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Entertaining madness – representations of mental illness on screen

Some classic mental health clichés1. People with mental illness are likely to be violent to others
What would films and TV dramas do without madmen and women hiding in the shadows waiting to pounce? In film after film the default story line involves deranged serial killers often inaccurately described as schizophrenic. The misconception is also fed by the heavy coverage any case involving violence committed by someone with mental health problems invariably receives in the news media. In fact, on average severe mental illness is a factor in only 55 of the 650 plus murders that occur each year in the UK and in as few as five of those 55 cases is the violence inflicted on a stranger. Despite worries that the closure of mental health hospitals may have placed dangerous people back into the community, the numbers of homicides committed by those with severe mental health problems have remained stable over the last 20 years. On average 3,500 people are killed each year by cars. In 2001, 50 people died in road accidents involving police vehicles. By contrast, people with schizophrenia are far more likely to hurt themselves. One in ten people with schizophrenia will commit suicide.

2. People with mental illness are constantly bizarreCharacters suffering from poor mental health are the stuff of drama. Actors portraying those with disabilities or illness often feature among the Oscar winners and usually are rewarded for their capacity to portray the most distressing aspects of the disease in question. The development of improved drugs and therapies means that many people with mental illness are able to hold together productive lives and experience prolonged periods of remission from symptoms. A significant number of people (25%) experience a single schizophrenic episode and make a full recovery.

3. Mad people experience visions
Film is visual, so how tempting it is for filmmakers to indulge in some intriguing special effects portraying their mentally ill characters experiencing visions. It is a prominent component of A Beautiful Mind. In fact mentally ill people are far more likely to experience aural disturbances than visual illusions.

4. Schizophrenics are people with split personalitiesNorman Bates in Psycho dressing up as his mother to commit murder while his gentler self lives on in ignorance of his crimes is probably the most famous cinema serving of this age-old mental health cliché. The fact that the phenomenon largely derives from a literary source, Dr Jekyll and Mr Hyde (1886) should raise suspicions. It was a 1957 film The Three Faces of Eve, starring Joanne Woodward, that promoted belief in multiple personality disorder (MPD) and a further boost came with the 1973 film Sybil – the tale of a woman with supposedly 16 distinct personalities. When the same story transferred to TV, Sally Field won an Emmy for her portrayal. It has subsequently emerged that many of the so-called ‘personalities’ may have been created by the psychiatrist who took to naming different moods that Sybil manifested during her treatment. Such conditions essentially developed through the interaction between patient and therapist are called ‘iatrogenic’. In the 1990s there was a huge explosion in ‘multiple personality’ (MPD) cases in the USA and to a lesser extent in this country. These were paralleled by an upsurge in cases of forgotten sexual abuse revealed through therapy and belief in widespread satanic cult activities. By 1998 there were over two dozen clinics in America specialising in the treatment of MPD cases. Now the bubble has burst and these clinics have disappeared, revealing the phenomenon essentially to be a fad.

5. A person’s mental health can be restored through a single moment of cathartic revelation – usually in therapyIn Joseph L. Mankiewicz’s 1959 slice of American gothic Suddenly, Last Summer, Montgomery Clift is able to restore Elizabeth Taylor to health by forcing her to relive her husband’s grisly murder at the hands of a cannibalistic gang of young boys. The same formula of a single heady confrontation with a past trauma occurs time and again in psychological dramas as the narrative gateway to a happy conclusion. This formula was also at work in the 1999 Winona Ryder vehicle Girl Interrupted, in which the discovery of an ex-fellow patient who has hanged herself is enough to propel Ryder’s character Susanna back onto the road to recovery.

Such abbreviated cures are the stuff of brief narratives. Unsurprisingly, mental health charities are eager to collaborate with the writers of soap operas when they are creating characters experiencing poor mental health. Rethink, for example, has worked closely with EastEnders and Emmerdale in recent years when storylines have featured characters experiencing schizophrenia. According to Rethink’s media officer Liz Nightingale, the benefit of having madness dealt with in a soap is that there’s time to provide a character with a context and to explore the invariable peaks and troughs of living life with the disorder. It also allows for a fuller exploration of the range of responses shown by the fictional soap community to the ill character’s condition.
6. Love is better than tabletsIn film after film love between patient and therapist is seen to bring about a cure. This is particularly true of films involving female therapists. One of the most famous is Alfred Hitchcock’s Spellbound. Although strong affection, even love, can be a feature of the transferred feelings between patients and therapists. It is considered completely unprofessional for a therapist to reciprocate, and yet the practice is celebrated in movies as an acceptable means of plot resolution. One of the most memorable must be the Elvis Presley film Wild in the Country (1961) in which the female counsellor played by Hope Lang is overcome with passion for Presley (there to receive help due to his diagnosed ‘delinquency’) during the first session. As he grabs her she cries: ‘We can’t do this. It’s wrong. We call it transference.’ To which Presley responds: ‘Honey – I call it love.’