Psychiatry and Mental Illness: Are They Mass Media Targets?

Psychoanalysis-contagious disease originating Vienna circa 1900-now extinct in Europe but occasional outbreaks among rich Americans. - 3001: The Final Odyssey, by Arthur C. Clarke

Nothing is sacred in America's pop culture. So when it embraces any topic, we've grown used to the relentless distortion that occurs, one that transforms reality into an odd combination of fact and fantasy. For those suffering from mental illnesses and the practitioners who treat them, the implications of a steady onslaught of often negative and inaccurate portrayals of mental illness in all forms of entertainment media are dire.

Battling the societal stigma that enshrouds brain diseases is difficult, and the ability to overcome centuries-old biases is often thwarted by the stereotypical representations of mentally ill individuals, as well as psychiatrists, psychologists and other therapists. The issue is nothing new, but the latest spate of movies, books and TV shows that involve mental health issues renews concerns that rather than progression there is a backslide into prejudice that militates against understanding.

Often the slights are not intentional, according to Jean Arnold, chair of the National Stigma Clearinghouse, a New York City-based hub of information for "stigmabusters" nationwide. In her experience, the creators of entertainment don't understand the harm they do when they include stereotypical depiction of mental illness.

"These people don't really mean to harm the mentally ill," Arnold said. "They do it inadvertently because they think that [using stereotypes] is the easiest route to take. But they're willing to change. They're not intending to be offensive once they're sensitized," Arnold said. She added that the entire mental health community needs to be more outspoken and willing to take on the entertainment industry when it steps out of line.

The publicity surrounding Woody Allen's latest release, "Deconstructing Harry," however, suggests that sometimes the motives for negative portrayals may be driven by "not-so-hidden" agendas. In the film, Kirstie Alley plays the role of a psychiatrist, one whose boundary breaches and neurotic emotional state are typical of the way psychiatrists are often portrayed in the media.

In a Dec. 11, 1997 USA Today article, Alley told the interviewer, "I don't like psychiatry. And I don't believe it works. And I believe psychiatrists are neurotic or psychotic, for the most part. I wanted to play her that way, and Woody just totally let me do it. I said, 'I want to be taking Prozac or drugs during the session with her patient.' I wanted to show that this woman is so twerked out that she has to take drugs, too. She takes her own medicine. So he said, 'Yeah! That's a good idea.' "

Efforts to reach Allen through his publicist to discuss his portrayal of mental health-related subjects in his movies were unsuccessful. But in the same USA Today article, he was quoted as saying, "I didn't give her even one direction. I never had to. Her instincts were right on from the start."

Alley is a member of the Church of Scientology and the international spokesperson for Narconon, the church's program for drug and alcohol(Drug information on alcohol) abusers. The church, through various affiliated groups, has publicly denounced psychiatry and psychiatric care.

Allen, meanwhile, has become the unwilling national icon for critics of mental health benefits parity, whose use of the term "Woody Allen Syndrome" connotes endless, pointless and often useless therapy, the cost of which will allegedly bankrupt the health care system.

Impressions created by members of the entertainment media, whether intentional or not, have a profound impact on the public, according to Glen Gabbard, M.D., author of the book Psychiatry and the Cinema. Originally published in 1987, an updated edition is scheduled for release next year by the American Psychiatric Press.

"Movies, to the American public are like what Greek drama was to ancient Athenians. They shape our culture and they shape our attitudes," said Gabbard, the Callaway Distinguished Professor at the Menninger Clinic in Topeka, Kansas. "Ever since McLuhan, we know how influential the electronic media is in shaping the culture."

Whether in the depiction of psychiatrists or mental illness, the history of cinema has not been kind, according to Gabbard, who can reel off the names of movies and their release dates with the ease of a seasoned film buff. Except for a "golden age" between 1957 and 1963, when 22 movies were produced featuring idealized portrayals of therapists, and a few exceptions in other years, neither psychiatrists nor the mentally ill have fared well.

In the past 30 years, Gabbard said, only three movies have portrayed therapists sympathetically-"I Never Promised You a Rose Garden" (1977); "Ordinary People" (1980): and "Good Will Hunting" (1997). In the latter film, although Robin Williams portrays a sensitive, understanding therapist struggling to help a gifted, but troubled, youth, the depiction of what Gabbard called "outrageous and preposterous therapy" detracted from the overall positive images in the film. "Therapy is seen as helpful and maybe some people will go to therapy because they see it as being helpful," Gabbard said. "What they expect when they get there is going to be a problem."