he followed up raves in “Hamilton” by stealing scenes in Spike Lee’s “She’s Gotta Have It” series, and his carefully constructed interior life is all the more impressive as he unveils Eladio over Zoom. Hickey is perhaps too good at the privileged white charmer, exuding an icky all-knowing energy from the get-go that pairs all too well with a devilish playfulness he deploys later on, and Swindell holds her own against Aduba.


Anthony Ramos in “In Treatment”

Suzanne Tenner / HBO

Acting isn’t one of the nagging issues tripping up Season 4, but Dr. Taylor is; as revealed in her weekly chats with Rita (Liza Colón-Zayas), a long-time confidante, Brooke is a mess. Spoiler embargoes prevent me from getting into too many details, but Dr. Taylor isn’t an untrustworthy narrator — we know what she’s doing when no one’s around to watch her — but she is an untrustworthy therapist, which creates unnecessary complications in how we interpret her professional advice.

She also takes on a disproportionate amount of the narrative focus. None of the 16 episodes screened for critics are wholly devoted to the patient, which can make it seem like the patients’ problems are just interruptions to Brooke’s story, which is overloaded with drama. It’s not just that Brooke is either unable or unwilling to set her personal life aside for her patients (again, it’s hard to tell how we should read some of her choices), it’s that scripts are unbalanced. Conversations often veer away from the person and into what the person represents. Each of Brooke’s clients in Season 4 come to embody an issue or group — Black American teens or privileged white men or essential workers who aren’t treated that way — more than they stand out as unique individuals in need of help. Sessions can feel like Brooke isn’t just trying to work out a problem for the patient; she’s trying to fix problems for the world.

Going that big and broad can feel — you guessed it — exhausting. “In Treatment” is still a theater piece, even if directors like Michelle MacLaren get off the couch as often as possible, and it still comes alive in spurts thanks to great performers bringing human moments to life. But the new season has lost that sense of personal discovery, and even mystery, that drove so much of the early stories. You don’t feel like you’re working alongside the doctor anymore, trying to get to the bottom of what’s being said or nudging patients toward voicing what’s kept unsaid. (You don’t even know if the doctor should be there!) What you’re doing is listening to people vent, which, sure, can be a big part of therapy. But there’s a reason therapists put limits on sessions. Eventually, all that talking just wears you out.

Grade: B-

“In Treatment” Season 4 premieres Sunday, May 23 at 9 p.m. ET on HBO. New episodes will air in pairs on Sunday and Monday nights until the 24-episode first season concludes.

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