It’s quite audacious to put on a play looking at the way a rapacious middle-class media takes the stories of the working class, chews them up and regurgitates them as entertainment in Islington – the proud heart of luvvie land. But that’s the theme at the heart of The Treatment – currently playing at the Almeida. The character we are asked to empathise with at the start of the play. Anne with her working class accent and upwardly mobile pretensions is used and possibly abused from the start both for our entertainment and that of the producers Jennifer and Andrew.

The story opens with Anne telling her story of mistreatment by her estranged husband to two strangers. The “treatment” of the title could be some form of talking therapy. It is only as Jennifer focuses on the more visually stunning or salacious parts of the story that we understand this is a movie pitch. Written in 1993, this seems strangely prescient – public revelation as therapy is now almost accepted as normal, but in a world where sushi is seen as strangely exotic (the one detail that really dates the play) this would have been almost unknown – Jerry Springer was only just establishing his style at this time.

The Treatment is at times a jarring drama. It asks us to examine ourselves and our responses to the art we are watching as we do so. The Greek tragedy of Anne and Simon’s relationship is mirrored by the shallow casualness of Jennifer and Andrew’s and, through it, we are asked to examine our own attitudes towards love and what is costs us. Anne is punished for her emotional crimes in a way Andrew is not – it is clear his wealth and class insulate him from such punishment but also from any depth of feeling.

There are themes in The Treatment that may have had more resonance to audiences in 1993. The subplot of the mistreatment of 60s dreamer Clifford by the next generation would have got a more sympathetic ear before we realised quite how badly baby boomers had screwed us all. For me, this theme also places the piece outside of this age, though others in the audience may have disagreed.

I was keener on the staging of the play than I was of the set. This probably speaks to my own prejudices as a city woman. The investment in a huge background cast really pays off. The core cast is rarely seen alone as in each scene there are people going about their business in the background, foreground and everywhere. This makes the small stage feel like a large and yet cramped city, evoking the island of Manhattan perfectly. On the other hand, the blank, beige walls of the production office seemed wrongly dull to me. Totally unlike the kind of projection a character like Jennifer would be expected to present through her space.

The Treatment is a good play but it is a little too sprawling. The comic relief of the taxi driver added nothing for me. The outsourcing of the ultimate nastiness to Anne from Andrew and Jennifer to John felt weak as he had no other real role in the drama. There are too many characters to care about. Maybe this too is deliberate. As a comment on cities, perhaps the crowded cast reflect that sense of claustrophobia that urban living gives you.

But this play made me think. It touched me and it moved me. It has its faults, and some aspects of it haven’t dated well, but the themes are so strong and so well played by a subtle and clever cast that you can’t help but leave the theatre with profound questions about what art is for.

A treatment has so many meanings from therapy to a script. The Treatment does the same for the viewer. It forces you to look at yourself as therapy does, and it reinterprets and neatly repackages reality as art does. If it is at all unsatisfactory, one can’t help but ask if that is not a deliberate choice by this clever drama.

4/5 stars.