Russian Doll as Case Study: Lessons for Therapists By Stanton Peele, PhD on 3/18/19 - 1:40 PM

Russian Doll is the mind-boggling Netflix series created by Natasha Lyonne, who stars in and also directs several of the episodes. Intensely psychological, the show explores the life and mind of its main character, Nadia, as she repeatedly emerges from death to relive her life.

Lyonne was famously addicted to heroin in her twenties, as a result of which she developed a heart infection requiring open-heart surgery. She recovered (she is now 39) to achieve acclaim as an actress, most notably in her role as the heroin-addicted inmate Nicky in the Netflix series Orange is the New Black.

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Since Russian Doll is inescapably about loss, self-destruction and addiction, reviewers tend to focus on standard treatment bromides in their reviews, including the determinative role of trauma and the need for treatment. But in fact, the show is brilliant because it smashes all these therapy icons, replacing them with the truths of lived experience, human connection and purpose.

Here are those truths:

Trauma is not definitive. The series uncovers Nadia’s trauma, seen through a little girl’s eyes, in the form of her mother’s madness that causes Nadia to be taken from her. Nadia’s problem wasn’t an event, but the absence of a fundamental relationship in a child’s life, which family friend and therapist, Ruth (played by Elizabeth Ashley) jumped in to fill as her foster mother.

But the series is about overcoming trauma. Rachel Syme describes this existential recovery process in The New Republic:

“With every death scene, Lyonne peels back another layer to show us a new trick. After months of dying, Nadia finally wants to live. She wants more joy, more pain, more music, more dancing.”¹

Nadia’s recovery is also not, as some drug policy reviews of the series suggest, due to her inadvertently taking the therapeutic hallucinogen ketamine. That this drug caused her epiphany is refuted when her friend points out that they had taken ketamine together before. Besides, no one else at the party who consumed the drug went down her existential rabbit hole.

Lesson: Trauma is not a permanently life-altering event, but one experience people encounter on their life journeys.

Recovery occurs through lived experience. Nadia consumes many drugs, drinks heavily, and is addicted to cigarettes. But she undergoes no therapy, doesn’t enter rehab, and attends no 12-step groups. Nor does she embark on traditional recovery, announce that she’s an addict, or take a vow of abstinence.

Instead, after repeatedly dying, each time due to self-inflicted or seemingly random traumas, she seeks a path to affirm life. Having once been addicted is an experience that can add value to life, as Nadia illustrates through the twists in her tale as she ripens her personal pain into a valuable, worthwhile existence.

Lyonne herself followed this process, as suggested by Joy Press in a Vanity Fair piece, titled, “Natasha Lyonne Can’t Stop Living.”

“Lyonne has a way of making everyday life feel like a tremendous, defiant adventure. A larger-than-life personality, she wields wit like it’s an Olympic sport, and exudes a sense of hard-earned wisdom. I wouldn’t describe her as someone “at peace” so much as a person O.K. with where she stands.”²

There is therapy in Doll, as practiced by Ruth, Nadia’s surrogate mother. Ruth practices Eye Movement Desensitization and Reprocessing (EMDR) therapy as a way for her clients to unlearn trauma. But Ruth never administers this therapy to foster daughter Nadia. And she downplays its consequence to an EMDR client; when she releases the man into the street, she instructs him to convert what he has learned into actual life changes.

Lesson: Change occurs on the street, in life, not in the therapist’s office.

Recovery is built on human connection. Nadia constantly returns, after dying, to the bathroom of an apartment filled with “friends” with whom she is celebrating her 36th birthday. But she doesn’t seem to care about any of them, other than a polysexual female couple who are her best friends. Nadia lives alone--except for her missing cat, who has seemingly abandoned her. Yet she interacts with many people in meaningful ways, including a resident of Tompkins Square Park who cuts her hair and she provides with shoes, and a helpful, concerned, all-night deli-grocery store owner.

It is in this deli that Nadia finds her alter ego, a co-sufferer in her life-and-death-and-life syndrome, Alan (Charlie Burnett). Alan is also undergoing a life crisis stemming from loss, a loss that resulted from his own rigidity and personal limitations. Their shared experience is, understandably, a strong bond between the two existential argonauts. Thus, Nadia and Alan help one another. They cure themselves when they reverse their ingrained tendency to ignore other people’s pain and misery (including each other’s when they first unknowingly met). Their two-person support group involves each performing acts of unsolicited kindness for strangers.

When they emerge at the end, their cure is not centered around happiness.

“You promise if I don’t jump, I’ll be happy?” Alan asks.

“No, man,” Nadia says. “Absolutely not. But I can promise you won’t be alone.”

Lyonne herself acknowledges her indebtedness to many people, starting with series co-creators Leslye Headland and Amy Poehler. She shares her deepest intimacy with Chloë Sevigny, who plays her deranged mother:

“Chloë is my closest person in life, and there was really only one person that it felt like it was safe to entrust that role to. Probably the most incredible moment for me was walking home with my little director’s binder in the East Village and watching the sun begin to rise. And I’m like, this is a very different kind of sunrise than what I’ve experienced historically at this hour. This was the good guy’s version of that, and it was deep stuff. Chloë and I had walked those streets so many times, and now it was this world that we had built.”³

Lesson: Recovery occurs when people create rewarding worlds marked by control, connection, and purpose.

And this is exactly the journey therapists should undertake with their clients.


(1) Rachel Syme (Jan. 30, 2019). Russian Doll is a Spiky Comedy About Self Destruction. The New Republic.

(2) Joy Press (Jan. 31, 2019). Natasha Lyonne Can’t Stop Living. Vanity Fair.

(3)Kathryn Shattuck (Jan. 25, 2019). Natasha Lyonne Has a New Life: It’s Just That She Keeps Dying. New York Times.

File under: Musings and Reflections