Freud would’ve had an absolute field day with Sam Fortner. A serial killer who lives with his mother? That’s Norman Bates–level creepy.
Whereas the first two episodes of The Patient established the terms of Alan’s isolated captivity in horrifying detail, this episode adds in a third (and eventually a surprise fourth) player. First, Sam’s mother, Candace Fortner (Linda Emond), arrives to disrupt the world we thought we knew. This allows Alan to speak to someone other than Sam about both Sam’s mental state and his own predicament. As Sam’s mother, Candace knows that this kidnapping situation is wrong, but she’s willing to overlook that if it means her son might be healed.
When the episode opens, we pick right back up where we left off. Candace wobbles uncertainly down the stairs and comes face-to-face with Alan. The way that Carell ekes out a tentative, unthreatening, and uncertain “hullo” as Alan greets this mystery person is just so terrific that the show obviously had to use it twice. Candace wastes no time introducing herself, and while Alan is a bit taken aback by the fact that Sam’s mother is complicit in this situation, it’s honestly not the biggest shocker. Feelings of love, duty, and responsibility are all strong motivators that can contribute to family members enabling one another to continue maladaptive behaviors. Alan knows this, but he’s smart. He calls upon these exact feelings to appeal to Candace to free him.
The back and forth between Candace and Alan begins with wide shots, looking down on Alan from Candace’s elevated perspective on the stairs, with Alan looking up at his would-be savior. But as the scene progresses and it becomes clear that Candace isn’t willing or able to help Alan, director Kevin Bray pulls the camera in for close-ups of both of their faces, indicating that they’re on an equal playing field here. They’re both trapped, albeit in very different ways.
So Alan tries to make lemonade from this lemon of a situation he’s just been handed. When Sam returns that evening, Alan reveals that he met Candace and proposes that they engage in some family therapy. Sam is initially reluctant. He says his mom was a good mom because she made him sandwiches and did his laundry, as if those were the only two solid metrics of a quality mother. (Insert eye roll here.) But eventually he agrees to let her join in.
During this evening session, Alan also tries to get Sam to unlock his chain, at least for the therapy sessions. He asks Sam what he might picture in a situation where Alan attacks him, and Sam drolly responds that he pictures Alan in chains. We know what Alan pictures: a moment in which he can smash his heavy porcelain pitcher and then go ham on Sam with one of the sharp shards. Even though it becomes clear that Sam isn’t going to grant Alan’s request, in a session later in the episode, we see that Alan has placed the pitcher on the table, perhaps as an insurance policy if anything should go wrong. Alan is quietly attempting to protect himself at every turn, and the show is smart to make these attempts so subtle that they might fly under the radar if we didn’t have access to some of Alan’s innermost thoughts. Sam surely doesn’t suspect anything because he agrees to bring his mom down for a session the very next day.
While Sam protests that his relationship and history with his mother have absolutely nothing to do with his violent compulsions, it quickly becomes clear that they do, and it’s to the show’s credit that their bond is presented in a complex and layered way. Not everything in therapy can be traced to childhood experiences and trauma, but our behaviors and thought patterns are often deeply rooted in experiences from our formative years. Both nature and nurture play significant roles in how we’re shaped, and as we learn more about Sam’s life, it seems that the abusive relationship with his father and the passive reaction from his mother to said abuse have contributed to who he is today.
During the session with Candace, Alan successfully gets her onboard with his plan to ask Sam to form an agreement with her. He links Sam’s behaviors to his mother’s well being and encourages Candace to ask Sam to refrain from continuing to do what he’s doing in order to protect her. But Sam feels like he’s been protecting her his entire life. We hear more from Candace than we do from Sam in this session, but Candace makes it clear that she feels that she and Sam would formed some sort of alliance against her abusive husband (Sam’s father) when he became violent. While this is a common way that survivors might look at this situation, Candace fails to recognize that she should have been the one protecting her son. She was an adult, and Sam was a child, and it raises alarm bells when she says that they “found refuge in one another.”
So it’s no surprise that the family session backfires spectacularly. Sam doesn’t really want to explore any of that messy family stuff; he just wants Alan to fix him with some magic wand or a clever string of phrases as they attempt to slurp down pho with plastic spoons. But therapy doesn’t work like that. Life doesn’t work like that.
As a therapist myself, I’m really loving the depiction of the pushback that Alan is getting from Sam throughout these sessions, because even when people want to engage in therapy, it can be very difficult to process the past and give up negative coping mechanisms. In their evening session, Sam plunks down some food containers from the restaurant where his would-be victim works. He’s scratching the itch and testing the waters. When Alan tries to explore these feelings with Sam, he’s horrified to hear his patient say that every one of his victims deserved what they had coming to them.
When Sam leaves, Alan shouts up to Candace for reinforcement, but she’s not having it, so Alan is left alone to grapple with the potential ramifications of his most recent session with Sam. Throughout the episode, Alan also struggles with his memories of his son and his wife, recalling a time when his wife sang at his son’s wedding. On paper, that memory sounds lovely, but in Alan’s reality, Ezra married into a family that practiced Orthodox Judaism, where women are not permitted to sing at religious ceremonies … and yet Alan’s wife insisted on doing so anyway. Ezra provides the emotional core of the memory. As he gets increasingly uncomfortable with the situation, he gazes over at his father, a wounded and distressed look in his eyes. Alan stares back with defiant confidence. It’s not great. Families, amiright?
Later that night, Alan wakes up to a car in the driveway. Sam has brought home something other than five-star food. This time, he has a body in tow. The man is still alive, with duct tape wrapped around his head and blood trickling down his face. Alan’s reaction is one of sheer terror as he realizes that he might just be responsible for whether or not this man leaves the basement alive.
• When Candace initially comes down the stairs, she starts speaking with Alan about Mary, Sam’s ex-wife. Alan stoically — yet hilariously — tries to keep up a modicum of professionalism by maintaining confidentiality in this regard.
• Early on in the episode, we see that Sam has provided Alan with a copy of the DSM, which is basically a diagnosis bible for professionals in mental health. However, if the show takes place in the present, then Sam has provided Alan with an outdated copy of the DSM. The one Alan is reading has been out of print for almost a decade.
• Nathan Barr and Justin Burnett’s score continues to drive the narrative with a tense undertone of suspense and caged emotion. It’s adding a rich additional layer to the experience of watching this show.