Psychiatry and Celluloid

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Psychiatry and mental illness are popular topics in cinema with varying degrees of accuracy tied into marketability. After all romance, sex and violence sell, so we can expect torrid love affairs between therapist and client, psychiatrists who feast on the livers of their patients with a glass of Chianti, and paraplegic PTSD sufferers recovering after sex with Mexican hookers.

Now I do admit One Flew over the Cuckoos Nest is a fine piece of cinema and Jack Nicholson is always fun to watch, and I have known a couple of nurses like Ms Ratchett. But you would never put a classic sociopath on an open ward with psychotic and demented patients. Nor would schizophrenics gain therapeutic benefit from engaging in antisocial acts. The ECT and lobotomy procedures are exaggerated for dramatic effect. The psychiatrists are fairly dimwitted and plagued with Rosenhan syndrome.

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In contrast, A Beautiful Mind (above) is a fairly accurate depiction of mental illness and it’s effect on loved ones. The psychiatrist, Christopher Plummer is sensitive and competent. Insulin coma was used at one time with some effect. The delusional thinking process of schizophrenics is correctly depicted but they generally have auditory not visual hallucinations. But cinema is a visual medium.

Psychiatrists in film are sometimes portrayed as lascivious horn dogs (which is sometimes true) seduced by histrionic or  borderline female nymphomaniacs. In the film Final Analysis Richard Gere and Kim Basinger go at it feverishly, but her sister was the actual patient. So the ethics are murky. This is less so when Freud’s associate Carl Jung engages in spanking and bondage with his patient in A Dangerous Method (there is no evidence he actually did). Sexual acting out between patient and therapist as a manifestation of countertranference is never therapeutic. But where Ingrid Bergman is the therapist in Hitchcock’s  Spellbound it does seem to be. Certainly I myself would never question the ethics of making love with Bergman. As her colleague said (this was 1945): “Women make the best psychoanalysts until they fall in love. After that they make the best patients”.

As far as psychiatrist pathology goes, let’s face it, you don’t devote your whole life and career to the philosophy ” if the mind fits shrink it”  and not come out the other end a little off centre. Be as it may I have never met a colleague like Hannibal Lecter (top of article). I knew one who chewed on his tie, another that did psychoanalysis wearing sandals and Hawaiian shirts in February and I like to “smoke” my pen but none that enjoyed feasting on patient viscera.

Specific disorders are variably well portrayed in these films..

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OCD: Bill Murray in What About Bob?(above). I have had patients with his rituals but none would have goldfish bowls around the neck due to germ concerns. There are egotistical shrinks like Dr Marvin who talk to kids with puppets.

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Hysterical personality: Scarlett O’Hara (above) of course in a textbook portrayal (Gone With the Wind)….”I’m too young to be a widow. My life is over. Nothing will ever happen to me again.”There are indeed beguiling drama queens like Scarlett in the real world. They can be fun to date. Once. As patients they are seductive and theatrical. I had one that in an attention seeking pique of drama passed out on the floor. I sipped my coffee waiting for her to finish her act.

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PTSD: Tom Cruise (above) in Born on the Fourth of July. Watch his startle reaction to firecrackers. In truth there are no small number of contemporary  cases that suffer as he did and shortages of qualified people to treat them, empathic Mexican sex workers notwithstanding.

Borderline personality disorder: Glenn Close in Fatal Attraction. Scarily on target though animal cruelty is more common with psychopaths. Violent homicidal rages and self-mutilation are not unusual in these patients. Tough to treat and the only patient that a  therapist will dread seeing and react to with aversion and malice.

Autistic spectrum: Rain Man. Again pretty accurate, though the so-called “Idiot Savant” term is dated and a rare variant but then most of the daily psychiatric grind is not generally celluloid material.

Multiple Personality: lots of choice here like Sybil or The  Three Faces of Eve. A popular topic more common on the screen than in office reality where it requires enthusiastic practitioners to generate dozens of alters. Fine theatre but poor therapy.

My favourite entry would be Hitchcock’s Psycho though I do think that Norman Bates was psychotic as the title suggests.
And that’s my brief contribution on the subject and though I am a recovering Netflix addict, I still feel that reality is for people who can’t cope with cinema.

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One Response to “Psychiatry and Celluloid”

  1. Papi says:

    Cinema emphasizes some things and de-emphasizes others to get people to buy tickets. There are enough looney tunes in real life (1 in 4 are said to be mental ill so if your three friends are healthy, go see a shrink) that cinema is only there for the not-so-humdrum (AKA exciting) cases.

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