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December 4, 2009 4:04 PM   Subscribe

6 Mental Illness Myths Hollywood Wants You to Believe. A smart, funny take on some of the most common Hollywood movie tropes about mental illness.
posted by ShawnStruck (100 comments total) 13 users marked this as a favorite

 
Ten minutes to Wapner.
posted by turgid dahlia at 4:06 PM on December 4, 2009 [2 favorites]


This is great--I wish it had touched more on the therapy process and how it's been portrayed in stuff like The Sopranos, Good Will Hunting, etc. (by that I mean frustratingly inaccurately).

Can I just say that I hate beyond all hatefulness the HBO show In Treatment? And do you know why? Because it's about a psychologist who consistently breaks ethical rules, but it's presented in a way that makes people think this is what therapy is like. But it's really just what therapy with an asshole therapist is like.
posted by so_gracefully at 4:15 PM on December 4, 2009 [7 favorites]


Next. A bunch of things Hollywood gets wrong about:

Physics
Genius
Artists
Learning
Peer Groups
Death
Biology
History (all the time!)

etc.
posted by oddman at 4:17 PM on December 4, 2009 [7 favorites]


Hmm. Kind of unconvinced by the rehabilitation of electroshock therapy. Possibly that's just predjucice due to family history and some stuff that happened in the 70s.
posted by Artw at 4:19 PM on December 4, 2009 [4 favorites]


Dori from Finding Nemo was pretty horrifying. Of course, fish that size only have a working memory of three seconds.
posted by infinitewindow at 4:20 PM on December 4, 2009


I get this, really I do, and I do wish there was a better understanding of mental illness in our world, but the tone of hitching strikes me as a little ridiculous on the topic of savants and sociopaths, especially. The complaint that the "average" person with mental illness doesn't fit the Hollywood cliches shouldn't really be a surprise to anyone; Hollywood doesn't typically do average people. If peoe don't already know this I don't really think they'll get the subtleties of mental illness anyway.
posted by six-or-six-thirty at 4:22 PM on December 4, 2009 [1 favorite]


Sigh. Bitching and people.
posted by six-or-six-thirty at 4:23 PM on December 4, 2009


Hmm. Kind of unconvinced by the rehabilitation of electroshock therapy. Possibly that's just predjucice due to family history and some stuff that happened in the 70s.

Seconded. Maybe they should preface some of their observations with "recently". I've personally met people who were locked in mental institutions against their will and subjected to ECT. Forgive us for holding folk images of those in mental health that are less-than-sympathetic.
posted by Sova at 4:24 PM on December 4, 2009 [2 favorites]


Hmm. Kind of unconvinced by the rehabilitation of electroshock therapy.

Oh, believe me, there's a whole anti-ECT advocacy community out there that is very unconvinced. The issue is not quite as simple and clear cut as Cracked presents it, which is, forgive the pun, not shocking.
posted by The Straightener at 4:27 PM on December 4, 2009 [5 favorites]


All the stuff about how sometimes the crazy is people being creative and genius-like always kind of irks me. Mostly the crazy is people being crazy and annoying and thinking they are all creative and genius like, which is really not the same thing.
posted by Artw at 4:34 PM on December 4, 2009 [3 favorites]


The Charming and Witty Psychopath

I'm not going to say that most psychopaths/sociopaths are charming and witty, but uh, Ted Bundy was pretty charismatic.

The article calls these myths, but what it means is... minority cases, I guess?

Also adding my name to the list of people not impressed with the ECT defense.
posted by emperor.seamus at 4:37 PM on December 4, 2009 [2 favorites]


Dori from Finding Nemo was pretty horrifying. Of course, fish that size only have a working memory of three seconds.

That's actually not true at all. (Look it up!)
posted by Sys Rq at 4:37 PM on December 4, 2009 [3 favorites]


The bit on sociopaths was a bit off. He compared it to anti-social personality disorder, but wouldn't it make more sense to compare "sociopathy" to narcissistic personality disorder, as far as "real" DSM-IV disorders go.
posted by delmoi at 4:43 PM on December 4, 2009 [1 favorite]


Can I just say that I hate beyond all hatefulness the HBO show In Treatment?

You can say it, but you risk me having no idea what you're talking about. I know he felt attracted to one patient, but I can't remember seeing him break one ethical rule, and I have seen every episode.

re: The list. Usually I disregard these things, because they tend to be written by people who lack a fundamental understanding of what a narrative film actually *is.* In the same way that the scenery in a stage play is blatantly not a real house, movies use tons of things to stand in for reality. It's less obvious, because a modern movie is much closer to looking like reality than a stage play, but it's still there. When you see that the "dark" bedroom is actually slightly lit- you have not "busted" Hollywood. That is a convention- because cameras cannot film in the dark. We accept that it stands for the dark, just like we know the cardboard scenery in a play stands for real stuff. When you say "movie characters never go to the bathroom lol," you have not uncovered a major oversight. Movies only show the parts that matter to the story. It's not an uninterrupted recording of people's lives- it's a story.

This article, on the other hand, has a little more merit. Mental illness is a serious issue, and I do think movies have some obligation to be realistic when it affects people's perception of real social issues. Also, these cliches of mentally ill behavior (haha! wacky OCD guy!) are used by writers in lieu of actual characterization. This sucks because a) it's bad writing that makes bad movies, and b) it reduces people with mental illness to nothing but the illness.

As for The Sopranos, I always found the therapy thing ridiculous. Anyone with even a rudimentary knowledge of how therapy works knows that a therapist is obligated to report serious crimes her patients tell her about.
posted by drjimmy11 at 4:44 PM on December 4, 2009 [12 favorites]


I know a girl from highschool who's sister lost her ability to form new memories for a couple of days. The cause: hitting her head. (specifically she fell on her head in a Taekwondo fight)

I don't think this article is very accurate.
posted by delmoi at 4:47 PM on December 4, 2009


Oh and don't even get me started on the depiction of mental illness and antidepressants in Garden State. That kind of dishonesty is pretty epidemic in indie films, sadly. The characters are not people- they are tools for the filmmaker to manipulate the audience with, and canvases for him to be cutesy on.
posted by drjimmy11 at 4:48 PM on December 4, 2009 [12 favorites]


As for The Sopranos, I always found the therapy thing ridiculous. Anyone with even a rudimentary knowledge of how therapy works knows that a therapist is obligated to report serious crimes her patients tell her about.

Well, I don't see how that matters. People are obligated not to commit serious crimes in the first place, so obviously it never happens. As we know, no one ever skirts their obligations.
posted by delmoi at 4:48 PM on December 4, 2009 [3 favorites]


If you want the critical perspective on ECT Doctors of Deception is a popular book in that movement. My experience with ECT as a social worker is limited but from what I've seen doctors use it in the throwing shit against the wall stage when nothing else is working and they don't know what else to do. They don't know that ECT will work but at that point for the person in question it's either ECT or suicide so they voluntarily undergo the treatment. I have seen it not work, where the person is now not only still suicidal but it also confused, disoriented and distressed about being on a locked psych ward because their short term memory is totally blown out and they have no idea how they got there or why they're there.

I understand that like many other psychiatric practices, while many claim the treatment was hellish many others claim it saved their life, so I'm not trying to slander the practice, but simply provide the other perspective that the Cracked writer fails to provide.
posted by The Straightener at 4:49 PM on December 4, 2009


Dori from Finding Nemo was pretty horrifying. Of course, fish that size only have a working memory of three seconds.

Here is a (short) video that seems to demonstrate just the opposite. Just click on the "fainting fish" link.
posted by bearwife at 4:49 PM on December 4, 2009 [3 favorites]


Actually I just read the article and it's terrible. Sorry. I had assumed it would be calling out things like the absurd depiction of schizophrenia in "A Beautiful Mind." That article, if it existed, would have some good points.
posted by drjimmy11 at 4:50 PM on December 4, 2009 [1 favorite]


Yeah. It's hard not to agree for the most part. But. Wow. Talk about a complete cynical misread of One Flew Over the Cuckoos Nest. At least in what I saw in that movie/book.

Meh. Hollywood is a pretty easy target. Kinda lazy analysis over all IMHO.
posted by tkchrist at 4:52 PM on December 4, 2009 [3 favorites]


People are obligated not to commit serious crimes in the first place, so obviously it never happens. As we know, no one ever skirts their obligations.

Pardon? Tony is a mobster, of course he commits crimes. That is believable.

His therapist, on the other hand, is depicted as basically an upstanding member of society. I could *maybe* buy that she eventually falls in love with him and is willing to risk her career and innocent lives to protect him.

But the fact that it never even comes up (at least not in the episodes I've seen)? That's ridiculous. It seems pretty clear the writers either misunderstood the idea of client confidentiality, or chose to ignore it in service to their plot device.
posted by drjimmy11 at 4:54 PM on December 4, 2009 [1 favorite]


Previously-ish, here's a (very good) website featuring film reviews from a professor of psychiatry.

This was a fun list, but I would like to be a huge nerd and point out that Spider-Man 2 wasn't about a mentally ill villain, but rather one who had expensive whatzahoozit tentacles that turned mind-controlling after a supervisory microchip broke. Comic book hocus pocus, but not any real misinterpretation of mental illness.

However, that House episode was indeed very silly. I know that House is hocus pocus straight up and down, but I expected that episode to be more clever than it was.

As for In Treatment, my only complaint with the show was that it was only occasionally interesting, and that it represented the nadir of HBO's temporary obsession with therapists as narrative devices. I actually preferred Tell Me You Love Me.
posted by Sticherbeast at 4:56 PM on December 4, 2009


Sorry. I had assumed it would be calling out things like the absurd depiction of schizophrenia in "A Beautiful Mind." That article, if it existed, would have some good points.

Oh man, this. Having someone close to me suffer from this disease, I have stayed far away from this movie after seeing the trailer. Might be unfair of me, but I only have so much time in this world. Spider was very good, however.
posted by Sticherbeast at 4:59 PM on December 4, 2009


Admittedly, I have never bought a copy of Cracked magazine in my life, as I grew up with Mad and always saw it as a sleazy spinoff. However, this is not a bad critique of what Hollywood gets wrong about mental illness (and as oddman points out above, just about everything else).

Insofar as ECT goes, although others are certainly more well informed than I am, my understanding is that the voltage (amperage?) is a fraction of what it used to be and that a lot of people suffering from severe depression endorse the efficacy of the procedure, despite the fact that doctors still do not know why/how it works.
posted by kozad at 5:00 PM on December 4, 2009 [2 favorites]


His therapist, on the other hand, is depicted as basically an upstanding member of society. I could *maybe* buy that she eventually falls in love with him and is willing to risk her career and innocent lives to protect him.

Yeah, 'cause getting whacked would be just swell for her career.
posted by Sys Rq at 5:03 PM on December 4, 2009 [3 favorites]


OK, Spiderman 2 is in the first item. This is a movie where the containment problem for practical fusion power was solved with giant, semi-intelligent robotic arms - and then demonstrated in an office in Manhattan.

Yeah, that's where I stopped reading.
posted by heathkit at 5:04 PM on December 4, 2009


Anyone with even a rudimentary knowledge of how therapy works knows that a therapist is obligated to report serious crimes her patients tell her about.

Actually, this is false for the most part. Therapists are bound by confidentiality, and when people report feeling suicidal, homicidal (but has not yet harmed the person), or child/elder abuse do require a report to the relevant authorities to protect the people involved. BUT a client who says "oh I killed someone", "oh I have HIV and I've had unprotected sex with 25 people" are still protected by confidentiality. I don't think any of us knows exactly why these things are still considered to be 'protected', but there are legal and ethical precedents for it.
posted by so_gracefully at 5:04 PM on December 4, 2009



Yeah, that's where I stopped reading.


Too bad, the article is pretty funny. Not ot be taken as seriously as you might have.
posted by Liquidwolf at 5:09 PM on December 4, 2009


Okay, yeah, whatever. But Dr Katz is still okay, right?
posted by Sys Rq at 5:11 PM on December 4, 2009 [4 favorites]


My son is Autistic and, as far as I know, he can't play blackjack for shit.
posted by MikeMc at 5:14 PM on December 4, 2009 [18 favorites]


Snapping out of delusional homicidal rampage - ludicrous.
Sapient self-driven arms that defy basic principles of leverage much less metallurgical science - meh.

People actually do snap out of murderous rages. Psychology is swell and all, but armed gunmen have been stopped in the act of killing hostage after hostage by an authoritatively shouted "Stop that right now young man!"
So 'cure' no. But 'what the F am I doing?' moment of lucidity, yeah, that does happen.

And I don't know about the implied insult toward the mental health profession that makes ECT in One Flew Over the CooCoo's nest so irritating, but that movie is pretty old and it's pretty clear the villain in it (the big nurse) is pretty evil and doing it not in the best interests of the patients.

Myth: "Having a Mental Illness is a lot Like Being a Superhero"
...ever fought someone with a mental illness?

"Moviemakers love the idea of a sociopath brutally murdering people one minute and making hilarious observational comments the next"
Ted Bundy? Kristen Gilbert? No?
posted by Smedleyman at 5:14 PM on December 4, 2009



The bit on sociopaths was a bit off. He compared it to anti-social personality disorder, but wouldn't it make more sense to compare "sociopathy" to narcissistic personality disorder, as far as "real" DSM-IV disorders go.

No. Sociopathy is considered the far end of the antisocial personality disorder continuum. In other words, every sociopath has antisocial pesonality disorder but not everyone with antisocial personality disorder is as extreme as to merit being called a sociopath.

Sociopathy is generally measured with Hare's psychopathy checklist and the terms sociopath and psychopath are interchangeable. Everyone who rates psychopathic on that metric will also automatically already rate an ASPD diagnosis.

I liked the fact that they claimed that the mental health field doesn't buy that a good kick in the ass will fix the mentally ill. Unfortunately, this isn't true either: there's a billion dollar industry devoted to selling tough love as a way to fix "troubled" kids, whether it calls it "boot camp" "wilderness" "emotional growth" "behavior modification" or "therapeutic" boarding school.

It *should* be the case that the mental health profession understands that that stuff is bullshit-- but unfortunately, there are still many high level mental health professionals who will quite sincerely recommend these programs to parents with profoundly mentally ill kids.
posted by Maias at 5:34 PM on December 4, 2009 [8 favorites]



Dori from Finding Nemo was pretty horrifying. Of course, fish that size only have a working memory of three seconds.


You'll want to read "8 Common Misconceptions About Fish That Hollywood Perpetuates," then.
posted by ricochet biscuit at 5:38 PM on December 4, 2009 [10 favorites]


This seems like a list written by someone who knows what Wikipedia is.
posted by hermitosis at 5:42 PM on December 4, 2009 [5 favorites]


Damn, and all along I thought that most of that stuff in movies was FICTION.

may I point out that FICTION can't be WRONG? It's FICTION!!!
posted by HuronBob at 5:43 PM on December 4, 2009 [1 favorite]


Well, when they do create an honest and accurate portrayal of mental illness it's canceled because it's too depressing. Wonderland didn't even make it to the third episode if I remember correctly.
posted by cjorgensen at 5:48 PM on December 4, 2009 [4 favorites]


Anyone with even a rudimentary knowledge of how therapy works knows that a therapist is obligated to report serious crimes her patients tell her about.

If a patient tells a therapist about intentions to commit a crime, or if he or she poses a danger to himself or herself or others, the therapist is obligated to report that. But if the patient tells the therapist about past crimes, no, the right to confidentiality applies. One movie that got this right was the movie Panic starring Willima H. Macy and John Ritter.
posted by orange swan at 5:53 PM on December 4, 2009


His therapist, on the other hand, is depicted as basically an upstanding member of society. I could *maybe* buy that she eventually falls in love with him and is willing to risk her career and innocent lives to protect him.

Yes, but

Pardon? Tony is a mobster, of course he commits crimes. That is believable.
posted by Pope Guilty at 6:01 PM on December 4, 2009


My son is Autistic and, as far as I know, he can't play blackjack for shit.

Seconded. He's awesome at riding Snow White's Scary Adventures 2,955 times at Disney World (I'm not making that number up). But ask him to help me rake it in on a trip to Vegas, and he leaves me high and dry. It's very disappointing.

But hey, I get to go on the Snow White ride a dozen more times tomorrow. So that's ok.
posted by Lokheed at 6:07 PM on December 4, 2009 [6 favorites]


Anyone with even a rudimentary knowledge of how therapy works knows that a therapist is obligated to report serious crimes her patients tell her about.

Actually, this is false for the most part. Therapists are bound by confidentiality, and when people report feeling suicidal, homicidal (but has not yet harmed the person), or child/elder abuse do require a report to the relevant authorities to protect the people involved. BUT a client who says "oh I killed someone", "oh I have HIV and I've had unprotected sex with 25 people" are still protected by confidentiality. I don't think any of us knows exactly why these things are still considered to be 'protected', but there are legal and ethical precedents for it.


In particular, the most notable case in that history is Tarasoff v. Regents of of the University of California. The crucial part of the precedent there (and most states adopted similar stances on this question) is that confidentiality is thrown out when there are specific threats and the therapist has reason to believe the threats are credible. In that case, Poddar did specifically say he intended to harm Tarasoff and the therapist in question reported this. Poddar was detained and eventually released, but the family wasn't notified. More to the point, confidentiality was thrown out with respect to the person at whom the threat was directed. The police already knew about Poddar, and it has long been the practice of detaining those who were a threat to themselves or others.

The ruling leaves confidentiality in place by emphasizing that the threats have to be specific and credible. People with a range of mental illness and various degrees of severity say things in frustration or confusion, and it's better to have them blurt those out to a therapist than conceal them or leave them otherwise unattended. In the cases of someone saying that they've already done things like infect others with HIV or kill them, disclosure doesn't offer anyone further protection and testimony from someone ill enough to be speaking to a therapist is unlikely to stand up in court without physical evidence. (And with that, would be of less importance. Confessing murder at $125 an hour is kind of a fantasy.) If they said that they intended to kill again or infect others with HIV then it might be time to break confidentiality, but only if there were someone a therapist could reasonably expect the patient to target. "I hate Mary Smith and I want her to die of AIDS" sort of thing. If the therapist expects a patient is violent but not to a specific target, then it would be time to talk about committing them to a hospital, but who would you disclose to in that case? Every possible sexual partner in the world? Every living thing the patient could kill?
posted by el_lupino at 6:09 PM on December 4, 2009 [1 favorite]


Mental Health is a myth.
posted by jonmc at 6:21 PM on December 4, 2009 [6 favorites]


The author of the article does not seem to understand the difference between anterograde and retrograde amnesia. Furthermore, concussions are one of the most common causes of amnesia (posttraumatic amnesia).

For someone criticizing Hollywood's bullshit, his prose is so saturated with references to pop culture ("traded more often than genital infections at Flava Flav's house") that it's nauseating.
posted by Houyhnhnm at 6:23 PM on December 4, 2009 [1 favorite]


Nothing about lobotomy, a popular enough movie topic.
So I guess lobotomy is and has been correctly depicted in films.
posted by hexatron at 6:26 PM on December 4, 2009


> "Can I just say that I hate beyond all hatefulness the HBO show In Treatment? And do you know why? Because it's about a psychologist who consistently breaks ethical rules, but it's presented in a way that makes people think this is what therapy is like. But it's really just what therapy with an asshole therapist is like."

I fail to believe that anyone parses that show as anything but Gabriel Byrne's character being a 50-something therapist who has a serious asshole streak running through him that needs to be beaten out. I mean christ alive, the scenes with him and Dianne West are brutal. Every single time I watch the episodes with them, I am stunned that the writers find some way to make him tolerable so the series can continue.
posted by saturnine at 6:35 PM on December 4, 2009 [2 favorites]


But the fact that it never even comes up (at least not in the episodes I've seen)?

It's touched on several times throughout the series, particularly when the said therapist visits her own therapist and they discuss her "special client". Once the relationship between Tony and the therapist goes to its inevitable conclusion, you realize that the therapist had issues of her own which kept her seeing Tony.
posted by Brandon Blatcher at 6:43 PM on December 4, 2009


Any sympathy I had for the writer has vanished now that I know he thinks Cloud's gunblade was stupid. HEY! WRITER! PERHAPS YOU DIDN'T NOTICE IT'S BOTH A SWORD AND A REVOLVER?
posted by Greg Nog at 6:51 PM on December 4, 2009 [7 favorites]


Whoops, I meant Squall, not Cloud. I'll go hj a few chocobos in atonement, now.
posted by Greg Nog at 6:53 PM on December 4, 2009 [1 favorite]


Well intentioned but bending the stick a little too far. One of the points of Cuckoo's Nest is that you're never really supposed to know if McMurphy is crazy or not, or if society is crazy. I mean, I know that's obvious, but they don't seem to get it. Or else find social commentary 'insulting.' Also: incorrect about all sociopaths having abusive, poverty-defined backgrounds. Read some Robert D. Hare or some Cleckley. Granted, the mere words 'sociopath' and 'psychopath' drive certain professionals up the wall, and consensus is splintered, but it's not exactly hokum. Not saying the piece wasn't entertaining, mind, just occasionally spreading disinformation of an equally galling kind.
posted by Football Bat at 6:59 PM on December 4, 2009


I'm not sure they actually saw (or read) Girl Interrupted or One Flew Over the Cuckoo's Nest, if they had they would know that:

1. The rebel hero actually is pretty darn fucked up in both.
2. The rebel hero doesn't succeed in curing the other crazys through being a disruptive penis.

So I guess lobotomy is and has been correctly depicted in films.

Yes, especially this one.
posted by Pollomacho at 7:02 PM on December 4, 2009 [2 favorites]


KRAKATOA: EAST OF JAVA

Basically, Hollywood can get anything wrong.
posted by Sidhedevil at 7:03 PM on December 4, 2009 [2 favorites]


Terry Gilliam's elevation and fetishization of "craziness" in his protagonists has always bugged me (Brazil excepted).
posted by Auden at 7:05 PM on December 4, 2009 [1 favorite]


IANAClinicican, but I am a psychologist, and while some of the comments in this article are worthwhile, there's a lot wrong with it.

Simply put, psychology is not a game of Jenga, wherein one crucial block can bring down the entire tower of mental illness. No one factor made the person snap, and shoving one thing back into place won't make them whole. If it did, this mental illness stuff would be easy.

I suppose the analogy here is supposed to imply that mental illness is not like Jenga (rather than psychology). However, the common practice of labeling people 'imbalanced' seems at least somewhat grounded in observation. One factor can, in fact, make a person snap. That's not to say that there aren't a number of slowly developing and complex underpinnings to any mental illness, but precipitating events are a very real phenomenon.

In reality, ECT works and it's safe.

That's questionable. It's definitely not the "fry the rebel's brain" sort of tool that took down Randal Murphy (though I don't doubt it could be used that way, and probably has at some of the less savory institutions), but there are very real risks associated with ECT including memory loss, reduced attention span, and myriad other cognitive deficits. There's a reason that ECT gets "picked last for the kickball team," although it does end up helping a lot of folks who are unresponsive to pharmacological interventions.

The victims usually can't form new memories, so while their personality is intact and long-term memories are there, they are continually having the reset button punched at random.

If they have anterograde amnesia. If they have retrograde amnesia, it's more like Hollywood suggests (though access to the "missing" memories rarely just pops back up again). The folks who are worst of have global amnesia, which involves both retrograde and anterograde aspects.
posted by solipsophistocracy at 7:09 PM on December 4, 2009


Kinda lazy analysis over all IMHO.

It's Cracked Magazine, not Dostoevsky.
posted by Michael Roberts at 7:30 PM on December 4, 2009 [2 favorites]


Well I just watched the series finale of Monk, and I think he's gonna be ok.
posted by The Deej at 7:36 PM on December 4, 2009 [2 favorites]


One of the points of Cuckoo's Nest is that you're never really supposed to know if McMurphy is crazy or not, or if society is crazy.

Finny, I thought the main point of One Flew Over the Cukoo's Nest is that the author hates all women who aren't either a) prostitutes or b) submissive Asians, and that all the myriad problems with society are all actually the fault of domineering women.

In other words, he's a pretty typical 60's writer.
posted by happyroach at 7:38 PM on December 4, 2009 [5 favorites]


I do not understand why so many people insist on calling this "Momento."
posted by naoko at 8:05 PM on December 4, 2009 [3 favorites]


Cracked.com articles warrant a FFP? Sheesh. The Onion is far more entertaining.
posted by Johnny Wallflower at 8:21 PM on December 4, 2009 [1 favorite]


You mean sociopaths aren't charismatic and charming? Then why do they keep getting elected?
posted by psycho-alchemy at 8:26 PM on December 4, 2009 [2 favorites]


Any sympathy I had for the writer has vanished now that I know he thinks Cloud's gunblade was stupid. HEY! WRITER! PERHAPS YOU DIDN'T NOTICE IT'S BOTH A SWORD AND A REVOLVER?

Squall's gunblade, Cloud had the sword bigger than his body, Squall had the gunblade. Though both of those Final Fantasies were fairly lackluster compared to the SNES ones, now undergoing their 3rd or 4th re-release.

The mental health depiction that always bugs the hell out of me is Tourette's. Not only does coprolalia, or the uncontrollabe urge to say swear-words, only represent about 10% of Tourette's sufferers, but it's so commonly associated with Tourette's that the two have become interchangeable and you have to stop and explain to people that Tourette's actually isn't the disease that makes people swear all the time.
posted by Ndwright at 8:35 PM on December 4, 2009 [1 favorite]


And I don't know about the implied insult toward the mental health profession that makes ECT in One Flew Over the CooCoo's nest so irritating, but that movie is pretty old and it's pretty clear the villain in it (the big nurse) is pretty evil and doing it not in the best interests of the patients.

Yeah, the ECT is the symptom, not the problem; had the novel been written twenty years earlier it would probably have used lobotomy for the same role, and set now could be using something like the awful behaviour of the snake-oil mobs offering "austism cures".

It's about the abuse of the vulnerable, not about the specific mechanism.
posted by rodgerd at 8:40 PM on December 4, 2009


“Mental Health is a myth.”
Mental Health will drive you mad... BANG YOUR HEAD!

“It's Cracked Magazine, not Dostoevsky.”

True. Dostoevsky wrote for Треснуто.

“the author hates all women who aren't either a) prostitutes or b) submissive Asians…”

*spit take * I give folks a lot of latitude on literary criticism but – wha? The Asian nurse is submissive? She’s the most competent character in the book. Only one that is making any real headway in terms of human compassion. McMurphy sure doesn’t. And there’s no one else who sees the nurse for what she is except the Chief. And even he doesn’t face her. He splits. Who’s still upstairs when he busts out of the place?
Hell the whole point of making McMurphy captain bad ass (war marine, escaped from a POW camp, lumberjack – all kinds of male virility stereotypes on top of that) as well as smart (literate, technically gifted (e.g. handwriting)) and savvy (gambler) in every way possible is to prove that even he as the most capable and (traditionally) most resourceful individual (at that time) can’t stand against what the nurse represents. And that certainly isn’t femininity in any way (as is made explicit many times).
What ½ assed narrow minded reviewer did you kite that take on the book from? They’re exactly the kind of machine Kesey was talking about. Jesus, it was about MKULTRA not f’ing misogyny.
Hates wome… you know the man married his childhood sweetheart? She didn’t change her name to Kesey. The man hung out with Mountain Girl. Typical 60’s writer – Samuel Beckett, Hunter S. Thompson, Eugene Ionesco, Jorge Luis Borges, Thomas Pynchon, Kurt Vonnegut, were one trick woman hating ponies?
Although hey, Catch-22 was pretty much all about “Aarfy" Aardvark and how it’s ok to rape and kill women and dichotomize them into ‘clean’ and ‘dirty’ so maybe I’m wrong.
Although apparently there was some kind of military battle or something going on in the interims while that thesis was being put forth and there’s some sort of satire involved. But yeah, Joseph Heller, just another typical 60’s writer.
posted by Smedleyman at 8:49 PM on December 4, 2009 [18 favorites]


To be fair, some people have been greatly helped by ECT, not to discount the people who have had their lives ruined by it. For people who are suicidally depressed and nothing else conventional has worked, ECT is a rational approach that should not be stigmatized. It's a fact that people have had horrible effects from it, but it's not a conventional therapy.

I'm not saying Cracked's article had a good description. It was much too positive. It's an extreme treatment for an extreme condition, with big risks to match. It should be available to those who need it, but it shouldn't be glorified.

Sherwin Nuland has a good TED talk on how ECT helped him. It's a really good and inspiring video, regardless of your personal opinion on ECT. (his opinion is pretty positive, but it's what pretty much saved him from a very deep depression that would have been treated by a lobotomy otherwise) The ultimate point of it, at least that I took from it, is that it is indeed possible to recover from a very bad situation, something that should be obvious to us, but which is all too easy to forget.
posted by mccarty.tim at 8:51 PM on December 4, 2009 [3 favorites]


Hmm. Kind of unconvinced by the rehabilitation of electroshock therapy. Possibly that's just predjucice due to family history and some stuff that happened in the 70s.

I guess this is where I'm obliged to note that my grandmother credits ECT as having saved her life, literally calling it "the best thing I ever did," and I think she actually got it in the 60s.

Oh and don't even get me started on the depiction of mental illness and antidepressants in Garden State.

Huh. I've been diagnosed as chronically depressed (and other things), and have had a lot of experience with antidepressants, and I thought that movie was pretty realistic.

As far as a lot of the other stuff (sudden changes of heart, sane man in an asylum, deranged people with a hidden talent, amnesia), a lot of it is used metaphorically. It's not supposed to be realistic, in terms of the audience believing that it would really happen. It's supposed to be realistic, in terms of the audience understanding that some deeper truth is being represented.

No doubt, taking a group of institutionalized inmates on a day trip is not going to instantly cure them. On the other hand, keeping them in a place where they are forced to constantly self-identify as mental patients is still troubling to many people, even if there isn't always a clear alternative. Also, while the Nurse Ratched character is the sort of despot more likely to be found running a military prison than a mental hospital, the truth is that there are a lot of people working in health care facilities who are more interested in their own little power trips than they are in the patients' welfare. McMurphy is an extreme case, but I find it very easy to believe that many "sane" people have been held in institutions much longer than necessary, simply because they pissed off the authority figures by refusing to jump through all the hoops.

Finny, I thought the main point of One Flew Over the Cukoo's Nest is that the author hates all women who aren't either a) prostitutes or b) submissive Asians...

Lots of evidence from Kesey's own life indicates that this is not true. But you might also want to check out his novel Sometimes A Great Notion, a book in which many women appear, none of them Asians or prostitutes.
posted by bingo at 9:33 PM on December 4, 2009


Well, when they do create an honest and accurate portrayal of mental illness it's canceled because it's too depressing. Wonderland didn't even make it to the third episode if I remember correctly.

These statements were slightly less accurate, but far more hilarious, when I initially read "Wonderland" as "Wonderfalls".
posted by roystgnr at 9:41 PM on December 4, 2009 [2 favorites]


The brain is an incredibly complex organ - who would doubt that running a bunch of current through it willy nilly is going to have unpredictable and potentially adverse effect?. It's like waving a degauss gun around your beowulf cluster (bad analogy, I know) to fix some subtle bug that seems to be hampering performance.

Pop-neuroscience is nothing more than a throwback to Hippocrates. People talk about neurotransmitters like they're humours. "Ah yes, you're unhappy because of your deficient yellow bile, I mean, uh, serotonin... yes". No responsible neuroscientist would encourage that kind of facile reduction, but you hear people say things like "depression is a chemical imbalance" or "it's a brain disease!" constantly, so much so that I have to think the psychiatric community is at least partially culpable for popularizing the view. I realize they're trying to express something along the lines of "depression is not always caused by events or ways of thinking" (something a few hardcore CBT-ers might challenge), but it glosses over a lot of difficult philosophy of mind in a way that's frankly irresponsible.

It stems largely from the cheapend Platonic dualism our modern western culture inherits via Christian scholastics. We're okay throwing around terms like "mental illness", and blaming them on "chemicals", but we're not willing to admit that to the extent that's true, consciousness itself is "just" a bunch of chemicals. I can sympathize, because the thought that our very selfhood and feeling-it-is-to-be-us is malleable and subject to all sorts of damage and random failure is pretty harrowing, much more so that more typical forms of injury and death. After all, are you really you if you've lost all your memories, become floridly and unremittingly psychotic, lose the ability to focus for more than a few moments, or become completely disinhibited?

Anyway, I think many of the distortions of the kind listed in the article are necessary for popular media, because the alternatives would raise questions and cause discomfort, which would not bode well for the box office.
posted by phrontist at 9:44 PM on December 4, 2009 [11 favorites]


You know, it's easy and a little glib to talk of the things that Hollywood "teaches" us, but this really struck home. When I was a kid - maybe seven or eight - my mom spent some time in the "looney bin" as she called it, and was treated for depression with electroconvulsive therapy. Now, as eight I knew what ECT was, ECT was when they held you down, carried you kicking and screaming down the hallway, strapped you to a table, and sent shocks through your body until you were foaming at the mouth and/or vomiting all over yourself. Knowing that this was what "they" were doing to my mom while my baby brother and I were at home alone with Dad (who is great, but wasn't mom) was traumatizing, to put it mildly. Also, like many kids whose parents have mental illnesses, I knew my mom's depression was my fault. That meant that the torture she must have been undergoing was also my fault. Imagining your mother being tormented is one thing. When you are eight, confused, she is the only thing in the world you trust, and you know it's your fault? I will never forget that feeling.

When I later went to counseling over my parent's divorce, I brought it up. When I went to Bible camp, I talked about it with the counselors there. Still until only a few years ago, well into my adulthood when I learned what ECT really is, I had to leave the room when those scenes were shown in films, because I could see my mother on that table instead of the poor unfortunate I was supposed to be sympathizing with.

Fuck the media for giving me years of mental anguish, years of horrific images of my mother's torment playing through my mind, years of self-blame, and years of embarrassment of being the adult who spontaneously bursts into tears at seemingly random movie scenes. Also: parents, please make sure your kids know what's realistic in movies and what is artistic license.
posted by arcticwoman at 11:19 PM on December 4, 2009 [10 favorites]


Oh, and to be clear, I think there is plenty of evidence indicating ECT is a reasonable option for people who have exhausted the others. But it leaves a lot to be desired.
posted by phrontist at 11:27 PM on December 4, 2009


Finny, I thought the main point of One Flew Over the Cukoo's Nest is that the author hates all women who aren't either a) prostitutes or b) submissive Asians

In certain circles, you could probably say this about any given writer and see heads nodding in agreement. It's like the "Christ, what an asshole" of film criticism.
posted by Afroblanco at 11:33 PM on December 4, 2009


I do realize that ECT has and currently is used for the best health of patients. But that hasn't always been the case. I remember we watched a documentary in a class after reading "The Bell Jar" (and yes Sylvia Plath did undergo ECT, and yes, she felt it ruined her in some ways mentally and socially), doctors used to prescribe ECT the same way they did partial lobotomies. I won't deny that ECT has it's purpose, but it's stupid to say that it wasn't commonly misused during the 50's and 60's.
And Christ, doesn't anyone give any credit to Kesey writing his novel after working in a mental hospital FOR YEARS. And what the fuck is the author thinking if they think McMurphy is perfectly sane? That means they haven't seen the movie or read the book, which make it clear that 1) McMurphy is fucking crazy and 2) he doesn't cure any damn person. It's not like The Chief escapes because he's cured, he escapes because (at this facility, at this time) the whole place is fucking looney. He finally comes to grip with the forcess that ruined his childhood, and decides to escape.
I'm sorry, I'm really glad this link has led to some great discussion, but this article is HORSESHIT
posted by cyphill at 11:48 PM on December 4, 2009 [2 favorites]


Christ, doesn't anyone give any credit to Kesey writing his novel after working in a mental hospital FOR YEARS.

This is exactly what I came here to post
posted by criticalbill at 12:16 AM on December 5, 2009 [6 favorites]


this article is HORSESHIT

Oh, and this
posted by criticalbill at 12:17 AM on December 5, 2009


What? Hollywood is getting mental illness all wrong?

That's just crazy talk!
posted by bwg at 1:32 AM on December 5, 2009 [1 favorite]


As for The Sopranos, I always found the therapy thing ridiculous. Anyone with even a rudimentary knowledge of how therapy works knows that a therapist is obligated to report serious crimes her patients tell her about.

This comes up in the very first episode. She tells him that he can't tell her about any crimes, basically, and so he just talks about his day-to-day business in vague, abstract terms -- which he usually does anyways. He never says "yeah I killed so-and-so", he says "There was a problem I had to take care of", even to his wife. But several things happen in the therapist's life that turn her relationship with Tony into more of a personal crutch for her, which her therapist tries to make clear to her, and she very gradually becomes more complicit and more habituated with his lifestyle. There are several points also where she snaps out of it momentarily -- once late in the show she says to him something like "you know I have to report any crimes" and he says something like "come on, who are you kidding?" Their relationship had already gone past that point. Sorry for this vague and rambling explanation, I'm a little hungover this morning, but The Sopranos is certainly very much aware of this point. Maybe if you saw a random episode from somewhere in the middle you wouldn't get this, but the show puts a huge amount of effort into developing their relationship to the point where her own role is very morally ambiguous.
posted by creasy boy at 2:39 AM on December 5, 2009 [1 favorite]


(keep in mind this is something the staff has failed to notice for years, but Hugh Laurie spots in a single goddamn day).

Counterpoint: Hugh Laurie.
posted by ersatz at 5:20 AM on December 5, 2009 [4 favorites]


...Sorry for this vague and rambling explanation, I'm a little hungover this morning, but The Sopranos is certainly very much aware of this point.

Thank goodness you rallied enough to write that excellent comment, creasy boy.

The thread was driving me nuts. Melfi stumbled many times as a therapist, but the writers never blithely ignored the ethical quicksand surrounding the treatment of a mobster.
posted by Jody Tresidder at 6:05 AM on December 5, 2009


Usually i defend the Cracked post, but that wasn't that great. Doc Oc isn't mentally ill, a robot has taken over his central nervous system and brain and so (in a sense of the story) it makes perfect sense that spiderman/peter would be able to rationalize with the "human" aspect of the man/machine hybrid monster.

And i thought house had a lot of medical consultants and based a lot of their plots on actual case studies. I remember seeing a lot of things from "the man who mistook his wife for a hat" or atleast one, the old lady with "cupid's disease" (sypihillis) and it was making her feel young and randy, or something.

I could be totally wrong, but the writing and the research seemed sloppy and it felt like (ironically?) the writer just through stuff in to prove his point. As if it was written buy the kind of guy who sits and watches 50 first dates once a week, but then turned around and wrote this, and the only thing about it is he took the unusual stance of "hollywood takes creative liberties" and then did very, very (extremely) light research on a couple of mental disorders and then jammed some examples into that.

I mean, wasn't One Flew Over the Cuckoo's nest about the fact that the sadistic and poorly trained Nurse's were running the show, and that the people with the mental problems were being mistreated and abused, and wasn't it a well researched book that actually lead to a lot of changes in the conditions and treatment at mental health facilities? I never saw Girl, Interupted, but i thought it was autobiographical. It just seems like the guy that wrote this article was poking fun at things that were better researched and written than his article, and spicing it up with a few examples that slighlty proved his point.

Long story short, i guess i didn't like it.
posted by djduckie at 6:37 AM on December 5, 2009


Pop-neuroscience is nothing more than a throwback to Hippocrates. People talk about neurotransmitters like they're humours. "Ah yes, you're unhappy because of your deficient yellow bile, I mean, uh, serotonin... yes"

In fairness, doctors did not start prescribing SSRIs to treat depression because they invented some theory about depression analagous to the 4 humors. Rather, SSRIs were contained in drugs used to treat people with other conditions, and doctors noticed that it helped the patients' depression as well.

I get the impression that proper administration of anti-depressants is like dermatology: you try drug X for a while to see if it works. If it does, great, if not, try drug Y, and so on. That is taking an empirical approach to treatment, rather than coming up with an arbitrary model (eg, the 4 humors) and trying to treat the patient in ways that conform to the model, regardless of outcome.
posted by deanc at 6:43 AM on December 5, 2009 [3 favorites]


phrontist: "It's like waving a degauss gun around your beowulf cluster (bad analogy, I know) to fix some subtle bug that seems to be hampering performance."

I know you tempered this comment later, and admit that it's a bad analogy, but responsible people do not use ECT to fix a "subtle bug".

Let's compare "he is depressed" with "he has a heart problem."

"He has a heart problem" could mean a wide variety of things: he has a minor heart murmur that needs no treatment, he has to be monitored regularly, he needs to eat better and exercise more, he needs medication, he needs a pacemaker, he needs surgery, he needs a new heart.

"He is depressed" could mean a wide variety of things: he is feeling a little sad this afternoon, he needs to eat better and exercise more, he needs more sunshine, he needs to see a therapist regularly, he needs medication, he needs an inpatient day program, he needs a full-time inpatient program, he needs ECT.

Almost no one gets a new heart when they would be fine with a prescription for beta blockers; no one gets ECT when they would be fine with short-term CBT and some sunshine. Did that happen in the past, when we had less information and fewer treatment options? Hell yes. And I'm sure that the stuff doctors do today is going to look ignorant or even barbaric in 50 years, if not sooner. That's a good thing. That means we're learning, progressing, and keeping an open mind about treatment.

If you want to talk about psychiatric fuck-ups (at least the proactive ones), they come from over-medication and incorrect medication. You're not going to get a special hearing when your shrink decides to give you 400mgs/day of Seroquel.
posted by kathrineg at 8:31 AM on December 5, 2009 [1 favorite]


The bit on sociopaths was a bit off. He compared it to anti-social personality disorder, but wouldn't it make more sense to compare "sociopathy" to narcissistic personality disorder, as far as "real" DSM-IV disorders go.

I'm not sure if "sociopathy" or "psychopathy" are even described in DSM-IV
posted by KokuRyu at 9:07 AM on December 5, 2009


A lot of these lists are really funny. I've been sucked in to a "reading stupid lists" vortex over here. If I don't log off from my computer by Monday, send help.
posted by grapefruitmoon at 9:28 AM on December 5, 2009


Can I just say that I hate beyond all hatefulness the HBO show In Treatment?

Oh, G-d, me too. But mostly because it was unbearably dull and awful rather than anything to do with the actual "treatment" that his patients were "in."
posted by grapefruitmoon at 9:29 AM on December 5, 2009


infinitewindow: Dori from Finding Nemo was pretty horrifying. Of course, fish that size only have a working memory of three seconds.

Common misconception, that.
posted by Dysk at 9:41 AM on December 5, 2009


Yeah, I think that movie sociopathy is more like NPD than anti-social pd, but if forced I would waffle and diagnose PD-NOS
posted by kathrineg at 9:52 AM on December 5, 2009


Sidhedevil: KRAKATOA: EAST OF JAVA

Basically, Hollywood can get anything wrong.


But surely, given the spherical nature of the globe, it is East of Java, just a very long way east.
posted by Dysk at 9:57 AM on December 5, 2009


The world is a globe...? I thought they made that up for Apollo 13
posted by kathrineg at 10:16 AM on December 5, 2009


Anyone who enjoys terrible Hollywood depictions of mental health problems and psychologists should Netflix the Bruce Willis flop “The Color of Night.” I don’t think anything can top this.

Bruce is a NYC shrink with attitude who comes down with a rare case of color blindness after his hard-hitting psychoanalysis has fatal consequences. Scott Bakula is his old buddy from psych school who lets Bruce “sit in” on a weekly L.A. therapy group he holds. The group seems to be of questionable benefit to its members...since each member has a completely different psychological problem. Sort of like the Breakfast Club, you get the nympho, the S&M maniac, the morbidly depressed divorced guy, and the kid with gender identity issues. The movie’s whole murder plot is built on a twist that is too hot for the DSM-IV.
posted by johngoren at 10:19 AM on December 5, 2009 [1 favorite]


A lot of these lists are really funny. I've been sucked in to a "reading stupid lists" vortex over here. If I don't log off from my computer by Monday, send help.

You're not wrong. As has been observed, it is up there with tvtropes for websites that can make huge segments of time vanish into the ether.
posted by ricochet biscuit at 10:30 AM on December 5, 2009


One of the things about ECT is that almost everything known about it today comes from Cuckoo's Nest, the 1975 film. But that film was based on a 1963 play of a 1962 novel, which was based on the institutionalization of the 1950s. The ECT treatment portrayed was already many years obsolete by the time of the movie, and de-institutionalization of the mentally ill had already begun in earnest. The plot of the film mirrors the reforms that were made, believing that patients would in many cases be happier in community-based settings, exposed to new stimuli and given more agency. The thing is, sanatoriums such as in the film were all over the country then. Nowadays a given state might have a handful serving the most ill cases, but half a century earlier almost every locality of any size had one. The one here closed in 1970.
posted by dhartung at 10:34 AM on December 5, 2009 [3 favorites]


Closing sentence lost when I hit wrong button.

Thus, not that long ago, institutionalization was as common as prison. Think about what a culture would look like if that were the case. Then realize it was your parents or grandparents living in it.
posted by dhartung at 10:37 AM on December 5, 2009


Course, these days the 80s solution of letting the mentally ill be homeless is the most popular. That's not exacly without problems either.
posted by Artw at 10:38 AM on December 5, 2009


Course, these days the 80s solution of letting the mentally ill be homeless is the most popular. That's not exacly without problems either.

Well, we also warehouse them in prison, where they usually don't get any/enough treatment for mental health issues.
posted by krinklyfig at 1:06 PM on December 5, 2009


The best part of that article was a link to a much better one about criminal profiling. I always assumed those profiling shows on TV were rubbish, but had no idea that it was pretty much as bad in real life as well.
posted by AndrewStephens at 1:57 PM on December 5, 2009


I know you tempered this comment later, and admit that it's a bad analogy, but responsible people do not use ECT to fix a "subtle bug".

kathrineg: I meant subtle in it's etiology, not in it's presentation.
posted by phrontist at 2:08 PM on December 5, 2009


Medium is straight up true though.
posted by Artw at 2:11 PM on December 5, 2009


If all you have is an ice pick, then every problem looks like a lobotomy. Or something. Suppose as a last option before somebody kills themselves, it's okay. "Hey a few of our patients are doing great! Just ignore those who wound up with vegetable brain".
posted by bravelittletoaster at 3:50 PM on December 5, 2009


Did you just call FF7 "lackluster"? Are you insane?
posted by Brocktoon at 6:05 PM on December 5, 2009


It's a long time since I saw The Dream Time but the main impression that I remember from the film is that taking a gang of mental patients out of their institution for some wild adventure, while it might cheer them up a bit in the short term (or in the case of the Christopher Lloyd character, nudge them in the right direction) it won't be some instant cure-all. ie the opposite to what the article implies.
posted by fearfulsymmetry at 3:34 AM on December 6, 2009


I love the delicious irony of Cracked correcting the mistakes of the media and, getting it just as wrong.

Insofar as ECT goes, although others are certainly more well informed than I am, my understanding is that the voltage (amperage?) is a fraction of what it used to be.

Actually, voltage had to be increased once the doctors started using muscle relaxants and, anaesthesia to prevent broken bones &c which were a common consequence of treatment early on. Also, there isn't a set standard that doctors can refer to when using ECT on patients, they pretty much go on gut instinct when deciding how much/how often to use it on a patient and, in many places the machines that are used aren't required to go through safety checks, so who knows how much they're actually being given.
posted by squeak at 9:06 AM on December 6, 2009


Metafilter: a disruptive penis
posted by Hairy Lobster at 11:10 AM on December 7, 2009


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