Why Are None of these People in Therapy? Doing Battle with Mass Grief in The Leftovers

"Do you want to feel this way?"

A mysterious man approaches Nora, a woman who lost her husband and two children in a split second three years before. Nora looks furious and on edge. She has just finished publicly berating a stranger whose bestselling book promises relief to people grieving after the Departure, a mysterious event in which two percent of the world's population (including Nora's entire family) disappeared from the earth. For Nora, there is no relief, no possibility of repair. 

Still, Nora deeply does not want to feel this way. She follows the mysterious man to an abandoned building where she is introduced to Wayne, a charismatic leader who claims to be able to hug people's pain away. Wayne promises a cure and Nora can't resist the temptation to find out if it's real.

In this regard, Nora is far from alone. Her world is full of people seeking a cure for their grief, existential despair, and metaphysical crisis. Some turn to cults like Wayne's that peddle a delusional vision of healing; others turn to cults like the Guilty Remnant, whose brutal nihilism offers an escape from all feeling. Very few, however, turn to the so-called talking cure — neither psychoanalysis nor any other clinical therapeutic approach. At the start of the series, there appears to be an unspoken collective agreement that therapy is no match for the spiritual and structural dysfunction of a post-Departure world. This is a sentiment that rings truer with each passing year in our own world — each marked by temperatures never imagined, by more unspeakable imperialist violence, by more ground ceded to fascist cultural repression. As the editors of the leftist psychoanalytic magazine Parapraxis put it in the introduction to an issue on the theme of "repair": "The old forms of 'cure' or even 'healing' are no longer available, trustworthy, or sufficient."1

Meanwhile, the new forms that have emerged in their stead are hardly trustworthy or sufficient, whether we're talking about the cults of The Leftovers or the wellness startups, self-help TikToks, or snake-oil-peddling influencers of our own timeline. And so in neither world has the possibility of therapy fully been extinguished. Though the show opens with Laurie, a former therapist, having literally renounced all talk by joining the vow-of-silenced Guilty Remnant, her silence carries the quivering tension of Chekhov's gun, bound to its inevitable explosion. And explode, it does — spectacularly so — at the end of the first season. But once the show's therapist is in, she's not the same one who checked out. Disillusioned with the purported cures of her old profession and her erstwhile "intentional community," Laurie fumbles her way toward something harder, something that can hold but not contain the harm she and others have done and endured in the face of a ruined world. Something we might call repair. 

Early reviews of The Leftovers praised its storytelling while expressing frustration and bewilderment at its air of devastation. It's just so heavy, they all seemed to say. I used to find this puzzling, as a viewer who turned to the show for its humor and surrealism as much as I did for its tragedy. But I've come to think the distaste was based in a thwarted desire for a certain kind of narrative repair that the show teases but consistently unravels — a trajectory toward healing that viewers in 2024 may find less plausible. In 2014, maybe, we were disturbed that the show resisted the conventions of the grief plot, almost mocking our desires for these characters to move through a recognizable Kübler-Rossian process. Now, I'm more disturbed when it seems to give me what I want.

***

The first time I watched The Leftovers, I had spent the previous four months watching one of my closest friends become unrecognizable. The signs were concerning, at first, though still within the realm of the conceivable. Leonor2 had always been witchy, but now she was watching hours of incomprehensible YouTube drivel from a schizophrenic cult leader who claimed aliens had transmitted a mystical intelligence synthesizing the I Ching, astrology, and Kabbalah directly into his brain. Leonor had always had a temper, but now she was screaming at her partner and their dog so menacingly that they were about to get kicked out of their housing complex. At first she asked her friends to help her by vetting therapists and calling treatment centers on her behalf, and then she found reasons to reject them all. In her view, no one could possibly have the expertise to deal with the demands of her increasingly convoluted psyche. After a few months, a distressing situation became unfathomable: she was threatening murder, claiming to be a weapon of mass destruction, and driving 100 miles per hour down the interstate while hallucinating. Within a year, she would be contacting me using a mass murderer's name as an alias.

Despite my deeply held conviction that psychosis is not inherently frightening or dangerous, I now cannot, in good faith, claim that it is never those things. So, I have some things in common with Nora as she builds a second family with The Leftovers' protagonist Kevin Garvey, whose grip on reality is lax, to say the least. The first time I watched Kevin Garvey take off in his pickup truck, driving 100 miles per hour toward an alternative medicine practitioner with big scammer energy who had promised to feed him poison that would kill the voice in his head, I said, out loud: you've got to be fucking kidding me. 

Like Nora, in the end, I walked away. After months of watching someone I immeasurably loved embrace a metamorphosis into a cruel and abusive false messiah, I was waking up every day in a panic and becoming untethered from the rest of my life. I signed a letter with an ultimatum: accept mental health care or we can't be in contact. We haven't spoken since. Every day I try and mostly fail to forgive myself, and I wrestle with my complicity in a system that makes sick people disposable when they don't submit to carceral and inhuman psychiatric "care." But when I watch Kevin confess to Nora that he is seeing and speaking to a dead woman, and I watch the fear and revulsion spread across Nora's face as he asks for her help, I do not relate to her. And when Nora unceremoniously abandons Kevin in the middle of the night, I am consumed with the kind of visceral fury that reminds me I'm not always what they call sane, either. 

Rewatching that scene, I text a mutual friend who also started watching the show after Leonor's breakdown: 

Can you even imagine

When my loved one was unlatching from reality, all I wanted on this forsaken earth was to hear the kinds of words from her that made Nora leave Kevin. When I heard Leonor had lapsed into lucidity for two minutes and asked to be taken to a hospital, I wept with short-lived joy and relief. But Nora treats that gift like a punishment. 

I know, it's not hard to see why. For Nora to accept that Kevin could claim responsibility for the things he'd done in an altered state would mean accepting that she could claim responsibility for the things she'd done in her grief. To accept that Kevin could be helped toward a less destructive orientation to the world would be to accept the same truth about herself. And to do so would mean losing her last connection to her departed family: her rage. I know. Leonor, my beloved and impossible hurricane of a friend, had a thousand reasons to cling to her rage before it fully enveloped her. At some point, though, prioritizing your attachment to your rage over the well-being of others — whatever the reason, it does kind of make you a dick. And more than that, I think: it makes you doomed.

***

Now I'm mixing up my analogies. Who is like me, and who is like the person I lost? Who is in crisis and who is cruel? But that's the thing about The Leftovers, as in life: the answer is everyone. (Except maybe Jill, who makes the only good decision in the entire series and goes away to college.) And although it's possible to recognize elements of profound dysfunction in almost everyone on the show, none of them seem even remotely aware that there might be a therapeutic pathway available to them, despite the fact that one of the lead characters is a therapist.

Probably the most common way people describe The Leftovers these days is "prescient," referring to the fact that we now find ourselves right about where the Garvey clan is at the beginning of the first season: several years into a collective grieving process whose magnitude and contours still mostly elude us. What we do know is that the world feels more unhinged than it used to. I had lived in New York for thirteen years when the pandemic hit, but I had never been kept awake by the screams of people breaking down the way I was most nights afterward. Everyone knows someone who had just barely been keeping it together in the early days of 2020, and then wasn't. There weren't nearly enough therapists to meet the demand of people newly seeking them, and with the market as our primary problem-solver we saw pre-ChatGPT-caliber bots being peddled as substitutes. 

Meanwhile, those of us blessed with actual human mental health practitioners found ourselves faced with a profession at a loss. What could therapy even offer? The panic we felt had little to do with our originary traumas, and a virus does not respond to self-talk. (Relatable.) No one knew how to begin processing deaths only witnessed via FaceTime. There was no outside perspective on the situation, no such thing as a neutral observer. It all felt too big for a 45-minute conversation every Thursday afternoon. It was too big.

So, right: prescience. It does feel correct that the universe of The Leftovers seems to contain exactly one therapist, who gave up her practice following a global catastrophe. At the same time, in our world and theirs, pop psychology offers solace — but only to some. In 2021, the New York Times ran a profile of Pauline Boss, the therapist who coined the concept of "ambiguous loss" to describe grief that lacks a traditional object: no body to bury, maybe no body at all.3 Emerging from her early research on absent fathers and fighter pilots, whose families ambiently mourned their psychological or physical presence, the concept grew to encompass all kinds of ruptures that lack cultural scripts or rituals for mourning: divorce, immigration, loved ones radically transforming due to addiction or mental illness. 

In her book The Myth of Closure, Boss expands the concept from its grounding in individual relationships to the societal scales of pandemic grief and racial injustice. She attributes COVID denialism, at least in part, to Americans' misplaced faith in the possibility of closure: "While pandemic deniers are not using the term 'closure,' their actions reflect their beliefs in it. Case closed, no danger, absolute thinking. . . . Our task now, in a time of so much suffering, is to acknowledge our losses, name them, find meaning in them, and let go of the quest for closure. Instead of searching for closure, we search for meaning and new hope."4  

The Leftovers takes this ostensibly reasonable approach and spits right in its face. In the scene that opened this essay, from the season 1 episode "Guest," Nora goes nuclear on the author of the bestselling memoir What's Next, which frames his departed family members in terms of ambiguous loss. "What is ambiguous about your family being gone?" Nora seethes. "If you were in pain you would know there is no moving on. . . . What's next? What's fucking next? Nothing is next! Nothing!" This is, of course, the same nihilistic logic that drives the Guilty Remnant, who believe that to remember the losses of The Departure is to renounce meaning in everything that came after it. 

The fact that the actual therapeutic framework of ambiguous loss encourages neither a positivist pursuit of happiness (as espoused by the memoirist) nor a melancholic refusal to move forward (as espoused by Nora and the GR) is lost on everyone in the Leftovers universe. Stripped of the capacity for meaning-making after a meaningless catastrophe, they either repress their devastation or become consumed by it. In this world bound to raw extremes, therapy is structurally impotent, a thing of the before times that failed to protect anyone from the catastrophic After. But devotion to devastation does offer a kind of protection: the assurance that you can survive the worst possible thing because you're always already in it. As Laurie's former-patient-turned-cult-leader Patti tells Kevin just before her death, "There was a time I told Laurie everything. And then she told me everything. But she came to me because I offered her something that you could not: purpose." Implied is that Laurie the therapist couldn't offer it to Patti the patient, either.

And yet, something is going on with Laurie the therapist. While every single thing that happens on the show might be characterized as extreme, there are times when things get Too Big even for these very big characters. That's when Laurie shows up. When Tommy gets left alone with Wayne's love child and his lost faith, there's Laurie loitering by the cursed departure memorial. When ghost-Patti starts telling Kevin maybe Jill would be better off if he killed himself, there's Laurie at the gates of Jarden. When Kevin hallucinates Evie in Australia, who does he call? When things are getting scary over at the Garvey Messianic Cult compound, who slips them all a tranquilizer to make sure Kevin's given informed consent for his ceremonial drowning? Who does Nora call when Kevin shows up sixteen years later acting like Dougie Jones from Twin Peaks: The Return? Laurie's got her own shit, to be sure, but when the narrative needs a stabilizing presence, it's Laurie, every time.

Laurie the therapist moves in tension with another figure: Laurie, the failed healer. When she contemplates suicide at the end of the final season, it seems to be grounded in an acceptance that she has not been able to heal anyone — her family, her patients, her former brethren in the GR — except maybe, paradoxically, herself. Their problems are too big. They are not just existential or psychological but social, structural, cosmological. So, she lets go. When Laurie plunges backward into the Pacific Ocean, she drops away from a world-ensnaring web of wounds too enormous for any therapeutic philosophy to grasp.

But then, sweet mercy, Laurie lives.

***

I often think back to the Google Doc that Leonor's friends populated and maintained, a long list of therapists, psychiatrists, inpatient and outpatient treatment centers. Under each was another list specifying which of Leonor's many self-identified needs for support overlapped with the provider's specialties. While some were personal, others named forms of systemic rupture and oppression. No practitioner or practice checked all the boxes, so she always had reason not to trust. How could she know this trauma specialist would understand her experience as an immigrant, or that this treatment center would never subject her to surveillance? Of course she couldn't. She wasn't wrong. But as she became more convinced that her problems were too structural and complex for any therapist to handle, the truer it became, because she wouldn't let anyone try to reach her. Shortly before her first full psychotic episode, she declared mental health care just wasn't for her; she was healing herself.

I don't know that any of the names on that list could have made Leonor's story turn out differently. What I do know is that, once her mania reached a point where her options shifted from therapists to cops and ER staff, her range of possible trajectories diminished rapidly. We all know the mental health care system is in crisis, but I'm not sure you really know it until a social worker tells you it's a good thing this is the first time your loved one has been homeless because otherwise they would have discharged her on the spot. Even under the purportedly felicitous conditions she was in, the hospital did what it typically does, which is spend 48-72 hours pumping a person full of antipsychotics that take weeks to fully kick in and then send them off with a prescription regimen they have no capacity to follow. That's why anyone with intimate knowledge of severe mental illness was appalled by New York Mayor Eric Adams' proposal to reduce homelessness by having cops round people up off the subways and deposit them in the understaffed and underfunded psychiatric hospital system. The one thing worse than therapy at addressing the effects of complex systems of institutional neglect and control is, well, the systems themselves. 

That's something The Leftovers understands about our world, in a way I haven't seen any other show quite capture. First, apocalyptic catastrophe is chronic rather than a traumatic event — whether it's climate disaster, the takeover of schools and courts by fascist moralizers, pandemics that never really end — and second, catastrophe doesn't necessarily obliterate social and political structures so much as it zombifies or makes caricatures of them. The cops, represented via the avatars of Kevin Jr. and Sr., are literally psychotic. The church is broke, hemorrhaging congregants, and bought out by a nihilist cult. In Jarden, the hospital's emergency department is managed by a physician whose husband is regularly the source of patients' injuries. The fire department is a band of vigilante arsonists. The federal government has two departments: one staffed with murderous psychopaths (Bureau of Alcohol, Tobacco, Firearms, Explosives and Cults) and the other with pointless bureaucrats (Department of Sudden Departures). Scientific research has been co-opted by conspiracy theorists and suicide-machine salesmen. The show has a traumatic relation to the emergency response system, returning over and over to the busy lines and frantic, futile voicemails of October 13th. Though that day didn't outright destroy the institutions that structured daily life before it, it surely ruptured any sense that they could be depended on in a crisis. The systems still exist, but you navigate them at your own risk. 

Though we don't see much of the pre-Departure America, it's hard to imagine it was much different from our own 2014, which was arguably the beginning of the so-called Trump Era and was marked by the Flint water crisis, Ferguson protests, Ebola outbreak, record ocean heat, and 273 mass shootings, including the UC Santa Barbara massacre whose incel and white-supremacist perpetrator Elliot Rodger came to represent a rising tide of far-right violence. Even in 2013, when HBO ordered the pilot, trust in American institutions was already plummeting. And so, when Patti came to Laurie's office predicting that "something terrible's about to happen," she surely wasn't the only one portending the end of the world. But Laurie's attempts at redirection—insisting that Patti's anxiety must be related to her ex-husband — are emblematic of mainstream therapy's tendency to personalize or pathologize global issues. The exchange is nearly identical to those cited in a recent Scientific American feature on eco-anxiety: 

In the aftermath of disaster, though, Laurie's approach changes. She does not attempt to unearth the subterranean motives for others' behaviors — which are often, post-catastrophe, quite clear on the surface — but to respond with compassion and understanding toward the person in front of her. As Amy Brenneman put it in a 2017 interview, reflecting on Laurie's transformation from her initial hardened persona, "It's a scenario where people say, 'I have these crazy beliefs, I'm going to do this crazy action and I know you're going to judge me.' But in each case, Laurie says, 'I support you.' It's a real sea change."6

And so we see her nodding with understanding as her loved ones hurtle further into a delusion that her ex-husband is a messiah, and being present for Nora as she maniacally pursues what looks like suicide by technosalvationist scam. Is it enough? Who can say? But it is, more or less, something the people in her life need. Those of us who have frantically googled "how to talk to a person with delusions" can recognize Laurie's approach as a kind of therapeutic industry standard: affirm the person's feelings, don't argue with their reality, and don't indulge it. 

We can also recognize the limits of this approach. Does just recognizing someone's pain get them not to plunge into the suicide machine? No. Does it get them into secure housing? No. Does it change the nature of a psychiatric care system that sets people up to become more paranoid and precarious? Does it do anything about the fact that every day our world seems to get hotter, heavier, and more cruel, full of more reasons to leave this reality behind? No, it's not enough. But sometimes it's all we have, and it's what gets everyone through to another day still alive.

A little-known piece of Leftovers lore is that the writers intended for Laurie to kill herself. They wrote the scuba-diving episode, filmed it, watched it, and realized Amy Brenneman had not played the part of a woman who wanted to die. Plus some of them couldn't live with what they'd done. So, they brought Laurie back last-minute as Nora's therapist, seemingly pulling an about-face on the therapy-critical stance the show had built over three seasons. If we take Nora at her word about what transpired in the machine, we're left with an ending fit for the leather couch: Nora went to the source of her trauma — an individual, identifiable origin—and only by doing so could she move past it. Curtain closed on the grief plot. It's out of step with everything the show has led us to expect, and, famously, it's hard to believe. There is a world of Redditors devoted to the idea that Nora is lying in her final monologue, and while it's a fun question to debate at parties, I'm not sure any answer changes much about the tenor of her final decision to accept Kevin's love. At that point, she's spent the entire episode trying to prevent him from puncturing the façade of the escape-life she'd invented as "Sarah," a woman who seemingly has never had or lost a family. And she has spent sixteen years avoiding the family she might still be able to salvage — the family whose fracturedness and resilience reflects the grieving world in which it was formed. Whatever we might take "healing" to mean, Nora's final incarnation does not fit easily into it. 

But when I see Nora pick up the phone and call Laurie in the series finale, and my heart leaps to learn that Laurie still lives, I understand why, despite everything, The Leftovers needs its therapist. It is a show that, at every turn, begs us not to confuse not-being-enough with being pointless. Nothing will heal the loss of the Sudden Departure and there is no such thing as closure. But there is purpose beyond the self-cannibalizing kind Patti offered. Even Nora can see it in the end, regardless of whether you think her story is true. Either she left the notion of closure with her actual children or she narrated it away, but in either case, she did find a something next inside her grief. For decades, Laurie was the only thing she brought with her. 

***

In the ongoing loss of my friend's madness, of not knowing whether someone I loved is alive or dead, there are two songs that will turn me to a puddle on the floor: the piano theme from The Leftovers and "MAN IS LIKE A SPRING FLOWER" by Lingua Ignota. In the latter, after about three minutes of austere, Bulgarian-folk-inflected incantations figuring "the heart of man" as everything from a "crushed horse's tail" to "the hand of God extended," the otherworldly singer Kristin Hayter switches gears to a swelling and mournful coda that would be perfectly at home in any closing sequence of The Leftovers:

And yet we hold it anyway. Just ask Kevin in the penultimate episode of the show, "The Most Powerful Man in the World (and His Identical Twin Brother)," weeping as he extracts from his own heart the key that will end his escapades to the afterlife. It is his first act of looking directly into his life's deep well of loss, and into his fear of his own smallness in the face of that loss, and resolving not to run from it. That is, what some of us therapized nuisances might call "the work." 

In lesser writers' hands the metaphor would sink into sentiment, but The Leftovers doesn't let us avoid the gnarly material reality: to hold one's literal heart is to bleed, to spurt, to gurgle. To hold one's "heart" in a therapeutic process — to face the enormity of grief or trauma in all its forms — is no less physical, no less a source of visceral fear and revulsion for most. To hold it is to say: Yes, it is impossible. Yes, it is unbearable. Yes, it is everything it touches, it is enormous. But it is not too big to behold or be held. 

This is what Laurie the therapist offers her broken world, and what The Leftovers offers ours: permission to say the heart is not enough, but if we don't hold it we are doomed; we cannot hold it alone; we are not too late. 

The future comes back, like doves. It doesn't look the way you thought it would. It doesn't care how many times you've missed it.

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Liz Bowen is an assistant professor in the Center for Bioethics and Humanities at SUNY Upstate Medical University. She is the author of the poetry collections Sugarblood (Metatron Press, 2017) and Compassion Fountain (Trembling Pillow Press, 2022).

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