They Don’t Use Straitjackets Anymore?

Mental Illness in Popular Media

Few things signify occupational prestige in the United States more than the lab coat & stethoscope tandem. Whereas public respect for the once-proud legal profession and the clergy (cough, cough) has declined precipitously in recent years, Americans still love physicians — and they can’t get enough of them on television. From St. Elsewhere and General Hospital to the current ER and Grey’s Anatomy, audiences have long flocked in droves to medical dramas, in large part due to the fact that hospitals — like police stations and courtrooms — are ideal stages for storytelling. Things happen in hospitals; there’s always a crisis erupting, and more importantly, a crisis that can be resolved within the span of a 60-minute broadcast. The maverick House, MD regularly scores big Nielsen ratings by stamping out illness with Dirty Harry-like zeal, and some critics have even commented that the series almost operates like a crime show, with Detective House on the trail of culprit maladies.

On the flip side, however, are those other doctors the public isn’t clamoring to see nearly as often: psychiatrists and clinical psychologists. While The Sopranos’ Dr. Melfi and the title character of Huff have given therapists a bit of TV limelight as of late, let’s face it — serious shrinks (no, Frasier Crane doesn’t qualify) have been largely ignored by the small screen. But it’s not their fault; it’s more of a question of what you can do with the mentally ill. If I’ve got a Junior Mint stitched up inside me after a botched surgical procedure, good ol’ House can generate great drama by turning my plight into a race-against-the-melting-chocolate-clock. But the clinically depressed aren’t going to snap out of their funk within the span of a single episode, if ever; so the most convenient option is to turn mental illness into comedy. Hey, that guy sure is crazy! He’s wearing women’s clothes!

M*A*S*H’s transvestite-era Klinger wasn’t really mentally ill, and television hasn’t generally been interested in portraying characters with more debilitating disorders. Part of what made the “it was all a dream” finale of Newhart so fitting is that most of the characters Dick Loudon encountered in Vermont were even more eccentric than the patients who filed into Bob Hartley’s office on The Bob Newhart Show. To its credit, M*A*S*H eventually introduced a psychiatrist to help the members of the 4077th deal with the horrors of war, but these instances were always emotionally draining and basically made you forget that you were supposed to be watching the show for laughs. Tony’s visits to Dr. Melfi were initially conceived as the backbone of The Sopranos when it first aired — beating the lackluster film parody Analyze This to the punch by a few months — but it soon became apparent that outside of his occasional “panic attacks,” there really wasn’t anything wrong with the leading mafioso; he was simply a guy in a very high-stress job who needed a sounding board. (Personally, I thought the series could’ve done without the plot element entirely, and Melfi’s role was clearly reduced as the show progressed.)

Cinema has long been a much more natural venue for stories of the mentally ill. There’s greater latitude in exploring darker themes — particularly since you don’t have to revisit the same issues on a weekly basis — and the Academy gets predictably weak in the knees for fish-out-of-water tales where some handicapped individual is trying to make their way through “normal” society. (See Rain Man, My Left Foot, What’s Eating Gilbert Grape, Sling Blade, et al.) Even without looking at the question quantitatively, it seems likely that films of this ilk do extraordinarily well on Oscar night relative to their numbers.

Of course, advocates of the mentally ill would prefer it if mental disorders hadn’t become a key ingredient of another popular (with audiences, if not always critics) cinematic staple, the this-loon-will-kill-us-all theme most commonly found in thrillers and horror movies. Where would the fright-film industry be without the critical escaped insane asylum inmate population? Halloween, largely inspired by the classic Psycho, kickstarted the slasher film wave of the late 1970s — but more importantly, reinforced the public fear that the mentally ill are dangerous. My friend Molly McAshan — both a big-time cinema wonk and a former graduate student in clinical psychology — brought up this point recently during a radio show we did together, informing me that the vast majority of mentally-ill folks were no danger to anyone. Other facts I was surprised to learn: there are no such things as “asylums” anymore (too much of a negative connotation), and more shockingly, straitjackets are no longer used as restraining devices. Perhaps people got wise after watching Mel Gibson’s separating-the-shoulder trick in Lethal Weapon?

Other notable movies have had intertwining relationships with societal attitudes and concerns towards the mentally ill:

Rain Man: While this Dustin Hoffman/Tom Cruise vehicle was heavily lauded upon its release, sweeping most of the Academy Awards in 1988, only recently have we begun to see a great deal of attention placed on autism and its possible causes. (This is partly because some people believe the disorder is on the rise, and partly because of attention drawn to it in other mass media, such as Mark Haddon’s popular novel The Curious Incident of the Dog in the Night-Time. Most people were surprised later to find out that, no, not all folks with autism are savants at math like Hoffman’s Raymond Babbitt. Incidentally, the film not only got the general public excited about casino card-counting, but also served as the beginning of the end for K-Mart — its popular catchphrase “K-Mart sucks” immediately entered the public lexicon and quite possibly had a role in sending the big-box retailer on a downward spiral that ended in bankruptcy five years ago.

Primal Fear: More often than not, the general public isn’t thrilled when defendants successfully obtain a “not guilty by reason of insanity” trial verdict. I never understood the consternation; the law is merely substituting one form of prison for another, as Jack Nicholson certainly discovers in One Flew Over the Cuckoo’s Nest. Twenty-six years after shooting President Ronald Reagan, John Hinckley, Jr is still confined to a Washington D.C. hospital, and he’ll undoubtedly be there until the day he dies. In this 1996 film, Richard Gere’s defense lawyer argues that his client, played by Edward Norton, was insane when he murdered an abusive priest. But how does one verify mental illness? And how would one later prove that they are “cured”? (Although this, according to Molly, is another term which clinical psychologists don’t like to use.)

Fight Club: While it’s not explicitly stated that Edward Norton’s unnamed character is mentally ill, one certainly comes to that conclusion by the end of the 1999 film. Not only does it serve as a particularly scathing attack on the material excesses of yuppiedom and consumerism (a theme shared by American Psycho, written five years before Fight Club, though its cinematic counterpart wasn’t released until 2000), but director David Fincher’s adaptation also arguably ranks as one of the few films to improve upon its literary source material — not so much in the graphic nature of the fight scenes, but rather the visual tricks that Fincher employs, such as Tyler Durden’s flickering appearances before he’s formally introduced, or the way in which the narrator's carefully-selected condo furnishings are neatly itemized on screen.

The Manchurian Candidate: Interestingly enough, the American Psychological Association has neither formally accepted nor denied “brainwashing” as a concept. (Many scholars have been asked to study this topic in relation to court cases involving religious cults and the like.) Whether or not it it’s actually possible to convert someone into a “sleeper agent” and have that person unknowingly perform the bidding of another, there’s no doubt that the device makes for great cinema. Sure, it’s easy to be afraid of Michael Myers; after all, the guy is wearing a mask and brandishing a variety of sharp implements. But it’s even more frightening to be assaulted by someone who was calmly standing next to you just seconds ago. (We’ve seen variations of the theme employed successfully in countless TV shows and films, including Invasion of the Body Snatchers, The Thing, and the current Battlestar Galactica, as well as in the 1962 and 2004 versions of this film.) It’s a concept that gets right to the heart of the latent fear the public has of the mentally ill — that they are impossible to read and could snap at any time without warning.

Mazes and Monsters: This 1982 production wasn’t even a theatrical release, but a humble made-for-TV movie. Most contemporary viewers have never heard of it, but as a former geeky paper-and-pencil role-playing-gamer (well, former RPGer — I’m certainly still a geek), I’d be remiss if I didn’t mention the impact this movie had on the community. Based on a Rona Jaffe novel, M&M starred a pre-celebrity Tom Hanks as one of a group of college students who play a Dungeons & Dragons knockoff, and while doing so, Hanks slowly loses his marbles and becomes unable to distinguish between fantasy and reality. Hanks — later referring to himself as his character, a holy man named Pardeux — is narrowly prevented from joining his deceased older brother by leaping off one of the Twin Towers, and the story concludes with poor Pardeaux sequestered at his home under his parents’ (or “innkeepers,” as he calls them) care. The movie was released at the height of D&D’s popularity, and served as perfect tool for religious groups who wished to educate their congregations on the “corrupting influence” of these sorts of games.

As wildly implausible as Mazes and Monsters was, well ... that’s what movies are great at doing: playing on existing fears, if not necessarily generating new ones. I’ve made it thus far in life without requiring the services of a mental-health professional, but should that day arise, I’ll think of M&M when trying to quell my own doubts about whether the person sitting across from me is actually paying any attention to me. It could be worse: In Todd Solondz’ 1998 film Happiness, psychiatrist Bill Maplewood seems to be listening intently to a patient drone on about his life, but we can hear Bill’s mind via a voice-over thinking “dozen eggs ... gallon of milk ... bread ... ”