'Cine-diagnostics': Mental illness on the Big Screen
"Silver Linings Playbook," one of nine pictures nominated for the 2012 Oscars, featured a bipolar hero. (The last nominee with an Axis I protagonist was "A Beautiful Mind," a lamentably inaccurate portrayal of paranoid schizophrenia, which nevertheless became a beautiful gold mine for Universal Studios.)
My research shows that "Playbook" is one of a half handful of films about bipolar disorder. This set me wondering about the prevalence of various psychiatric disorders in a small group of so-called "mental health" movies focused on the specific syndrome of the hero/heroine, as well many more movies from other genres that provide sufficient material to infer a character’s diagnosis.
Why has cinema favored some disorders while others go neglected? Obviously, there are no statistics on this score. The following remarks about what I’ll call "cine-diagnostics" are based my own impressions rather than established fact.
Whether a feature film (I’m excluding documentaries) focuses on a specific psychiatric disorder or contains characters so well drawn that a diagnosis can be sussed out, filmmakers have always been especially attracted to syndromes that they perceive as hallmarked by especially melodramatic symptoms and behavior. (Of course, the disorder’s presentation might not be as electrifying in real-world psychiatry.)
I suspect that producers and filmmakers conceive that characters with "spectacular" symptomatology offer more entertaining narrative possibilities than less sensational maladies, thereby generating bigger box office revenues. When it comes down to the wire, a disorder’s prevalence or clinical accuracy usually will not count as much to the industry as the picture’s profit potential.
That’s not always a bad thing. See my article on "In Treatment," the HBO series, on internationalpsychoanalysis.net for more on this point.
The largest group of "mental health" movies was produced from about 1957 to 1963, a period in which increasing public knowledge about psychiatric illness coincided with greater acceptance of its treatment. Krin and Glen O. Gabbard have explored this golden age of "pro-therapy" pictures in their estimable "Psychiatry and the Cinema" (Washington: American Psychiatric Association Publishing, 1999).
The Gabbards note that former World War II military physicians, who became conversant with promising new therapies during service, were instrumental in demystifying psychiatry upon returning to America. (These methods were often taught by émigré psychoanalysts who had fled Nazi persecution.) Not unsurprisingly, some of the most popular pro-therapy movies were about wartime and post-war post-traumatic stress disorder. Films like "Home of the Brave" (1949) often portrayed PTSD’s more melodramatic features.
After the Golden Age, other "spectacular" syndromes depicted in mental health pictures and popular genres included: conversion disorder ("Freud," 1962); multiple personality disorder ("The Three Faces of Eve," 1957); dissociative disorder ("The Swimmer, 1968"); erotomania/de Clerambaults syndrome ("Fatal Attraction," 1987; "The Story of Adele H," 1975); alcoholic hallucinosis and delirium tremens ("The Lost Weekend," 1945); acute schizophrenia ("The Snake Pit," 1948); and compulsive gambling ("The Lady Gambles," 1949; "California Split," 1974).
Antisocial personality disorder was, and still remains, the most prevalent – often immensely popular – Axis II category, particularly in mainstream fare featuring sociopathic characters who relish mayhem and murder ("The Talented Mr. Ripley," 1999). Movies about antisocial serial killers have done so well in recent years that they’ve become an industry staple ("Silence of the Lambs," 1991; "Manhunter,"1986).
Major depression doesn’t usually present the florid symptomatology of multiple personality disorder or acute paranoid schizophrenia. Arguably, that’s why major depressive disorder (MDD) seems to appear far more often in thoughtful indie or foreign cinema than in action-oriented mainstream movies.
MDD has evoked some of the greatest acting by accomplished actors in cinema – for example, Victor Sjöström’s despairing aged physician in "Wild Strawberries," (1957); Jeremy Irons’s despondent Antonio in "The Merchant of Venice," (2004); and Steve Cochran’s inarticulate, ultimately suicidal despair in "Il Grido," 1957). ("Il Grido" – "The Cry" in English – is a neglected small masterpiece by Michelangelo Antonioni.)
Other psychiatric disorders/conditions less often addressed at the multiplex include Alzheimer’s disease ("Away From Her," 2006); autism/savant syndrome, ("Rain Man," 1988); and mental deficiency ("I Am Sam," 2001); "Light in the Piazza," 1962). One wonders if filmmakers imagine that a film about Alzheimer’s disease would be too close to the bone for older viewers and might not interest young viewers, who don’t imagine they’ll ever grow old. (The Dustin Hoffman character in "Rain Man" was a misdiagnosed savant, possibly for narrative purposes, but I would rate him in an autistic category.)
I can’t easily account for the dearth of movies about autism and the mentally challenged. Perhaps there’s a mistaken assumption that audiences would be turned off by such pictures because of the uncomfortable, if unacknowledged sense of "otherness" these syndromes evoke in some people, filmmakers included. (The "praecox feeling" of schizophrenia comes to mind.)
