Masterpieces and mental illness

There's a lack of information on teaching psychology using film, so I was pleased to be asked to review this book. Madness at the Movies is a labour of love, primarily, of film and film-making, applied to characterise specific psychiatric disorders. It arose out of a successful optional module available to psychology and medical undergraduates and students of 'widely varied topics' at Yale University.

The book itself is structured by mental disorders, consciously starting from the more 'extreme' disorders of the self (schizophrenia, dissociative identity disorder) to the more common and relatable (depression, OCD). Each chapter starts with a spotlighted film, with the author underlining that his choices were primarily based on quality. He favours the masterpiece. Psycho, the author admits, poorly represents dissociative identity disorder, but is still an excellent example of Hitchcockian suspense.

It becomes clear that film can increase understanding of mental illness in many ways. Film can express a mental illness as a metaphor: Melancholia for example, tells the story of a planet colliding into Earth, which symbolises the feelings of hopelessness in depression. In more realist films, such as Woman Under the Influence, we see mental illness emerge in the context of a working class family, and gain an understanding from an 'outside perspective'. An 'inner madness' can be observed in film using special effects (Repulsion, The Shining), or using simple devices such as inner narratives (American Psycho). Films are often a mix of all these things, examining 'madness' through context, characters and story.

The author loves film: each chapter has a detailed section on the context, acting and directorial decisions that created the final cut. More space is devoted to describing films than discussing how it relates to mental illness per se. Yet, as an experienced psychiatrist, the author captures the 'essence' of disorders with care and nuance, using vivid clinical examples. This is reflected in the Chapter on depression, which focusses on a film about an adolescent's attempted suicide (Ordinary People).

However, I believe there are three issues. First, although the author is very conscious about his use of language (he mentions how he kept the somewhat controversial word 'madness' in the title as he considered it 'catchy'). However, 'madness' can unintentionally sound pejorative, and can sound dismissive, when the author used the phrase 'garden variety' madness to refer to OCD. Second, although this is based on a module, there is no lecturer guide, which felt like a missed opportunity to explain the pedagogic approach. Third, this is not a 'core' psychopathology text (the author states as much) so it would be inappropriate mainstay for a psychology student. There is no mention of the biopsychosocial approach, CBT or transdiagnostic approaches. Indeed, his approach is firmly within a diagnostic medical model of psychiatry, resting on the DSM-V.

In brief, this book would provide a general reader (or film enthusiast) with a plethora of intriguing insights on mental illness. I would recommend this to any student considering clinical work, be it psychology or medical student, as key concepts and behaviours associated with mental health disorders are clearly explained. And, like me, you might discover some unforgettable films that take you somewhere you didn't expect. I thank the author for shining a light on some genuine (often forgotten) masterpieces.

- Reviewed by Scott Cole, Associate Professor, York St John University.