Mark Ruffalo in I Know This Much Is True, Sky Atlantic

This is hardly the time for misery porn. But often the keenest tragedies stockpile so much hurt that they function as an escape – albeit a cold, grey and lonely one.

Throughout I Know This Much Is True, the house painter Dominick Birdsey (Mark Ruffalo) drowns in stories of child abuse, murder, self-mutilation and rape. Whenever you think turning a worse corner is impossible, a new tragedy strikes or an old trauma is revealed that tests him further. Other than the biblical Job, it’s hard to imagine a more unfortunate man.

Although these are maybe the worst times to release such a drama, this six-part series is an emotional distraction of the heaviest kind. Maybe Dominick’s troubles can help us forget our own for a while.

Mark Ruffalo plays house-painter Dominick, a house-painter caring for his schizophrenic brother

I Know This Much Is True starts with a striking image, one that brutally slices into memory. Dominick’s twin brother Thomas (also Ruffalo), who suffers from paranoid schizophrenia, chants Christian messages inside a library – before raising a curved knife and sawing his hand off. It’s a sacrifice to God for the sins of George H W Bush, who’s sending troops into Iraq at the time of the story (1990).

This purposeful incident propels Dominick to tell his story in a thick and beautiful voice-over, which wanes as the series continues. He dips into the stressful and mortifying memories of growing up with his mentally unstable brother, his abusive stepfather (John Procaccino) and his submissive mother (Melissa Leo), who’s now dying from cancer.

Smoke from the past billows into his present as he tries to make sense of his family’s hard luck: searching for his estranged birth father and reading a memoir by his maternal grandfather, a revolting misogynist.

Ruffalo also plays Dominick's twin brother, Thomas

Filmmaker Derek Cianfrance (Blue Valentine, The Place Beyond the Pines) directs the entire series and co-writes with Anya Epstein (The Affair), adapted from Wally Lamb’s 900-page tome of a novel. Cianfrance’s previous film – the underrated but imperfect adaptation of M L Stedman’s The Light Between Oceans – suffered from trying to pack so much story into an airtight 132 minutes; I Know This Much Is True feels like a reprieve.

Cianfrance turns to telly without sacrificing his cinematic edge. He and cinematographer Jody Lee Lipes (A Beautiful Day in the Neighborhood) shoot on gritty 35mm, frames filled with tragic depth and colour; white hairs spark on the celluloid. The camera stays close: you experience all the upset with Dominick. Cianfrance concludes the first episode with an excruciating extended take, tracking Dominick in shallow focus as his brother is admitted to a high-security psychiatric hospital.

Dominick fights against the help, including the blunt and brilliant social worker Lisa (Rosie O'Donnell)

Dominick’s abusive childhood spills into his male toxicity as he constantly resists help from anybody, particularly women. Although he’s a difficult man to like, especially in this more enlightened climate, you’d have to be inhuman to feel nothing for him. He meets his brother’s blunt and brilliant social worker, Lisa (Rosie O’Donnell), who won’t tolerate his anger but still helps him.

The same goes for his near-robotic but deeply empathetic therapist Dr Patel (Archie Panjabi), and his very caring ex-wife Dessa (Kathryn Hayn), and his young and slightly ditsy girlfriend Joy (Imogen Poots). Most episodes contain moments when screaming at the screen is justified, as Dominick pushes against their help – hiding any glimmer of vulnerability.

Kathryn Hayn stars as Dominick's ex-wife Dessa

Ruffalo joins a select gaggle of dual-performance roles, shooting his scenes for Dominick then halting production to gain weight for Thomas. Like other ‘twinning’ performances (Jeremy Irons in Dead Ringers, Armie Hammer in The Social Network, etc), the difference is so stark, the characters so idiosyncratic, that it’s as good as watching two separate people. If there’s any actor who’s shown the most admirable and seamless transition out of superhero Spandex, it’s Ruffalo.

I Know This Much Is True shows the harm that male toxicity can bring, and how hereditary it is. These days, when that kind of masculinity can lead the world, the series offers a rebellion – a signal for men to be better despite what they’re birthed into. It’s an upsetting, absorbing and educational journey.

I Know This Much Is True airs on Sky Atlantic at 2am and 9pm on Monday 11 May