in Books Films Television

Psychiatry at the movies

I’ve just been writing a review of the book Movies and mental illness 3 which will appear here as soon as it is published in print. It’s a handbook for anyone who wishes to use cinematic depiction of mental illness to teach and understand its presentation. It’s more of a textbook than something that can be read enjoyably cover to cover but nevertheless worth a look.

Practically any relevant major film, even one which only fleetingly depicts an altered mental state, is included.The dedication of the authors is such that they are not too proud to include some films which, although they illustrate psychopathology, are otherwise almost without artistic merit (although concerned readers will be glad to hear that Swept Away is not included)

The depiction of mental illness in film

Mental disorder has long been a compelling topic for filmmakers, as its depiction tends to deliver compelling personal struggles and exploits well established fears.  Unfortunately the treatment of mental disorder in film is often inaccurate and negative; dramatic films are primarily intended to entertain and as such they have little desire to stretch their audience and pander to popular stereotypes.  A reason to be concerned about this is that the pervasiveness of cinema means that for many people these narratives are their primary source of mental illness information.

Cinematic stereotypes of mental illness:

Patient as rebellious free spirit

In One Flew Over the Cuckoo’s Nest {I would recommend the film, the novel and also Tom Wolfe’s account of Ken Kesey’s Merry Pranksters} Jack Nicolson as Randal McMurphy takes on Nurse Ratched and the psychiatric establishment. 

Patient as homicidal maniac

In film this can apparently be traced back as far as 1909 with D W Griffith’s The Maniac Cook.  The Joker in The Dark Knight is an example as well as the Halloween films which feature an escaped psychiatric patient making mincemeat of attractive American teenagers.

Patient as seductress

The 1964 film Lilith stars Warren Beatty as a hospital therapist who is seduced by a psychiatric patient played by Jean Seberg.

Patient as enlightened member of society

This can be linked to work of RD Laing and Thomas Szasz.  King of Hearts (1966) and A Fine Madness (1966) are examples.

 Patient as narcissistic parasite

Here someone with mental disorder is depicted as self-centred, attention seeking and demanding.  In films like Annie Hall Woody Allen practically invented this.

Patient as zoo specimen

These films treat people with mental illness as objects of amusement or derision for the entertainment of people who are ‘normal’.  Me, myself and Irene encourages us to laugh at someone with ‘advanced delusionary schizophrenia with narcissistic rage’.  Described here as ‘almost entirely devoid of accuracy, sensitivity and subtlety’.

Some dominant themes concerning mental illness:

Presumption of traumatic aetiology

Here the belief that a single traumatic event is the cause of mental illness is promoted.  In TheFisher King Robin Williams plays a former college professor who becomes homeless and psychotic after witnessing his wife being gunned down in a restaurant.

Schizophrenogenic parent

A widely held (but discredited) misconception that holds parents (mother most often) responsible for the development of serious mental disorder in their children.  When this theory was popular it was thought to be due to the double bind – opposing messages from a parent.  In Shine, a film about the life of pianist David Helfgott, the father is alternatively loving and hateful.

Harmless eccentricity is frequently labelled as mental illness and inappropriately treated.

One Flew Over the Cuckoo’s Nest is emblematic of this.  McMurphy appears to have no psychiatric disorder, but yet once he is in the psychiatric hospital he cannot escape.


Psychiatrist portrayals have been classified into three stereotypes.

‘Dr. Dippy’ is comic, crazy, and foolish.  This sort of practitioner lacks common sense, prefers bizarre treatments, but, ultimately, does no real harm.

‘Dr. Wonderful’ is warm, humane, caring, and much prefers the use of non-physical treatments.  Robin Williams’ character in Good Will Hunting is an example.

Hannibal Lecter is an example of a ‘Dr. Evil’ (no relation) tends to be cruel and sadistic in the use of coercive physical treatments.  He may not be immediately identifiable, hiding, perhaps, in the benevolent guise of someone else.


Further reading:

The Portrayal of psychiatry in recent film

Psychiatrists are being driven mad by their portrayal on screen – Independent 4 September 2000

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  1. There was an article in the Guardian about this a couple of days ago.

    It annoyed me because it criticized The Crazies which is one of the best horror films of recent years (and not really about mental illness anyway, it’s about a toxic encephalitis – more like rabies than anything else.)

    He made some pretty sensible points though overall.

  2. I’ve thought about this a lot actually – how psychiatry and mental problems are portrayed in film, and also, on television. I remember so many television programmes I watched as a child that had scenes which poked fun at a Freudian ‘Dr Dippy’. They generally also mocked the idea of people ‘needing help’, as I suppose people do in day to day life. It’s no wonder I was afraid of treatment, I think, but perhaps I take all this a bit seriously…

  3. Takin’ over the Asylum was very good and featured a young David Tennant whose manic delusions come true and he actually becomes a time traveller, I mean radio star.

  4. In my limited reading of Szasz, I don’t recall him suggesting that any psychiatric patient was particularly enlightened. He seems to portray them more as antisocial or malingerers. He has always been keen to contrast his view with “anti-psychiatrists” like Laing.