“I Know This Much Is True” brings an empathic look at mental illness to HBO

I Know This Much Is True Mark Ruffalo in I Know This Much Is True. (HBO)

Derek Cianfrance’s new miniseries avoids pitfalls with well-rounded characters and two terrific performances from Mark Ruffalo.

I Know This Much Is True is pretty far from the upbeat fare most people are craving these days. It’s dark, it’s depressing, and it can even be bleak. But, it’s also miraculous. It’s an incredible meditation on mental health that’s still ultimately hopeful and a show rippling with empathy. Based on the Wally Lamb book of the same name, showrunner Derek Cianfrance (Blue ValentineThe Place Beyond the Pines) expertly manages to prevent the miniseries from feeling like nothing but psychological torture porn, creating something incredible instead.

By all accounts, Dominick Birdsey (Mark Ruffalo) does not have a good life. He’s a 40-year-old depressed divorcee who spends most of his waking hours painting houses and taking care of his schizophrenic twin brother, Thomas (also Ruffalo), who’s been in and out of mental institutions since their college days. His mother is dead, his relationship with his abusive stepfather is strained, and his biological father is a mystery. Dom is deeply lonely and altogether too accepting of his loneliness.

I Know This Much Is True introduces us to the Birdsey twins at the most horrifying and shocking moment of their lives. It’s 1990. Thomas has wandered into a library where he’s begun to shout Biblical verses before brandishing a knife and cutting off his own hand. With this, a chain reaction unfolds, leading to Dom’s struggle to keep his brother safe from the machinery of America’s warped mental health system.

The show uses Dom’s narration to bounce around through time. We see the boys’ childhood and their college days. We see the slow and then rapid decline of Thomas’s mental health. We even see Dom’s marriage and the heartbreaking, devastating reasons it fell apart. In between, we see Dom meet with professional after professional trying to do his best for his brother, who’s become a media sensation due to the horrific nature of his breakdown.

It’s in these moments that it becomes clear how much the show advocates for mental health. Rosie O’Donnell makes an appearance as a smart, even-keeled social worker who cares a great deal for the Birdseys. Archie Panjabi, on the other hand, plays Dr. Patel, the psychiatrist in charge of Thomas’s treatment—and perhaps the only person who really understands the gravity of Dominick’s pain. It’s so clear that the Birdseys are better off with these women in their lives, even with the endless red tape of a fractured system.

But beyond that, I Know This Much Is True understands a crucial lesson show many shows—especially shows about tortured straight white men—don’t. That’s that you cannot treat the other people in your main character’s life as props. Other people do not exist merely to propel our hero forward. They’re people in their own right, with their own sense of humanity and their own worries, fears, and loves. 

Cianfrance really understands how to let every character breathe. They all contain emotional interiority. It’s always clear what they’re thinking, why, and what they want. It all works to drive at the central theme of the show, which is that pain and suffering do not make you extraordinary. Everyone has their own pain and struggles. What matters is how they deal with it, how they cope. And coping is the one thing Dominick so clearly has no idea how to do.

[The characters] all contain emotional interiority. It’s always clear what they’re thinking, why, and what they want.

Thankfully, Ruffalo’s performance as the twins here is a career best. He melts into each brother so completely that it’s almost startling to remember that he plays both of them. Thomas has a gentle, doughy face with eyes constantly seem to be pleading for someone to understand him. Dominick, on the other hand, has cold, hard stares that look out at a world that has beaten him down time and time again. When the brothers hug and Cianfrance lingers on their faces, it’s enough to make the viewer want to weep.

It all adds up to what is by far one of the most rewarding and beautiful things HBO has produced. Its premise might seem like a weight too heavy to bear right now, and while the show is not bingeable—I strongly advise against watching more than one episode at a time once all the episodes have aired—it’s never, ever punishing. It only ever feels true. And that’s worth watching for.

I Know This Much Is True debuts this Sunday, May 10 at 8:00 pm on HBO.

I Know This Much Is True Trailer:

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