‘I Know This Much Is True’ Review: Mark Ruffalo and Derek Cianfrance’s Soul-Crushing HBO Adaptation

To start the second episode of “I Know This Much Is True,” writer-director Derek Cianfrance flashes back to Dominick and Thomas Birdsey’s childhood, as the twin brothers later played by Mark Ruffalo embark on a fateful class field trip to the Statue of Liberty. After Thomas suffers a very public, very embarrassing incident on the bus ride there, Dominick experiences feelings that resurface for the rest of his life: anger toward his jeering classmates, resentment toward his brother for humiliating him by association, and self-admonishment for turning, even for a second, against his family and his closest friend. By the time they reach the ferry to take them to the iconic New York monument, Thomas is too demoralized to make the journey and Dominick has to stay behind with his brother. As the flashback ends, Cianfrance frames the twins sitting next to each other, watching everyone else drift off on the ferry toward a gleaming symbol of the American dream — one they feel further from with each passing day.

Typically, I wouldn’t recap such a beautifully made, emotionally stimulating scene before it airs, but I honestly don’t know how many viewers will see it, since that would mean they kept watching after the first episode. “I Know This Much Is True” is one of the most harrowing television series I’ve ever seen, and I say that as someone appreciative of Cianfrance’s tragic big screen stories (including another significant, painful-in-retrospect bus scene) and as someone who adores “The Leftovers'” most heartbreaking moments enough to revisit them regularly. The first episode of “I Know This Much Is True” frontloads much of the anguish felt and reflected in this six-episode family drama, and even though it’s not wholly representative of the beauty to come, the series’ dour tone can overshadow its remarkable filmmaking, exacting performances, and poignant personal discoveries.

Based on Wally Lamb’s 1998 novel of the same name, “I Know This Much Is True” opens with the same grisly introduction: Fully grown and suffering from paranoid schizophrenia, Thomas Birdsey (Ruffalo) sits in a Connecticut public library and chops off his own hand as a sacrifice to God. Dominick (also Ruffalo), the older brother by a matter of minutes, is called off his house-painting project to the hospital, where he has to choose between obeying his brother’s wishes or signing a release that allows the doctors to reattach the hand. Everything from the words Thomas uses while pleading with his brother to the defense Dominick soon mounts for his decision inform the audience on the state of the twins’ relationship — and foreshadow the troubling family history about to unfold.

From there, Dominick becomes the lead protagonist and occasional narrator, as he tries to find the professional help his brother needs without letting the bureaucratic forces that be stick him in a violent would-be prison. While explaining why Thomas doesn’t belong at the Hatch Institution, Dominick guides viewers through memories of their shared past, and the series cuts between flashbacks to the Birdsey brothers’ childhood and time in college to outline what caused their current circumstance. Parental abuse, spousal abuse, and the death of a newborn have all shaped Dominick into an angry, closed-off adult — not unlike Cianfrance’s past male leads — and one who struggles to have a quiet conversation with hospital staffers (including a very strong Rosie O’Donnell) and who can’t force himself to explain his actions to a happy-go-lucky girlfriend waiting at home (Imogen Poots).

Atsushi Nishijima / HBO

Cianfrance recognizes Dominick’s hostility is getting in the way of his goals, from helping his brother to reuniting with his ex-wife, Dessa (played by the exceptional Kathryn Hahn), and the writer-director wallows with Dominick — watching him try to dig his way out of the deep hole he started in as a child. Shot in 35 mm throughout and capturing magnetic vistas of the Northeast (which should look familiar to anyone who saw “The Place Behind the Pines”), Cianfrance casts his troubled Connecticut setting in a kind of radiant murkiness; more “Twin Peaks” than “Ozark” (which swims in and out of clarity like an uncontrollable tide), it’s as though the earth could swallow Dominick and Thomas at any second, in what would be a mercy kill sent from heaven (just like Thomas predicts).

Meanwhile, Ruffalo has to balance the character’s alienating volatility with his sympathetic plight, a job which proves as challenging as playing two parts. As Thomas, the actor is a rounded ball of anxiety, appearing to gain weight to maximize the mentally ill brother’s softness; it’s impossible to be mad at Thomas, not only because he’s sick, but because he’s everything Dominick isn’t: quiet, reserved, and honest to a fault. Yet the sharp, mangy Dominick is constantly upset with his brother, for reasons both immediately obvious and long-hidden. As the limited series plays out, the siblings’ deep-seeded grudges are well-realized, and your attachment to both brothers intensifies — but it’s a long road to get there, and Dominick often makes you want to slap him upside the head, even though that kind of violence is what got us here in the first place. Cianfrance often takes scenes to an uncomfortable extreme, but Ruffalo shows more restraint. Each brother could become a showy caricature of their written selves, and yet he lives in the small, quiet moments as well as big, explosive outbursts.

At the end of “I Know This Much Is True,” a closing credits card dedicates the limited series to Ruffalo’s brother, Scott, who died in 2008, and Cianfrance’s sister, Megan, who passed away just last year. Such recent losses of close family members helps explain the raw nature of the two producers’ piece; it often feels like the audience is being asked to process as much pain as the characters onscreen, even if that means living with that ache for hours at a time. After reading those names, the hopeful final moments gain both pathos and resonance — like coming out of a dark tunnel you thought would never end, and, rather than squinting into the sunlight, being rejuvenated by its warm rays. Still, there can’t be that many Americans in need of such an upsetting trip, especially now, when reality is daunting enough. Like the fairy ride itself, “I Know This Much Is True” isn’t a journey everyone can take.

Grade: B

“I Know This Much Is True” premieres Sunday, May 10 at 9 p.m. ET on HBO.