TECHNICALLY SPEAKING

 

WHERE TO LOOK

Psychiatry in the Cinema by Glen O. Gabbard and Krin Gabbard (American Psychiatric Press) You’ll not find a more in-depth book on the subject, from the Golden Age of Cinema to Woody Allen’s films. (Oddly enough, he shows up quite a bit in the book.) Also of note is the filmography, with its pithy one-liners on how each film represents psychiatry. The Exorcist: Psychiatry is no match for The Devil. Exorcist II: Especially when the psychiatrist is female. Exorcist III: Or a chain-smoking wimp who is in fact destroyed by Satan.

WebMD is the home for all things medical. The site contains standard descriptions of various illnesses, as well as constantly updated articles that discuss the latest trends in healthcare and translate complex medical research into plain English.

AllPsych Online claims to be “The Virtual Psychology Classroom.” What’s particularly useful about this site is that all the info is broken down into bite-sized, digestible tidbits. If you’re just looking for a quick overview of just about anything psychiatric, this is your first stop.

PsychCentral is an online community for all things psychiatric. Chat rooms, blogs, you name it. Especially of interest for procrastinators is their SanityScore quiz a 20-minute test you can take that tells you how nuts you are and in what way. Although, if you’re a writer, you're probably already very in touch with your lunacy, thank you very much.

The Psychiatrist and the Screenplay
Written by Denis Faye

As much as Dr. Glen Gabbard would like to see Hollywood portray psychiatric disorders more realistically, he’s the first to explain why they can’t. “Psychotherapy ain’t showbiz,” he explains. “You could do a documentary about a psychotherapist treating a patient and be completely accurate and the audience would be bored to death, so you have to jazz it up a bit.”

Gabbard, who is Professor Director of the Baylor Psychiatry Clinic, has spent much of his career examining the intersection between the cinema seat and the therapy couch. He’s the author of the books Psychology of the Sopranos and Psychiatry and the Cinema (see sidebar). He’s advised on the films Eye for an Eye [Screenplay by Amanda Silver & Rick Jaffa], Article 99 [Written by Ron Cutler] and the upcoming Frankie and Alice. He also counseled Lorraine Bracco about her character Dr. Melfi from The Sopranos -- a show he should know about, given he literally wrote the book on the subject.

Gabbard talked with the Writers Guild of America, West Web site about psychiatric disorders on the screen and what the entertainment industry can do to get them right -- unless, of course, the industry person in question is Bill Murray, in which case he can screw up the facts all he wants, as long as he’s being funny about it.

What’s the biggest mistake screenwriters make when representing psychiatric disorders?

I’m hesitant to call it a mistake because they have a different set of values than I do as a psychiatrist, but I think it’s to sensationalize the disorder in such a way that showbiz counts more than accuracy. Now, I can empathize with their point of view. I’ve had many conversations with screenwriters and directors about this. They’re trying to entertain people, and they have no obligation to portray any profession or any disorder accurately. That’s the comeback that I’ve heard, but my retort would be that the stigma of mental illness is only exacerbated by media portrayals that associate mental illness with being a “homicidal maniacs” or a “psychotic killer.”

Similarly, the psychiatrist is often portrayed as a buffoon or an evil cannibal, like Hannibal Lecter. So it’s not just the disorders that are mis-portrayed, but also the treaters of those disorders.

So you think they have a responsibility that they’re missing?

Well, I would like to say that they do have some responsibility, although I’m coming from a biased perspective. From an artistic perspective, art owes no debt to reality, so I’m of a divided opinion in that regard.

The two that came the closest were The Sopranos and In Treatment. But both of those still pushed the envelope quite a bit.

What else has the industry gotten right?

Occasionally, they’ve been able to get pretty close, like A Beautiful Mind [Written by Akiva Goldsman]. That came pretty close to an accurate portrayal of schizophrenia. Another one was the Richard Gere film about bipolar illness, Mr. Jones [Screenplay by Eric Roth and Michael Cristofer].

The other thing I would say is that, at least, many films portray mental illness as real, as requiring attention. So, in one sense, film and television has called attention to the seriousness of mental illness, and I think too that it’s much better to depict these illnesses rather than ignore them and say, “This is something they shouldn’t show on film.” In that sense, there’s no such thing as negative publicity.

In our book, Psychiatry in the Cinema, we counted over 400 theatrically released films that show some type of psychotherapist at work. At least it normalizes psychotherapy. Characters are shown seeing a therapist because it’s a convenient plot device. In a novel, you can have an omniscient narrator who says, “John felt sad when he saw his girlfriend with another man.” In a film, you can’t do that without sounding hokey. But you can have a protagonist see a therapist to see a side of him the audience otherwise wouldn’t see. Because of that, there are therapists in all kinds of films who aren’t needed except for a protagonist to reveal something about himself that’s hidden. In that sense, the filmmakers have done a valuable service by saying that if there’s a problem, you see a therapist and there’s nothing wrong with that.

Are there any shows that might not have nailed it, but you’re able to just have a good time watching them anyway?

Sure. What About Bob? [Screenplay by Tom Schulman]. It’s ridiculous from a psychiatric standpoint, but I sit there laughing out loud at Bill Murray. Even though I’m passionate about psychiatry portrayals in film, I still enjoy myself at the movies.

If you had one bit of advice for writers tackling a project dealing with psychiatric disorders, what would that be?

Consult a psychiatrist who knows something about the disorder and its treatment. You need technical advisors to get things right.

Do you need to seek out specific psychotherapists for information on specific illnesses?

You want to get someone who’s specialized in a specific kind of treatment. With Googling, you can usually find that pretty easily.

What would you like to see in a movie or TV show just once?

One of the things I would like to see is a well-done psychotherapy process that improves the disorder. You don’t see too much of that.

I’ve seen some people improve, but not with psychotherapy that’s done well. Here’s a good example. Robin Williams won the Oscar for Good Will Hunting [Written by Matt Damon & Ben Affleck]. It’s very clear that the Matt Damon character gets better, but it’s totally outrageous when he grabs Matt Damon by the throat and slams him against the wall. He’d lose his license in any state in the country for doing that. But the narrative suggests, “Hey, that really worked! He got a whole lot better by being slammed against the wall and having Robin Williams tell about his dead wife.” So the therapy is completely ridiculous, but the patient gets better. You rarely see therapy that’s done well and then the maybe the patient gets better. Maybe an exception would be Girl Interrupted [Screenplay by James Mangold and Lisa Loomer and Anna Hamilton Phelan], but there aren’t too many like that.

In real life, do patients have a big cathartic turning point like Matt Damon did in Good Will Hunting?

I’m glad you asked that. That’s one of my pet peeves about cinematic psychotherapy. It focuses all the efforts on that one, big cathartic moment. Someone uncovers a repressed memory, has this huge emotional upheaval and appears to get better as a result.

The classic example of that is The Three Faces of Eve where Joanne Woodward has this epiphany when she recovers a memory that when she was 10 years old she kissed her dead grandmother. When she recovers the memory under hypnosis, she appears to integrate all three of her multiple personalities and they’re gone. We call it the cathartic cure. It’s pure showbiz, but you never see it in real life. If a patient did that in the office, you’d think they were putting you on.

And the problem, of course, in terms of my view is that the public has a misleading view. I’ve had patients come to me and say, “Aren’t you going to hypnotize me so I can uncover some buried memory from that past?” And I say, “No, that’s not how it works.” And they’ll say, “That’s funny. That’s how it works in the movies.”

Knowing what you know about the human mind, when you meet people, do you automatically start profiling them?

No, you have to pay me to do that. I don’t automatically work like that.

So you can turn it off and on?

Definitely.

Because a lot of screenwriters can’t go to the movies without automatically breaking things down for structure and character and arc.

Okay, let me tell you how that works for me. If I watch What About Bob, I’ll be laughing and enjoying Bill Murray, but if I’m going to write something about the movie, I’d see it again with a critical eye, not the eye that watched it for entertainment value. There may be something in my mind that says, “That’s ridiculous,” but I don’t let it interfere with my enjoyment.

So basically you’re implying that psychotherapists are more balanced people than screenwriters.

I wouldn’t go that far. I’ll tell you something. I always tell my students that “normal” is not a term we use in psychiatry because none of us have perfect childhoods. We all grew up with scars.