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Psychiatric Times. Vol. 16 No. 7
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The Cinematic Psychiatrist

By Glen O. Gabbard, M.D.
| July 1, 1999
Dr. Gabbard is the Bessie Walker Callaway Distinguished Professor at the Karl Menninger School of Psychiatry and Mental Health Sciences, and co-author of Psychiatry and the Cinema, Second Edition, American Psychiatric Press, 1999.

Whenever a Stanley Kubrick film opens, it is an event. Kubrick, who is considered by many the cinematic genius of the 20th century, made 15 feature films. The eager anticipation surrounding his last film "Eyes Wide Shut," scheduled to be released this summer, has intensified even further because of Kubrick's unexpected death last March at the age of 70. Although the film is shrouded in standard Kubrickian secrecy, leaks suggest that Tom Cruise and Nicole Kidman play psychotherapists who are sexually involved with their patients.

While many in our field will shake their heads in exasperation at more negative publicity for psychiatry at a time when the specialty is particularly beleaguered, we may take solace in the fact that filmmakers continue to be fascinated with what we do. In the first edition of Psychiatry and the Cinema (University of Chicago Press, 1987), my co-author Krin Gabbard, Ph.D., and I catalogued 250 theatrically released American films that featured some type of psychiatrist or psychiatrist-like figure at work. In the second edition, recently released by American Psychiatric Press (1999), we have identified nearly 450. This rather staggering figure excludes television movies, foreign films and assorted pornographic films in which psychiatrists and other mental health care professionals appear for "redeeming social value."

It all began with the 1906 silent film "Dr. Dippy's Sanitarium." Images of psychiatrists have continued and have included "Analyze This," the biggest box office hit in March of this year, and now "Eyes Wide Shut." Why is Hollywood so enamored with us?

Psychiatrist and film scholar Irving Schneider once quipped, "If psychiatry had not existed, the movies would have had to invent it. And in a sense they did." Film critic Parker Tyler referred to the movie house as the "psychoanalytic clinic of the average worker." Indeed, psychiatry and the cinema have always been inextricably intertwined. They both grew up in the early years of the 20th century and came of age together.

The psychotherapist has always been a marvelous plot device for filmmakers. While an omniscient narrator can describe the inner life of the protagonist in a novel, the cinematic medium must resort to a hokey voice-over or elaborate exposition that takes away from the action. A simpler solution is to have the protagonist visit a therapist so the audience can see a side of the character that isn't revealed in the action of the narrative.

In the 1971 film "Klute," Jane Fonda plays an apparently self-confident prostitute who visits a therapist and pours out her heart, revealing a vulnerability and complexity that surprises the audience. The same year George C. Scott appeared in "The Hospital," where he visits a psychiatrist early in the film to establish that he is depressed and contemplating suicide.

When psychiatrists are used in this way by the screenwriter, they are often faceless characters who have no personality and simply sit quietly and listen. In early Woody Allen films, such as "Bananas" in 1971, the analyst sitting behind him is nothing more than a silent audience for stand-up comedy routines delivered from the couch.

Throughout cinematic history, however, many psychiatrists and psychotherapists, who are actively involved in the action and take on importance as central characters have appeared. They may appear as romantic leads, such as in the 1938 classic "Carefree," in which Fred Astaire "psychoanalyzes" Ginger Rogers while wearing a tuxedo and dancing with his patient. They may play sinister figures such as Hannibal Lecter in the 1991 film "The Silence of the Lambs." Here, the psychiatrist is the embodiment of evil but also an extraordinarily astute clinician who can diagnose Clarice Starling's psychological conflicts by identifying her perfume and assessing her shoes and clothing with the clinical acumen of Sherlock Holmes.

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