Abstract: The portrayal of psychiatrists in popular movies has been colored by three main stereotypes: the “evil” doctor, the “kooky” doctor, and the “wonderful” doctor. On one level, these depictions represent the understandable ambivalence many people feel toward authority figures who, from time to time, may abuse their power. But on a more primal level, these stereotypes may be related to three archetypes that I call The Vampire, the Fisher King, and The Zaddik. A number of films and television programs are analyzed in light of these archetypes, and their antagonistic relationship to the “mundane”. Some implications for the future of psychiatry and the cinema are discussed.
As a psychiatrist, I usually try to stay away from movies about mental illness. In the first place, I feel that I’ve already “given at the office” and usually want a little respite from the ravages of schizophrenia, bipolar disorder, and suicidal impulses. More than that, though, Hollywood almost always gets mental illness wrong–and usually does a hatchet job on the psychiatrist, psychologist, or psychotherapist on the case. But why is this so?
It’s probably obvious that the general public has strongly ambivalent feelings about psychiatrists and others usually referred to as “shrinks”. (For purposes of this essay, I will use the term “psychiatrist” generically, even though, as physicians, psychiatrists occupy a unique niche among mental health professionals). This ambivalence shouldn’t be surprising–after all, how should you feel about someone who has the power to help you rise from the depths of depression, or, potentially, to lock you away in the bowels of an institution? Many still share Emily Dickinson’s perception that, when it comes to mental illness,
‘Tis the Majority
In this, as All, prevail–
Assent–and you are sane–
Demur–you’re straightway dangerous–
And handled with a Chain–
We are ambivalent about psychiatrists in roughly the way we are about priests and prophets–simultaneously revering and reviling them, wishing for their benign intercession while fearing their malign control. And, yes–it doesn’t help that some of us in the profession are great, inexhaustible gas-bags, as the producers of Frasier well know. But I think the story is richer and more complex than this. Beneath the Hollywood depictions of psychiatrists are some enduring and ancient archetypes–those primal structures of the human psyche that Carl Jung called the collective unconscious In this essay, I utilize the archetypal approach developed by psychologist James Hillman in his book, The Dream and the Underworld (1979). There, Hillman argues that dreams are phenomena that emerge “…from a specific archetypal “place” and that correspond with a distinct mythic geography…”. Hillman invokes the figures of Greek mythology, such as Hercules and Narcissus, to develop a “depth psychology” of dreaming. Similarly, I want to suggest that beneath the three stock movie-types described by Irving Schneider–Dr. Evil, Dr. Dippy, and Dr. Wonderful (Gabbard & Gabbard1; Clara2)–are three sustaining archetypes: respectively, The Vampire, The Fisher King, and The Zaddik. Finally, I argue that Hollywood’s attitude toward the “mundane” has created an inauthentic sense of both patients and their caregivers.
When I think of vampires, I think of Bela Lugosi’s wonderful movie portrayals of Count Dracula. As an adolescent, I was always mesmerized by Lugosi’s mix of old-world charm and diabolical evil. Nobody set a better table in the old castle than Bela, and nobody had more courtly manners. Too bad you probably won’t survive the night in Castle Dracula without having the blood sucked from your jugular vein…ah, well, I’ve met with worse at some motels on I-95.
The vampire represents one archetypal understanding of the psychiatrist: cultivated and intelligent on the outside, Pure Evil on the inside–a creature that saps his victims of their vital fluids (or “shrinks” their heads). This archetype, sadly, is always reinforced when a report appears of sexual abuse at the hands of a psychotherapist. (The same applies to the priest who sexually abuses the choirboy). In the cinema, the psychiatrist as vampire is nowhere better depicted than in the character of Dr. Hannibal (“The Cannibal”) Lecter, in The Silence of the Lambs. Lecter is both a brilliant psychiatrist and a mass murderer who devours his victims. Despite his outward calm, Lecter is, in Roger Ebert’s words, “…like a savage animal confident of the brutality coiled up inside him” (Ebert3). Lecter’s connection with vampires is elaborated in Thomas Harris’s sequel to The Silence of the Lambs, entitled simply Hannibal. There we learn that Dr. Lecter–now posing as a Renaissance scholar in Florence–traces his ancestry to a certain Giuliano Bevisangue, a fearsome twelfth-century figure. The name Bevisangue may be understood as a condensation of the verb bevere (to drink) and sangue (blood). The book cover of Hannibal is also strangely archetypal, showing an object that, from a distance, vaguely resembles the physician’s caduceus–but which proves to be a coiled serpent ingesting a human figure. Again, the primal image is that of the apparently benign care-giver who proves to be a monster.
The vampire archetype is played out in more or less flagrant ways in numerous “evil doctor” movies, including Laurence Olivier’s infamous Nazi dentist, Dr. Szell, in Marathon Man. Sometimes, the evil psychiatrist has a stand-in, as in Milos Forman’s One Flew Over the Cuckoo’s Nest, based on the novel by Ken Kesey. There, the infamous Nurse Ratched (a conflation of “wretched” and “rat s–t”?) serves as the agent of outward calm and inward evil. In Cuckoo’s Nest, psychiatrists are rather shadowy, background figures, but presumably it is they–acting under the evil influence of Nurse Ratched–who order Jack Nicolson’s McMurphy character to undergo “electroshock” treatment. In short, whether it is a creature who sucks one’s blood, devours one’s body parts, or fries one’s brain, the psychiatrist-as-vampire archetype underlies Hollywood’s depiction of “the thoroughly evil psychiatrist” (Clara2, p. 7).
The Fisher King
Fans of T.S. Eliot may remember that in his magnum opus, The Waste Land, Eliot plays with the mythic figure of the “Fisher King”–described, in Eliot’s own notes as “the impotent King of the waste land…” (Eastman4, p.1002). The Fisher King pops up in the medieval myths surrounding the hero-knight variously known as Peredur, Percival, or Parzifal–the basis for Wagner’s famous opera, Parsifal. (It was also the basis for the movie about a mentally unbalanced but inspired street person, played by Robin Williams). Depending on the version of the myth, the Fisher King is actually Parzival’s uncle, and is custodian of the Holy Grail. But because of his sinful ways, the Fisher King has either suffered some kind of sexual wound, or has been struck dumb. Ultimately, Parzifal restores the Fisher King’s power of speech, or heals his wound, and succeeds him as King.
Now, the Fisher King, as custodian of the Holy Grail, presents us with a paradox: he is a figure of authority who instructs Parzifal to “stay here with me a while, to learn courtesy and manners…I shall dub you a knight. ” (Goodrich5, p. 60). And yet, the King is himself wounded–in one version of the myth, he walks with a limp; in other versions (to which Eliot alludes), the King is impotent. In short, the Fisher King holds himself out as a “holy teacher”, but is himself sick and powerless. I believe that a debased version of this myth has shaped many cinematic representations of the psychiatrist.
Being a “wounded healer”, of course, is not all bad. We have the Judeo-Christian tradition that tells us, ” The sacrifice acceptable to God is a broken spirit” (Psalms 51:17). And in the Jewish mystical tradition, Rabbi Bunam of Pzysha tells us, “…it is a good thing to have a broken heart, and pleasing to God…A broken heart prepares man for the service of God.” (Besserman6, pp. 184-185). In short, if you’ve been thorough some heartbreak yourself, you will be in a better position to help others deal with it–the basis, perhaps, for the psychiatrist’s empathy. The risk, however, is that the “wounded healer” is not sufficiently aware of his or her wound, and continues to “act out” by mistreating or exploiting patients. Or, in a more benign comic mode, the psychiatrist is so oblivious to some obvious personal quirk or peccadillo that he or she becomes the butt of derision–a variant of “Dr. Dippy”.
We see a positive instance of the Fisher King myth played out in Robin Williams’s fine portrayal of psychologist Sean McGuire in Good Will Hunting. McGuire, we learn, is a maverick therapist working at a community college, and still grieving over the death of his wife. At one point, when Will (Matt Damon) makes some cutting remark about McGuire’s wife, the therapist grabs Will and pushes him up against the wall of his office, saying, in effect, “Don’t you ever go after my wife, or I’ll break your neck!” Now, this sort of behavior is, to say the least, frowned upon by the American Psychiatric Association and related professional organizations. And yet, in the movie, this is a critical turning point in the therapy: McGuire reveals himself as a vulnerable but powerful human being, and Will realizes that he is not dealing with some poofy, pompous windbag (as wonderfully portrayed by George Plimpton, Will’s previous “wounded healer”). In the case of Sean McGuire, the therapist’s wound is put to good use. In less restrained films (e.g., Lovesick, The Prince of Tides), the psychiatrist “uses” the patient or a relative of the patient to heal some inner wound or fulfill some urgent longing. Gabbard & Gabbard7 have pointed out that, in this respect, female psychoanalysts have fared worse than males: as of 1989, there were more than twice as many films portraying unethical sexual behavior on the part of a female analyst as there were portraying male analysts in this light.
In a more comic mode, the Fisher King myth appears in the guise of the psychiatrist as buffoon. Frazier Crane–the pompous but well-intentioned windbag–can never escape his own self-involved insecurities. Frazier’s “wound” is his unresolved narcissism, usually expressed as highfalutin’ rhetoric that contradicts common sense. It is left to Frazier’s sensible, ex-cop father to bring his son down to earth by exposing Frazier’s fatuity and pretentiousness. This comic version of the “wounded healer” seems to serve an important soothing function: it reassures the public that our seemingly omniscient (if not omnipotent) “healers” are just a bunch of over-educated, insecure fops–and that it’s really Joe Six-pack (father Martin Crane) who knows what’s what.
In the Jewish mystical tradition, the Zaddik is among the most revered of spiritual leaders. Somewhere between a rabbi and a saint, the Zaddik or “holy man” mediates between heaven and earth, between God and man (Dressner). The Zaddik helps his people break through the “blockage” that ordinarily separates man from God. Martin Buber describes the Zaddik in these terms:
“A helper is needed, a helper for both body and soul, for both earthly and heavenly matters. This helper is called the Zaddik…It is he who can teach you to conduct your affairs so that your soul remains free…he takes you by the hand and guides you until you are able to venture on alone.” (Dresner8, p. 135). (italics mine).
The Zaddik, I believe, is the archetype underlying the “Doctor Wonderful” character seen in many early Hollywood depictions of psychiatrists. In the 1980 film, Ordinary People, Judd Hirsch’s “Dr. Berger” comes close to this archetype. In one review of this film, Berger is described as “…the sort of doctor that anybody could trust, a rock of compassion” (Cannon9). I liked Hirsch’s portrayal of Berger, who, after all, struggles nobly to help his desperate patient, Conrad (played by Timothy Hutton), recover from a suicide attempt. But, in a sense, Dr. Berger is just too good to be true–too patient, too compassionate, too emotionally and physically available, and–most annoying to real psychiatrists–too damn perceptive. He is always prepared with just the right analytic interpretation, presented in just the right way. In short, Berger is a kind of secular saint.
In the recent film, The Sixth Sense, Bruce Willis’s mournful psychologist presents an interesting twist on the Zaddik myth. (He is, arguably, also an embodiment–or disembodiment–of the “wounded healer”, since he himself is wounded on many levels). Willis’s job is to rescue the soul of a sad and tormented boy who tells him, “I see dead people.” Without giving away the stunning revelation at the end of the movie, suffice it to say that Willis’s character truly mediates between the living and the dead, between earth and heaven. He is a secular “holy man” who is wholly dedicated to helping his patient–though, on another level, Willis is also trying to make up for his therapeutic failure with another patient.
One of the curious things about the Zaddik is his relationship with evil8 (Dresner). In order to lift the people above evil, the Zaddik must understand evil on a deeply personal level. At times, this means exposing oneself to the sins and failings of the, well, ordinary people–and, in more esoteric Jewish lore, even allowing oneself to be touched by sin. This is the danger that lurks within the archetype of the Zaddik, and within “Dr. Wonderful” as well. There is always that risk that the good doctor will fly too close to evil’s flame. This, too, is a potential path to the “corrupted” psychiatrist in the movies, though it seems to be less traveled than that of the “wounded healer”.
Television and the Psychiatrist
Perhaps because a television series can broaden and deepen a character over many months, it’s sometimes the case that psychiatrists are more realistically (if not always sympathetically) portrayed on TV than in the movies. I was always fond, for example, of Allan Arbus’s character, Dr. Sidney Freedman, on the old M*A*S*H series. Arbus managed to combine a deadpan, self-deprecating humor with a psychoanalyst’s wisdom and a touch of the absurd. In one episode, Dr. Freedman manages to persuade a skeptical Col. Potter (Harry Morgan) to permit a bonfire on the base. The psychiatrist rightly argues that it’s just the sort of controlled chaos the medical staff need to maintain their sanity. A less developed but “solid” character is the forensic psychiatrist, Dr. Emil Skoda, on Law and Order. Skoda isn’t at all flashy or brilliant; instead, he brings a kind of “street-savvy” to bear upon the case, and doesn’t take any guff from anyone.
Finally, Tracey Ullman’s therapist on Ally McBeal–while admittedly way over-the-top–nevertheless manages to hit the therapeutic target more often than not. She is saved from the “Dr. Dippy” stereotype by her relentless intensity, good-heartedness, and dogged pursuit of the patient’s “truth”. Moreover, few viewers are likely to assume that Ally McBeal’s therapist is supposed to be taken seriously.
Hollywood and the “Anti-mundane”
In the world outside of Hollywood, the work of clinical psychiatry consists mainly in slogging along. There is usually very little drama in the psychiatrist’s office: depressed patients talk about their misery; anxious patients describe their irrational fears; and psychotic patients detail their endless struggles with “voices”, the CIA, or–on a good day–the unscrupulous landlord. The therapist doggedly suggests new ways of looking at these problems; relates them to larger themes in the patient’s life; and, in the case of the psychiatrist, sometimes prescribes a medication. The “aha!” moments of psychoanalytic insight–those shattering epiphanies so prized in the movies–are rare, indeed. When insight occurs, it is usually gradual, hard-won, and even grudging. Getting a patient to see that he or she is not a worthless louse because of a broken marriage would be prized as a therapeutic triumph. In short, the work of psychiatry is quintessentially mundane. If there is a hero or heroine in this ongoing travail, it is surely the patient. The clinician is really something of a midwife–trying to deliver into the world the strength and insight that must grow within the patient. It is the patient, of course, who must bear the pain of parturition.
Hollywood has had very little to say about such everyday heroics. With the exception of a few films, such as Ordinary People, most movies on psychiatric themes involve the extremes or exceptions of mental illness: psychopathic serial killers (The Silence of the Lambs), multiple personalities (The Three Faces of Eve), or pathetic but loveable oddballs (What About Bob?). Indeed, when it comes to psychiatry, I believe Hollywood is fixated on the anti-mundane–the more bizarre, outrageous, or melodramatic, the better. Even a fairly empathic movie like The Prince of Tides felt obliged to throw in the gratuitous issue of the psychiatrist’s affair with the patient’s brother.
It has been argued, in this journal, that our task is to rectify “…the inauthenticity of representations of ordinary folks….” (M. Orleans, editorial, January 2001). I would suggest that in its zeal to avoid the mundane, Hollywood has given us precisely such inauthentic representations of patients and their caregivers. This is of more than academic interest, since, in my experience, the archetypes of the Vampire, The Fisher King, and The Zaddik have helped shape the public’s outlook toward psychiatry. If a part of your psyche is telling you that your doctor wants to seduce you, extract your thoughts, or fry your brain, you are likely to face the prospect of psychotherapy with reluctance, if not dread. I have lost count of the number of severely depressed patients I have seen who have refused to undergo safe, modern electroconvulsive therapy (ECT) because “I saw what it did to Jack Nicholson!”. I have had other patients express surprise that I could not literally read their minds–isn’t that what psychiatrists do in the movies? Even the relatively benign archetype of the Zaddik creates unrealistic expectations of miraculous cures and soul-wrenching revelations.
Where Do We Go From Here?
All that said, is it really the job of filmmakers to produce scientifically accurate and “socially responsible” movies about mental illness? I’m inclined to say “Sure, why not?”, but I hold out little hope that this will happen. I have seen little evidence of late that Hollywood representations of psychiatry are becoming more accurate or more even-handed. To be sure, the more sophisticated the potential patient, the less vulnerable he or she is to cinematic stereotypes. Unfortunately, that leaves out a large number of people in need of mental health services.
It might be argued that two near-impossible things need to happen before Hollywood produces a realistic portrayal of a psychiatrist. First, the stigma surrounding both mental illness and those who care for the mentally ill will need to disappear. And second, the public will agree to pay good money on a Saturday night to see a medical professional doing an imperfect but decent job, usually under trying circumstances, and often with very little “happening” in the melodramatic sense. I, for one, won’t hold my breath. But even if these twin goals were realized, society would likely not lose its ambivalence toward psychiatry and related professions. There is just too much power, too much energy, and too much danger surrounding the role of “healer” ever to permit a straightforward acceptance of those to whom we entrust our psyches. After all, when was the last time we saw an evil pastry chef movie, or a flick that extolled the saintly nobility of certified public accountants? No–so long as psychiatrists draw upon our deepest fears and most fervent wishes, there will probably always be Dr. Dippy, Dr. Evil, and Dr. Wonderful. Perhaps, though, as we come to understand the archetypes that underlie these stock characters, we will understand ourselves better as well. And then–who knows?–maybe Hollywood will stand up and take notice of the heroically mundane.
1. Gabbard, Glen O.; Gabbard, Krin: Psychiatry in the Cinema, 2nd ed., Washington DC, American Psychiatric Press, 1999.
2. Clara A: The image of the psychiatrist in motion pictures. Acta Psychiatrica Belgica 95:7-15, 1995.
3. Ebert, Roger: The Silence of the Lambs (review). Chicago Sun-Times, Feb. 14, 1991.
4. Eastman, Arthur M. (coordinating editor): The Norton Anthology of Poetry. New York, WW Norton, 1970, p. 1002.
5. Goodrich, Norma L: Medieval Myths. New York, Mentor Books, 1977, p. 60.
6. Besserman, Perle: The Way of the Jewish Mystics. Boston, Shambhala , 1994, pp. 184-85.
7. Gabbard, Glen O., Gabbard, Krin: The female psychoanalyst in the movies. Journal of the American Psychoanalytic Association 37:1031-49, 1989.
8. Dresner, Samuel H: The Zaddik. New York, Schocken Books, 1960, p. 135
9. Cannon, Damian (review): Ordinary People. Movie Reviews UK, 1999.(http://www.film.u-net.com/Movies/Reviews/Ordinary_People.html). For further reading: James Hillman: The Dream and the Underworld. New York, Harper & Row, 1979.
Author: Ronald Pies, MD is a psychiatrist affiliated with Tufts University School of Medicine, and Harvard Medical School. Dr. Pies is the author of several psychiatric textbooks, a poetry chapbook, and an inter-faith commentary on the Talmud (The Ethics of the Sages, Jason Aronson, 2000). He is an avid moviegoer who tries not to show his fangs during cinematic portrayals of psychiatrists. Address: P.O. Box 332, Bedford MA 01730.