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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017
| Contributor Information
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
The cinema and psychiatry came of age during the same period and share a common concern for human behavior, often under circumstances of considerable duress. But their clear affinities haven't always resulted in a high-functioning relationship. This collection provides an overview of how depictions of psychiatric conditions and treatments in cinema have evolved over time.
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
Because popular films have long favored crime stories, mental illnesses with violent manifestations are well represented. M is one of the few films of its time to present its character's actions as the result of compulsion rather than moral failure. "I believe that a director has to be a kind of psychoanalyst," said M's creator, Fritz Lang, who prepared for the film by interviewing psychiatrists and other health professionals involved in the treatment of murderers.
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
The relationship between cinema and psychiatry does not flow solely in one direction. Sometimes a film's conceit will gain traction within the psychiatric community. In recent years, the term "gaslighting" (inspired by this film) has come into vogue for explaining dysfunctional power relationships in which one party exerts undue influence on the judgment of another by causing the latter to question that judgment.
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
Oscillating wildly between fantastical optimism and suicidal ideation, Sunset Boulevard's Norma Desmond is a case study in delusional disorder—"still waving proudly to a parade that had long since passed her by," in the words of her gold-digging younger boyfriend. The film's decidedly acid-tinged worldview sees delusion as the very fuel on which the Hollywood machine runs, providing a constant stream of would-be stars to be eaten up and spit out.
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
Psycho is best known for its then-shocking scene in which Norman Bates, dressed in his dead mother's clothes, murders a guest in her shower. However, it's director Alfred Hitchcock's choice to end the movie with a psychiatrist's textbook diagnosis of Norman's multiple personality disorder that is perhaps most contemporary from a medical viewpoint. The scene captures the cultural shift toward when psychiatrists would be called on to make clinical sense of seemingly inexplicable acts of violence.
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
After the unrepentant Alex undergoes an experimental program of aversion therapy, he's rendered defenseless against the horrifically violent world that he once embodied. The film hinges on a classic debate about whether sociopaths are creatures of free will or the product of their culture and times. As modern brain imaging studies identify possible neurologic sources of criminal behavior, the questions raised by the film would appear to be as relevant as ever.
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
One of the more famous depictions of psychiatry in modern cinema, Cuckoo's Nest gets to the heart of the different goals of art and medicine. The film is primarily concerned with using psychiatry as a metaphor for how corrupt social institutions maintain order. Yet its relatively unsubtle "us versus them" dynamic had a demonstrably negative impact on the perception of psychiatric care[1] and contributed heavily to electroconvulsive therapy's diminished reputation.[2]
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
By the late 1970s, psychoanalytic concepts were so well known that they could find themselves openly discussed in an unlikely place: a major American comedy. Originally titled Anhedonia, after the psychiatric term for the inability to experience pleasure, Annie Hall thinks nothing of referencing Freud's Wit and Its Relation to the Unconscious in its opening minute, or in foregrounding its main character Alvy Singer's existential ennui.
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
The patient-doctor relationship is thrown out of whack in this early 1990s comedy (or horror film, depending on your professional perspective). The film takes a special glee in pillorying the self-help guru culture of the era, with the main clinician character continually prescribing his latest book rather than actual care.
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
Based on Susanna Kaysen's memoir of the same name, Girl, Interrupted provides an entirely more sober view of mid-century psychiatric hospital care than the fictional One Flew Over the Cuckoo's Nest. Though the female protagonists still deal with institutional frustrations in their pursuit of mental health, the late-'90s film is threaded through with an overall faith in psychiatric care.
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
Although the worldwide prevalence of schizophrenia ranges between 0.5% and 1%,[3] the condition is disproportionately represented in films about mental illness, and not always accurately. A Beautiful Mind presents Nash's condition primarily through his construction of visual hallucinations, though in real life, like most schizophrenics, he experienced only auditory hallucinations. The film also fosters the myth that schizophrenia and genius are somehow always linked.
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
Historical biopics are often guilty of providing simplistic causation theories for characters' behavior, and The Aviator is no exception, focusing on an episode of Hughes's childhood in which his germ-obsessed mother seems to transfer her condition to her son through repeated washings. The claim probably has its source in a "psychological autopsy" of Hughes conducted shortly after his death.[4] Although adverse early influences are thought to play a role in the development of OCD, more recent data indicate that the condition is due to brain disorders in a majority of cases.[5]
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
Melancholia's elaborate science fiction metaphor provides a unique means for depicting major depressive disorder. When it becomes clear that Earth will be destroyed in days, Justine seems to rise to the moment, conditioned as she is to the inevitability of tragedy and the pointlessness of action. The concept is not without scientific backing: Studies have shown that people with depressed mood states are better at solving social dilemmas.[6]
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
Director David O. Russell was inspired to make Silver Linings Playbook after his own son's struggles with bipolar disorder, and the film is instilled with a basic understanding of how mental illness is experienced—and sometimes imparted—communally. The film is not without its issues (it relies heavily on such concepts as fate and luck), but it is resoundingly contemporary in its portrayals. Through a mix of pharmacotherapy and social support, the characters emerge healthier while also accepting their limitations.
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
Given its largely escapist ambitions, film tends to avoid neurodegenerative conditions like Alzheimer disease. However, this recent drama with Julianne Moore addresses the matter directly by unflinchingly depicting how the early-onset form of this disease both unravels and connects a prosperous New York City family.
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
A favorite of screenwriters in need of twist endings—and actors eager to showcase their range—dissociative identity disorder (DID) has been well represented in countless films over the years. Split, the latest entry, continues the misrepresentation of DID as a condition that manifests itself violently. The film's recent success at the box office guarantees that we'll be seeing similarly poor depictions of DID in years to come.
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Cinemania: A Brief History of Psychiatry in Film
John Watson | September 27, 2017 | Contributor Information
Psychiatrists no doubt routinely treat patients whose concepts of their own conditions have been shaped, positively and adversely, by such films as these. To repurpose Alfred Hitchcock's thoughts on television, the movies have done much for psychiatry "by spreading information about it, as well as contributing to the need for it."
Tell us what you think: What cinematic representations of mental illness or care have resonated with you over the years? Please add your comments at Voice Your Opinion: Mental Health in the Movies.
Odd and Outlandish Psychiatric Treatments Through History
The path to psychiatric knowledge has been paved with brutal surgeries, happy accidents, and outright tragedies. Medscape highlights some of history's most interesting mental health treatments.Medscape Features Slideshow, April 2016
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John Watson
Freelance writer
Philadelphia, Pennsylvania
Disclosure: John Watson has disclosed no relevant financial relationships.
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References
Damjanović A, Vuković O, Jovanović AA, Jasović-Gasić M. Psychiatry and movies. Psychiatr Danub. 2009;21:230-235.
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