Psychiatrist Breaks Down Mental Health Scenes From Movies & TV | GQ

you're serious aren't you you're telling

us you killed those three young men on

the subway

and why should we believe you ain't got

nothing left to lose

not everybody does this it's extremely

rare and in fact

the joker unfortunately overplays the

idea that mental illness and violence

are linked

hey gq i'm dr eric bender i'm a child

adolescent adult and forensic

psychiatrist and this is the breakdown

first up bojack horseman okay

trey and i will be in the coke room

doing hand stuff otherwise

you don't know anybody here hollyhawk

has walked into this party and her

friend is teasing her right away you

don't know anyone

that is the worst thing you could say to

somebody who has what's called social

anxiety disorder

in social anxiety disorder people are

terrified that when they go into a

setting where they don't know people

or even when they do know people that

they're going to embarrass themselves

that people are going to

see that they're anxious they might get

so upset they might even have some

bodily pains like nausea or stomach

pain and they want to avoid the

situation

as she looks around she starts to get

more anxious you see her starting to

hyperventilate she's starting to get

short of breath

they're all kinds of anxieties and they

differ in very significant ways

sometimes anxiety is really serious and

we call things disorders if in fact the

anxiety

impairs people's functionings during the

day or in these cases

say if she does have social anxiety

disorder she avoids socializing

that's pretty important for development

that's impairing part of her life in a

part of her day

if it's a certain situation people avoid

that can be called a phobia like a fear

of snakes

fear of flying so there are specific

situations that arise

that cause people anxiety too oh

what do you see what you're having an

anxiety attack so look around the room

and tell me what you see

i i see people partying

and passing out this guy has done a

really good job here of using a therapy

technique called

grounding i have used this with patients

when they get super anxious

you can tell them to look around

themselves and to tell themselves where

they are

i'm standing here i'm in a room it is

tuesday

what else do you see um books pizza

boxes

i see light fixtures i see

an odd amount of four poofs that's a

terrific technique he also calls it an

anxiety attack

that is another word people use to

describe a panic attack she's clearly

having a panic attack here

he helps her with this grounding

technique you feel any calmer

yeah actually it's a trick my

psychiatrist taught me

i'm peter by the way so this party's

kind of crowded

you want to go get some air yeah if

there are a lot of people around you

blocking where you are and where you're

breathing yeah absolutely get out of the

room and get some fresh air you hear

fresh air because a lot of people have

trouble they're

they're trying to breathe so you want to

get them out to a place where they feel

like they have more access to air

so that can be more psychologically

helpful too but i think sometimes it's

even more

all right let me get out of this crowded

environment that's making me feel like i

can't breathe

the panic attack usually comes on sudden

onset and they can tell they're having

one

they might say yeah i suspect if i go

into that situation i'm gonna have a

panic attack

but when it happens it's just a super

sudden onset

for most people sometimes people with

anxiety tend to drink

more use substances more they want to

feel relaxed

alcohol can relax you to some degree

however

it can also on the rebound make people's

moods feel worse or make anxiety worse

so then you can run into bad cycles of

people feeling good

and then it wears off they take more and

they take more so there's this feeling

like you can help

but in the long run it might be hurting

more i can't believe that one of the

best

portrayals of anxiety and getting help

comes from a cartoon about

anthropomorphized animals but this is

really great

first off this guy's saying hey i go to

a psychiatrist that's going to make

hollyhock feel better

he's saying try this it's helped me

that's going to make her feel better so

this is a really good portrayal next up

joker you're serious aren't you you're

telling us you killed those three young

men on the subway

and why should we believe you ain't got

nothing left to lose

so i think about a couple of things the

first thing is psychopathy and

psychopathy is not a mental illness

it's not a diagnosis psychopathy is a

collection of personality traits

and that includes feeling no remorse it

includes being callous

uncaring the joker here is letting us

know he's exactly that he has no remorse

for killing these three people

he also says he has nothing left to lose

in a violence risk assessment in

forensic psychiatry you look

for things that are warning signs such

as

people who have been isolated and lonely

people who have felt traumatized and

persecuted

and those who don't have any resilience

factors factors inside that help them

recover from traumatic events or

external support and that's

exactly arthur fleck that's the joker

that can be what's called a pathway to

violence

not everybody does this it's extremely

rare and in fact

the joker unfortunately overplays the

idea that mental illness

and violence are linked it's important

to know that we don't know

why people get pushed over the edge and

there are very very few so that's really

important

at the same time there are people who

are repeatedly traumatized neglected

abused and there's a rage that can

develop

inside them and i see that sometimes in

psychotherapy when i'm talking to people

who've been chronically abused or

traumatized

but again those people do not for the

most part go out and commit any violent

acts my life is nothing but a comedy

let me get this straight you think that

killing those guys is funny

i do and i'm tired of pretending it's

not

there's a difference between psychopathy

and psychosis

psychosis is a break from reality people

are hearing things

seeing things it's called hallucinations

those are psychotic

issues the joker doesn't seem to have

any of that

in cases of psychopathy people use

others in

their lives to get what they want other

people are pawns oh

why is everybody so upset about these

guys

if it was me dying on the sidewalk you'd

walk right over me

we see his mood go back and forth from

irritable

to seemingly crying to almost laughing a

little bit

that can be called a couple different

things one word is lability where you

have such

shifts but what explains it even more is

probably a diagnosis of what's called

pseudobulbar affect and what that means

is

there's a disconnection between the

front of the brain the cortex and the

back of the brain the cerebellum

that connection actually helps us

express our emotions

when that's broken either because of

trauma and we know arthur flack has a

history of trauma to his head even that

connection can get disrupted and what

happens is there can be a sudden

onset of crying or laughing

even though the person might not even

feel as if something's humorous or that

they're sad it just starts

what do you get i don't think so when

you cross a mentally

something that also shows that this is

more of what's called psychopathy and

not a psychosis a break from reality is

that he's telling murray exactly what's

going to happen this is what you get he

knows clearly what he's doing that shows

he's of a sound mind

he does not have any psychotic issue at

this time he's not

hearing voices he's not seeing things he

doesn't have delusions

in fact his complaint about feeling

discarded that is a common feeling among

people who do

try to seek help in the system for the

traumas they've experienced

psychopath you hear that word and you do

think of a serial killer because a lot

of the serial killers show

psychopathy they don't care people are

just pawns in their lives they're there

for entertainment

and i think in the joker's case you

might look at him and say here's this

dude dressed all and clown makeup

there's got to be something wrong with

him

well he's actually trying to be noticed

in some ways this guy's lacked attention

for his entire life

and he's been neglected he ends up

getting pushed over the edge and again

we don't know why that happens and

he turns to violence there is a genetic

component to mental illness and his

mother did have severe depression

it's also much more common that people

realize one in five americans will have

a mental health challenge within a year

and in fact

half of americans will have some mental

health issue during their lifetime

while the joker ends up portraying this

link between violence and mental health

issues that doesn't exist

or it perpetuates that stereotype it

does do a very good job of showing that

resources can get pulled at any time at

the end of the movie the social worker

is explaining that nobody cares about

people like him

that in fact money goes away and that

does happen a lot

so clinics might be there and then

they're relying on funding that suddenly

gets pulled

and that translates into less help for

people who really do need it

next up rain man sally gibbs dipped

sally

461 00192

how did you know my phone number how'd

you know that you said read the

telephone book last night tip sally

okay so this is something it's pretty

rare it's called savant syndrome first

off

the idea of someone being able to read a

phone book and memorize it and know

phone numbers that is a pretty

extraordinary ability

right now they're supposedly maybe one

in a million people living with savant

syndrome that means there's a certain

gift and it's usually in a few areas it

could be an

art in arithmetic or math it could be in

music

so here we see raymond is able to

memorize phone numbers he has this

savant syndrome

he also has autism autism is a

developmental disorder which means that

as someone is developing

they don't develop in the way most

people in society would develop and in

autism you look at two main areas you

look at how somebody's developing and

how they're communicating and that

includes do they

make eye contact and communicate with

language do they actually

seek out reciprocity or do they offer

reciprocity meaning can they participate

with someone in a conversation in a

normal way

or do they not point things out not try

to draw attention

to things in their world and not respond

to people and you look and see

how they respond to non-verbal cues

non-verbal language people with autism

can have some deficits in some of those

areas

another area you look at is the

interests of people with

autism where someone maybe just hones in

on one thing

and sticks with that and has an unusual

attachment to that one thing

or do they have a broad range of

interests also you look to see if

somebody has what's called stereotyped

behaviors it's an attempt to really

soothe oneself but it doesn't really fit

we see a little bit of self-soothing

here in rain man where raymond at first

is rocking back and forth like this he's

trying to calm himself down

so these are things that i look for in

autistic spectrum disorders

it's also important to note autistic

spectrum disorder or autism

it's a wide spectrum just like if you

say you're sick

you might have a cold or you might be in

the icu and need surgery

if someone has autism they could be

impaired severely

and raymond is more towards that end or

someone can be highly functioning and

have what used to be called asperger's

disorder where they don't really have

the

problem of never developing language

which can happen in severe cases of

autism they might develop

language but there are these other

quirks about them

chris i don't have my toothpicks no you

don't need toothpicks i don't want my

toothpick you don't need toothpicks for

anything

pancakes keep sliding off you're gonna

eat with a fork i don't have my maple

syrup either i'm gonna be without my

maple syrup

and my toothpicks here we see what's

called an adherence to a routine that

doesn't make sense to most

people but to someone with autism like

raymond that routine really is important

and you can see

his brother just wants to get breakfast

he just wants to eat but

when there's a shift from that routine

it can be very hard for someone with

autism to deal with that

in terms of why a lot of people believe

it is a comfort it's a soothing thing

and when he's pulled away from that he

has some trouble

definitely definitely not gonna not

gonna have my my pancakes

so tom cruise well he seems to be a

jerky guy

in the movie in some ways he's

responding to raymond at least in this

scene

the same way most people would feel

frustrated

i see this with families sometimes with

children with autism for instance or

even adults

they just want to eat breakfast they

don't want to go through this routine of

like putting things out in a certain way

so a lot of times families will say to

me do we do this do we just

go with these routines or what there is

a method of teaching

people with autism to discover and

to work on behaviors that are not

adherent to their routine

applied behavioral analysis is the

technique

and you are really positively

reinforcing behaviors

that help someone deal with shifts in

their routine you reward that

and that teaches them that they can

actually do something outside of their

routine they want

there are times when you do feel forced

to go along with this adherence to

routine

but there are ways to change that

a2 82 a2

it's a lot more nade two to three plus

246 total change what also is seen here

is more of this savant syndrome

about half the people with savant

syndrome have autism the other half have

other

abnormalities in their brain development

in fact the person

kim peak whom supposedly raymond babbitt

was based on

he actually had a different type of

issue with his brain

not related to autism but again savant

syndrome is very rare

rayman does a wonderful job of bringing

to the screen a topic that was not

talked about at all

this was great it started a conversation

the challenge here is that rayman ends

up making people

think that if you have autism you have

some superpower and that's

not the case next up the undoing

the defendant's mother told you that

jonathan suffered neither guilt nor

grief

in reaction to his four-year-old

sister's death

they were certain once the shock wore

off the suffering would begin but it

didn't it never came

there's a difference in my mind between

suffering and remorse

not being able to suffer to me doesn't

suggest that someone doesn't

care some people really push away those

feelings they don't let themselves feel

sad about it

just because somebody doesn't grieve the

way we would expect doesn't make them a

psychopath

but the lack of remorse seen again and

again and again and again

that could make somebody a psychopath if

i'm looking at a lack of remorse i'm

looking for other

qualities about somebody too a

collection of personality traits to say

they're psychopathic so that might mean

somebody lies consistently about their

background and who they are

where they are what they're doing

somebody is

very glib able to feign interest in

things

i don't look for just no grief and no

remorse i'm looking for this collection

of things together

you told your friend sylvia steinitz

that you believed your husband suffered

from narcissistic personality disorder

wasn't a professional diagnosis but your

opinion

narcissistic personality disorder is

another type of personality disorder

a narcissist they do have a sense of

grandiosity a sense of self-importance

there might be

fantasies about unlimited power beauty

money things like that there are a

number of other

ways someone can be a narcissist but

there's a term called malignant

narcissism which is used to describe

people who do have the narcissistic

personality disorder

that include this lack of empathy that

include using people in exploitative

ways

in fact when we look at serial killers

sometimes we say that serial killers

have malignant narcissism that there's

this lack of empathy and again these are

psychopathic traits

as well psychopathy is really

interesting because even in populations

that are very

genetically isolated you might get a

psychopath

popping up just they're born that way

that's the idea that

innately there's just this callous

uncaring nature to them

the old way of looking at psychopathy

they had what were called factor one

traits

there were traits about your personality

and they had factor two traits that was

the criminal behavior

so there's different layers of criminal

behavior and doesn't have to be murder

some people think that there's

white-collar psychopaths so to speak

where in

companies people are doing things that

are kind of dodgy not exactly following

the rules

and maybe those are psychopaths too

there was a book a couple years ago

exploring how

many ceos might have psychopathic traits

perhaps there's something about power

perhaps

in order to get to that level you have

to not care about other people you have

to

demand a certain level of treatment and

respect and that's what narcissists do

so there are all these different factors

of narcissism but like i said it doesn't

mean they all lack empathy however

perhaps there's some degree of that in

certain people that do make it into

those positions

doctor in your practice do you not tell

patients that

sometimes they so want to believe in

their partners that they

they choose to unknow things and see

things there are cases of serial killers

where their partners had no idea that

they were out there killing hundreds of

people

that's pretty common that people don't

know about that side of their partner

i think as a psychologist or as a

psychiatrist you might actually

try to hone in more on people's

personalities but you know separate

business and pleasure so maybe there was

a lack of ability for her to see that

it wouldn't surprise me next up as good

as it gets

i think what this character is certainly

trying to depict is something called

obsessive-compulsive disorder or ocd

now obsessive-compulsive disorder means

that an individual has obsessions or

intrusive thoughts that don't feel right

to them they feel what's called ego

dystonic it doesn't mesh with how they

actually

think or believe or feel but something

so powerful about them that they obsess

over them

and then what we saw here is what's

called compulsive behavior

the compulsions are the behaviors you do

to get rid of that anxiety over the

obsessions

it's a pretty extreme example jack

nicholson's character has

the obsessions over being dirty and the

obsessions over numbers and the

obsessions over this

i mean that's a pretty extreme example

but that's what hollywood does to try to

depict

these things what's not seen is just

how powerful the obsession itself can be

you kind of glean that from the fact

that he's doing all these things

that that obsession about being dirty is

so upsetting to him but that part's left

out it can be an extremely uncomfortable

feeling not to

participate in the compulsive behavior

his anxiety level might be

sky high and that's why he's doing this

to avoid that feeling

so he's driven to do it to get rid of

that severe severe anxiety there are

ways to treat this there's

cognitive behavioral therapy it's a way

of challenging your thoughts the

cognitive part

even more specifically is something

called exposure response prevention

you expose yourself to the thing that

makes you so anxious

so if it's that he's going to be dirty

you might have him touch something

that's dirty

and then wait not wash his hands

immediately and the idea is with

repeated exposures

he could actually have his anxiety level

go down over time

we don't know why it happens it does

just come in and start

and you really do need to treat it with

exposure and response prevention

and also some medications people can

actually have rituals or routines that

they do that seem very obsessive but

never really get diagnosed

so for instance if you're always worried

about the door being locked

and say you live with somebody who

doesn't always keep it locked and you go

back and check

that serves a functional purpose that

means there's a reason you do that

making sure you're safe but at the same

time for some people there might be an

element

of an obsession about that a fear that

somebody's going to break in a fear that

the door is not locked

so you can have ocd symptoms and not get

diagnosed

hi help

if you want to see me you will not do

this you'll make an appointment

so here we do start to see just how

upset jack nicholson's character is with

these anxieties and these obsessions

these compulsions that he has

if someone has ocd they're not

necessarily going to be a jerk and act

this way

the psychiatrist responds well by

putting limits on things and boundaries

we're not going to do this now

if you want an appointment make an

appointment i think that's also

really important in treatment with

anybody to have good boundaries but you

do start to see

how hard this is for this character

typically this doesn't happen with ocd

there are other mental health issues

where maybe somebody has really bad

boundaries

i think that's what they're hinting at

too that he has other personality traits

that make it hard for him to interact

with people in his world but at the same

time you see how much pain he's in

if you take responsibility to keep

breaking

the room around two years ago

i also regrew my beard but you're not

interested in changes in niche

that's not typical for someone with ocd

that they don't have any interest

in other people i think what they're

getting at here

is that there's something about this

character that's beyond ocd

that could be a personality disorder

there's a difference between

obsessive-compulsive disorder and

obsessive-compulsive

personality disorder ocd the phrase is

you're uncomfortable you're really

uncomfortable with what's going on

ocpd obsessive-compulsive disorder the

phrase is

you make other people uncomfortable

because you want things

in a certain way and you believe it

should be in a certain way not because

of ocd

just because of the way you're wired

here they're mixing a little bit of both

next up girl interrupted am i in trouble

for kissing an orderly or giving my

boyfriend a

job susannah is supposed to have

a diagnosis of borderline personality

disorder what that means is

somebody's interacting with the world

vastly different than the cultural norm

and it causes problems for them

borderline was originally used to

describe someone who's on the border

between neurotic

meaning managing a lot of anxiety and

psychotic having a break from reality

you have some very interesting theories

about your illness

you believe there is a mystical undertow

in life

quick sense of shadows

we see a couple things that suggest she

does have borderline personality

disorder

you have references to reckless behavior

which can occur

and they're hinting that it's the sexual

episode she's had there

is this description of quicksands of

time which might be more philosophical

but the idea of shadows is she

seeing things at times does she feel

like there's something else there

there can be chronic feelings of

emptiness there can be an

unstable sense of oneself that's what's

being identified here by the

psychiatrist

your progress has plateaued does that

disappoint you

i'm ambivalent in fact that's my new

favorite word

this is actually really good therapy the

psychiatrist identifies a plateau

and she feels this patient can handle it

and pushes her a bit to say

you know what what do you think about

your treatment

it means i don't care that's what it

means on the contrary

susanna ambivalence suggests

strong feelings in opposition she says

she's ambivalent and she's

really identifying something i see in a

lot of patients there are two types of

feeling there's both a desire to get

better

and there's this desire to give up a lot

of times those are the opposing feelings

so you really do see ambivalence in

patients and identifying it is very

important for the therapy

the prefix as in ambidextrous

means both the rest of it in latin

means figure the word suggests that you

are torn

the doctor does a great job in pointing

out that it's not about not caring it's

about the

conflict between really wanting to get

better and feeling like this is so hard

i'm never going to get better and i

can't do this

ambivalence isn't a diagnosis but it's

commented on

it certainly can be commented on and it

is fodder for the therapy i mean that's

certainly something to talk about and

she picks up on it well

i signed myself in i should be able to

sign myself out you signed yourself into

our care we decide when you leave

you can sign yourself involuntarily and

you can

argue that it's time to leave the

hospital they can't keep you like this

unless and you're staging itself danger

to others or you're gravely disabled

how much will you indulge in your flaws

what are your flaws are they flaws

if you embrace them will you commit

yourself to hospital

for life you typically don't have this

kind of intensive psychotherapy when

someone

is in the hospital for a short time this

was a different time

the 60s and this psychiatrist does a

really good job she's actually bringing

forth all the questions that someone

with the borderline personality disorder

might be facing but not know how to

articulate they're wondering are they

really a bad person

that unstable sense of self or are they

not are there different ways to see

things

if i go down this path of thinking about

myself how will my life look if i go

down this path how will life be so she

does a really good job articulating for

the patient

what might be inside her what she might

be thinking what she might be feeling

and that can be a really effective

therapeutic method

there are a lot more pressures on kids

and adolescents these days what used to

happen is if you were getting bullied at

school you were having a disagreement

with somebody

you could go home and have a respite at

least for you know 10 hours 12 hours

now you can't it's non-stop there is

social media there are

text messages that it's just non-stop

not only in a negative way because maybe

people are

cyber bullying but also kids today feel

like their social life

revolves around who's commenting on this

and who's done what so

there's this drive to be social that way

to keep up

and that can cause a lot of anxiety

another good thing that girl interrupted

does is it shows

someone who can participate in their

treatment and who's not

quote-unquote crazy a lot of depictions

of mental illness

show people who are so affected by their

illness that they can't

function in society susannah here does

not have psychotic

illnesses she might have some beliefs

about herself that aren't true but that

could come from trauma it could come

from other things

so girl interrupted does a good job of

showing that you can have somebody who

is quite functional

for many people mental illness is a part

of who they are it doesn't define them

next up inside out wouldn't it be great

to be back out on the ice

oh yeah that sounds fantastic

it's a pretty good depiction of

depression in a teenager

people often expect kids and teenagers

to appear sad when they're depressed but

more commonly you see teenagers as

irritable

there is literally the absence of joy in

her mind

and she's not necessarily sad she's

irritable

she doesn't know what to do or what to

say that might be polite because she's

not focused on that

did you guys pick up on that uh-huh

something's wrong should we ask her

let's probe but keep it subtle so she

doesn't notice

so how was the first day of school she's

probing

us the other part of this that's really

good is the depiction of the parents

while humorous

the mom's wondering what do i do what do

i do for

my daughter something's not quite right

they have a sense that something's not

okay

i think it's pretty clear as you see her

more throughout the movie that she's

suffering from some depression

in depression you look for a depressed

mood or

that irritability in an adolescent you

look at loss of appetite

difficulty with sleep are the things

that interested her still

joyful to her so hockey used to be it

doesn't seem to be anymore

how she's concentrating she's not even

focused on the questions it's kind of

huh what

you look at all of these things and

together they describe a picture of

depression

kids feel a lot of different things and

especially in the teenage years

what they're interested in is new to

them they don't know how to

explore that sometimes so all these

feelings do intermix and do

exist in the head of a teenager i'm

somebody who doesn't believe that

teenage years need to be all kinds of

crazy

i think actually they can be enjoyable

years but it's important for parents

to let kids explore life and to

take chances school was great all right

riley is everything okay

sir she just rolled her eyes at us what

is her deal

riley also just moved from minnesota to

san francisco which is like moving to

the moon

so it's totally understandable that she

would feel out of place

even little things are hard for her to

get used to when i see kids one of the

things i ask are there any major life

changes because it can really be

jarring to somebody riley i do not like

this new attitude oh i'll show you

attitude

no no no no stay happy what is your

problem just leave me alone

it is common for kids and teenagers

though to have mood issues to have

depression to have anxiety and in some

areas the bay area for instance

new york is a high pressure so you often

see kids with a lot of anxiety

that's it go to your room now

good job gentlemen that could have been

a disaster

well that was a disaster with

adolescence there are certain approaches

that i

recommend parents take you learn a lot

more from an adolescent when you are

sitting

side by side with them or walking side

by side with them as opposed to direct

eye contact

that's more threatening for a teenager

so if you go to a baseball game

or if you're driving or walking you're

going to get a lot more out of that

teenager than you would if you're

sitting there

talking them eye to eye also probing is

a good word you don't have to probe

the teenager you can make observations

you can make

quick observations that can be really

helpful for fostering conversation

this movie is actually really supposed

to be about mental health they had

consultants

working on the film psychologists and

people who really did explore emotions

they really wanted to get it

to be an accurate depiction of mental

health issues so i really like this

movie and i think they did a good job

depicting that

and also the parents feel so helpless

and they just want their kid to feel

good

and that's a message i see all the time

from parents

next up lars and the real girl midwest

living

or country home

that's what i would say first thought

you'd have about this guy is that he's

psychotic he has some delusional

thinking here

meaning he believes this doll is real

despite evidence to show

she's not real in real life you'd never

see a psychotic

issue like this because this lasts

through the whole movie

and psychosis is generally not that

persistent

when someone has a psychotic disorder

you'd have episodes of that

lars in the movie is being depicted as

somebody who

really has no interest in relationships

he's wearing gloves at times too doesn't

want to touch people

so it's never really explained in the

movie what lars has

but when i look at him i think he has

some form of autism

probably what would have been called

asperger's we don't use the term

asperger's disorder any longer

what used to be those criteria are now

fit under

autistic spectrum disorder he can

communicate with people

but he has trouble with relationships he

doesn't know how to have them

and that can be part of the problem in

terms of how they socialize and

communicate with other people

the fact that he does want to have it

makes me think he falls more in line

with

an autistic spectrum disorder as opposed

to

other psychiatric illnesses that you

might see where someone stays away from

other people and fails to have

relationships with them

one of those things is schizoid

personality disorder where a person

doesn't want to have any contact with

anybody they

see no meaning whatsoever in

relationships he seems to see

something because he wants to have this

relationship with bianca he brings her

to the doctor

and is concerned about her blood

pressure and i really think the best way

to think about lars is what's the poetic

meaning behind

it but if we're looking for a mental

health diagnosis it probably falls more

in line with autistic spectrum disorder

i want you to bring her in every week

for special treatment

can you do that

yeah are you sure that that's necessary

i like to look at the whole emotional

picture of lars that's certainly what

the doctor here does

what lars does have trouble with is

interacting with other people

at times he's seen wearing black gloves

even he doesn't want to touch people

said it hurts if you look at the

psychological

way to interpret that the emotional part

of it he had a mother who died early

to the point that his father wasn't

available to him that's some significant

psychological trauma for a kid not to

have parents who are emotionally

available

so wearing those gloves might signify

it's painful for him to even imagine

being able to touch somebody because he

feels so removed and so isolated from

people

so there's a real emotional meaning

behind this movie and the doctor picks

up on it

i look forward to getting to know you

bianca so

this doctor is also a psychologist in

the movie

in this case she's recognizing that this

doll means

something to lars it's not just a

psychotic disorder which means it's not

just

some delusion there's something here

more emotional for him

and she picks up on that she asks him to

come back and she's starting to

some might say play into the delusion

but i think what she's doing

she's creating what's called a holding

space what that is

in psychology is a place for someone to

make a transition from something

very difficult emotionally to another

place that can be also difficult

emotionally

i think for lars he's transitioning from

not really knowing how to have

relationships with people

to even trying and this doll is kind of

the object that he starts to use to make

that transition

it's a good thing this is in wisconsin

because good luck getting somebody to

buy into this in new york city

but in this town this doctor can foster

the whole town the inquire about bianca

and make it seem like she is real

because she sees it is something

important to lars

i think again this is more of a magical

movie in that sense

there is that emotional component to it

if you are a functioning

person in therapy coming every week

there could be

some therapeutic component to talking

about the doll

he's not hurting anybody with the doll

he's not causing any violence he's not

doing anything that would make it seem

like he's not functioning or needs to go

to hospital

so this is certainly a path to try to

understand him more

next up silver linings playbook

mom i can't find my wedding video mom

wake up what is it where's my wedding

video it's

after three o'clock what are you doing i

looked in here but this is all you're

up here for your sewing and everything

this is a good depiction of a manic

episode

a manic episode means that for about a

week

someone has had increased energy with no

need for a full night's sleep maybe just

a couple hours

they can be really elevated with their

mood and they can be irritable

there's also a grandiosity a sense of

self-importance

possibly even doing things that are

somewhat dangerous or reckless and we're

seeing

him start to spiral into this manic

episode here

we know the character has a bipolar

disorder bipolar disorder

means that there's this change in mood

from baseline to this expansive

elevated state there can be the other

side a depressive episode but it doesn't

have to be for somebody to be diagnosed

with a bipolar disorder some people with

bipolar disorder

have only a manic state every now and

then they don't have the depressive

low you can get something in a manic

episode called increased

goal-directed behavior you can be really

focused on one thing some people it's

like i'm going to write the next great

novel i'm going to change the course of

humanity

i'm going to rebuild this wing of my

home this is a much

smaller task but he does get very

focused on finding this wedding video

it's not unheard of to have a task that

doesn't seem to mean a lot

suddenly take up all of someone's time

when they're in the middle of a manic

episode

hey it's my wedding it's my wedding

video

what's also important to note is that

their family

are woken up in the middle of the night

the family involvement is quite often

seen a family can get really disrupted

because of an untreated episode or

because of these episodes

you have to make some hard choices if

this were going on and he's manic like

this and he were actually

violent with the family and not able to

stop he might have to call the police

and have him

brought in to a mental health hospital

so that he can be at least evaluated for

some time and calm down

he's a cop what are you doing it's a

medication problem yeah

he's fine he's fine now you want to send

him back to baltimore the mother

says it's a medication issue it can be

really demeaning to

a patient to feel like everything's

dismissed and it's just about medication

it's true that that often is said and

it's really painful to the person who

has the bipolar disorder or any mental

health

issue it's common with mental illness

that people do have strong feelings

about their medication

there can be side effects in a bipolar

disorder if it's a manic episode you

would try to put the brakes on with an

anti-psychotic medication and those

medications do have side effects they

can make people very sleepy

there can be weight gain but it's a

bigger danger to have somebody who's

manic

who can do dangerous things you can use

some medications including

antipsychotics

as mood stabilizers for long-term

treatment family members can really

support people with bipolar disorder or

even other mental health issues

in many ways or you can ask them what's

it like to have this they might not want

to talk about it but just

saying something like if you ever want

to talk about this i'm certainly willing

to talk about it with you i want to be

here to help you

so just knowing that somebody's there

for you to talk about can be

super helpful support and love are very

important when it comes to

helping somebody with mental illness it

can't cure it that's the knock on the

movie is that

everything turns out fine and there's

some hint that pat starts taking his

medication again but

it's a hint it's not something that's

shown very clearly so you

do need to have love you do need to have

support but it's not going to clear

everything

next up a beautiful mind saw my name on

the lecture sleeve

who are you talking to tell me who you

see here we see

a depiction of schizophrenia and

schizophrenia is often misunderstood

schizophrenia is a psychotic illness

it's an illness meaning there's a break

from reality

schizophrenia is the diagnosis you give

after seeing someone have a consistent

psychotic

episode or episodes over a certain

amount of time

so at first it would be a psychotic

episode or a psychotic

break but you wait to diagnose

schizophrenia until

time has passed and it's still there a

month long

of hallucinations or delusions or

thought disorder

in schizophrenia visual hallucinations

are not as consistent

as this guy charles his so-called

roommate i think they're trying to

obviously get you to see that

he's seeing something that's not really

there but you don't usually see

something as consistent it's more of a

blur it's more temporary the doctor

really does try to ask john what's going

on what are you seeing and that's a good

technique what i often like to do is say

something like

do you feel like your mind is playing

tricks on you do you feel like you're

seeing things other people aren't seeing

or hearing things other people aren't

hearing

sometimes that can be a little bit more

gentle than what are you seeing but i

think

it is a good idea to figure out what is

this person seeing

there's no one there john there's no one

it's right there

some of these medications do have side

effects that can include drooling

but it shouldn't be a deterrent from

taking medication

because the medications can help with

delusions and hallucinations that really

impair someone's ability to function

one thing that a beautiful mind did was

it kind of correlated having

schizophrenia and having a psychotic

illness with having genius or that he's

a genius because of his schizophrenia

that's not the case you're not going to

become a genius because you have

a psychotic illness like schizophrenia

he might have a high

intellect and also have schizophrenia

but it's not the cause

of it in fact there's what's called a

downward drift

if someone has a psychotic illness and

doesn't get treated

over time it becomes harder and harder

for them to function in society not that

they get smarter and smarter

and they actually have a really hard

time functioning in their daily life

my name is john nash i'm being held

against my will

somebody call the department of defense

you do sometimes see

patients yelling out like that who are

delusional or are paranoid that they're

being held against their will and

sometimes they are being held against

their will because they're believed to

be a danger to themselves or others or

because they actually can't provide

themselves with food clothing and

shelter they're gravely disabled which

is more of what

he is but you do see people sometimes

yell like this

this is an old psych ward it's pretty

big and there are a lot of people around

i think in this shot here there's maybe

six mental health providers i feel like

in some states there might not even be

six mental health providers there's such

a shortage of mental health providers

but a psychiatric ward can look like

this

where there are rooms and those rooms

are private rooms for people this is

dramatized to some degree they usually

don't look like jails so that part's a

little bit off

but i can see that they're trying to

show that the patients are housed here

in their individual rooms and doors on

the left

i think it's really important for media

to get depictions of mental health right

because people get a lot of their

information from these

movies even though it's not necessarily

accurate

it's important to be accurate i was at a

convention once this girl stood up

started crying and said when am i going

to see a depiction of someone with

mental illness who's not going to make

me feel like i'm going to turn into a

serial killer

so that's reason enough to have accurate

depictions so people don't

feel shamed about themselves so people

don't feel ashamed to go into treatment

so people can have conversations and

people can really pursue the help that

they need

thanks so much for watching these clips

with me i enjoyed breaking them down and

i hope you did too

hope to do it again with you in the

future

[Music]