Murderous, unstable, and practising medicine; how do the ways that films present psychiatry, psychology, and neuroscience affect both patient and doctor?
So, what about the misconceptions of psychiatrists and mental health professionals? Could it be that the harm caused by inaccurate writing is so far-reaching that those working in the field are impacted too?
Archetypes have been at the heart of character building and development since the beginning of the art form. Providing a model of traits and behaviours associated with a role or a character-type, these archetypes are a comfortable and familiar format to audiences, in turn, leading to the creation of stereotypes.
Not harmful on their own, it’s when these stereotypes are used (even unintentionally) as weapons to harm a particular group that they become troubling.
In this case, psychiatrists, or other mental health- or brain- or science-related professionals.
Certain cues have corresponding expectations; however, storytellers must keep in mind that audiences may go on to expect those same behaviours from perceived cues in ‘real-life’.
The ‘crazy is evil’ trope is a textbook example of this happening, as discussed in my previous blogs and by other writers in InSPIre the Mind.
As with our perceptions, tropes and archetypes can also change over time.
Science fiction of the ’70s and ’80s popularised “The Mad Scientist” — a figure who messes with forces they cannot understand only to fall victim to their own egos. This is such a familiar and timeless trope that it’s even recognised by some as its own sub-genre.
In extreme cases, science fiction/horror movies such as Reanimator (1985), but even comedies like Back to the Future (1985), often present this “mad scientist” as a socially and emotionally incompetent, repressed, awkward man who knows everything except how to relate to people.
Some audiences recognise particular cues to suggest that these characters may be coded by the writers as having a form of behavioural disorder, like ‘being on the spectrum’, albeit a very stereotypically presented one.
However, the word ‘coded’ implies intent on the writer’s part. In most of these ‘mad scientist’ films, we do not know if this is the case, or, rather, if the writer just perpetuates stereotypes in which scientists are described as marginalised people, with all the features that ‘real’ marginalised people have.
By linking these negative characterizations to attributes associated with mental disorders, we prime audiences to respond to people they come across in the ‘real world’ in the same way that heroes in these movies respond to their ‘mad’ villains.
So, we meet a scientist, and we think that he (they are usually a he) must be, at best, odd, and at worse, a killer.
Cinema of the ’90s and ’00s saw this ‘mad scientist’ evolve into a more subtle villain — the doctor or the psychiatrist with nefarious motives, preying on vulnerable patients simply because they can.
Movies which focus on this harmful dynamic paint psychiatrists as dangerously sociopathic, and this is simply untrue.
The most well-known character that comes to mind is Dr Hannibal Lecter from Silence of the Lamb (1991), and recently re-proposed in the NBC series Hannibal (2013–2015). This a villain who time-and-time again disregards the well-being of his patients completely, focusing instead on how he can manipulate them to do his bidding. Here we have a doctor, a psychiatrist, a man well respected in his field, and, of course, he is also a serial-killer-cannibal-manipulator-sociopath.
In the psychological thriller, Unsane (2018), we see a woman wrongfully committed into a mental institution, when her stalker takes advantage of his position at an asylum. The clinicians and staff are also tricking people into voluntarily admitting themselves, for an insurance scheme. The film sets up the faculty administration as cold, apathetic, and willing to torture people for some quick cash. It implies, that they cannot be trusted.
M. Night Shyamalan’s Glass (2019) presents a similar dynamic. Yet again, there’s a larger conspiracy at play. The psychiatrist, Dr Staple, continually manipulates the three men under her care, convincing them to believe that they are psychotic and unable to distinguish reality from fiction.
What ties these films together is the irredeemable psychiatrist or doctor who gaslights and tortures the protagonist. This is not a character to empathise with nor to admire. The audience never roots for Dr Staple, nor the staff in Unsane.
Such cinema feeds into the false idea that psychiatrists eagerly wait for the opportunity to misdiagnose people and lock them up in asylums.
All it would take is to trust a doctor once, admit to being occasionally sad or scared, and then BAM, you are locked up!
These negative and dramatised versions of clinicians have significant real-life consequences, and not just through patient mistrust for doctors.
Across the board, medical fields are struggling to fill the increasing vacancies, and although applications to psychiatry have increased over the last two years, the amount of posts actually being filled is still inadequate.
Research investigating which factors may influence recruitment into psychiatry shows that negative opinions relating to the respectability of psychiatry deters medical students from specialising in this field.
In this 2017 review, researchers found that 30% of medical students choosing their speciality are discouraged to choose psychiatry due to the stigma around the field. Similarly, 53% of students are discouraged by the (alleged) lack of scientific bases in diagnosis.
In another study, most medical students were uninterested in pursuing psychiatry due to the negative attitudes towards psychiatrist from other doctors and health professionals.
As I’ve discussed over my three episodes, such social and cultural perceptions are inarguably influenced by the media that we consume. They affect the ways we respond to things in the real world.
When we continually see people of a particular group characterised as evil or villainous or emotionless, we inadvertently link those same negative traits to real people of that group.
Prospective students repeatedly see psychiatry and psychology portrayed as an illegitimate science, where sadistic doctors turn to as a way to feed their manipulative egos.
This is incredibly damaging. It creates an atmosphere of distrust by patients and the general public.
So, we have come to the conclusion of my 3-episode series on cinema and mental health.
What does the future hold?
In my blogs, I have constantly encouraged scriptwriters to write more true-to-life accounts of mental illness — both of sufferers and of professionals involved with it.
But the audience, as well, should be more critical and informed. We should be able to distinguish fiction from reality.
We should know, when watching Bird Box, that psychiatric patients are not criminally insane that can escape an extra-terrestrial invasion by colluding with the killing forces.
We should know, when watching Hannibal (the movies, but more so the series), with its unending list of shifty clinicians, that psychiatrists are not impatient, arrogant cannibals.
We should know, when watching psychological thrillers, that things are hyperbolised for dramatic effect.
If the audiences think more critically about the content they consume, the stigmatising harm done will be minimal to non-existent. But the data I have discussed above shows that this is not always the case — even for a well-informed audience such as medical students.
Of course, things are getting better.
Audiences are increasin
gly informed and conscious of the media that they consume.
Through social media, we can leave immediate feedback, engage in discussion, provide commentary. If the content of a movie or a TV series is truly over the top, patients and professional organisations complain. But there is still a-way to go.
The solution is to depict mental health and mental illness in all its breadth, complexity and diversity.
There are still people, within both the film industry and the general public, who stand in the way of progress, claiming that diversity is pandering.
But diversity isn’t pandering.
Diversity is reality.
It’s about time that the films we watch reflected that reality properly.