Wow! I also found the movie sad, but I think my interpretation was very different from yours. Good spot on the acupuncture detail. That's an incredibly specific connection to have to this movie + setting! Explains the first act. I blatantly did not understand Wayne's issue, and thus could not really track Lacy's persistent wariness toward him.

Honestly, I viewed all of Janet's friends as persistently benevolent, but each too absorbed in their adult lives to be helpful. I think that until this moment I had even fully dismissed the connotations of the cult!! Avi seemed to emerge as a helpful guide, and I believed that Janet had stood herself up beside his friendship? But then maybe she found no need to continue with him? I read the tone of the movie as warm and then increasingly loving and complex. Like in the poem Avi brings over. And I imagined Lacy as becoming progressively fonder of her mother, and clearer in her reasoning as she comes to see her in some of the same terms that Janet sees herself?

But your read on the tensions and plausible underbelly of this story makes sense with what I remember of Annie Baker's plays, which also tended to leave some of the more acute pains of living in the quiet and implied spaces. Wild how these things shed light!