‘This Is Us’: Pamela Adlon on Randall’s ‘What If?’ Therapy Session and His Big Rebecca Confrontation

“The anxiety of confronting somebody and knowing that they’re going to say no is very stressful,” Adlon tells TheWrap

This Is Us Sterling K Brown Randall Pamela Adlon
Photo by: Ron Batzdorff/NBC

(Warning: This post contains major spoilers for Tuesday’s episode of “This Is Us.”)

“This Is Us” guest star Pamela Adlon reprised her role as Dr. Leigh in Tuesday’s installment of the NBC family drama to give Randall Pearson (Sterling K. Brown) a much-needed wakeup call during a very intense “what if?” therapy session. During the episode, titled “After the Fire,” Randall sits down with Dr. Leigh and tells her exactly what he thinks his life would have been like if he had stopped his father, Jack (Milo Ventimiglia), from going back inside their house when it was burning down and survived after the fire.

His first go at this is a rosy, happy life in which he finds out about his biological father, William (Ron Cephas Jones) almost immediately after the house fire, because his mother Rebecca (Mandy Moore) finally decides to tell Jack, something she never actually did when he was alive. This leads to Randall being able to have all three of his parents in his life and to him having the same wife, kids and job he has right now. The main differences here are that William survived his cancer, all thanks to Randall being there to help catch it early, and Jack and Randall figure out Rebecca’s memory problems early enough to get her into the clinical trial–

Yeah, here’s where Dr. Leigh cuts Randall off in the middle of this dreamy scenario to ask him to be honest and challenge himself to actually move outside his comfort zone and tell her what scares him the most about what could have happened if Jack survived that night.

“I love all of that. And I like that you can’t get mad at her because he goes to get help,” Adlon told TheWrap. “He seeks counsel from her and she’s like, ‘Oh, you’re blowing smoke up everybody’s ass and your own ass forever. And you’re not letting yourself off the hook.’ And I’m sure people are gonna get mad at my character because they love Randall so much, but she’s just literally doing her job. She’s doing her job.”

By the end of the session, Dr. Leigh has listened to a second “what if?” version of Randall’s life, one that is much less rose-colored and upsets him. Dr. Leigh forces Randall to realize he can’t control everything — and that he still harbors resentment toward Rebecca for keeping William a secret from him for 36 years.

This is what leads him to finally confront Rebecca at the end of the episode and ask her for the only thing he’s ever asked of her in his life: That she do the nine-month clinical trial for Alzheimer’s in St. Louis, Mo. that he found for her. And when he calls her to ask this, she agrees.

“It was finally his breaking point. And even though he was getting, like, really anxious with the therapist, the therapist is unflappable,” Adlon said. “You know, Dr. Leigh is unflappable. I mean, she’s been down this road before with many people. So even when he lashes out at her, and then he comes back, and then he lashes out again, I think he realizes that he’s ready to do the work, he’s ready to do the work — even though he seeks her out and then he rejects her and then he seeks her out again and they’re in the middle of it and he insults her.”

“At the end of the day, it’s all because you’re in avoidance,” the “This Is Us” guest star added. “You don’t want to go do these hard things. He doesn’t want to go to his mom and be rejected by her. He’s just trying to appeal to her sensibilities and he just wants her to go, ‘OK, son, I’ll do this for you.’ The anxiety of confronting somebody and knowing that they’re going to say no is very stressful. So that’s what he needed armor for. He needed to get armor to be able to confront Rebecca.”

The “Better Things” star couldn’t tell us if we’ll see her again, but she did tell us she doesn’t think Randall is anywhere near done with therapy yet: “Oh yeah, it’s not just one and done. For sure.”

As for working with Sterling K. Brown, well, Adlon had nothing but lovely things to stay about working with him for such an intense episode.

“For me, it was one of the most extraordinary experiences as an actor or a person in this industry that I’ve ever had, working with him on those scenes,” Adlon said. “Like, doing this two-hander, it was watching a master. It was literally breathtaking.”

No, seriously, she had NOTHING but good things to say about SKB.

“I gotta tell you, I never saw anything like it,” she continued. “And the amount of time and care that went into shooting the scenes, it felt like we were doing a play and my jaw was literally on the floor. I could not believe how much he does and gives in every scene. It was absolutely one of those things where I thought, ‘Oh, we’re gonna be done by like 10:30 in the morning,’ because we started at 6:30 — and then at 7:30 that night we finished and I was like, ‘Oh, this is what it’s like to have all the time and money in the world to honor something.’ But I gotta tell you, I can’t talk about Sterling enough. I mean, it’s like a cliche — that’s why you’re laughing — because everybody you talk to is like, ‘Oh my God!’”

“This Is Us” airs Tuesdays at 9/8c on NBC.

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