David Lynch and psychosis

The word 'surrealist' is frequently applied to the work of maverick American film director David Lynch (Bradshaw & Gilchrist, 2007). This automatically links his name with the art movement that has drawn the most on psychology and psychiatry, specifically the idea of the unconscious and dream interpretation. While 'surreal' has come to be shorthand for any work of art that draws on bizarre or difficult imagery, I believe that Lynch's dark and mysterious films can be seen to draw upon-and to inform-concepts in modern clinical approaches to psychology, especially the psychology of psychosis.

Watching a David Lynch film can give the viewer the impression that the director intuitively understands the underlying mechanisms of psychotic experience. Furthermore, in an age where experiential and subjective approaches to understanding mental illness have fallen out of favour, David Lynch may also offer some insight into the feeling of what it is like to suffer from psychosis.

Epistemological impulsivity and delusional thinking: How Lynch exploits our narrative understanding
Richard Bentall (2004) coins the term epistemological impulsivity to describe the tendency in deluded psychiatric patients to jump to conclusions about the world around them. In simple experiments to test deductive thinking, such patients jump to conclusions using less evidence and with a greater degree of confidence. This tendency is seen by some (e.g. Garety et al., 1991) as being a key underlying factor in the production of delusional thinking, especially paranoia, which is often based on very small amounts of evidence.

Paranoia comes with an inherent sense of personal threat and concomitant fear. Inland Empire's dark and chilling world is produced in part by David Lynch's use of story. While fear is generated with genuinely unsettling imagery and dark shadowy lighting, it also comes from the carefully managed attrition of any recognisable storyline. The audience, who have been led through the early stages of the plot with some of the conventional devices of storytelling (coherent dialogue, linear chronology) are suddenly thrown into a world of unfamiliar film cuts, unexplained locations and wordless acting. We are forced to jump to our own conclusions and build what narrative we will from scant concrete evidence as to events. Our sense of sense itself forces us to put something together and, given the presence of ominous emotions and apparent malice, what we put together is a paranoid and terrifying vision of the intentions of the characters in the film and even the world we inhabit.

In short, Lynch uses our natural epistemological impulsivity against us to generate fear: in this case the human proclivity to build story from elements that may or may not actually be bound as a conventional narrative.

Source Monitoring and the horror of hallucination: Lynch's famous dream sequences.
The most widely held understanding of madness is that it involves some breakdown of our perception of reality. Nowhere is this startling facet of psychosis more evident than in the appearance of hallucinations.

Hallucinations are defined by the Oxford Dictionary of Psychology as a 'perceptual experience similar to a true perception but not relating from stimulation of a sense organ' (Colman, 2001). The inability of psychotic patients to distinguish hallucinations from reality (as opposed to a simple excess of perceptual input) is considered by many psychologists to be the important psychological difference between 'psychosis' and normal cognition.

The disorientation engendered by the experience of hallucinations is another tool in David Lynch's armoury. In Inland Empire, sequences from dreams and earlier versions of the film being shot by Jeremy Irons' director character are interspersed with footage of the 'reality' in which Laura Dern is an actress making 'High on Blue Tomorrows'. This idea of showing multiple levels of reality is a characteristic of Lynch films. Unlike other directors he goes to great lengths to disorient the viewer by removing the conventional indictors that normally signpost the transition from one text world to another (Werth, 1999). This tendency to remove the tools that allow audiences to monitor the source of what they are witnessing may elicit an experience that resembles the psychotic patient being 'taken in' by their hallucinations.

Disordered Language and apparent 'madness': When Lynch makes limited sense
One controversial 'symptom' present in psychosis is disordered speech, controversial because it is unclear what ramifications it has for the psychology of the individual displaying it (Bentall, 2004). The nonsensical sounding sentences often articulated by psychotic individuals are felt by many to contain an underlying meaning, even if they are initially isolating and peculiar. Clinicians who get to know their clients may soon discern some running themes in the types of phrase that emerge in these utterances and may detect the nature of the issue that lies beneath the emotions being experienced.

In Inland Empire we are confronted with a number of pieces of dialogue whose meaning can only really be grasped at. This is especially prominent when the film flips to a room containing a family of human size rabbits. They have a dialogue with a background laughter track, one such runs as follows;
Rabbit A: 'I have a secret'
Rabbit B 'It won't be long now'
Rabbit A 'I hear someone'
This exchange sounds 'mad' in the sense that there is very little coherence from one interlocutor to the next. However, the fact that both continue as though it makes perfect sense to them, and the fact of the laughter track lending a sense of comprehension at some level, forces us to reconsider the snippets of talk in relation to the film's plot. When we think about it in this way we are able to make theories about what is being said (Do the Rabbits know Laura Dern is coming? And can they hear her approach?). The experience of this kind of determined interpretation reminds us of disordered language and the possibility that meaning resides somewhere in otherwise obscure fragments.

It would be churlish to say that Lynch adequately sums up the psychotic experience and presumptuous to suggest that he intends to. However, for the psychologist interested in getting closer to the experience of suffering a psychotic illness, David Lynch's latest film offers the possibility of first hand understanding of the fear and confusion encountered when facing reality.

References
Bradshaw, P. & Gilchrist, A. (2007). How to make a Surrealist film. The Guardian, 05 March.
Bentall, R.P. (2004). Madness Explained; Psychosis and Human Nature, London, Penguin.
Colman, A.M. (2001). Oxford dictionary of Psychology, Oxford University Press.
Garety, P.A., Hemsley, P.R. & Wessly, S. (1991). Reasoning in deluded, schizophrenic and paranoid patients. Journal of Nervous and Mental Disease, 179, 194-201.
Werth, P. (1999). Text Worlds: Representing Conceptual Space in Discourse. Harlow. London.