In "Suddenly Last Summer," the Tennessee Williams drama about matriarchy and mental illness in and out of a psychiatric facility, the writer describes madness as the most horrible doom on earth. He most likely intended to characterize the experience of those battling mental illness, because for others, the doom of madness is now and long has been an entertaining amusement and profitable venture. The 17th century European enterprise of selling and buying tickets to gawk at those confined to psychiatric institutions established there was money to be made from Schadenfreude.
Psychiatric misery as public spectacle continues today. Since the early 20th century, we've been observing depressed, manic, and schizophrenic characters -- from more of a distance -- through motion pictures: the Cineplex is our present-day analog to the coliseum of psychiatry.
Films about mental illness do provide more than voyeurism. They can act as a voice of dissent against the poor treatment of people with mental disorders, and are among our most highly esteemed works of cinematic art. Earlier this month, the Academy of Motion Pictures Arts and Sciences extended its longstanding tradition of praising psychiatry in the cinema by nominating yet another movie about mental illness for Best Picture: "The Hours." Receiving nine Oscar nominations including Best Picture, Best Adapted Screenplay, and three nods for outstanding performances, the film traces the volatile lives of three women and their relationships to one other through the Virginia Woolf novel, "Mrs. Dalloway."
It's folk wisdom that the Academy favors films about disability, yet few legends are so statistically well-founded. Of films winning Best Picture between 1990 and 1996, almost half featured disabilities and two-thirds of those focused on psychiatric disorders. When nominations are added to the mix, at least one film, screenplay, or performance relating to mental illness has been in the running for an Academy Award every year since 1954. Last year alone, five films containing psychiatric themes -- "A Beautiful Mind," "I am Sam," "In the Bedroom," "Iris," and "Mulholland Drive" -- pulled in a total 18 nominations from all categories.
If "The Hours" wins Best Picture on March 23 in the 75th year of the Academy Awards, mental illness movies will have received back-to-back Best Picture awards for the first time. Last year's winner, "A Beautiful Mind," the story of John Nash, his schizophrenia, and his Nobel Prize in economics, won the Best Picture, Best Director, Best Screenplay, and Best Supporting Actress laurels after receiving eight nominations overall.
That Oscar fancies mental illness is clear; more puzzling is that it does so at a time when those who are ill in real life are publicly shunned. Two-thirds of those suffering from serious mental illnesses -- those most resembling the characters seen in films honored by the Academy -- will never receive treatment. Moreover, the World Health Organization finds that psychiatric disability accounts for about a fifth of the world's total disabilities, yet less than one cent of every U.S. dollar spent on medical research goes to schizophrenia, a most debilitating form of mental illness.
So why does one of our most revered cultural institutions annually recognize -- amidst a culture that does not -- the lives of those suffering psychologically?
Some say it's the drama. The Best Picture Oscar giggles now and then ["Shakespeare in Love" (1998); "Annie Hall" (1977); "The Sting" (1973)], but hasn't had a really good laugh since 1934 when "It Happened One Night" won all five major categories: Picture, Actor, Actress, Director, and Screenplay (adapted). [Interestingly, madness was a central theme in the only two other films to win the five awards -- "One Flew Over the Cuckoo's Nest" (1975) and "Silence of the Lambs" (1991).]
Dr. Otto Wahl, author of "Media Madness: Public Images of Mental Illness," describes how films about mental illness are excellent candidates for Oscar recognition. "Films depend on larger than life stereotypes," he says. "Movies require something that stands out and mental illness is pretty dramatic. It grabs people's emotional attention by eliciting strong feelings or tugging for sympathy."
Others believe U.S., and specifically Hollywood, attitudes toward psychology attract audiences and filmmakers to questions of sanity. "In this country, in general, more people naturally think of being treated by a shrink," says film scholar David Thomson, author of "The New Biographical Dictionary of Film." "And cultural attitudes in Los Angeles have much to do with the nature of the film business as a social entity."
During the making of Alfred Hitchcock's "Spellbound," David O. Selznick's psychotherapy greatly influenced the production process. The film, which received the 1945 Best Picture nomination, "grew out of producer Selznick's fascination with his own psychological treatment," says Thomson, who also wrote "Showman: The Life of David O. Selznick."
"Once, while Selznick's analyst, Dr. May Romm [who served as a psychiatric consultant to the film], took him through some fairly elementary analysis of himself, he burst out: 'I love this. It's just exactly what we do in a script conference. We talk about the story from all possible angles. We bring up a lot of possibilities, look for one that will work best, and construct a story from these various psychological sources.'"
Dr. Glen Gabbard, director of the Psychiatry Clinic at the Baylor College of Medicine and author of "Psychiatry and Cinema," suspects Hollywood shines the spotlight on mental illness for a more provocative reason: shame. The film community knows its products are a poor substitute for health care, and "awarding Oscars is a way of dealing with the collective guilt over our society's horrendous neglect of the mentally ill," he says.
Susanna Kaysen also believes mental illness movies, such as the one made from her book "Girl, Interrupted," are an act of contrition. "There might be some way that Hollywood is making up for its sins by making movies [about mental illness]," she says. "They can have these huge, stupid summer blockbusters, and then churn out some sentimental portrayal of mental illness to feel better about themselves."
Triumph and Tragedy
The 1999 film version of "Girl, Interrupted" centers on Kaysen's residency at Boston's McLean Hospital. When her character (played by Winona Ryder) leaves the psychiatric institution never to return, the film takes a turn toward the tear-jerker. So when Kaysen told me, "There's nothing more heartwarming than a courageous person overcoming a disability -- Yuck!" she describes, in part, the film made about a period in her life.
Even though critics often reject feel-good films, Oscar worships them. Scott Hicks, who directed "Shine" -- a film receiving seven Oscar nominations in 1996, says films about madness gets star treatment from the Academy because mental illness fits nicely into the "triumph of the human spirit" genre. "The struggle against impossible odds becomes an incredibly wide net that can be tossed over everything," he says. "'Lawrence of Arabia', 'Cabaret': these too are struggles against impossible odds."
Certainly, inspirational characters are sprinkled throughout mental illness movies -- John Nash or the young woman in "I Never Promised You a Rose Garden" (1977), for example -- but beating the odds is quite rare. More commonly, the "triumph over adversity" picture show features a vulnerable person struggling to master and perhaps accept unfortunate circumstances: Courage in the face of adversity is a more apt description. Think about "Rocky," Oscar's favorite hero. Do we even remember that he lost?
When we look more closely at "triumphant" films as a whole, they are more complex than the category or the critics allow. Dustin Hoffman's memorable performance in "Rain Man" (1988) won three awards for the film (Best Actor, Best Picture, and Best Screenplay). The outstanding achievement in this story, however, belongs to the character played by Tom Cruise and his struggle to accept his role as caregiver; Hoffman's character remains autistic. It's a fine story, but has a different outcome than might be expected given its place in the against-all-odds camp.
"Shine" (1996), the story of David Helfgott's musical brilliance and psychological misfortune, warms our hearts, without frustrating our minds with false hope. "I'm often asked by people, how is David now?" says Hicks, who also directed "Snow Falling on Cedars" and "Hearts in Atlantis." "David is still David. He's very much like he was, but sometimes people are almost disappointed that he isn't cured." Shine's take-home message is one to which most people, independent of their psychological constitution, can relate. "The point was that he found love, he found acceptance; he found a life and has independence," Hicks said. "It was never about the miracle cure."
With Oscar looming, "The Hours" might be wise to take refuge in its tragic disposition -- even in the shadow of "A Beautiful Mind" -- because, for mental illness movies, tragedy trumps triumph.
Among the celebrated tragedies to receive Academy's calling card, "Amadeus," the tale of Mozart as he fatally succumbs to exhaustion, won eight Oscars in 1984. No other mental illness movie has been so admired by the Academy, but many Oscar-nominated films before and after 1984 have been as calamitous. "Hamlet" won Best Picture in 1948; "Apocalypse Now" was nominated for Best Picture of 1979; "Sophie's Choice," a Best Picture nominee in 1982, did not lift spirits; and "American Beauty," Best Picture of 1999: no screwball comedy, indeed. Of the five mental illness movies nominated in 2000, three-"Pollock," "Memento," and "Requiem for a Dream" -- end bleakly.
It is said that regardless of the form tragedy takes-death, disability, disaster-melancholic characters seduce Academy voters year after year and interpretations of mental illness do not betray the tradition. Remember Jessica Lange's Oscar-nominated performance in "Frances" (1982), where, in the title role, she unravels under Hollywood's pressure that she conform; Miranda Richardson's artful unriveting as T.S. Eliot's wife in "Tom and Viv" (1994), which earned her a second shot at an Academy Award; and Ellen Burstyn's nod for Best Actress as a frightened, frantic woman addicted to prescription medication in "Requiem for a Dream." None of these stories foreshadows recovery; in fact, in all, the human spirit loses.
The mood of the mental illness movie swings from a respect for resiliency to mournful regard, finally resting for a while with a prurient interest in a murderous villain.
"Hollywood has regularly made appallingly violent, anti-social figures into virtual heroes," says David Thomson, author of "The New Biographical Dictionary of Film." Indeed Hannibal Lecter could be considered part of the triumphant genre for his successful conquests, but should we lionize his cannibalistic success with the same enthusiasm we applaud Oskar Schindler?
The sociopathic killer entered Academy consciousness in 1937 when Robert Montgomery was nominated for Best Actor for his performance in "Night Must Fall." In 1961, Norman Bates introduced a new slur, "Psycho," into the language, and by 1990, Kathy Bates' turn in "Misery" brought gravitas to the female homicidal sociopath. Not until "Silence of the Lambs" (1991), though, did two serial killers compete for screen time, with Buffalo Bill playing villain to Lecter's criminal hero.
"We can say that the impact of any individual film is not that great, or it's just for entertainment," says Dr. Wahl, who in addition to "Media Madness" wrote "Telling is Risky Business: The Experience of Mental Illness Stigma." "The problem is when we look at the patterns of portraits of mental illness. The stigmatizing or frightening aspects clearly overwhelm positive portrayals. They solidify stereotypes, some of which have to do with how frightening and bizarre people with mental illnesses are, when people with mental illnesses are everybody and anybody: friends, neighbors, and co-workers."
Individuals with serious mental illness are, in fact, more likely to be victims, rather than perpetrators of violence. Because films, including those nominated for Oscars, link psychiatric illness and violence, many people are, in effect, blacklisted from full community participation because they are assumed a hazard to the health and safety of others.
Perhaps the most fitting explanation for why the Academy Awards so often congratulate films about psychiatry are the acting opportunities such material provides. Roles reflecting psychiatric disability are so coveted, characters with severe mental illness could be considered the patron saints of actors seeking critical acclaim.
As writer Christy Brown in "My Left Foot" (1989), Daniel Day-Lewis became the actor most revered by both acting enthusiasts and the disability community. Two-thirds of those with cerebral palsy have intellectual impairment, but Brown's autobiography tells the tale of a child who communicates he is sound in mind. What Day-Lewis portrayed so brilliantly was Brown's ferocious intelligence, in spite of the uncooperative motor areas of his brain. What qualifies the film as a mental illness movie is Brown's co-occurring alcoholism.
Television host and Chicago Sun-Times film columnist Roger Ebert explains that Oscar smiles upon actors in films about mental illness "for the same reason it likes people with other kinds of disabilities or people with much makeup. The reproduction of ordinary behavior is not considered acting: the Academy prefers acting that calls attention to itself." Under these rules, "The Hours" should have no competition for Best Picture this year. It is a film about a woman in love with a man dying of AIDS whose mother was inspired by a writer played by an actress wearing a prosthetic nose, all against the backdrop of mental illness.
With nominations for Nicole Kidman (Best Actress,) Julianne Moore (Best Supporting Actress,) and Ed Harris (Best Supporting Actor,) "The Hours" could join the only two films in Academy history to win three of the four acting Oscars (no film has won all acting categories, although the entire cast of four was nominated for the unsettling "Who's Afraid of Virginia Woolf?" in 1966). This year "Chicago" got four acting nominations, and "Adaptation" received three, but history favors "The Hours" as those films previously awarded three acting Oscars -- "A Streetcar Named Desire" (1951) and "Network" (1976) -- also contain memorable portraits of madness.
While Meryl Streep's performance in "The Hours" is conspicuously absent from the 2002 Best Actress race, her nomination this year for Best Supporting Actress for her role in "Adaptation" made her the most nominated performer in Oscar history. Four of her 13 previous nominations were for performances in films taking on mental illness: "The Deer Hunter" (1978), "Sophie's Choice" (1982), "Ironweed" (1987), and "Postcards from the Edge" (1989).
Also with four nominations for roles in Oscar-honored mental illness movies is Bette Davis. In each role for which Davis was nominated, she excelled as a wobbly actress: "Joyce Heath in Dangerous" (1935), "Charlotte Vale in Now", "Voyager" (1942), "Margo Channing in All About Eve" (1950), and "Jane Hudson in What Ever Happened to Baby Jane?" (1962). Davis' fascination with Hollywood characters was eclipsed only by Hollywood's fixation with its own pathology. "All About Eve," the story a woman whose excessive ambition arguably brings into question her mental health, received more acknowledgment from the Academy Awards than any other film until 1998, when "Titanic" matched it with 14 nominations.
If Ms. Davis and Ms. Streep are the queens of madness in the movies, Jack Nicholson is no less than their court jester. Including his nod this year, Nicholson's twelve Oscar nominations, make him the most Oscar-nominated male actor. He approaches every performance with a squirrelly eccentricity, but three nominated performances feature behavior that receives clinically diagnoses: Randle in "One Flew Over the Cuckoo's Nest," Francis in "Ironweed," and Melvin in "As Good as it Gets."
"One of the big things Hollywood always misses is how many people in the world have some kind of disability but just get on with it," observes author and critic Thomson, making the case that the glory bestowed upon those acting mad might be overdone. "There is a theory that spectacular madness is very demanding and hard to play," he says. "I'm not sure that is always true. Sometimes ordinariness is the hardest thing to play. Taking the mad road is akin to an easy way out."
"If Nicholson wins this year," adds Ebert, "it will be because he calls attention to himself by playing an ordinary man, something he so rarely does." Ordinariness is most interesting to Oscar when it's out of the ordinary.
Many of film's greatest actors and legends -- Olivier, Swanson, Crawford, Stewart, Bergman, Page, Brando, DeNiro, Pacino, Malkovich, Norton, Redgrave, O'Toole, and Katharine Hepburn -- received Academy Award nominations for portrayals of emotionally unsteady characters. The talent, shine, and range of these stars notwithstanding, could it be that performances depicting mental illness also seem particularly astute because most filmgoers cannot comprehend what it could be like to be disabled?
The Academy of Motion Pictures Arts and Sciences disproportionately praises actors who choose roles dramatizing mental illness and the films in which they appear. Disability is such a marginalized experience that Academy voters may simply find performers in mad roles worthy of the highest prize the profession has to offer.
Andrea Clark is a freelancer writer in the San Francisco Bay Area.