By: David Taylor, MD
Would you agree that movies reflect society’s perceptions of mental illness? Naturally there are many types of films and not every blockbuster, rom-com or documentary is going to have the same kinds of in-depth character development. But in general, the portrayal of mental illness in film is often thought to reflect society’s perceptions, biases and stigmas of those suffering from diseases of the mind.
For example, Hitchcock’s classic thriller ‘Psycho’ (1960) perpetuates the myth that equates insanity with a deranged and murderous psychopath. At the time the film was released, mental illness was a poorly understood and frightening phenomenon suitable for a dramatic movie. In fact, the audience was so naive about the topic that, to minimize confusion, the movie concludes with a psychiatrist’s lengthy epilogue detailing the psychic origins of the main character’s pathology. The film’s title alone is a derogatory jab at those who suffer from mental illness. (However, in fairness to the director, I suppose an alternate title such as “Norman Bates – A Story of a Man with a Complicated Relationship with His Mother” might not have worked well either.)
Almost 50 years later, mental illness has achieved a cultural prominence that was unimaginable just a few generations earlier. Diagnoses are better understood, treatments are more available, and society is more tolerant of diversity. For example, ’A Beautiful Mind’ (2001) is the inspiring life story of a Princeton mathematician who won a Noble Prize despite his impairments from schizophrenia. In ‘Lars and the Real Girl’ (2007), we find a compassionate depiction of mental illness in which the main character is embraced by family, friends and community despite his unusual and awkward delusions.
One of the most interesting observations about movies and mental illness is that each has the power to affect the other. In other words, just as our beliefs about mental illness can influence movies, the movies can also influence the beliefs of those with mental illness. For example, ‘The Truman Show’ (1998) imagined an artificial world where everyone — except for one unknowing individual — is portrayed by actors for a hyper-reality TV series. Although the plot sounds farfetched, last year the New Yorker magazine (“Unreality Star”, Sept 16, 2013) profiled NYU psychiatrist Joel Gold who evaluated nearly 50 patients whose delusional beliefs mimicked the movie. Dr. Gold even coined the term, Truman Show delusion, for an individual who “believes that he is being filmed, and that the films are being broadcast for the entertainment of others.”
The extraordinary ability of movies to both mirror and transform our beliefs makes them a valuable teaching tool. Since 2012, I have taught a Fiat Lux freshman seminar called ‘Mental Illness and the Movies’ which explores the portrayal of mental illnesses in popular film. Of course, movies are rarely designed to be faithful representations of reality and often include inaccurate portrayals of mental illness that perpetuate stigma. Themes of violent insanity, incompetent physicians or abusive staff can reinforce the prejudices and discrimination against individuals with mental illness. Through ‘cinemeducation’ this class provides a much needed opportunity to correct these misrepresentations, gain a better understanding of mental illness, and appreciate the wide diversity of individuals in our society.