How Good Is Hollywood at Portraying Mental Illness?

Not great, says psychologist and film buff Danny Wedding.

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Oct 21 2014, 8:00pm

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Look at any classic horror film—Nightmare on Elm Street, Friday the 13th, The Shining—and you're likely to find mental illness. It's a convenient, if inaccurate, explanation for the maniacal violence that makes up the backbone of these stories. But in most films portraying mental illness, especially violent and bloody horror films, real life pathology is willfully abandoned in favor of melodramatic storytellling. At best, it's lazy; at worst, it publicly and repeatedly demonizes the people who need the most help. In a recent article I wrote about the mentally ill being killed in disproportionate numbers by police, many people commented along the lines of “Well, of course, they’re much more dangerous,” which anybody working in mental health can tell you is not only untrue, but is the direct result of the media’s focus on a fictitious link between mental illness and violence.

I spoke with Dr. Danny Wedding, a former director of the Missouri Institute of Mental Health and co-author of Movies and Mental Illness: Using Films to Understand Psychopathology, to learn more about some of the more common movie myths.

VICE: How do you think mental illness is generally represented in film?
Dr. Danny Wedding: I mean, slasher films like Friday the 13th, films that portray people with mental illness as homicidal maniacs, those are pretty awful, and there are a lot of myths still being portrayed in films. But at the same time, there are many major films that do a surprisingly good job, and it’s becoming increasingly common for directors and producers to hire psychologists and psychiatrists as consultants.

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What about the connection between violence and mental illness?
Yeah, perhaps the most common myth is that people with mental illness are dangerous and violent, and the evidence is very clear that somebody with a disease like schizophrenia is far more likely to be the victim of violence than to be the perpetrator of violence. People with mental illness, homeless people who you see on the street typically, they are victims. They’re robbed, they’re raped, they’re murdered, but they’re not robbers, rapists, and murderers. Usually when violence occurs, it occurs with family members, it doesn’t involve strangers, and usually involves people who are mentally ill and abusing drugs or alcohol.

Do you think that people like yourself—psychologists—are also misrepresented?
Yes, but it’s getting better. There are a number of recurring motifs. Sometimes mental health professionals are presented as being incompetent and buffoons… Did you see the movie What About Bob?

Actually I just watched that recently. With Bill Murray?
Yeah, right. I think it’s a great movie, but Richard Dreyfuss plays a psychologist and he’s kind of bumbling and incompetent, and I think there’s a lot of humor, but often times therapists are portrayed as looking foolish, looking silly, and not having much to offer. Sometimes, in movies like Hitchcock’s Psycho, they are portrayed as omniscient, they can see into the deep, the dark, and dirty. They see things that no one else can see. Sometimes, in movies like Silence of the Lambs, they’re portrayed as murders—Hannibal the Cannibal was a psychiatrist. In a movie like The Prince of Tides, they’re portrayed as unethical. Frequently in films, psychiatrists and psychologists are shown sleeping with their patients, having affairs. There’s a movie called Tin Cup in which a therapist trades psychotherapy for golf lessons and winds up seducing the golf pro. That portray therapists as being unethical or ineffectual or having powers that they really don’t have, like a special ability to see inside somebody’s personality and to make predictions about behavior, and the fact is that psychologists and psychiatrists really aren’t much better than anybody else at predicting future behavior.

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So who do you think did it best?
There’s a Canadian film called Clean, Shaven. It’s about schizophrenia. I don’t know if you’ve seen it or not, it’s not all that well known, but that’s a movie I frequently recommend when asked that question. Actually a recent film that was real popular was Silver Linings Playbook, and I thought it was a pretty accurate portrayal of what bipolar disorder looked like. Did you see The Hours? It’s a film about Virginia Woolf, and without question Virginia Woolf had bipolar disorder. I thought it did a really nice job of portraying what that looked like.

Do you think films have gotten better over the last few years in this regard?
I think they really have. I think Ron Howard did a remarkable job with A Beautiful Mind. He’s an amazing director. It’s a very sympathetic portrayal of John Nash, who was a brilliant man but, of course, it showed John Nash having visual hallucinations whereas most people with paranoid schizophrenia have auditory hallucinations. Ron Howard took some license and it’s much more creative and much more vivid and powerful to show visual hallucinations in a film medium.

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You said there are some other myths being perpetrated. What are some of the big ones?
Well, the first is the presumption of traumatic etiology. Movies suggest that if a person develops a mental illness then it was because of something awful in their past, perhaps something in their childhood. The Three Faces of Eve and films about dissociative disorder usually suggested somebody was abused physically or sexually as a child. You might’ve seen Robin Williams in the The Fisher King. He was really quite good and he portrayed a man with all of the symptoms of schizophrenia, and yet all of this developed after his fiancée was shot to death in a restaurant, and an experience like that would lead to post-traumatic stress disorder. You wouldn’t become schizophrenic as a result. Many people develop mental illness with no history of trauma at all in their past.  

Another especially pernicious myth is that of the schizophrenic parent, and the presumption that a person who becomes mentally ill does so because of bad parenting. Or that love will conquer mental illness. While I think that love is important, and having a supportive, caring family is critical to somebody overcoming a mental illness, love alone will not make a disease like schizophrenia go away.

What’s the most egregious offender in your opinion?
Well, you know, it’s an old Jack Nicholson movie, but The Shining showed Nicholson becoming homicidal and trying to kill his wife and his child, and it is pretty awful. Nightmare on Elm Street showed Freddy Krueger as a patient whose mother had been in a psych hospital and he had a violent mental illness himself. Those are two of the most egregious. Some are so bad it’s so hard to even talk about them. Almost all of the films that link mental illness with violence also involve sexuality in some way, so people are not just killed, they’re raped and sexually violated and then killed.

Photo via Flickr user annie_is_okay

Taxi Driver is a pretty violent film, but I’ve always appreciated Bickle’s slow descent into madness. A lot of movies tend to jump from sanity to insanity pretty quickly.
Oh, it's one of the greatest films of all time. Scorsese’s an amazing director. I think Taxi Driver is a fairly accurate portrayal of what mental illness looks like. In general, most categories of mental illness are insidious, with a gradual and slow onset. A disease like schizophrenia may start in your late teens and fully manifest in your mid 20s, other illnesses like Alzheimer’s may start very slowly in your 60s and fully manifest in your 70s. Some disorders have an immediate onset. Are you familiar with the term conversion disorder?

No. 
Well, occasionally someone will be in a situation where they’ll develop, for example, hysterical blindness. So a classic example would be a woman who sees her child get run over by a car in front of her, and she goes blind and she can’t see, and she’s examined by ophthalmologists and optometrists and experts and neurologists, and there’s no reason for her blindness, but her blindness is very real; she can’t see. The presumption is that on some psychological level it’s a way of undoing this terrible thing she saw happen.

What are some other causes of mental illness in the real world?
Mental illness is such a broad area it’s kind of like saying, “What is the major cause of disease?” There are lots of things that cause mental illness. We know that genetics plays a huge role; if you look at something like suicide, the likelihood of having a child commit suicide increases by about four-fold if a parent has committed suicide. We know that stress certainly plays a role; experience with trauma plays a role. We have lots of mentally ill soldiers coming back from Iraq, in part because they’ve been exposed to trauma. So, there are a lot of different causes for mental illness, and often times these make for fairly interesting films. 

Follow Jules Suzdaltsev on Twitter.

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