A review of Wedding, D. (2024). Movies and Mental Illness. Hogrefe. 514 pp. ISBN 9781616765538. $68.00 (pbk).

When presenting the nominees for best film at the Royal Festival Hall in London, actor Michael J. Fox described cinema as “magic” that can “change your life.” Clinical psychologist, professor, and author Dr. Danny Wedding feels the same way. His passion is watching, writing, and lecturing about the fascinating ways mental illnesses and psychotherapists are portrayed in film, at times accurately, and at other times entirely off the mark.

DSM-5, the diagnostic bible for mental health, establishes 265 diagnoses with clarifying modifiers. These verbal descriptions often create confusion in therapists (“Umm, which diagnosis best describes this patient?”) since symptoms may overlap and patients’ sufferings can manifest themselves in different ways. In contrast, behavior comes alive when viewing patients who display their symptoms on film. In his preface, Dr. Wedding quotes Alfred Hitchcock: “Drama is life with the dull bits cut out,” which succinctly describes what makes it easy to portray what is going on in someone’s mind in the movies.

Dr. Wedding firmly believes that “films are a powerful medium for teaching students, engaging patients, and educating the public about psychopathology.” He names many films that present sympathetic portrayals of mentally ill people and the professionals who work with them. He also describes other films that portray those with mental illness as aggressive and dangerous, and the psychologists and psychiatrists who work with them as arrogant, ineffectual, and crossing boundary lines, including sexual ones. 

Many movies show psychiatrists as the primary professionals, with psychoanalysis as the dominant type of therapy and social workers as the most ethical of therapists. Such portrayals help us appreciate why so many people have erroneous ideas about mental health workers and the treatment they provide.

To say that Dr. Wedding’s book is thorough is an understatement. Chapters cover all diagnoses, from neurologically based symptoms to stress-based symptoms, including neurotic, psychotic, personality, sexual, and addictive disorders, as well as a final chapter on treatment modalities.

Within each chapter, Dr. Wedding provides dialogue excerpts from the movie. One excerpt I particularly liked was from Kissing Jessica Stein (2002) when the character describes her anxiety disorder:

“I check my answering machine nine times every day, and I can’t sleep at night because I feel there is so much to do and fix and change in the world, and I wonder every day if I am making a difference and if I will ever express the greatness within me, or if I will remain forever paralyzed by muddled madness inside my head.”

Another example is from the award-winning film The Hours (2002). Here is Nicole Kidman playing depressed Virginia Woolf, speaking to her husband:

“If I were thinking clearly, Leonard, I would tell you that I wrestle alone in the dark, in the deep dark, and that only I can know; only I can understand my own condition.” 

This newest edition of Dr. Wedding’s book updates his list of favorite films. It expands the coverage of international films, for he views many of these films as more powerful and accurate than films made in the United States.

The book has informative appendices that aid anyone looking to know which films portray which pathology and how well they do it. Where appendices often provide raw data and are of little interest to readers, Dr. Wedding suggests that readers might start with Appendix 6 to identify interesting films and then check out what he has to say about them in the main body of the book.

Appendix 1 lists the American Film Institute’s Top 50 Heroes and Villains.

Appendix 2 offers a syllabus for a course in abnormal psychology that integrates films.

Appendix 3 provides recommended websites for movies and movie databases.

Appendix 4 lists twelve misconceptions perpetuated in movies about mental illness and those who treat such illness. An example is “Love alone conquers mental illness.” 

Appendix 5 lists balanced as well as unbalanced portrayals of psychotherapists in movies, the unbalanced list being the longest. 

Appendix 6 is the most extensive. Its 106 pages rate films that illustrate psychopathology from 5-Ψ, “a must-see film combining artistry with psychological relevance,” to 1-Ψ, “don’t bother to watch.” Along with the ratings, Dr. Wedding provides 1 to 2 sentence descriptions about each film to help movie lovers decide what to watch.

An example 5-Ψ film is Shine (1996), the true story of David Helfgott, an Australian musical prodigy whose brilliant career is interrupted by the development of an unspecified illness, probably schizophrenia. The film suggests that David’s domineering father was directly responsible for his illness, conveying the misleading message that love and hope can conquer mental illness:

“David, if you go, you will never come back to this house again. You will never be anybody’s son. The girls will lose their brother. Is that what you want? To destroy the family? If you love me, you will stop this nonsense.”

Another 5-Ψ film is an oldie but goodie, winning five top Oscars. One Flew Over the Cuckoo’s Nest (1975) portrays what life is like in an in-patient ward with electroconvulsive therapy (ECT) being an essential part of the treatment plan. Randle P. McMurphy, commenting on ECT, says, “They was giving me ten thousand watts a day, you know, and I’m hot to trot! The next woman takes me on is gonna light up like a pinball machine and pay off in silver dollars!”

To summarize my review, if you are an aficionado of film or plan to teach or take a course on abnormal psychology and would appreciate having illustrations of accurate as well as inaccurate descriptions of mental illnesses, Dr. Wedding’s book will be an invaluable resource for you.