Book Review May 27, 2015

Movies and Mental Illness: Using Films to Understand Psychopathology, 4th ed

Matthew A. Becker, MD

J Clin Psychiatry 2015;76(5):e671

Article Abstract

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Literature addressing the intersection of cinema and mental health issues is varied in focus but represents a growing interest among film and psychiatric historians, as demonstrated by the numerous books currently available on this subject and the myriad backgrounds of the authors. Several books focus predominately on portrayals of mental health clinicians, their patients, and the stigma of psychiatric disorders over the span of cinematic history, which tend to mirror conflicted and evolving societal attitudes. Other books focus on the educational value of films with psychiatric themes.

 

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Movies and Mental Illness: Using Films to Understand Psychopathology, 4th ed

by Danny Wedding, PhD, PsyD, and Ryan M. Niemiec, PsyD. Hogrefe Publishing, Boston, MA, 2014, 460 pages, $59.00 (paper).

Literature addressing the intersection of cinema and mental health issues is varied in focus but represents a growing interest among film and psychiatric historians, as demonstrated by the numerous books currently available on this subject and the myriad backgrounds of the authors. Several books focus predominately on portrayals of mental health clinicians, their patients, and the stigma of psychiatric disorders over the span of cinematic history, which tend to mirror conflicted and evolving societal attitudes. Other books focus on the educational value of films with psychiatric themes.

Current projections suggest significant and mounting shortages of psychiatrists despite a growing population of individuals with chronic, severe, and comorbid psychiatric disorders requiring specialized care. Various studies and theories have proposed reasons for the declining number of psychiatrists, including the difficulty of attracting medical students into psychiatry. The behavioral health science curriculum warrants reevaluation to address at least some of these issues. The incorporation of movies in the teaching of psychopathology represents an innovative and exciting modality that may help attract more students into mental health careers, as cinema can be a particularly engaging and powerful educational tool. A good movie can engage the viewer on an emotional as well as intellectual level. In their masterful and entertaining yet thoroughly well-referenced and academic book Movies and Mental Illness: Using Films to Understand Psychopathology, Fourth Edition, Dr Danny Wedding and Dr Ryan M. Niemiec painstakingly provide detailed descriptions of numerous films over the eras, with critical thinking questions, references, and fictional patient evaluations specific to the selected movies, and in doing so succeed in highlighting cinema as an effective modality for teaching psychopathology and for intellectually challenging students on psychiatric differential diagnosis and treatment.

The authors demonstrate an encyclopedic knowledge of domestic and international movies, as well as fictional depictions and documentaries, that portray the span of psychiatric disorders covered in the DSM-5. Drs Wedding and Niemiec select movies of different eras but focus on contemporary films, some of which have only recently been released at the time of this review. The authors use the DSM-5 to arrange their table of contents of 16 chapters. Indeed, the reader can effectively use this book to learn the DSM-5. It is an amazing accomplishment that, for even relatively obscure diagnoses, the authors have ready a diversified portfolio of relevant movies. Chapter 2, for example, focuses on neurodevelopmental disorders and discusses a wealth of films for topics such as intellectual disability, autism spectrum disorders, and attention-deficit/hyperactivity disorder that I, for one, was surprised could be effectively depicted and, equally important, could pique the interest of producers, directors, screenwriters, and actors. Contemporary domestic and foreign films, fictional portrayals, and documentaries are available for these and the majority of psychiatric disorders in the DSM-5.

Drs Wedding and Niemiec highlight a remarkable Spanish movie, Me, Too, a fictional account of a college graduate with Down’s syndrome who falls in love with a "normal" woman. The actor, Pablo Pineda, similar to the character in the movie, has Down’s syndrome and graduated college successfully. I was so intrigued by the movie and Mr Pineda’s performance that I watched interviews of this inspiring and insightful individual. That is one of the strengths of the book: it intrigues the reader through fascinating and detailed accounts of varied films on a vast assortment of mental health topics. I re-watched several movies I had not seen in years, and I viewed for the first time numerous movies I was unaware of until reading this book. The movie Shine is a brilliant fictionalized account of a real-life musical prodigy with severe mental illness, which I initially saw when it was released years ago and which I became interested in watching again after reviewing this book. I believe the correct diagnosis of the main character is schizoaffective disorder, bipolar type, but the movie is likely to stimulate students to debate a wide range of potential psychiatric diagnoses, which is of course the point in teaching psychiatry. The French movie He Loves Me, He Loves Me Not is a fictional yet, in my opinion, incredibly accurate depiction of a person with delusional disorder. I had never heard of this film before, but after watching it, I was stunned by its emotional and intellectual power.

In addition to the movies mentioned in this review, Movies and Mental Illness: Using Films to Understand Psychopathology, Fourth Edition, discusses many others that can serve as valuable teaching tools for learning about various psychiatric issues and disorders. One can always quibble about the comparative value or accuracy of different movies or documentaries in depicting mental illness, but as a whole I agree with the choices of Drs Wedding and Niemiec as particularly accurate and intellectually and emotionally stimulating.

The 8 appendices are thought provoking and further support the need to engage students by using less conventional teaching methods, in this case cinema. I particularly enjoyed the lists of recipients of PRISM Awards and SAMHSA Voice Awards, which recognize media portrayals of people with substance use and/or mental health disorders. Drs Wedding and Niemiec include a sample course syllabus with group discussions and selected films on the gamut of DSM-5 psychopathology that could serve as an outline to create a successful course to educate students on mental illness, differential diagnosis, and treatment options. A topic discussion on, for example, the DSM-5 criteria for bipolar disorder, schizophrenia, or major depressive disorder that is preceded and/or followed by group or individual viewing of a selected movie based on the topic may prove a valuable course. The recommended websites and film index are thorough, up to date, and excellent. I highly recommend this book to educators, mental health care clinicians, and students.

Matthew A. Becker, MD

[email protected]

Author affiliations: University of California San Diego School of Medicine.

Potential conflicts of interest: None reported.