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HBO’s Pioneering ‘In Treatment’ Is Back for Another Therapy Session

More than a decade after the drama first engrossed viewers with its groundbreaking format, ‘In Treatment’ returns for a fourth season, with Uzo Aduba as the lead therapist. “We just wanted to show that these people are not superheroes,” co-showrunner Jennifer Schuur says.

HBO/Getty Images/Ringer illustration

The fourth season of In Treatment looks different. It’s not just a matter of who sits in the therapist’s chair, though the casting is both pointed and significant: Uzo Aduba as Dr. Brooke Taylor, a Black woman who cuts a very different figure than Gabriel Byrne’s Paul Weston, from the first three seasons, or Assi Dayan’s Re’uven Daga, from the Israeli original BeTipul. (In Treatment, which first ran from 2008 to 2010 on HBO, began as a close adaptation of BeTipul, which ran from 2005 to 2008 and spawned a slew of international remakes.) It’s the very space she occupies.

Rather than a typical therapist’s office, quiet and understated, Dr. Taylor lives in a spectacular mid-century house with a sweeping view to match. Los Angeles sunlight floods the open space where Brooke sees her patients; at night, when she ruminates on her sessions, a sort of rectangular lava lamp sways hypnotically from side to side. Brooke’s atrium flows into her living room, which flows into her kitchen, which flows into her deck, an organic arrangement stimulating enough that the viewer doesn’t mind spending hours on end in what’s still the same space.

“We’ve all been confined in our homes,” explains Jennifer Schuur, a longtime TV writer who served as co-showrunner for the revival. “We weren’t sure that people would want to be locked in a tiny office crowded by books and dark wood and leather seating and feeling very confined.” So the production filled the house—in reality, a soundstage on the Warner Bros. lot—with warm colors and lush plants. Unlike most TV shows with remarkable real estate, though, In Treatment goes out of its way to explain how a single woman can afford to live in what’s plainly a multimillion-dollar home: Brooke’s recently deceased father was an architect who designed the house in L.A.’s affluent, historically Black Baldwin Hills. Even when In Treatment is meant as an escape, it’s still grounded in truth.

When In Treatment first landed stateside, it earned widespread acclaim (and a couple Emmys) for its groundbreaking format. Rather than condense its plot into a single hour, In Treatment aired five nights a week, with each day corresponding to a single patient—sometimes Paul himself. Fans could be completists or pick and choose which story lines to follow, while the show as a whole mirrored the structure of an actual workweek. With dozens of episodes a season, the work could be grueling, a factor in both behind-the-scenes turnover and the series’ short initial run. But In Treatment also popularized a highly serialized, time-compressed style of viewing that anticipated the streaming-enabled binge-watching that’s since become standard. This time around, HBO will air six cycles of four episodes, aired in back-to-back pairs on Sunday and Monday nights. It’s likely many viewers will simply shotgun the weekly batch on the streaming service HBO Max.

With intense, extended scenes featuring just a handful of actors, In Treatment also functions as an acting showcase. The first three seasons featured decorated veterans (Dianne Wiest, Glynn Turman, Irrfan Khan), young breakouts (Mia Wasikowska, Dane DeHaan, Alison Pill), and beloved fixtures (Josh Charles, Amy Ryan, Blair Underwood). The fourth maintains that tradition while also expanding the show’s depiction of who seeks therapy and why. Hamilton’s Anthony Ramos plays Eladio, a home health aide whose rich employers pay for his sessions. John Benjamin Hickey (The Good Wife) plays Colin, a disgraced tech mogul whose therapy is a condition of his parole. And Quintessa Swindell (Euphoria) plays Laila, a queer teenager brought to Brooke by her grandmother, who has concerns about her sexuality. Liza Colón-Zayas rounds out the cast as Rita, a longtime friend and confidant who takes the place of a therapist as Brooke’s interlocutor.

In the 11 years since In Treatment was last on the air, therapy gradually shed some of its stigma, especially in popular culture. On Showtime, the docuseries Couples Therapy ups the ante by filming actual sessions with real-life patients. Part of that shift can be attributed to the show itself. “Where I come from, if you have to see a therapist, then you’re touched. You’re crazy,” says Joshua Allen, Schuur’s co-showrunner—a point of view he’d internalized when he first encountered the show. “Back then I was like, ‘Only people with disorders have to see therapists.’ And In Treatment was like, ‘No, you can just be going through it as a person.’”

Schuur believes that increasing acceptance of therapy hasn’t been equally distributed. “Sure, it’s been normalized by upper-class white people—probably by the shows that we’re watching,” she says. “But I also think there’s still a large stigma in certain communities of color. Part of our priority in reimagining In Treatment was to be able to show that going to therapy does not mean you are crazy. Going to therapy means that you are on the hunt for an advocate who wants the very best for you, at all times.” That effort is reflected not just in the characters’ demographics, but the conversations between them. Laila, for example, comes from the same well-to-do Baldwin Hills milieu as Dr. Taylor, which gives them a kind of shared language around therapy and its perception. “Laila and Dr. Taylor are two people who come from a community that already has a preconceived notion of what therapy is—something that’s not really done within our community and not well understood by past generations,” Swindell says. “So when [they] come together, [they] mutually deconstruct those ideas.”

To make a TV show about therapy, In Treatment borrows heavily from another medium entirely. With extended scenes locked into a single location, In Treatment can feel closer to the stage than the screen, a fact reflected in the backgrounds of its creative team. (Hickey won a Tony in 2011 for his role in The Normal Heart, while writers Chris Gabo and Jackie Sibblies Drury are also playwrights.) The effect is, in part, democratic; an HBO subscription may cost money, but the price is far lower than a ticket for an Off-Broadway production. As Colón-Zayas sums it up, In Treatment is essentially “the best theater on television.”

The playhouse parallels extend to production. Each episode was filmed in just two days as a single scene, as opposed to the dozens that make up a typical half-hour of TV. “It’s not very often in television where you get to write a 23-page scene of dialogue. That is rarefied air,” Schuur says. “You can’t hide behind explosions and special effects.” It’s a heavy lift for both writers—each of whom was assigned to a specific character’s set of episodes (Schuur and Allen split Brooke’s)—and performers. Hickey would practice by monologuing in headphones while walking his dogs through the Hollywood Hills; Swindell, who’s had issues with memorization in the past, describes a “fight or flight” response to her first script. Naturally, no one had a greater burden than Aduba. “Ginger Rogers said, ‘I did everything [Fred Astaire] did but backwards and in high heels,’” Hickey says. “Uzo was having to do that every single day because she had three other patients. Sometimes I’d get to work and be like, ‘Oh, learning this is so difficult.’ And she’s like, ‘Yeah, tell me about it.’”

HBO hasn’t been shy in admitting the decision to renew In Treatment, with its small cast and lack of crowds, was heavily influenced by the pandemic. The show itself is set not just in lockdown, but the precise juncture we’re at in May 2021: after vaccines have made some amount of in-person contact safe, but not so much that things are fully back to normal. (Brooke’s typical office is in a medical building, hence why she’s practicing out of her home.) While scripting episodes months in advance—basically, predicting the future—could be seen as a challenge, Schuur says the choice to make the pandemic present but not overwhelming was a practical one.

“When you start to get into the nitty-gritty of that, which I have spent too much time doing, you start to realize you’re not going to want to put your actors in masks,” she explains. “You want them to be able to interact with each other, especially a show like this [that] lives and dies by the actors’ faces.” In Treatment lucked out with current reality more or less lining up with the show’s tentative forecast, though Schuur notes there were contingency plans in case things took a turn. Besides, there are some concessions to the Zoom therapy age many of us are still living in: Eladio’s client is immunocompromised, so Ramos and Aduba mostly interact via video chat.

In Treatment’s draw is partly the variety among patients, from Laila’s adolescent insecurity to Colin’s layers of self-delusion. But just as Paul’s dysfunction, which came to include a divorce and a malpractice suit, grew to define the series’ first stateside run, Brooke’s personal issues start to take the spotlight. (Paul may no longer be the focus of In Treatment, but he’s still a peripheral presence; he’s become a celebrity in lockdown, a sort of Dr. Fauci of the soul.) Most of her specific problems are considered spoilers, but they serve a broader thematic purpose. “Psychologically, she’s a hoarder,” Allen says. “People walk into Brooke’s house now, not just her office. And they leave their stuff there and they get to leave. But Brooke is [still] there.”

Like the stage shows it mimics, In Treatment can cross into the overwritten and overwrought; without much physical action, the only way to escalate is to yell. The choose-your-own-adventure structure can mitigate this somewhat—personally, I was drawn to Colin, who makes for an effective contrast with Brooke and experiences the season’s most stark revelations in the 16 episodes I saw. But even as it rejoins a TV landscape that’s caught up to it in many ways, In Treatment remains resonant, if not as singular as it once was. “We just wanted to show that these people are not superheroes,” Schuur says. “They are human beings, just like the rest of us. They have lives that have ups and downs.” No one is exempt from the lessons a good therapist can teach. Least of all a therapist.