In a commentary on a recent Grey's Anatomy episode called "Wishin' and Hopin'," Joan Rater, one of the episode's writers, explained that the episode was "really about Alzheimer disease. How devastating it is to families, how it turns spouses and children into caretakers, how it robs people of their memory, their identity."5 In the episode, Ellis, mother of one of the main characters, Meredith Grey, suffers from middlestage Alzheimer disease. But on this one day, she has a lucid moment, recognizes her daughter, and remembers everything up until the last 5 years, when she has been in a supervised living facility.
"The concept of someone with this disease having a lucid day is real," Rater said. "The disease varies for everyone, but experts we talked to said that patients have bad days and good days, and then sometimes they have great days where it seems like they are their old selves."
In the FX television series Dirt, a drama about the ruthless editor of a celebrity tabloid, actor Ian Hart portrays Don Konkey, a paparazzo who suffers from schizophrenia and who is often reluctant to take his medication. To research his part, Hart said he relied on his memories of distant relatives who have schizophrenia, some reading materials about the disorder, and BBC radio documentaries that featured conversations with individuals who have schizophrenia.6
One of the most thorough investigations of schizophrenia is in a new independent film, CANVAS, starring Academy Award–winner Marcia Gay Harden as Mary, a woman suffering from schizophrenia who paints her dreams on canvas; Sopranos' Joe Pantoliano as her husband, John, a construction foreman; and newcomer Devon Gearhart as Chris, their 10-year-old son.7
In the story, Chris attempts to conceal his mother's illness, but her bizarre public behavior alienates him from his schoolmates and widens the rift between him and his father. When Mary's illness leads her to violence, endangering her family and herself, John hospitalizes the woman he adores and tries to cope by building a large sailboat in his driveway. When Chris is suspended from school for fighting with bullies, John punishes him. A pivotal confrontation follows between father and son, ending in a reconciliation during which they come to terms with Mary's illness.
The film, an award winner at several film festivals even before going into general release, is a fictional narrative. Yet, its story is inspired by real childhood experiences of writer/director Joseph Greco, whose mother has schizophrenia.
"She was actually hospitalized for several months when I was a child. That's where the idea for the story came from," he told Psychiatric Times. Greco's father taught him how to sail.
"That is how we were able to cope as a family, by him taking me sailing," he said. "I'm lucky, because I had a really great father. In some instances, he was both the father and the mother, while she was away in treatment. We leaned on each other and that is really what the movie is about—how a family ultimately can overcome problems if given the right opportunity."
"My goal first and foremost was to tell a good story and make a good movie to entertain people, but I would also like people to learn about mental illness and if we can combat stigma in the process, then all the better," he added.
Obtaining professional input
Beyond relying on his own experiences for the plot, Greco told Psychiatric Times that he did some research about schizophrenia.
"I wanted to be sure that I portrayed mental illness accurately and sensitively, so I enlisted the support of the mental health community. In particular, there is a script consultant that I worked with, Susan Dempsay, who founded a rehabilitation center [for individuals suffering from severe and persistent mental illness] called Step Up on Second. Her son, unfortunately, has schizophrenia, so she has a personal connection to mental illness and first-hand experience. More than that, she has consulted on other movies."
Before the film was finished, Greco invited Stella March, national coordinator of StigmaBusters for the National Alliance on Mental Illness (NAMI), to attend a rough-cut screening in Beverly Hills. She urged Greco to send the movie to NAMI's headquarters in Arlington, Va. Last July, it was shown at NAMI's national convention, received 2 standing ovations, and was praised by NAMI's executive director Michael Fitzpatrick, MSW, as "one of the few dramatic films that can be considered authentic in its portrayal of schizophrenia— presenting both heart-breaking and heart-warming dimensions and even touches of humor." The film has since received enthusiastic reviews from entertainment industry critics, including John Anderson writing for Variety.
Not only Greco, but also Harden and Pantoliano researched schizophrenia. At Greco's request, they spent a day visiting Fountain House in New York City, a self-help program operated by individuals recovering from mental illness, in collaboration with a professional staff.
Before the film goes into general release, Greco said, "We are doing our best to give people in the mental health community a first look at the film."Greco and Pantoliano recently screened the film at a gathering of psychiatrists and other mental health professionals at Tufts University.
Drama for therapy, education
When viewed as a whole, mental health issues are being portrayed more accurately in recent movies than in the past, said psychotherapist Birgit Wolz, PhD, MFT, author of E-Motion Picture Magic: A Movie Lover's Guide to Healing and Transformation. The improvement in accurate portrayals parallels an improvement in psychiatric diagnoses, she told Psychiatric Times.
In her own work,Wolz uses movies as a catalyst for the psychotherapeutic process and for educating mental health professionals. Currently, she is developing an online continuing education program for psychologists and others that will utilize specific movies to illustrate diagnoses cited in DSM-IV-TR.
It is a way to learn about fairly dry material in an entertaining format, she explained. For example, the movie As Good As It Gets can be helpful in diagnosing obsessive-compulsive disorder, while Mr Jones presents a useful picture of bipolar disorder.
With Ofer Zur, PhD,Wolz has written an online CE course, "Therapeutic Ethics and the Movies—What Films Can Teach Psychotherapists About Ethics and Boundaries in Therapy."8 The course uses movie vignettes to discuss such ethical dilemmas as confidentiality, self-disclosure, touch, and out-of-office experiences.
"We looked at several movies where therapists are portrayed and in just about every one there is a boundary violation, so it is easy to portray ethical issues," Wolz said, adding that she and Zur are collaborating on a second course on ethics and the movies. Examples Wolz provided include Basic Instinct and Mr Jones, in which sexual relationships occur between therapist and client; Antwone Fisher, in which a client is invited to a family dinner with his therapist; and What About Bob? in which a client follows his analyst on his vacation.
Wolz also has developed an online course on cinema therapy. In the course description, she explains the power of films: "Movies affect us powerfully because the synergistic impact of music, dialogue, lighting, camera angles, and sound effects enables a film to bypass our ordinary defensive censors. They draw us into the viewing experience and at the same time—often more easily than in real life—afford a unique opportunity to retain a perspective outside the experience, the observer's view."9