Exaggerations and Stereotypes of Schizophrenia in Contemporary Films

I. Introduction

When films like Girl Interrupted (1999) and A Beautiful Mind (2001) were released to the public, people began focusing their attention on mental illness and its depiction in cinema. The representation of mental disorders in contemporary films has been scrutinized by critics for years—especially those films that deal with schizophrenic individuals (Abu-Akel & Abushua'leh, 2004, para. 1). Often media analysts argue these characters are portrayed as overly hysterical, unpredictable, and dangerous. They believe that the general public's limited and skewed knowledge of mental illness is fortified by the misrepresentations and exaggeration of the media (Parcesepe & Cabassa, 2013, para. 1). Those who suffer from schizophrenia reported that they feel rejected by society becomes of the negative representations of mental illness in movies (Dubin & Fink, 1992, p. 1). Therefore, an examination of how schizophrenia is portrayed in films deserves further study.

It is true that shock value in the portrayal of schizophrenia is irresistible to filmmakers, but National Alliance on Mental Illness reports it is also true that those suffering from schizophrenia are affected by the distribution of these films. Filmmakers tend to focus on violence, traumatic events, and hallucinations when depicting and shaping characters with schizophrenia. Some critics argue that films overdramatize these elements and doing so dehumanizes people with schizophrenia (Hyler, Gabbard, & Schneider, 1991, p. 1045). The purpose of the current paper examined the prevalence of misconstrued schizophrenic cases in contemporary films. The author content analyzed 10 different movies: The Soloist (2001), A Beautiful Mind (2001), Clean Shaven (1993), Shine (1996), Shutter Island (2010), A Caveman's Valentine (2001), Benny and Joon (1993), The Snake Pit (1948), Pi (1998), and The Visit (2015), all featuring a schizophrenic protagonist. The current study compared previous research on schizophrenia with the fictional representation of the disease in contemporary films. By looking at the frequency of four common stereotypes associated with the disease: violence, using love as a cure, abuse in mental hospitals, and gifted individuals, the author tried to examine how contemporary films are representing those with schizophrenia. This study also looked at the prevalence of violence to measure how exaggerated the symptoms are.

II. Literature Review

According to the American Psychiatric Association, Schizophrenia is "a chronic brain disorder that effects about one percent of the population" (Carpenter & Parekh, 2015, para. 1). The symptoms associated with the disease can range from hallucinations, delusions, having difficulty staying motivated, and problems thinking and concentrating (Wahl, 1995, p. 4). These symptoms usually appear in early adulthood, and affect men and women equally, but earlier onset for men tends to be more frequent. Due to these complex symptoms, there are multiple misconceptions about the disease.

Many of these misconceptions are conceived and explored in the entertainment industry—more specifically in films. A significant amount of research has been done on studying negative stereotypes in movies. For instance, the negative portrayals, according to Hyler (1991), were categorized into stereotypes: homicidal maniac, rebellious free spirit, enlightened member of society, female patient as seductress, narcissistic parasite, and a zoo specimen. More specifically, characters in these films are often times portrayed as violent, living in an abusive environment, being extremely gifted individuals, and using love as a cure for the disease (Owen, 2012, para. 7). Although violence and gifted individuals could be realistic portrayals of schizophrenia, they are often exaggerated in films (Beachum, 2010, p. 8). Movies are designed to entertain and engage an audience— directors in the past have used filmic devices to show deformed perceptions of space from the perspective of schizophrenic characters, and dismal lighting to set a dark and sinister tone. Schizophrenic characters are also called "crazy," "loony," and "deranged" (Pirkis, Blood, Francis, & McCallum, 2006, p. 523) by mentally healthy or "sane" characters—reinforcing the stigma.

Researchers have concluded that these wrongly portrayed or exaggerated symptoms of schizophrenia in films can negatively affect the public's view of the disease (Hyler et al., 1991, p. 1045). In a study done by Domino (1983), students who watched One Flew Over The Cuckoo's Nest (1975) had more negative attitudes toward schizophrenic individuals than those who did not view the film. This perception did not waiver over time, and it did not change after viewing more positive depictions of the disease.

People in the United States have claimed violence and unpredictability are the most pressing concerns when it comes to individuals with schizophrenia (Abu-Akel & Khalid, 2003, para. 1). Researchers have suggested that this is due to contemporary films exaggerating the frequency of violent actions committed by schizophrenic characters (Swanson et al., 2006, para. 9). In actuality, most people with schizophrenia are not dangerous or violent (Beachum, 2010, p. 13). Additionally, mental hospitals in films reveal institutions as barbaric prisons where patients are treated poorly, although in recent decades it has become a legal requirement that hospitals use the least restrictive restraints possible (Kapp, 1999, p. 4). Additionally, many films showcase schizophrenic individuals as having tremendous intellectual abilities, but researchers have found that although some schizophrenic patients have a gene that optimizes their mental capabilities, most don't have the discipline or focus in order to truly execute these gifted traits (Meyer et al., 2007, para. 3). Lastly, films tend to feed the myth that "schizophrenia can be cured by the special empathetic understanding of a loving helper" (Owen, 2012, para. 5). However, this has yet to legitimately be proven—most individuals control the disease through the use of prescription medication (Carpenter & Parekh, 2015, para. 2). But medication may not work for every patient, as studies have reported: "80 percent of those who stop taking their medications after an acute episode . . . have a relapse within one year, whereas only 30 percent of those who continue their medications . . . experience a relapse in the same time period (Flynn, 1998, para. 9).

This study focused on two research questions based on these stereotypes that other researchers have found to be falsely represented in contemporary films. The first question aimed to evaluate how films portray schizophrenia, based on these perceived misconceptions. The second question asked if these negative symptoms are exaggerated in contemporary films. After analyzing 10 popular movies featuring a schizophrenic protagonist, the current study tried to answer these questions.

III. Method

Through the use of content analysis, the author was able to qualitatively measure how schizophrenic characters are portrayed in contemporary fi lms and whether or not their symptoms are exaggerated. Ten movies were chosen for the analysis, all collected from the IMDB database that lists some of the most popular fi lms featuring a schizophrenic protagonist: The Soloist, A Beautiful Mind, Clean Shaven, Shine, Shutter Island, A Caveman's Valentine, Benny and Joon, The Snake Pit, Pi, and The Visit. These fi lms were released to the public between 1948 and 2015, a wide range of years to record how the depiction of the disease has evolved over time.

After recording the protagonist's age, gender, and race, each movie was evaluated for four stereotypes: violence, using love as a cure, gifted individuals, and abuse in mental hospitals. These four appeared in multiple articles that attached stigma to schizophrenia and studied which stereotypes are the most prevalent in the media.

These four stereotypes need to be defined more thoroughly for accurate categorization of fi lms. It was defined that violence occurred anytime the schizophrenic protagonist acted to harm another character physically, or disrupting space and objects with his or her aggressive actions. According to the definition, love as a cure was used when the movie comes to a close, and the schizophrenic character's previous symptoms appear to have lessened signifi cantly, due to another person's presence in their life. Gifted individuals were defined as schizophrenic characters that are extremely talented in music, art, mathematics, or the sciences—to the point that other characters are pointing out their abnormal abilities and comparing them to societies standards. Lastly, abuse in mental hospitals was defined to have occurred when the schizophrenic protagonist was being incarcerated in an institution that harms or treats them unjustly—where the fi lm is dehumanizing the character and setting out to depict mental hospitals as torturous institutions.

While watching 10 movies, the current author checked protagonists' age, gender, race, presence of violence, abuse in mental hospitals, existence of gifted individuals, and use of love as a treatment for the disease. The author also counted the number of instances where specifi c schizophrenic protagonists were violent to others or themselves.

The method was adapted from Pirkis, Blood, Francis, and McCallum' s study (2006) and Hand's study (2010).

IV. Findings

Based on the analysis of 10 different movies that featured a schizophrenic protagonist, the author tallied the frequency of violence and calculated an average of all the movies combined, as shown in Table 1.

Based on the analysis of 10 different movies that featured schizophrenic protagonists, the author recorded age, gender, race, and whether or not the character met the listed stereotype, as shown in Table 2.

V. Discussion

Based on Table 1, it could be concluded that schizophrenic characters in these fi lms demonstrated a high frequency of violent behavior, averaging six occurrences per movie of violence toward others. Additionally, there was an average of about fi ve occurrences per movie of a schizophrenic character harming himself or herself. But according to the Medical Health Association, people with schizophrenia are more likely to harm themselves than others. But the data collected from the fi lms suggests the opposite.

It is true that rate of schizophrenics connected to violence remain somewhat higher in proportion to offenders in the general population, but according to a study done by Walsh, Buchanan, and Fahy (2002), the prevalence of such circumstances still fall below 10%. This number does not correspond with the 10 fi lms, 90 to 100 minute long, in which the schizophrenic protagonist acted violently an average of about 6 times per movie. Additionally, four protagonists in these fi lms committed a murder, but in reality only 13% of homicides a year are connected to schizophrenic individuals (Matejkowski et al., 2011, para. 2). Another interesting finding was the prevalence of violence in fi lms that dated 2000 to 2015. The Caveman's Valentine, Shutter Island and The Visit were all movies released in the 21st century and all showcased the highest frequency of violence according to Table 1. The Caveman's Valentine (2001) demonstrated the highest occurrence of violence at 13 times involving the protagonist harming others, and 10 times harming themselves. The Visit, released in October 2015, is a close second with 10 occurrences of violence toward others. These findings suggest that the frequency of violence in contemporary fi lms has increased in recent years, compared to those fi lms that were released in the 1990s and later. One study found that "people today are 2.3 times more likely to describe a person with a serious mental illness as prone to violence than they were in the 1950s" (Pirkis, Blood, Francis, & McCallum, 2006, p. 1). A national survey found that the mental illness most often associated with violence is schizophrenia, and although it is true that 19% of people with schizophrenia committed assaults, only around 3.5% committed what could be considered a serious act, which injured another person (Swanson et al., 2006, para. 6). A solid explanation for this increase of violence from fi lmmakers is the desire to draw out a shocking reaction from their audience—feeling that the only way to accomplish this is injecting exaggerated scenes of brutality in their storylines to receive that instant response from viewers. David Cox, a television producer and writer once said: "Their [the fi lmmakers] task isn't to portray the truth, but to construct stories" (Cox, 2013, para. 4).

The fourth column in Table 2 (Race) shows that protagonists suffering from schizophrenia are frequently Caucasian and male, but rates of schizophrenia are higher among African Americans than any other race (Nauert, 2010, p. 1). The last column that recorded whether or not the protagonist fell into the "love as a cure" category shows that 80% of the fi lms gave the impression that love for another person could cure schizophrenic symptoms, which is not known to be a permanent and legitimate treatment. Most individuals are only able to control the disease through the use of prescription medication (Carpenter & Parekh, 2015, para. 2). But in one study, only 1 out of 400 fi lms featured effective drug therapy (Owen, 2012, para. 5). Due to the viewers' need for an emotional payoff, fi lmmakers are creating improbable endings to their works purely to satisfy the audience's need for a "Disney moment" or happy ending to the story.

As for the stereotype of gifted individuals with schizophrenia in contemporary films, the data reported that 50% of the films watched featured a schizophrenic protagonist with above average intellectual abilities in music or mathematics. Nearly all those listed were based on true stories, although the portrayal of their lives with the disease were skewed at times. In Sylvia Nasar's biography about John Nash, which the film A Beautiful Mind was based on, she states that the filmmakers "invented a narrative that, while far from the literal telling, is true to the spirit of Nash's story." In the film, Nash nearly drowns his son in a bathtub, believing that his friend, Charles, was keeping watch. In reality, because of Nash's paranoid delusions, the audience learns that his friend Charles, didn't actually exist. Although Nash did suffer from auditory hallucinations, he was not diagnosed with having visual hallucinations, despite what the film depicted (Chmielewski, 2013, p. 40). This suggests that the scene where Nash almost kills his son did not actually happen.

The sixth column in Table 2 focused on abuse in mental institutions, exhibiting that 40% of the schizophrenic protagonists experienced some kind of cruelty in an insane asylum. After watching the films, a notable observation was that a majority of the storylines were set in either the 1940s or 1950s, when mental hospitals were exercising horrific acts on patients. Therefore, modern viewers could come to the conclusion that mental institutions were currently practicing these techniques. In one study, 74% of people believed that electroconvulsive therapy is dangerous and traumatizing based on films—the same study found that this is not the case—ECT is administered today as a muscle relaxant for schizophrenics, who are unconscious during the process and most report feeling no pain after the procedure (Breggin, 1998, p. 19). However, it should be known that some patients report negative side effects post treatment, such as memory loss, fatigue, insomnia, and other physical and cognitive issues (Donahu, 2007, para. 2).

Another form of brain stimulation being used in the medical field is deep brain stimulation (DBS), which involves sending low electrical impulses to specific parts of the brain of those who are treatment resistant. After its introduction in 1987, DBS has been used in an attempt to lessen the side effects of mental and movement disorders, such as depression, Parkinson's, and schizophrenia. The procedure involves local anesthesia; therefore, it should not hurt the patient (Mayberg et al. 2005, para. 8). But this information is not conveyed in films, leaving the public with a negative perception of mental institutions and procedures.

The fifth column (Violence) shows that 100% of the schizophrenic characters in these films demonstrated some act of violence. In a national study of violent behavior, 1,410 patients diagnosed with schizophrenia were told to report incidents of violence over the course of six months, with the verification of their family members. About 19 reported acts of violence within those six months, 3% reported acts of serious violence, and 80% of the participants reported no violence (Chmielewski, 2013, p. 29 & 30). This study supports the current author's findings and calls for a closer look at why violence is so present in films featuring a schizophrenic character.

One study reported that alcohol is one of the clearest predictors of violence in individuals with schizophrenia, but none of the characters in these 10 films touched a drink, eliminating liquor from the list of explanations (Hall, 2003, p. 13). Additionally, one explanation to take into consideration could be a connection between societal violence and the mentally ill. The public considers those classified as insane having an immediate correlation to guns and explosives, knowing that they might not be held responsible for their actions thanks to the "insanity defense." But many schizophrenics are living in a fractured mental health care system. "The discomfort of . . . nine months of hospitalization was not nearly as bad as dealing with the stigma for the last forty years," said one member of a support group (Culwell, 1992, p. 41). Madness and evil are inseparable. "Nothing sells like insane, unpredictable, undetectable, gory killer . . . who has caused a great deal of pain and anguish to friends and relatives of the victim—all of high moral character" (Kalbfleisch, 1979, p. 9). So perhaps the audience enjoys being frightened by characters that are violent and have no comprehensible motive. Filmmakers are able to capitalize on that factor, and actors who want the acclaim are more likely to aim for those kinds of roles—look at Jennifer Lawrence, Kathy Bates, and Heath Ledger, all winning Academy Awards for their portrayal of mentally ill characters. The reasoning for this violent behavior could vary from film to film, but legitimate data does not back up these portrayals of violence from schizophrenics.

The current study has some limitations: Other than a small sample size of 10 films, it focused on only four stereotypes. Additionally no positive stereotypes were included in the research, limiting the results by only addressing the negative stereotypes.

VI. Conclusion

It is true that researchers, like Owen (2012), observed the portrayals of schizophrenic patients in contemporary films, and found that many of the films portrayed an unrealistic socioeconomic status for those characters with the disease. But it still reinforced the idea that erratic and dangerous behavior is a constant when dealing with those fighting schizophrenia. Although sensationalizing schizophrenia to sell movie tickets has been effective over the years, filmmakers who choose to avoid legitimate portrayals of schizophrenia are presenting audiences with crude and monstrous characters that contribute substantially to the discrimination and stigma attached to individuals living with the disease.

It is time to eradicate these misconceptions and stereotypes. As more empirical evidence starts presenting itself, the emphasis can be taken off schizophrenics as homicidal maniacs in films and directed toward creating and reshaping a more accurate perception of those suffering with schizophrenia.

Acknowledgements

This author is thankful to Kenn Gaither, associate professor and associate dean at Elon University, for his supervision and advice, without which the article could not be published. The author also appreciates numerous reviewers who have helped revise this article.

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