Mental Illness on the Screen: No More Snake Pit

Mental Illness on the Screen: No More Snake Pit

Just 2 minutes before an episode of
the television show Boston Legal
aired, Roger Pitman, MD, professor
of psychiatry at Harvard Medical
School, received a telephone call from
his sister-in-law informing him that the
show would include a segment on propranolol,
a drug he was researching for
the prevention and treatment of posttraumatic
stress disorder (PTSD).

After watching the "Selling Sickness"
episode,1 Pitman was amazed at
how quickly his research, albeit substantially
embellished, had made it to a
popular television show viewed by
more than 10 million people.

The episode included a fictional story
about a 16-year-old girl, Michelle,
who had recently been molested by a
rabbi, and about the ensuing conflict
between her divorced parents over
whether Michelle should take the "forgetting
pill." Michelle's psychiatrist father
sought a court order to permit her
to take the pill, while her mother opposed
it. The pill was propranolol (Inderal),
a ß-blocker, which is FDA-approved
for the treatment of hypertension
and angina pectoris, among other

In the courtroom drama, the father's
attorney described the drug as essentially
blocking "adrenaline from entering
the nerve cell, and adrenaline attaches
emotion to memories. If you take
the drug quickly enough, it can prevent
you from remembering and being
scarred by the trauma." He then added
that it had been used "with soldiers suffering
from PTSD with good results."

Opposing the drug's use, Michelle's
mother argued: "You just can't erase the
bad parts of life," and "our best artists
are informed by their pain. . . . Certainly,
if the trauma affects your life, treat it,
either behaviorally or with medication.
But some miracle amnesia pill, so you
have no memory of bad things—what
kind of brave new world are we entering

The episode segment ends with the
judge ruling against Michelle being given
the drug.

Boston Legal's writers "used artistic
license to make more out of this than
there currently is," Pitman said. "I
thought the [drug's] effects that were
portrayed in the show were beyond
what we know the effects to be, but . . .
the discussion of the ethical issues was
fairly good."

Pitman believes the Boston Legal
script was based on a CBS 60 Minutes
segment aired November 26, 2006, in
which correspondent Lesley Stahl interviewed
him, other researchers, and
study participants with PTSD who had
received propranolol.2

"The 60 Minutes show indicated that
this research was experimental and that
there were not any firm results yet,"
Pitman said. "Now, in . . . Boston Legal,
the plaintiffs were portraying it like it
was this miracle drug. On the other
hand, the defendant's lawyer did say
that it hadn't even been shown to be effective

Summarizing his reaction to the
episode, Pitman said, "It was an interesting
show, but what we need is more
data rather than more interest. . . . At this
point, the most important thing for us to
do is to continue our research and see
what there really is to this drug."

Writers draw on life experience
As with the Boston Legal episode, many
story lines of television series and films
are increasingly imitating life. But is the
information accurate? The importance
of this question is highlighted by a 2001
Healthstyles Survey that found more
than half (57%) of regular viewers reported
learning something about a disease
or how to prevent it from a daytime/
prime time drama.3

Certainly, when mobster Tony Soprano
sought treatment for panic attacks
in The Sopranos, the process and purpose
of psychotherapy received wide
exposure. The television series provided
one of the best depictions of psychotherapy
"to ever appear on film or
television," according to Glenn Gabbard,
MD, Brown Foundation Professor
of Psychoanalysis at Baylor College of
Medicine and author of a book about
The Sopranos.4

Increasingly, writers, directors, and
producers of prime time shows or feature-
length films, along with actors, are
shifting away from mental illness
stereotypes and seeking the input of
psychiatrists, psychologists, other mental
health experts, family members of
the mentally ill, and those suffering
from the disorders.


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