Sam, the killer, is the one seeking treatment, but by the time this drama is over, nearly everyone in this drama reflects upon past actions and decisions or dies trying. David Bianculli, NPR, regarding The Patient (Hulu series)

Don’t get any ideas, I jokingly told my client (patient) who had just raved about The Patient and was recommending it. If you’ve already seen the series, and I hope you have because this whole post is a load of spoilers, you’re aware that the premise involves a client (patient), Sam (Domhnall Gleeson), who kidnaps and imprisons his therapist, Alan (Steve Carell), hoping to be cured of serial killing.

Therapist Lessons Learned (Tongue in Cheek? You Decide)

1. Never publish a book showing you’re an authority on therapy. Your supposed expertise could be your downfall when the next client comes a-knocking (you out).
2. Never fire your clients for not doing the work. You might not be fired back—and your work just got a whole lot harder.
3. Therapy provided under extreme duress does not work. Well, at least not for you.
4. Sometimes involving a client’s loved one (or acquaintance) into his therapy backfires enormously. I mean, maybe you can handle certain people—your client’s cheating spouse, for instance—but his most recent blindfolded, hands-bound, kidnapping victim who’s now going to die because of you?
5. Sometimes involving a client’s parent in therapy backfires enormously. Can you say Dysfunctional Enabler Who Doesn’t Want to Change?
6. Helping your client gain insight isn’t all it’s cracked up to be. I mean, when he then strangles his abuser to the point of near-death is it really such a great breakthrough?
7. A therapy bond, once made, can be hard to break. Or kill.
8. The ethic of confidentiality can actually be breached. You do NOT have to keep your victimization by a client confidential. That is, if you can actually find someone to tell.
9. Dead (or otherwise gone) therapists can still be helpful. Imaginary sessions can often lead to deep insights—if not particularly long-lasting.
10. Never lie to your client about his prognosis. If you pronounce that your uncured, still-murdering client has in fact made great progress so it’s time to end, you just might be forced to stay around forever.
11. Never offer your honest appraisal of your client’s need to be locked up. He is not going to want that.
12. Accept that you’re unlikely to ever know the positive therapeutic effects you’ve created for your patient’s post-treatment life. Huh, he’s actually listened to you. And now you’re dead.

On a more serious note: “Can Serial Killers Be Rehabilitated?”

Lori Kinsella, J.D., Psy.D., answers this question in a recent Psychology Today article (not connected to The Patient). Check it out. Her main points as expressed upfront:

Serial killers prioritize rewards in decision making. Consequences are of little or no value to serial killers.

Research suggests that brains and neuronal activity of people with psychopathy are different from those of typical people.

In the future, drugs may help rehabilitate psychopaths by controlling neurons in specific brain regions.