As part of my ongoing work on history of psychiatry and film, I have been thinking recently about the ways that hallucinations and delusions are represented in television and film – what function they serve within narratives and what cinematic techniques are used to portray either those who are experiencing them, or subjective states of delusion and hallucination. What has become apparent at an early point in my research is that experiences of states associated with mental disorders are objectified in film in often quite subtle ways, whereas drug induced experiences seem to be at a more advanced and mature stage. In this blog post I offer some reasons for why this is the case and draw upon film theory that understands cinematic representation as the construct of a dominant social and cultural class to speculate that the forms of representation made popular by Hollywood stands in the way of subjectively representing extreme states of mental disorder. Whilst the dominant mode of representation is a challenge, I conclude that recent work including most notably Charlie Kaufman’s I’m Thinking of Ending Things (spoilers etc etc), provide some hope that subjective representations of extreme states of mental disorder are possible within mainstream visual media.
Depictions of delusional or hallucinogenic states for the most part are due to characters taking drugs, and these have seen a lot of development during the C20th. In a recent tweet I asked for recommendations for scenes depicting delusions and hallucinations. Although not a scientific result, the majority of people responded with examples of scenes that depict psychological states under the influence of drugs. Many of these scenes, such as in Easy Rider, seek to express subjective experiences of drugs and give a sense of selflessness, loss of control, disassociation, or the breaking down of the given reality that structures everyday life: on the last point one of the most poignant moments of the Sopranos’s sixth season is Tony’s world becoming shattered by his experience taking mescaline. Whatever the purposes, drug experience have become increasingly more commonplace since the heyday of counterculture. Most recently, Midsommar and Enter the Void have given immersive treatments of delusions and hallucinations of drugs from first person perspectives that have used the latest in CGI to provide immersive experiences.
On the other hand, delusions and hallucinations as a result of a psychological disorder seem to be less well developed in their cinematic representation. They are rarely first-person and when they are, they perform quite a crude plot twist function, one that is often akin to the ‘it was all a dream’ trope. They are frequently third-person, depicting breakdown from an outside perspective.
For instance, A Beautiful Mind is often thought to be one of the exceptions to this rule, but the way it is shot in fact objectifies Nash’s experience. For example, a scene early on in the movie appears to depict a subjective experience of a hallucination: a point of view shot is used to express how Nash sees mathematical patterns all around him, in a colleague’s tie.
These attempts to provide a subjective representation are undermined by the external shots of Nash that establish the scene but ultimately objectify the main character because the subjective point of view shots are reliant upon the external ones for their meaning. This is also seen later on in the film once Nash’s breakdown occurs in his psychiatrist’s office. Similar point of view shots are used to depict an hallucination of Nash’s – he imagines that his former college roommate is in the office. The scene switches rapidly between a close up of Nash’s face, and point of view shots that show his roommate sitting in a seat across from him. The audiences awareness of this being an hallucination is reliant upon objectifying the main character. A couple more examples to drive this point home: Abel Ferrara’s Bad Lieutenant shows a third person depiction of the main character’s (Harvey Keitel) hallucination of Jesus Christ in church. And in Black Swan – there are depictions of hallucinations, but these are external to the subject, but these possibly make more sense because the film is trying to express disassociation experienced by the main character.
The difference then here is that with drug representations, as in the examples cited, they can be and frequently are purely subjective depictions of hallucinations and we are pulled into the sense of loss of reality that the character is experiencing. The severe corruptions of perception and even personality that accompany psychotic states are reliant on external shots for their meaning. and at the same still give a comprehensible plot: in those with psychosis or other psychological disorders, a reality of some sort is presented to compare the delusional states to: that being other people in the room, or the establishment of the scene. There are arguments that German expressionism depicted mental disorder figuratively in films like the Cabinet of Dr. Caligari, but there are few examples of films that present the distortions of reality associated with certain psychological conditions in a non-naturalistic manner, or one that appeals to an external reality.
The theorist Nöel Burch notion of the institutional mode of representation (IMR) might be helpful here to explain why representations of mental disorder have to appeal to an external reality in order to make sense to a viewer. The IMR describes the dominant way in which films are shot, and is a socially constructed form of representation that reflects bourgeois values because it is designed to help films sell by being as widely accessible as possible. Films that not shot in the IMR are hard to watch and usually very experimental. In contrast, IMR films of Hollywood replicate the way that most people perceive reality most of the time and in so doing widen their appeal, making them more viable as commercial objects. This is part of their appeal – Hollywood films are so immersive because they are shot in a style that sucks audiences in by presenting a ‘naturalist’ form that is very easy to watch.
The IMR stands in the way of representing mental disorders principally because of its reliance on an objective cinematic naturalism that is incompatible with the kinds of hallucinations experiences in many psychological disorders. The psychologist and philosopher Louis Sass describes in his phenomenology of schizophrenia how hallucinations are there and are not there for many of the patients he has treated in practice. Sass invoked later Wittgenstein and Husserl to make sense of what he viewed to be the paradoxical experiences of schizophrenia. In brief, Sass sought to contest the prevailing notion that all psychotic episodes, especially those associated with patients diagnosed with schizophrenia, lose touch with reality. According to Sass, schizophrenic patients are in fact connected to reality and in some ways are highly sensitive to it. He thinks that they overload what they see with meaning to the extent reality takes on new dimensions. What he terms the given reality of every day experience pales in contrast to the associations made, and are projected on to what is perceived – Sass understands this as a kind of hyper associationism. These hallucinations are difficult to represent in the visual media, at least within the confines of Burch’s IMR.
But, it is not impossible to use these modes of representation to depict experiences that accompany severe emotional distress. In I’m Thinking of Ending Things, the audience is placed in the subjective state of the main character and for much of the film it is unclear what is being depicted. Without spoiling too much and going deep into analysis, the film has a creeping sense of unease as events begin to get stranger and stranger – odd things happen, repetitions occur and small details make no sense, which all add to a growing sense of uneasiness that is difficult to quite put a finger on. The film provides an experience that immerses and displaces, and even after it ends it is hard to understand what was there and what was not. Whilst it may not be possible to give a full representation to hallucinations and delusions in commercial films, works like Kaufman’s can perhaps imbue in us the sense or feeling of what it may be like for those experiencing severe psychological distress.
Kevin Matthew Jones 