Psychiatrists on the Silver Screen

By Rhys Bevan-Jones, Hywel Dda Health Board and Cardiff University (Institute of Psychological Medicine and Clinical Neurosciences)

Psychiatrists in Film

I have a special interest in the relationship between psychiatry and the visual arts, film and multimedia, and I often use film clips when teaching psychiatry to medical students at Cardiff University School of Medicine. Films can engage students and can help demonstrate mental health issues, for example various mental states and disorders. It is important to be cautious and selective however when using films as teaching aids as there are many poor or inaccurate portrayals of mental health difficulties, although these examples can help promote discussion as well on issues such as stigma. The practice of psychiatry and psychiatrists have also been a focus of many films, and these may influence people’s perception of psychiatrists.

Whilst there are many ways in which to categorise the depictions of psychiatrists in film, some (e.g. Schneider in ‘The American Journal of Psychiatry’ in 1987) suggest lumping them into three categories. The first category includes the evil psychiatrist, sometimes referred to as ‘Dr Evil’. This representation dates back to the early 20th century German Expressionist films, such as ‘The Cabinet of Dr Caligari’ (1920) and the ‘Dr Mabuse’ series. A recent example of ‘Dr Evil’ is Hannibal Lecter, played by Anthony Hopkins (another Welsh connection) most famously in ‘The Silence of the Lambs’ (1991), and by Brian Cox in ‘Manhunter’ (1986). A second category is ‘Dr Wonderful’, the psychiatrist who does everything to help his or her patients, although often becoming involved in their personal lives as a result. Examples include Madeleine’s Stowe character in ‘Twelve Monkeys’ (1995) and Bruce Willis in one of his more sensitive roles in ‘The Sixth Sense’ (1999). The third category is not as well-defined, but could be described as the humorous eccentric, and is sometimes labelled as ‘Dr Dippy’. These representations are seen in the Mel Brooks film ‘High Anxiety’ (1977).

In which category would the psychiatrists in ‘A Dangerous Method’ be placed? It may be argued that they could go into all three. Whilst Jung does not accuse Freud of having ‘evil’ intentions, he argues that Freud is too controlling and authoritarian as the father of psychoanalysis. Others might see both Jung and Freud as ‘Dr Wonderful’ as they work tirelessly to develop their ideas and practices and help their patients. Freud also expresses his fear to Jung in one scene that he might be mocked (possibly as a ‘Dr Dippy’) and that psychoanalysis might be seen as unscientific, especially if he incorporates Jung’s ideas.

A crucial difference between ‘A Dangerous Method’ and the films referred to above is that the characters in those films are fictional, whilst Freud and Jung are of course two of the most famous and influential psychiatrists in history. The film might well influence people’s perceptions of psychiatrists (perhaps as therapists who analyse dreams and have impressive facial hair), even though psychoanalytic psychotherapy does not have a central role in mainstream psychiatry in the UK today. However it has influenced a number of other psychotherapies and some of its ideas resonate in today’s medical practices. Psychoanalytic theory has also permeated the arts and culture in general and remains influential in these fields.

Freud’s Welsh connection

Another important figure in the history of psychoanalysis is Dr Ernest Jones (1879 – 1958), one of the most distinguished psychiatrists to come from Wales. Jones was a close friend to Freud and his biographer. I refer to him because my SciScreen talk landed on St David’s Day and the evening was sponsored by the Welsh Psychiatric Society.

Jones was born at 12 Woodlands Terrace, Gowerton, near Swansea, and there is a blue plaque to commemorate this. After qualifying at University College Hospital, London, he became interested in psychiatry. In 1907 he came across Carl Jung, and shortly afterwards he met Sigmund Freud who soon became a colleague. Jones was president of the International Psychoanalytic Association for many years, and had a great influence on the development of psychoanalysis in the English-speaking world. In 1938 he helped to rescue Freud and his family from Vienna and brought them to London. He wrote Freud’s definitive biography, which is a major source for the history of psychoanalysis. Ernest Jones died in 1958, and his ashes were laid in the family grave at Cheriton church, Gower near Swansea.

sciSCREEN Lite - Patience

On Wednesday March 21st at 6.15pm at Chapter Arts Centre, there will be a sciSCREEN Lite - two introductory talks - before the film Patience (After Sebald) commences.

A richly textured essay on landscape, art, history, life and loss, Patience (After Sebald) offers a unique exploration of the work of internationally acclaimed writer W.G. Max Sebald (1944 – 2001) via a walk through East Anglia tracking his most influential book, The Rings of Saturn. The much anticipated new feature by the Grierson Award-winning Director of Joy Division, Patience is the first film about Sebald internationally, marking ten years since the writer’s untimely death, and with contributions from major writers, artists and film-makers.

The speakers will discuss the making of the documentary and will place Sebald within the wider context of modern German literature. The screening will be followed by a Q&A with the speakers:

• Di Robson, Producer. She is Co-Artistic Director of Artevents and Director of DREAM (Di Robson Event and Arts Management), and Co-Curator / Producer of The Re-Enchantment.
• Professor Gerrit-Jan Berendse FLSW, Professor of Modern European Literatures and Cultures, School of European Languages, Translation and Politics, Cardiff University.

‘Grant Gee's film should make anyone want to read The Rings of Saturn and the rest of Sebald's relatively small but exquisite oeuvre, some eight or nine books in all.’

Philip French, The Observer

Psychoanalysis and Buddhism: Three Phases of a Cultural Encounter

By Steven Stanley, Cardiff School of Social Sciences

We might say that psychoanalysis and Buddhism are both therapies; diagnosing and alleviating our psychological or existential suffering. But the productive, one hundred year dialogue on the margins of these traditions did not begin quite so auspiciously.

Phase 1: Orientalism

Freud and Jung famously fell out over the issue of spirituality.

Freud says psychoanalysis needs to be scientific, not mystical. Religion is an illusion (Future of an Illusion, 1927). Meditators are deluding themselves. Their ‘oceanic experiences’ (Civilization and its Discontents, 1930), or feelings of oneness with God, are an escapist regression to infantile narcissism, or fetal experience in the womb.

Franz Alexander quickly followed suit, describing some advanced Indian meditative states as melancholia, catatonia, or schizophrenic dementia. Nirvana is the ‘deepest regression to the condition of intrauterine life’.

Perhaps the historical Buddha would have been diagnosed as a paranoid schizophrenic?

Orientalists pathologised Eastern religious practitioners to further the European project of imperialist colonization.

Phase 2: Ambivalence

Jung is an important figure in the dialogue between psychology and religion. He discusses Christianity, Hinduism, Taoism, and Buddhism - particularly their mystical strands. Like William James, he saw religion as a psychological reality.

Individuation is Jung’s key concept for spiritual and personal growth. The highest goal is unus mundus: a numinous state of unity of consciousness and unconsciousness, similar to some meditative states. We need to step aside and let the unity of Self or God archetypes guide us toward wholeness.

Jung visited India and was interested in yoga. He developed his own ideas and interpretations of it, sometimes disagreeing with yogic philosophy.

He wrote a commentary to the Tibetan Book of the Dead (1937); an introduction to D.T. Suzuki’s Zen Buddhism (1949); and had a conversation with Zen scholar Hisamatsu (1958).

While Jung admired and studied Eastern philosophy, he argued against its widespread use in the West. We cannot copy or steal from each other’s ways. Each must pursue their own path. Westerners are unable to assimilate such culturally distant ideas and practices.

Phase 3: Integration

The post-WWII encounter between Japan and the United States allowed American psychoanalysts to learn Zen.

Karen Horney investigated Morita Therapy in which you pay ‘wholehearted attention’ to everything you do. It fitted a 1950s conservatism of accepting the world, rather than changing it.

In 1960, Erich Fromm argued Zen and psychoanalysis offered parallel ways of liberating the modern person from civilization – through the relaxed spontaneity of ‘beginner’s mind’.

But both lacked experience of meditation.

In 1979 Kornfield, Ram Dass and Miyuki – psychology professionals who had trained in Eastern spiritual practices - debated whether ‘psychological adjustment is liberation’. How compatible is the narcissistic ‘growth movement’ with spiritual development? Much of the debate concerned Buddhist and Jungian ideas.

Buddhism and meditation had started to enter the consulting room. Middle class Buddhists were in analysis. Analysts meditated to train their attentions, cultivate ‘unconditional positive regard’ for clients, or create internal ‘holding environments’. Perhaps the talking cure on the couch could compliment the ‘silent cure’ on the meditation cushion? Buddhist and psychoanalytic schools intermingled.

Mindfulness meditation is important in these integrations. It involves recollecting what is happening while it is happening; becoming more aware and engaged with the present moment. It fits some analysts’ turn from a ‘there and then’ focus on the influence of past traumas on the present, to a ‘here and now’ focus on relational meaning-making between therapist and client. Instead of a transcendent absorption state, it offers a third way beyond expression and repression.

Conclusion

In an interesting twist of fate, psychoanalysis never became a science. While Buddhism became increasingly secularized. Indeed, psychoanalysts have played an important role in interpreting Buddhism as a psychotherapy. The Buddha has become ‘the first psychologist’.

Freud’s aim was to move people from neurotic misery to common unhappiness. Now, positive psychologists are trying to optimize our wellbeing through a ‘science of happiness’. How does this square with Buddhist teachings encouraging us to go ‘beyond the pursuit of happiness’ for its own sake? Perhaps we are misunderstanding Buddhism in the way Jung warned. And perhaps there is a grain of truth in Freud’s critique. Are we deluding ourselves once more?

Recommended Reading:

Safran, J. (2003). Psychoanalysis and Buddhism: An Unfolding Dialogue. Boston: Wisdom.

History, Psychoanalysis and A Dangerous Method

By Keir Waddington, Cardiff School of History, Archeaology and Religion

In using the intellectual and emotional ménage à trois between Jung, Freud and Spielrein to explore Edwardian debates about psychoanalysis, Cronenberg uses history in particular ways. While Freud himself was never interested in film, Cronenberg’s cinematic history repackages popular ideas about psychoanalysis, presenting a narrative bristling with lengthy expositions, father figures, word association, and the interpretation of dreams to feature what many believe are psychoanalysts’ core preoccupations – sexual transgression, Oedipal complexes, neurosis and suppression all wrapped in Edwardian manners. If A Dangerous Method departs from usual cinematic representations of psychoanalysts in its efforts to uncover the historical and philosophical backbone of modernity, Cronenberg’s history needs, much like the dreams recounted in the film, to be interpreted.

Leaving aside that it was Anna O, Freud’s first patient, who coined the term “the talking cure”, that Freud first used the term psychoanalysis in 1896, and that others were experimenting with his methods before Jung, including British psychiatrists who adopted aspects of “the talking cure”, Cronenberg’s beautifully composed film gets some of the story right. Certainly, Jung admired Freud’s work, notably his Interpretation of Dreams (1900), and a paternalistic and troubled relationship did develop between them. As A Dangerous Method shows, Freud considered Jung his natural successor until they fell out in 1912 for a variety of personal and professional reasons, including theoretical differences about the libido and the unconscious. Jung was interested in the occult – he wrote his doctorate on the psychopathology of the occult – and as the film shows he researched word association, though Cronenberg neglects to tell us that the relationship between Jung and Freud started after Jung sent Freud his work on word association, which he believed supported Freud’s theories. Equally, Spielrein was a patient of Jung’s at Burghölzii asylum and they did have an affair. While medical ethics at the time were more about conduct between doctors rather than between doctors and patients, and popular imagery of medical practitioners often associated them with a rapacious sexuality, Jung was dismissed when the affair with Spielrein became known. Spielrein did go on to be a colleague of Jung’s and worked with Freud before returning to Russia, while Otto Gross did have an influence on Jung, who later claimed that his entire worldview changed when he treated Gross. So far so good.

At one level, Cronenberg might be forgiven for not giving the viewer much of the context of Freud and Jung’s ideas. While this is hard to do in a film, it does mean that Cronenberg’s history is a selective one, particularly with regard to how many continental psychiatrists at the time were becoming concerned with new theories of the mind – both organic interpretations associated with neuropathology and more psychotherapeutic models. As the film suggests, work therapy and hydrotherapy were employed in asylums; restraint was used for violent patients, but psychiatrists other than Freud and Jung, particularly those in France and Germany, were also turning to new approaches with a new group of neurotic and hysterical patients who it was felt were amenable to psychodynamic treatments. Equally, the period saw new theories about sexuality and an interest in ‘sexual inversions’ or perversions.

Freud and Jung were influenced by these ideas, but we do not see this in A Dangerous Method. Although Phillip French in the Guardian argues that the film is an ‘objective, historical look at the early days of psychoanalysis’, Cronenberg offers up another version of the ‘founding’ myth of psychoanalysis. While he adds in Jung and Spielrein, A Dangerous Method downplays how psychoanalysis was part of a larger psychotherapeutic movement; overlooks how Freud’s ideas were shaped by work on neuropathology, hysteria and hypnosis; and misses out some great stories, such as how Freud advocated the use of cocaine as a mental stimulant and aphrodisiac or how his claims about incest in Viennese society nearly got him into trouble. Cronenberg equally overlooks that Bleuler, the director of Burghölzii who appears fleetingly in A Dangerous Method, was a key earlier promoter Freud’s ideas, influencing Jung to use word association to test Freud’s theories. Cronenberg’s vision of the history of psychoanalysis equally overstates public opposition, telling us more about contemporary anxieties among psychoanalysts in North America than it does about the Edwardian dimension. True, the sexual dimension of Freud’s ideas was unpalatable but was more often downplayed as evidence suggests that the British public enthusiastically took to work on the interpretation of dreams. Cronenberg also gives his characters a degree of prescience – for example, in how Jung dream foretells the First World War or in Freud’s warning that psychoanalysis represents a ‘plague’ coming to America where psychoanalysis was to have a considerable influence after 1945 – which says more about his sense of inevitability than it does about the period.

And finally, there is the relationship between Jung and Spielrein and of course the spanking. True, Spielrein was beaten by her father. True, Jung lied to Freud about Spielrein, suggesting that she was a fantasist. It is true that women were institutionalised because they were viewed, as Spielrein describes herself, as ‘vile and filthy and corrupt’, but there is also evidence (such as from contemporary pornography) that Edwardians engaged in and enjoyed a broad spectrum of sexuality, which was not always seen as aberrant. More importantly, there is no evidence that Jung and Spielrein’s relationship was a sadomasochistic one. If the sadomasochistic dimension is untrue, Cronenberg further misrepresents the relationship between Spielrein and Jung: Jung was her dissertation supervisor, while he and Freud belittled Spielrein as a colleague while simultaneously using her ideas about the ‘death instinct’.

Cronenberg then prefers a racier history that continues to support the foundation myths about psychoanalysis. His A Dangerous Method helps obscure some of the richness out of which psychoanalysis developed, and downplays the other interesting histories that might be told.

Gender and Agency in A Dangerous Method

By Rachel Cohen, Cardiff School of Journalism, Media and Cultural Studies

It can be argued that Cronenberg’s movie is doubly fascinating for film scholars, since it is not only a text that can be read from a psychoanalytic perspective, but is also a movie about psychoanalysis. Given that recent screen theory research has begun to criticise many of the key arguments in the field for their narrowly phallocentric approach, it is also interesting that this theme is itself mirrored in the film’s narrative through Jung’s criticisms of Freud’s analytic work, in which everything is always and ultimately “about sex”. I’ve chosen in this paper to focus on the themes of gender and agency that can be observed in the film: this might also enable viewers to think about some of the strengths and weaknesses of psychoanalytic film theory as a critical approach.

The arguments which have come to dominate much screen theory are feminist ones, and it is Laura Mulvey’s seminal essay Visual Pleasure and Narrative Cinema (1975) that has perhaps proved most influential within this body of work. In her essay, Mulvey argues that the narrative and point-of-view of classical Hollywood cinema are inherently gendered in accordance with what she describes as the patriarchal unconscious: that is to say that dominant cinema reinscribes patriarchal conventions by privileging the male in terms of both narrative and spectacle. According to Mulvey, then, film reproduces a binary structure that mirrors the gendered power relations operative in the real social world: a structure organised around the opposition of active/male and passive/female, male looking and female to-be-looked-at-ness. Notably, perhaps, this theoretical framework is based upon an imagined (not actual) spectator, who is passively positioned in relation to the film text: a matter which can certainly be said to problematise the role of real (especially female) viewers.

Interestingly, then, A Dangerous Method can in fact be theorised quite meaningfully using this framework. This is so since, from the very outset of the film, we are offered representations in which the active-male/passive-female binary is powerfully encoded, as we see a hysterical Sabina being forcibly restrained by a team of male staff. Here, madness is coded as “feminine”: a phenomenon offered up for the scrutiny of (sane) men. Moreover, throughout the film, female desire (seen as inextricably linked to female aggression) is shown to be both destructive and threatening. Through Jung’s relationship with his wife Emma, we learn that wives and daughters - and so, by extension, the very process of female reproduction - function primarily to stifle masculine agency: indeed, Jung refers more than once to having renounced his professional ambitions because of Emma’s pregnancies. Emma even apologises to Jung for having “failed” to give him the son she imagines he so desires, believing that this is a significant causal factor in his adulterous behaviour. Meanwhile, as the nature of Sabina’s neurosis is more fully explored, we learn that she derives great erotic pleasure from being “punished” and, given that Emma knowingly suffers Jung’s infidelity throughout the movie, its female characters could be described as inherently masochistic. The masculine/feminine dichotomy is also manifest in Freud and Jung’s disparate approaches to their analytic models: whilst Jung is keen to introduce an element of “mysticism” (connoting femininity) into his work, Freud is adamant that psychoanalysis must remain “scientific” (connoting masculinity). Importantly, of course, it is this difference of sentiment that heralds the final demise of their relationship. As the film’s narrative continues, female sexuality is linked to the idea of contamination: Jung tries to break off his affair with Sabina by telling her that he has an “illness” and, later, en-route to America, Freud suggests to Jung that they are “bringing the plague” in the form of psychoanalytic practice itself. It is worth noting that themes of contamination are often central to Cronenberg’s work more generally: see, for example, The Fly (1986), Rabid (1977).

The male/female opposition is further emphasised via the film’s aesthetics, since virtually all female characters are shown dressed in white. The mise-en-scène (the elements we see within each shot) of key sequences featuring these women is also dominated by the same colour which, of course, symbolises purity, or virginal status. The men, meanwhile, wear black suits/waistcoats over white shirts, connoting, perhaps, their role in “containing” the feminine. The colour red is also significant: after Sabina loses her virginity to Jung, we see a close-up of her virginal blood on the bed’s white sheets. The film then cuts immediately to a scene in which Emma gives Jung a gift: the sailing boat that he has always wanted. The boat, importantly, has red sails; symbolic, perhaps, of his own sexual awakening, as well as a warning of the danger that is yet to come as a result of his relationship with Sabina.

Despite these observations, however, I would argue that it is perhaps the tensions between active and passive gender positions that are of particular significance in the movie. Whilst these tensions can certainly be read as “gendered” ones, they also evoke another of the key themes that underpins much of Cronenberg’s cinematic work, that is the notion of transgressing boundaries, especially those that represent “inside” and “outside”: for instance Dead Ringers (1988), Videodrome (1983), Existenz (1999). In this respect, Sabina’s madness - barely contained in her writhing body - threatens to escape and wreak havoc on those around her. These tensions become manifest in and are played out across the film along several different axes, for instance, sanity/madness; sin/purity; openings/obstructions (both corporeal and psychological); surrender/restraint; scientific/spiritual, son/father, analyst/patient, virgin/vamp: and we sense that the boundaries between all of these categories are threatened by the spectre of unrestrained femininity.

Further, whilst (as I have shown) the film can usefully be read in terms of its reinscription of patriarchal ideologies, it is also important to observe the extent to which notions of the patriarchal, the paternal, and the “father” are themselves portrayed as threatening. It is, after all, the beatings administered by Sabina’s father that trigger her neurosis (far from her madness being an inherently female attribute). Jung’s patient Odo - formerly himself a therapist - emphasises that he is afraid of his own father. The troubled relationship between Freud and Jung, meanwhile, is organised around the father/son configuration: Freud refers to Jung as his “son and heir”, whilst Jung describes Freud as his “father figure”. Significantly, of course, Freud withdraws his “paternal” support as soon as he senses that Jung is goading him to “risk his authority”, and this particular scene could also be read in psychoanalytic terms as an awakening of the Oedipal drama between the two men. The (Oedipal) shift that this signifies in their relationship is once again symbolised aesthetically in the film: which, having previously depicted Freud and Jung sharing a conventionally patriarchal position (the “head” of a family dinner table), later shows them facing one another from opposite ends of a conference table, emphasising their rivalry, both professional (their disagreement over the future of psychoanalysis) and personal (over Sabina herself). Sabina, meanwhile, comes to occupy both sides of the feminine binary, that is, virgin/vamp as the film progresses. Interestingly, towards the end of the movie, she effectively takes up a masculine subject position: reclaiming her agency by informing Jung that she was capable of damaging him far more severely than she did, but chose not to do so. Jung, meanwhile, criticises what he describes as Freud’s “passive” (feminine) model of psychoanalysis, in favour of a more active (masculine) one, indicating a similar reversal of gender roles.

Ultimately, we might like to think about the extent to which we, as real viewers - in contrast to the imagined spectator conceptualised within screen theory - are “positioned” by the film text in terms of gender and agency. Do our responses merely constitute a passive reinscription of the patriarchal unconscious envisaged by Mulvey, or are there more complex spectatorial dynamics in operation?

Rachel runs her own blog which can be found at: www.thewallsofwonderland.wordpress.com

Cardiff sciSCREEN on Viewfinder

Hi All,

For those of you who have an interest in film, Cardiff sciSCREEN is on the front page of the British Universities Film and Video Council online magazine Viewfinder. Click here to see the article.

Dangerous Method - March 1st.

The next Cardiff sciSCREEN will be on Thursday March 1st from 6pm at Chapter Arts Centre when we will be discussing themes brought up in the film Dangerous Method.

Directed by David Cronenberg and starring Michael Fassbender, Keira Knightley and Viggo Mortensen, the film explores the birth of psychoanalysis by focussing on the relationship between Sigmund Freud and Carl Jung. After the film screening there will be discussion, debate and a wine reception. The talks will cover the representation of the female characters, popular and professional attitudes towards psychoanalysis in Edwardian society, the depiction of psychiatrists in film, Freud’s Welsh connection, and one hundred years of psychoanalysis and Buddhism. This event will be sponsored by the Welsh Psychiatric Society (WPS).

Speakers:

Dr. Keir Waddington – Cardiff School of History, Archaeology and Religion

Dr. Steven Stanley – Cardiff School of Social Sciences

Rachel Cohen – Cardiff School of Journalism, Media and Cultural Studies

Dr. Rhys Bevan-Jones - Hywel Dda Health Board, and Cardiff University School of Medicine (Institute of Psychological Medicine & Clinical Neurosciences)

Tickets for the film are to be purchased from Chapter Arts Centre (6pm showing on March 1st). The discussion and debate will commence after the film in the room Stiwdio. This part of the event is free but places will be limited by the size of the venue. This room is, however, larger than previous events.