The Patient review: Domhnall Gleeson and Steve Carell strap into the rollercoaster from hell

Has it truly taken until now for Domhnall Gleeson to play a morally conflicted serial killer? Maniacal melancholy is an emotional register that the Dubliner seems born to bring to the screen – and he does so with quiet aplomb in The Patient, an absorbing new psychological drama (streaming on Disney+ from today).

This is a two-hander in which Gleeson’s Sam is a bunched fist looking for someone to punch. Opposite the Irishman is Steve Carell, who was once best known for sparkly farces such as Anchorman and the US version of The Office but who has long since transitioned into fraught straight man.

He’s never been straighter than in The Patient, in which he portrays Alan, a therapist whom the troubled Sam has kidnapped and chained in the basement.

Sam feels bad about this. Not too bad, though, because he knows the incarceration is for a good cause. Which is to stop Sam killing again. The depiction of serial killers is so unfair, he explains to his shrieking shrink. Consider Buffalo Bill from Silence of the Lambs – he’s “like a robot”. Whereas Sam is a murderer with feelings.

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He doesn’t enjoy taking lives. It’s just that the urge to do so is overpowering. Right now he has at the top of his wish list a mocking restaurant owner. (Sam works as a health inspector.) Where Alan comes in is talking Sam down from the roof on which he has trapped himself.

There is a version of The Patient that would unfold like the old Gabriel Byrne vehicle In Treatment, with bonus blood spatters. But that isn’t the series that Joel Fields and Joe Weisberg (producer of The Americans) have brought to Disney.

For one thing they resist glamorising Sam. Far from a fascinating villain, he’s a sad sack in a baseball hat. Wisely, the show gives equal time to Alan, as we flash back to his estrangement from his Orthodox Jewish son.

None of which would work without riveting performances. Gleeson and Carell, without ever suggesting that they’re trying to upstage one another, do what is necessary with searing turns across each spare 30-minute episode.

Gleeson captures the schlubby banality of a man average in every way aside from his compunction to kill. Carell is a wasps’ nest of shredded nerves and traumatised befuddlement. Together the two leads cook up a thriller that rarely strays from the therapist’s couch yet is likely to make you feel you’re strapped into the roller coaster from hell.