This episode of American Horror Story is as upsetting as the source of its title, and it’s a testament to just how committed this season is to returning to its more dark and serious roots.

Alma (Ryan Kiera Armstrong, Anne with an E) and Ursula (Leslie Grossman, Love, Victor) truly proved themselves to be as vile as they had established themselves to be. While Belle (Frances Conroy, Joker) herself was still awful, it was as if her overstated persona and bluntness softened the viewer’s perception of her cruelty. With Alma and Ursula, they’re just a child and a greedy woman who are willing to destroy a helpless woman from the inside out for no other reason than to make their lives more convenient. While Harry (Finn Wittrock, Ratched) is still the shoe in for the “Worst Husband of the Year”—a title once crowned to Belle’s husband before she killed him—he, at least, still retains enough sense to not dispose of Doris (Lily Rabe, The First Lady) or torture her.

More than anything, it’s the psychological attacks on Doris that make this episode difficult to stomach. Watching her struggle to be heard and believed as everyone around her wants to keep their success, even if that means using her pregnancy and personal dreams against her, is more horrific than murders or blood drinking.

It’s a wonder how Alma became so vindictive and manipulative—she doesn’t do any favors to the reputation of homeschooled kids—and watching her try to convince Doris to take the pill with the express intent to get rid of her, under the guise of believing her to actually be talented enough for the pill to work, is stomach churning and impressive, especially in regards to Armstrong’s acting. The moment when she finally convinced Doris to take the pill was as tragic as it had been built up to be.

Even more so when she began to lose her hair and succumb to the pill’s negative effects. The season did a great job establishing running visual and auditory motifs, as when Doris began to hear the sound of the baby’s heartbeat there was an immediate tension and suspense instilled, as the auditory motif was already established as the precursor to a bloodbath.

While not completely a surprise, there was still enough previously set up to make Harry’s interference in Doris’ filicide feel less expected than it otherwise could have been. It was a wonder, however, that his heightened aggression as a result of the pill didn’t cause him to lash out and kill at least Ursula when they revealed what they had done.

But, then again, his pathetic, self-absorbed monologue to Doris did reveal his true feelings, so there was probably less distress and anger than there should have been if his assertions about family and love were as genuine as he had tried to convince himself they were. Though, perhaps, that’s also a result of the pill, as it was only when he achieved success that any thoughts of leaving Doris for more would even be somewhat logical.

All in all, this was the best episode of the season as it truly achieves the titular horror they strived for, made good on the running visual and auditory motifs they had established in order to ramp up the tension and conflict which reached levels they hadn’t yet reached previously—understandable, as they needed to work through the narrative to reach this point, this being the penultimate episode of this part of the double feature—and with the plot threads beginning to intersect, it made for an episode that demands full, undivided attention.

Watching Mickey’s (Macaulay Culkin, Home Alone) descent was as tragic as when Karen (Sarah Paulson, Ratched) finally took the pill herself. Whereas Doris taking the pill elicited fear and suspense, Karen doing the same elicited heartbreak; she tried so hard to stand by her beliefs, but the broken system gave her no option, which was an antithesis to all the others who took the pill.

For the others, Mickey included, they took it because they wanted success. Mickey took the pill because he was already at the bottom and wanted out—a valid want, which was why his decision was the most sympathetic—but he did it with the goal of success and all the luxuries that come with it which, again, is still valid. Harry took the pill because he wanted to financially support his growing family through his work, Belle and Austin (Evan Peters, The Mare of Easttown) continue to take it because they’ve become accustomed to the success and need the power, and Alma took it to be the best without having to try.

They took the pill with the express knowledge and catch that they achieve all they wanted and more. Even those for whom the pill didn’t work, as seen with Doris, they wanted to reach their goals and be successful, and there’s nothing wrong with that, but Karen took the pill to stay alive, with no wants or inclinations to follow the path of success that all the others have gone down, which made for a very interesting result when she made it very clear that she was never going to be indoctrinated into the ways of Belle and the others.

Karen in general was the most interesting of the episode as she remains the only character not completely motivated by the allures of grandeur. Of course, she did dream about not being treated poorly and being financially stable, possibly even rich, but she and Mickey had a different outlook. Both poor, they both knew that getting out of their situation was near impossible, and they were both talented.

Mickey saw his situation as one that barred him from being able to pursue his talent—which isn’t inaccurate, as he had to spend most of his time trying to get by—whereas Karen saw her situation as one that barred her from being able to pursue her talent as a career. She went to the beach to paint in this episode which Belle mocked, saying that she had nothing to show for it. While it could be taken as her thinking the paintings were ugly, another interpretation could be that she doesn’t see the point in making art if it’s not monetizable or, in some way, earning the artist praise and success. Last episode, pre-pill Belle said that she would write no matter what as it’s part of her, but she’s lost that belief entirely, scoffing at it when shown through Karen. It will be interesting to see her reaction to Karen’s final masterpiece next to Mickey’s dead body.

While once again heavy handed in their dialogue to establish just how awful the vampires are, and Ursula managing to stay alive being a giant disappointment, this episode was an overall success as the running visual and auditory motifs kept everything cohesive while also adding to the narrative, and the visual parallels of Doris and the first Pale Person introduced in the show were a nice touch, so it will be interesting to see how everything plays out in Red Tide’s finale next week.

Rating: 8.75/10