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James Charney on the Campbell Conversations

James Charney, MD
James Charney, MD

Program transcript:

Grant Reeher: Welcome to Campbell Conversations, I'm Grant Reeher. My guest today is an accomplished mental health clinician who's also a movie buff. And he thinks that movies can help us better understand mental illness. Dr. James Charney is a practicing child and adolescent psychiatrist on Yale University's medical school faculty, and he's also the author of a new book titled, “Madness at the Movies: Understanding Mental Illness through Film”. Dr. Charney, welcome to the program.

James Charney: Thank you for having me, glad to be.

GR: Glad you could be here with us. It's a really interesting book. Let me just start with a little background question. Why did you decide to write this book at this moment in time?

JC: Well, I'm going to have to give you the short version of this because this is a story that can probably fill our half hour. I've been wanting to write this book for the better part of 20 years. Before that, I was teaching the subject of this book as a course at Yale for undergraduates, for seniors. And it was a seminar that was sponsored by two different departments, because the subject of the course, “Madness and the Movies” straddle two disciplines. It was about abnormal psychology, and it was about film. And it was an attempt to use film to understand abnormal psychology, but also to use the watching of the films to improve your ability to observe and to analyze and also to learn a little bit about how films have their effects, what's the craft of film that make them work. I've always found that fascinating. So I taught that course for about 15 years at Yale. And then as I retired and spent more time away from New Haven, I wound up having opportunities to teach the course in other places, versions of the course. But in the back of my mind always was, I really would like to record this as a book, to share it with a wider audience, but also a little bit as a legacy, to be able to have a project that was really a passion of mine for so many years could people could relive it and experience it and if they haven't experienced it in person when I was teaching it, they could enjoy it on the road. However, I never got down to writing it. I had a hard time imagining how I could write about the movies. I couldn't expect people to watch the movies just because they had bought my book or wanted to read the book. When I was teaching the course, every one of the students watched the movie the day before, it was fresh in the minds, they watched it together, it was a shared experience. And as a result, it was fresh in everyone's mind and we were able to refer to it, talk about it, analyze it in detail. How do you deal with that in a book that people are going to be reading? They may not have seen the movie and they may have difficulty accessing the film. And also just ballpark procrastination, just ordinary procrastination just didn't happen. So I was very, very lucky that I have a son who's well published and as he keeps churning out books, he would say, Pop, you want to get this book done? And I would say, yes. And then he'd say, shall I keep nudging you? And I'd say, yes, but I didn't do anything. And what made it happen was COVID. Because all of a sudden I was pretty much in lockdown, and I had no excuse. And by that time, I had been obsessing about it long enough that I figured out, I thought, a way to make the book accessible to people who didn't necessarily have the movie in front of them.

GR: It’s funny, I've talked to several authors on this program in the last couple of years where COVID is the answer to this question.

JC: Well, it certainly helped me out, so I had no excuse. My son was very good, he helped me organize a proposal, he helped help me choose the various publishers to present it to. And once I found the publisher, Johns Hopkins University Press, I was on a roll. And I discovered something that I, I actually knew was I loved writing and I loved researching it. I loved reliving the course. And it was the best year and a half or two years I've spent. So, it was very gratifying. And I guess that's a long answer to your short question.

GR: Well, you've already spoken to the thing I wanted to ask you next, which is some of the ways in which movies can help our understanding of mental illness and you talked about that at the beginning about how you use it in your course. One of the things in particular that I was wondering about that, I wanted to get your reactions to, was whether you think movies can help viewers have more of a sense of empathy for people who are suffering from mental illness, because there is a lot of judgment in our society about this. Do you think that movies can help with that?

JC: I really do think they can, and it's one of the reasons it matters to me, if films portray various mental illnesses accurately, even if their agenda isn't necessarily to teach. For instance, a movie that I have a great deal of mixed feelings about is the movie, “Joker”, that was very, very big and very popular just before COVID hit. In fact, it is the film, the R-rated film, with the largest box office in history - internationally. And so it was a very, very big film, and it portrays the Joker character, it's an origin story. It portrays it as though it is taking it very seriously. It's a one off in the world of comic book movies. Trying to really kind of get under the skin of what would make somebody become an arch villain. And the problem is that it doesn't trust its audience, I think. In that it throws so many different incompatible mental illnesses into this one character that it's a bit of a mess. And I think it's a missed opportunity because there would have been a very, it could have been straightforwardly a portrait of the making of a psychopath, it could have been straightforwardly the portrait of somebody who had maybe a borderline personality disorder or had problems with mood because we know that in the film they do show Joker acknowledging that he's had periods of deep depression. Instead, they hand us a mix of symptoms that covers such a broad category that you can't categorize and as a result, you can't really understand them. And yes, people didn't watch this movie to be taught about mental illness, but would it have hurt for them to do it right? And yet, I think they could have told a very good story. Now, as a teacher in my book and in the course, every once in a while I would choose a very good movie that was very bad in its portrayal of mental illness because showing what they got wrong was another way of getting at what's right. If you can point out something and say, this doesn't happen this way or it doesn't happen, if this person has this problem, he's not going to have a separate symptom that reflects another problem. And so showing a bad movie or discussing a bad movie could be educational too. But I would much rather talk about and experience a film that gets it right, gets under the skin of it so we can kind of really experience what it might be like to have that illness. And if you, as a member of the audience, are witness to that, you're going to be empathizing. You can't help it. And so I think it's a wonderful thing. It can remove the stigma because it's presented in a way that allows you to imagine, maybe I could have that problem.

GR: I'm Grant Reeher. You're listening to the Campbell Conversations on WRVO Public Media and my guest is Dr. James Charney, a clinical psychiatrist and the author of, “Madness at the Movies: Understanding Mental Illness through Film”. So you talked about the Joker, and that was something else I wanted to ask you about in terms of, we have a sense of the upsides of this, this is about the downside. Do you think, though, that Hollywood has tended to make us view people with mental illness as more dangerous than the average person on the street?

JC: Oh, yes, absolutely. In part because it's, a film that shows someone who's kind of benignly off center is not necessarily that engaging or that interesting, so they ramp it up. I mean, you know, it is true that a percentage of people who do violent things are psychopaths. But it's not the majority of them, by a long shot. And yet you might think that the world is filled with psychopaths, you look to your left, you look to your right, and there must be one there. The film seemed to suggest that, in part because that's what's exciting, that's what what's dramatic. Similarly, films often suggest that someone who is violent might be violent if they're psychotic, if they’re not in touch with reality. And in fact, the opposite is true. If there's any violence in someone who is psychotic, it is usually toward themselves. It is much less likely that the violence will be toward other people, though that can happen if someone is paranoid enough and psychotic enough that he or she thinks that someone is out to hurt them and are really aggressive in a meaningful way, they could strike out. But the percentages are very, very small and movies don't match that percentage.

GR: Yeah. So you mentioned the movie, “Joker” having such a huge audience worldwide and the impact that it had. I did want to ask you, let's set the Joker aside for a minute.

JC: Please do.

GR: Give me the like three or four, and just name them, I don't go into detail about each one, but the three or four movies in your mind that have had the biggest impact on the public's understanding about mental illness. I mean, several come to my mind, but I'm curious how your choices are going to match up with mine.

JC: Well, you're asking a question that's a little bit different from one I prefer to answer, which is how the movies that have affected the public's understanding of mental illness more than others, because I'm not exactly sure how to measure that. I can tell you the films that I think are…

GR: Your hunches, your hunches, because you're a movie buff and a psychiatrist.

JC: For instance, “Prozac Nation” was a film that brought the conversation to the table. The whole concept of someone who is so depressed they needed to be hospitalized and whether or not medications could be helpful. That was based on a memoir, it was basically a true story. And what's her name, Elizabeth Wurtzel, I think, was the author of that. And it was made into a very good movie with Angelina Jolie and Winona Ryder. And, no I got that wrong, that’s, “Girl, Interrupted”.

GR: Right, yes.

JC: Also another film that that had a big audience and portrayed mental illness sympathetically, dramatically. Got some of the details wrong but it matters less because they got a lot of things right and it had a big impact, again, putting the conversation on the table. Magazines were writing about it, newspapers were printing articles judging how accurate it was or how inaccurate it was. As a result, people were thinking about it. The film that that inspired my course and the book is a movie that was a big, big hit called, “Ordinary People”, directed by Robert Redford. It won the Oscar for its year on which I think was 1980. It's a beautiful film it's beautifully acted. Donald Sutherland, Timothy Hutton and Mary Tyler Moore and Judd Hirsch playing probably the best psychiatrist portrait in the movies. And it's the film that inspired the course because when I saw this film I said, if I can find other films this good, that this effectively get under the skin of a person with an emotional crisis, in this case a beautiful portrait also health how it affects the family. And also a very vivid and convincing portrait of how therapy can help. If I can find a few other films on different types of mental illnesses, this is something that I think would be the backbone of a course and then the backbone of this book. So, “Ordinary people” is just a wonderful example of a movie that gets it right.

GR: Interesting. You're listening to the Campbell Conversations on WRVO Public Media. I'm Grant Reeher and I'm talking with Dr. James Charney. He's a practicing child and adolescent psychiatrist on Yale University's medical school faculty, and he's also the author of a new book titled, “Madness at the Movies: Understanding Mental Illness through Film”. So, you gave me your two or three greatest hits and certainly I remember, “Ordinary People” being very powerful when I saw it. A couple that you didn't mention that I thought would be sort of the ones that people would point to right away, would be, “Psycho”, “Three Faces of Eve”... well, let's start with those two. How come that didn't pop into your mind right away?

JC: Well, it obviously did because it's in the book. And it was something, of course, it was a film I taught. But actually the reason I taught it, it was less for the portrait of the mental illness, which this one is a bit of a muddle too, and more for the fact that this movie changed the way we watch movies and I thought that was fascinating. Because the ending was such a surprise, Hitchcock was brilliant at marketing and he pretty much invented the: you have to stand in line to get into the movie on time, which was not the way movies were seen before. So I found that interesting. “Psycho” seems to want to suggest that we're dealing with somebody with a multiple personality disorder, and what's very nice is they do have a psychiatrist at the end who calms you down after the excitement of the movie saying, no, that's not the case and it's also not the case that he's a transvestite, but in fact, he has a psychotic disorder, but that kind of gets lost in the shuffle. It's a powerful film, it points to some kind of mental illness, but it doesn't tell us really what's going on. And what was the other one you mentioned?

GR: I mentioned, “Three Faces of Eve”, you don't need to comment on that one, that goes back a ways.

JC: The brief comment about, “Three Faces of Eve” is, it's a mediocre film with a powerhouse performance by Joanne Woodward.

GR: Right.

JC: But it's almost like a classroom documentary. It keeps on over-explaining things, it's a clunky screenplay. It's a film that doesn't hold up, it’s very much of its time.

GR: And you mentioned one of the things you liked about, “Ordinary People”, I'm kind of jumping around here, but you've given me different things to think about, was the portrayal by Judd Hirsch of the therapist.

JC: Yes.

GR: And I don't know if this is in your book, but I wanted to get your take on the movie, “Good Will Hunting”, because that has a portrayal of a therapist as well that is featured quite heavily in the book. What's your thought about that one? That of course was Robin Williams, Robin Williams being the therapist, I should have mentioned that, but go ahead.

JC: I would have loved to be in the same room with Robin Williams and not necessarily as my therapist. I actually have the final chapter of the book is on therapy, how therapy is portrayed in the movies and that's where I talk about, “Good Will Hunting”. The Robin Williams character breaks about a dozen therapy rules. Among other things, you don't choke your patient because he presses the wrong button emotionally and he lectures more than teaches therapy. But what is very good are several early scenes where he does something where he is engaging the Matt Damon character by talking his language and by saying that they have some shared experiences. This is a very good way for a therapist who is using a model that, family therapists use this model more, they're much more talkative and much more revealing about their own persons than someone who's got an analytic background or a psychodynamic background, where there tends to be an insistence that the therapist is relatively neutral or even invisible as a person in the room. But if you're willing to acknowledge who you are as a human being with your patient, you can help the patient begin to feel like you can understand him or her if you are able to say, I've had that experience too, or at least I know about that experience and Robin Williams does that. He talks about the fact that they're both weight lifters, he talks about his relationship with his wife, he acknowledges how brilliantly intelligent the Will Hunting character is, but at the same time makes the point that being intelligent intellectually doesn't make you intelligent emotionally. And so that's where he falls into, he's a little bit too full of himself and he talks too much. As I’m doing right now.

GR: (laughter) Well, it's your book.

JC: But it's a very good movie and a very entertaining film.

GR: Yeah. So two other questions about the movie specifically, and then I have some other questions for you more generally, but, is there one movie that you think has had the worst impact in terms of misinforming our understanding of mental illness, the one that would be at the top of, instead of your hall of fame, your hall of shame.

JC: I can't think of a worst. Very commonly if I mention to people, you know, maybe I'm being introduced to them at a party or something about something about my book or the course, they hear the title, “Madness of the Movies” and the very first movie that is that comes to mind is, “One Flew Over the Cuckoo's Nest”. People are always saying, are you teaching, “One Flew Over the Cuckoo's Nest”? That is not a bad portrayal, but it is a very shallow portrayal and it really is not a good movie to teach about the experience of mental illness because it's not about that. It's about the politics of psychiatry and the politics of therapy and how hospitals can misuse or mistreat people who have some kind of mental illness. And also at the time, it was also a portrait of some people who retreated to the life in a hospital when you could, when you could stay indefinitely in a VA hospital, for instance, simply because they couldn't quite deal with the world outside. So it was more about politics and society than it was about any one individual. As a result, it's not a teachable film about psychology. So it doesn't make it a bad film, it's an extraordinarily good film and wonderfully well-acted, beautifully directed. It's a favorite of mine, but not on this subject.

GR: That's interesting.

JC: I don't know, do you have one that you were thinking of that is particularly bad?

GR: No, no, no. Because I, you know, I'm probably one of the people that's been misinformed by these things. But that's a real interesting take on, “One Flew Over the Cuckoo's Nest”. If you've just joined us, you're listening to the Campbell Conversations. I'm Grant Reeher and my guest is Dr. James Charney. He's the author of, “Madness at the Movies: Understanding Mental Illness through Film”. I've got a more personal question from my perspective, actually, for you, if I could, and it's about the portrayal by Hollywood of people on the autism spectrum. And certainly when you bring that up, “Rain Man” comes to the front of everybody's mind. My son is on the autism spectrum and recently, well, a couple of years ago, we watched a TV series on Amazon called, “As We See It”. I don't know if you've seen that.

JC: I don't know that one.

GR Oh, okay, you might want to check that one out because the show does a good job demonstrating the fact that if you've met one person with autism, you've met one person with autism. But at the same time, it did capture some shared tendencies. And as we were watching it, it resonated both with me and with my son. And so, you know, it was interesting for that not only to watch the show, but to watch us watching it. And I just was wondering, are there particular films that you think have done a good job with that particular issue?

JC: There are. First of all, one of the difficulties in even talking about autism in films or talking about it at all, is it really is a spectrum disorder, which means, speaking to what you were just mentioning about that program, which is that there are so many different ways that it's expressed, so many different degrees of disability and by no means do we have an understanding of them. So to use to say someone is autistic, they could be so compromised that they can't in any way take care of themselves and can barely leave the house. Or you can have somebody who's just a little bit eccentric and yet, it fits the autism definition. And, you know, in general, one of the common elements is a difficulty, a kind of reading other people's expressions, a need for saneness and have difficulty transitioning from one moment to another or one focus to another, but the degrees are just dramatic. “Rain Man” is a very good portrait of a certain kind of autism. And I can't put my finger on a particularly good film, not that there aren't any, but I'd have to go back and kind of remind myself of the autism. I actually don't deal with autism in the book and I never did in the course either, I just had to choose my diagnosis. So I haven't researched it as much. But I'll tell you, there's a TV series that does a wonderful job of portraying the essence of a high functioning person with autism, and it's the, “Extraordinary Attorney Woo”, I believe it's on Netflix. Do you know it?

GR: I don’t, no.

JC: It's a Korean show, it's a series. It's not a movie, but it's a series of about 35 episodes and it is charming. The lead is a young woman who has many, many symptoms of autism. But she becomes the very first lawyer, attorney, practicing attorney in Korea as an autistic person. And it's a fictional story, but it's very real in terms of its portrayal of the society and it's a terrifically engaging movie. And the woman who plays the part has an Audrey Hepburn kind of charm. It's a comedy drama and I would recommend it. It’s sweet and it's accurate.

GR: Great. I'll check it out. So we got about a couple of minutes left. I want to squeeze a couple, two questions at least in if I can, because I’d really be remiss if I didn't get to one of these. But first of all, briefly, are other than film, are there other artistic mediums in your experience that you have found particularly good at conveying important aspects about mental illness?

JC: Well, one of the things that a novel can do, and there are many novels, and don't put me on the spot to name titles right now, but there are many novels that are very good portraits of mental illness. And one of the things they're able to get at that films don't do so well is, beyond the behaviors that can tell you how a person is thinking. Films that don't do that as well. Certainly artistic expression can convey emotional problems, not just disabilities, but emotional feelings, whether it's painting, whether it's sculpture, whether it's craft art. So there's so many ways that it can be expressed in a way that can communicate the experience to someone else.

GR: Yeah. Back in the 80’s, I thought German expressionism that I saw a lot of these galleries in New York was very powerful that way in terms of emotional pain. So last question is, and I should have given you more time to answer this because it's where you start your book, but you grew up liking horror movies even though they scared you and at the beginning of your book, you told a story about seeing the, “Creature from the Black Lagoon” and then having nightmares. I had to laugh out loud when I read that because I had exactly the same experience, I was drawn to that thing and then regretted it. But, just in a minute or even less, tell us about the natural relationship between movies that incorporate mental illness and horror.

JC: And horror? The short version is that horror films are really good at tapping into some of the deepest fears we have. It's not just fears of death, it's fears of pain, it's the fears of the unknown, fears of people or experiences that are just different enough to be unnerving. And all of those are part of the experience of someone who has a mental illness. They're also part of our own normal emotional experience and the ups and downs of life. So horror, you know, cranks up the intensity and often the level of violence and somehow in experiencing it in a horror film, we can often say, well, I'm glad that's not happening to me!

GR: (laughter) Well, we'll have to leave it there. It’s a really interesting book, I recommend it to everyone who's listening. It's both fun and it's really informative at the same time. That was James Charney, and again, the title of his book is, “Madness at the Movies: Understanding Mental Illness through Film”. Dr. Charney, thanks again for taking time to speak with me.

JC: Thank you, Grant. I really have enjoyed the conversation.

GR: Me too. You've been listening to the Campbell Conversations on WRVO Public Media, conversations in the public interest.


Grant Reeher is Director of the Campbell Public Affairs Institute and a professor of political science at Syracuse University’s Maxwell School of Citizenship and Public Affairs. He is also creator, host and program director of “The Campbell Conversations” on WRVO, a weekly regional public affairs program featuring extended in-depth interviews with regional and national writers, politicians, activists, public officials, and business professionals.