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Hollywood Quarterly (1947) - Psychiatry and the Films




Psychiatry and the Films


Lawrence S. Kubie's wide professional experience includes posts in universities, hospitals, and research centers as neurologist, psychiatrist, and psychoanalyst. During the war he served as Special Consultant, Air Surgeon's Office, and Scientific Consultant, E.T.O. Among his published works is the book, Practical Aspects of Psychoanalysis.

Increasingly, artists have concerned themselves with psychiatry. It is irrelevant to view this as good or bad, since it has been inevitable. Over the years, as art and literature gradually turned away from the presentation of history, mythology, and religion, and from moral and spiritual exhortation, they became techniques by which the artist attempted to voice his own life, his own personality. Sophistication soon led him from the obvious to the obscure, until presently he found himself struggling to express the more chaotic aspects of his personality, to wit, that in him which was neurotic. This trend long antedated the discoveries of psychoanalysis; but once psychoanalysis had appeared, with its promise of an ultimate inclusive understanding of human nature, then psychoanalysis was destined inevitably to infiltrate into art and literature. To the artist's equipment this added some half-understood and usually oversimplified formulae, some fragments of scientific knowledge, and a pseudo-technical vocabulary with which to decorate his thoughts. In due time the movies reached a similar phase. Here, however, the psychiatric invasion brought with it not merely many new opportunities but also many new problems.

To understand this it will first be necessary to consider the emotional and cultural influence of films in general. In a sense all art is an effort to live vicariously, that is, by substituting fictional experience for direct personal experience. In its potential capacity to achieve precisely this no other art form can approach the movie. The most important single fact about the film is this quasi-realism. Indeed, its unique capacity to simulate reality is so great that it regularly overwhelms the feeble capacity of the average adult to discriminate between reality and fantasy. When, as in a moving picture, something seems to occur before our very eyes, no matter how impossible and contrived it may be, we feel as though we had been eyewitnesses to life itself. "I was there, Charlie," is the feeling. It takes a critical and sophisticated mind to resist this impression, to maintain a firm hold on reality, and immediately or in swift retrospect to sort out the possible from the impossible. In the average movie audience few are capable of this. Most are extraordinarily passive, swayed by a film as a Nazi crowd was swayed by Hitler. Consequently, the subtly stylized quality of the movies may exercise a powerful formative or deforming influence on our culture, creating such tacit assumptions as that ordinary folk look as movie stars look, and behave as they behave in films, and that events really happen in that artificial fashion.

Often enough the paper-backed dime novel of our childhood was equally incredible and almost as exciting; but it never endangered our hold on reality to a like degree. This was because reading forces the reader into a more active participation than the passive role of a spectator at a film. No matter how vivid they may be, all texts leave much to the reader's imagination; and as we read, we exercise imaginative effort of our own. This leaves certain automatic, unconscious, self-protective opportunities at the disposal of the reader, that is, to let his imagination run freely or to shut it off. On the screen, on the other hand, little or nothing is left to the imagination; and the ancient dime novel seems actually to have come to life. Under this powerful influence the sense of reality by which we humans must try to live can take a beating from which some minds may never wholly recover.

If this is true for the average adult, obviously it can be even more dangerously true for the child. The child's immature hold on reality is so insecure that it is easily shaken by the vivid and lifelike scenes with which the films confront him. If anyone doubts this, let him watch the scattering of cowering and miserable little figures among the fascinated children at a horror film, alternately peeking and covering their eyes. Then during ensuing weeks let him study their sleep and their dreams and their play, and their human relationships, and their eating and excretory functions. More often than we like to admit, we might find a reaction not unrelated to the combat neurosis of war.

It is too bad that adequate studies of this kind have not been made, because it is not necessary that the vivid and compelling pseudo-realism of the movie should be destructive. This happens only when the industry abuses its capacity to make the unreal seem real. If on the other hand it presents human beings as they are, and human events as they really occur, it can become the most significant educational implement we have ever known. Its very capacity to simulate direct experience gives to the film a unique power to educate the heart as well as the mind. In this direction its potentialities have not been realized or developed, precisely because the industry as such has never studied the effects of the instrument which it uses.

At this point let us apply these general considerations to the problem with which we started, namely, the role of psychiatry in the movies. Currently, many books and films are exploiting the widespread interest in the neurotic aspects of human nature. It is a significant innovation in our culture that people are beginning to recognize the fact that neurotic problems are universal. If the full implications of this were presented properly in films, they would help to create something quite new in everyday life. But it is not easy to do this; and script writers and directors are confronted by many technical and psychological difficulties as they venture into these new fields.

First to consider here are their own conscious and unconscious feelings, and those of audiences as well, about mental ailments. Guilt and anger and fear are deeply buried in all of us; and in everyone there is some intimation of jeopardy, however remote, from conflicting inner stresses. Yet these very internal conflicts at the same time give rise to a fearful fascination with mental disorders, and to the need to dispose of that fear in some comforting fashion. Consequently, whenever mental frailty is portrayed in the films, whether as minor neurotic quirks or a frank insanity, a considerable part of any audience is both fascinated and terrified on levels deeper than the plot alone would stir. There is hardly a member of any audience who does not secretly identify himself with some aspect of the illness that is portrayed. Such an identification may be conscious, or it may be unconscious, or it may be partly one and partly the other. The individual may jitter with terror, or he may fail wholly to realize that he is afraid. He may just feel uncomfortable, or he may protect himself by being "bored" or by rejecting the film angrily as impossible and ridiculous. He will feel most superior and most secure, however, when he can make fun of the whole business, as when the story turns the tables on psychiatry and makes the psychiatrist appear foolish and the patient the possessor of wisdom. Then the fool becomes the wise man, mental illness becomes a mere figment of a psychiatrist's imagination, and the audience can laugh it all away. There are several such cheap and easy formulas; and I offer them gratis to all script writers. To have a popular success on your hands all you need is to make the psychiatrist into a stumblebum as in Harvey, or into a villain as in Shock, or, alternatively, to remove the sting by turning the psychiatrist into a beautiful blonde who throws her arms around you between "treatments," as in Spellbound. The formula is as sure-fire as Horatio Alger; but I cannot help wondering whether the movies (and the stage, too, for that matter) want permanently to remain on so infantile a plane as this.

Let us consider the problem from another angle. Could films on psychiatry retain their wide dramatic appeal if they dropped all Hollywooden and melodramatic trappings and portrayed the human spirit simply and directly? If human interest in psychopathology is as deeply rooted and as widespread as I have indicated, and if truth is at least as strange as fiction, then it ought to be possible, for example, to rewrite the Seventh Veil in such a way as to give it universal significance. That young pianist's neurosis would be shown to grow out of the unavoidable stresses of everyday family life, without any exceptional or melodramatic features. There would be no early orphanage, no pathological bachelor uncle, no auto wreck, nothing which would make of the patient anything special and unusual. This would not merely be more true to life; it would also carry a more inescapable appeal. Of anything which is unusual and exceptional the spectator can say always, "But this could not apply to me." It is only when neurotic character traits are seen to develop out of the humdrum yet highly charged banalities of the nursery years of every man and every woman that it becomes impossible for anyone to evade its significance for himself.

As another example consider the treatment of dreams. The dream in films has literally no relation to the dream of real life, because in their efforts to portray dreams the films have misused color, movement, sound, and confusion. Only rarely do people dream in colors, yet movie dreams are spattered with color like a child's finger-painting or the colored comics of a Sunday supplement. Film dreams are as full of action as an old-fashioned Western; yet with rare exceptions real dreams, on the contrary, have little active movement. For the most part they are made up of a swift succession of static flashes, not unlike old-fashioned "living pictures." Again, most dreaming is silent and visual. Sounds, voices, and words are heard only in rare staccato fragments if at all. Yet movie dreams are filled with conversations, elaborate songs and dances, and general sound effects. Finally, confusion is an essential quality of actual dreams because events which occurred at widely separated times and places are condensed into images which merge into one another, with quick shifts in locale and subtle changes in the identity of the dream figures. Incidents are left incomplete and ambiguous in meaning, and feelings may seem inappropriate to what is taking place. These are some of the sources of significant confusion in real dreams. How does the movie dream present this? It rises to heights of imaginative power which are truly impressive, and suggests this confusion just by hiding everything in clouds of hazy steam.

It would seem that even rudimentary study should make it possible for Hollywood to make better dreams than this artificial nonsense. It is far from impossible to indicate the subtle thread of significant meaning in the seeming chaos of dream imagery; and if the films are going to portray psychic processes at all, whether normal or abnormal, it would seem reasonable to demand that this be done with maturity.

More recently an additional element has complicated still further the affair between psychiatry and the film industry. Films are no longer limiting themselves to an effort to portray human suffering, that is, the internal struggles and external behavior of people with emotional or mental difficulties. They are also trying to portray the technical processes of psychiatric diagnosis and treatment. This is a further important step; and, depending upon how it is used, it too can be powerfully educative or seriously distorting. Up to the present time, with one or two notable exceptions, the films which have attempted this have been a curious hybrid of the documentary film and the worst kind of melodrama. Everything is either too quick and easy as in Spellbound, or too melodramatic as in The Seventh Veil. In other less responsible efforts they have been either ridiculous horseplay or an old-fashioned horror story. Here again it is not too much to demand that, when the films deal with universal human suffering and the struggle to alleviate it, they should not distort it.

I do not believe that there is an easy solution to any of these problems. Two steps, however, might be taken which would lead toward such a solution.

First, and most important, the film industry could establish a permanent endowment for an independent research foundation to study both the special uses of films in emotional and intellectual education and the general influence of all kinds of films on our current culture. Both would have to be studied with different age groups, drawn from different economic, educational, cultural, national, and geographical segments of the population. The impact of the films, and more particularly of the psychiatric film, on patients of various kinds would also have to be investigated. Under psychiatric leadership such investigations would have to be carried on jointly by psychiatrists, sociologists, educators, clinical psychologists, and cultural anthropologists, with adequate statistical controls. This could not fail to help the film industry as a whole to achieve maturity and to realize its extraordinary, undeveloped potentialities. At the same time there can be little question that it would open up vast new empires of expanding markets and save large sums of money annually lost on unsuccessful films. Therefore it would seem to be good science, good citizenship, and good business to organize such a research institute as soon as possible.

My second suggestion is directed partly to the film industry, but more particularly to scientists and to scientific bodies. When he advises any industry, the scientist, and especially the psychiatrist, should always be in a position in which his objectivity and impartiality will be above suspicion. This means that he must play a role analogous to that of the expert adviser to a court of law, and never that of the hired expert whose testimony is for sale to an interested party. Consequently, the psychiatrist should never allow himself to be hired by an individual film company which is interested merely in purchasing his scientific prestige as a backing for a particular film. Indeed, it should never be the business of an individual psychiatrist acting alone to pass on any film. Instead, our national scientific associations might well set up special boards to advise Eric Johnson's office on the technical accuracy of any film which directly or indirectly depicts technical subjects and processes. Such an advisory board should not and could not act as a censor; but it could give or withhold the right to use a statement that the film had been approved by the appropriate scientific board.

Of these two suggestions, the need for an independent research institute is by far the more important and far-reaching in its implications both for the industry and for the community. The other is more a matter of common sense, common scientific decency, and social responsibility on the part of scientists themselves.

Notes & References

  • Harvey. Play, Mary C. Chase, 1945. Shock, 2oth C-F, 1946. Director, Alfred Werker. Story, Albert De Mond. Screenplay, Eugene Ling.
  • Spellbound, Vanguard-UA, 1945. Director, Alfred J. Hitchcock. Novel (The House of Dr. Edwardes), Francis Beeding. Screenplay, Ben Hecht.
  • The Seventh Veil, Sidney Box-Ortus-Univ (Brit.), 1946. Director, Compton Bennett. Original screenplay, Muriel and Sidney Box. 117