Touched With Fire: Film and Social Media Address Stigma

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Touched With Fire

Joan Miro’s description of the artistic process: “The works must be conceived with fire in the soul but executed with clinical coolness.”¹

Recently, I attended a screening of Touched With Fire-a movie that revolves around the lives of two poets who struggle with their bipolar disorder. After experiencing accurately portrayed episodes of their illnesses, the male and female lead characters are hospitalized and meet. What ensues are scenes familiar to patients, families, friends, and those who treat them.

The screening was followed by a discussion that included Paul Dalio, the film’s writer and director; Kay Jamison, PhD, who appears in the film; and J. Raymond DePaulo, Jr, MD, Chairman of Psychiatry and Behavioral Sciences at Johns Hopkins University. Drs Jamison and DePaulo serve as the Co-Directors of the Johns Hopkins Mood Disorders Center.

While other films such as Silver Linings Playbook, Infinitely Polar Bear, and Mr Jones, have also featured protagonists with bipolar disorder, Touched with Fire has gone the next step and recognized that film can be a powerful vehicle for conversation and social change in the fight against psychiatric stigma. Pre-release screenings were scheduled across the country: experts from the National Network of Depression Centers (NNDC) member centers were included on panels.

Other leading grassroots organizations-including NAMI, DBSA, International Bipolar Foundation, Active Minds, Mental Health America-as well as local foundations partnered as well. To convey his message even more broadly Mr Dalio has released videos with PatientsLikeMe.com, which conveys his own experience with the illness, finding hope, and learning to thrive while embracing treatment-and now combating stigma.

Psychiatric stigma

Psychiatric stigma is the systemic and internalized stereotypical negative attitudes against people labeled as mentally ill.² When conceptualizing stigma it is important to recognize the dynamic interplay between knowledge, attitudes, and behavior. Ignorance or attitudinal or prejudicial beliefs result in a social injustice that goes hand in hand with discriminatory behaviors, causing direct harm to those affected.^3,4

Prejudice throughout our society is pervasive: it is not limited to the lay public and it encompasses health care professionals.⁵ Formal medical education about mental illness has not reduced stigmatizing attitudes. On the contrary, such education has been found to increase stigmatizing attitudes.⁶ This is particularly troublesome given that medical students experience depression and mental illness at higher rates than the general population and deteriorating mental health during their training.⁷

Interventions to combat stigma have ranged from the use of standard medical curriculums, to interventions which have relied on intergroup contact theory in which individuals have direct exposure to the stigmatized population. Social contact has been effective in decreasing negative attitudes about mental illness.⁸ However, the impact of psychiatric clerkships on attitudes has been both positive and negative.⁴

Another methodology to combat stigma utilizes the arts. Educational strategies using entertainment may reach audiences that might otherwise not be reached by targeted educational campaigns.³ These interventions are consistent with intergroup contact theory, and filmed interventions have been found to have anti-stigma effects.^9,10

What can you do? >

What can you do?

What can practicing psychiatrists and mental health professionals do to combat stigma? Given the trend in the translation of health education utilizing media, practicing clinicians might consider how films such as Touched With Fire and corresponding content (which can be found on PatientsLikeMe.com) can be used with patients and families. One of the themes evident in the film was the struggle that patients with bipolar disorder experience when it comes to their mood. 

The film portrayed the seduction of mania and how challenging it can be for patients to give up their states of euphoria and what some perceive (accurately or not) to be its benefits. Mr Dalio’s comments on PatientsLikeMe.com include his reflection on coming to terms with bipolar disorder, the painfulness of dulled emotions after initial treatment, and how he ultimately learned to thrive with his illness. When paired together, his film and personal disclosures, have the potential to serve as valuable resource and tool when working with patients and families.

Film can be a powerful vehicle for conversation and social change in the fight against psychiatric stigma.

Practicing psychiatrists and mental health professionals are increasingly challenged to do more with less, shortened lengths of stay, and managing increasingly ill patients in community settings. While there are treatment guidelines of evidence-based practices, patients need to be engaged and a partner in treatment. Discrimination remains all too common for those with mental illness and it often presents obstacles to care.

New approaches are needed to reduce stigma, enhance prevention, and promote early detection and treatment of mental health disorders. Current educational practices need to be evaluated to determine content that reinforces stereotypes and creates a culture of prejudice and discrimination. Non-traditional approaches and interventions can help to engage patient, families, and communities in this conversation.

Acknowledgement: This article comes from our partner, National Network of Depression Centers.

Editor’s note:Touched with Fire won a Best of Show Award in the IndieFEST Film Awards.  Along with this award, the film received an Award of Excellence: Health/Medicine/Science, an Award of Excellence Special Mention: Actress: Leading (Katie Holmes as Carla) and an Award of Excellence Special Mention: Actor: Leading (Luke Kirby as Marco). The film is available digitally via iTunes and Amazon and was released On Demand, DVD and Blu-ray on June 7, 2016. Website: http://www.touchedwithfire.com

Disclosures:

Ms Beaudry is Administrative Director and Nurse Research Manager at the Johns Hopkins Mood Disorders Center, Baltimore, Maryland.

References:

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