In the classic film the Wizard of Oz, the titular Wizard, at first glance, is a force to be reckoned with, indeed appearing great and powerful. However, he is accidentally revealed to be not a wizard, but a man using pyrotechnics and other tricks. As he tries to keep his identity hidden he utters the famous line, “Pay no attention to that man behind the curtain.”
This phrase was once symbolic of the relationship between the entertainer and the consumer. “The show must go on,” no matter the drama backstage, for the audience will just see the final product. While this has started to change in a world of behind the scenes photos, blog posts, and endless celebrity tweets, we as an audience can still pay no attention to the man or woman behind the curtain. Vin Diesel is a massive fan of Dungeons and Dragons. Comedian Chris Farley was taking antidepressants when he passed away from a drug overdose. Alice Cooper is a golf advocate and has a yearly golf tournament to fund his charity for teenagers. For casual fans of these actors, these facts can be surprising.
If we often focus on the characters on screen, and ignore the complexity of the actors behind them, do we do something similar with facts portrayed on screen? There are many things we assume about the world based on how they are portrayed on film or television, where the complicated truth is hidden behind the curtain. It may not always be a conscious action. There are many “facts” that we all believe, without knowing where they originated from. If pressed, we would never say that we learned these facts from a movie. However, what are the odds of successfully navigating an asteroid field? Most people would answer with the statistic from The Empire Strikes Back (3,720 to 1). The truth is a bit different (Not even 1 to 1).
In particular, movies strongly influence how we imagine mental health, mental illness, or neurological illness, often influencing what we as an audience think is the truth. From movies it would be easy to argue that people with neurological illnesses such as autism or intellectual development disorders have “special powers” as seen in films such as Rain Man or Forrest Gump. In reality, special autistic abilities (savant behavior) do occur in about ten percent of people with autism. However, all savants do not necessarily have autism.
It is a recurring plot twist in movies and TV shows that the villain of a story is actually a character with an evil alternate personality, the most famous example being Psycho. Meanwhile, a survey of films between 1990 and 2010 revealed that a third of characters with schizophrenia (which is not split personality, by the way) are depicted as homicidal in films, while the majority of these characters display some sort of violent behavior . In real life, people with mental illnesses are more often the victim of violent behavior than the perpetrator .
Finally, psychiatrists in fiction are often portrayed as either evil or mad themselves at worst (Silence of the Lambs) and ineffective or phony at best  (Watchmen). In comparison, a study of films dedicated to dementia found that only half of the featured patients had even consulted a doctor . While no person is perfect, a discussion with any psychiatric or neurological professional should reveal that such stereotypes are hurtful to the doctors that are trying to help, and can scare away people who may be uncertain about seeking help.
I imagine at this point, that many of you reading this would point out that there are good examples of the media portraying mental health and mental illness. A Beautiful Mind, Silver Linings Playbook and Still Alice are good examples of more accurate and balanced portrayals of mental illness. These films do what movies should do – allow people to connect to the characters.
These movies may not present every aspect of the mental illness correctly. Many movies featuring schizophrenic characters, for example, focus on what are classified as “positive” symptoms, such as delusions and visual hallucinations, and leave out “negative” symptoms, such as flat affect and avolition (essentially a lack of emotional reactions or drive), although these latter symptoms occur more often . I’m afraid this may be because some symptoms can trigger a greater emotional response from a general audience. However, the emotional connection is where the strength of movies lies. The audience can see a character contribute to the plot with his or her goals, fears, desires, and actions. This three dimensional character is different from the character completely defined by his or her mental or neurological health.
However, we as an audience must be careful even with positive portrayals, as at the end of the day movies are meant to be entertaining not necessarily educational. We all can be guilty of ignoring the man or woman behind the curtain, because in a way the curtain is what film and television are. We often forget that what we watch are characters, not real people.* Portrayed positively or negatively, we need to remember that real people experiencing mental or neurological illness exist beyond the screen, and a 120 minute portrayal of their lives can never provide the entire picture. We need to use discretion with what appears on the screen, and instead leave it with a willingness to meet these real people with no assumptions about who they are and the trials and triumphs they face. So go ahead, pull back the curtain and see who is actually behind it.
* This comment is in no way meant as an insult to the skill of actors, but as a comment on audience interpretation.
Bibliography of Research Articles
- Owen PR. Portrayals of Schizophrenia by Entertainment Media: A Content Analysis of Contemporary Movies. Psychiatr Serv. 2012;63(7). doi:10.1176/appi.ps.201100371.
- Hopson J. The demonisation of psychiatrists in fiction (and why real psychiatrists might want to do something about it). Psychiatr Bull. 2014;38(4):175-179. doi:10.1192/pb.bp.113.045633.
- Segers K. Degenerative dementias and their medical care in the movies. Alzheimer Dis Assoc Disord. 2007;21(1):55-59. doi:10.1097/WAD.0b013e31802f2460.
If you are interested in more examples of stereotypes seen in media, I recommend checking out “TV Tropes: Hollywood Psych” for an expanded collection of examples across different genres and topics.