"The emphasis on popular films is partly because we only wanted to recommend films people could get at their local Blockbuster store," responds John when teased for giving the trifling divorce movie "Bye Bye Love" a full write-up but supplying only a few sentences of commentary about the more complex Ingmar Bergman film "Scenes From a Marriage." "But there are other reasons. HMOs today only allow patients from six to 10 visits -- 80 percent of my clients are covered by HMOs -- so you can't spend too much time trying to set up a film or explain it. You need to deal in headlines. You get into a discussion of character, then move on to something relevant in the client's life. Film is just a catalyst, to get to more substantive issues. And frankly, most of our clients wouldn't sit through 'Scenes From a Marriage.'"

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"There is a danger you run with more powerful films," he adds. "You don't always know where they're going to lead. 'Scenes From a Marriage,' if assigned inappropriately, could end up pushing a couple toward an unnecessary divorce. We can't possibly know all the hot-button associations a particular client might make even with a film we've used before. So if we err with our suggestions, it's on the side of caution, especially because with our book we're making them for people we've never met." Things can even go wrong with clients seen face to face, John acknowledges. "I had a woman whose son was going to prison. I had her watch 'The Shawshank Redemption' because I wanted her to see that although prison is a bleak situation there's always hope and that the human spirit is resilient. The truth is it backfired. All she came away with was 'Oh my God, my son's going to be raped or beaten to death.'"

The points the Hesleys make about sticking to the mainstream are well taken, and they undoubtedly know what clicks with their clients. If there are two general criticisms that can be leveled about video guides to date, though, it's the narrow range of selections and the willingness of authors to include works they admit are of little artistic merit merely because the films address a particular topic. The inclusion of the cloying "Dying Young" in one guide is all the more vexing because though it's about death, nobody dies, reportedly because test audiences objected to that.

One can't help but wonder if in some cases films that upended a patient's expectations -- thematically and even aesthetically --- might be more efficacious. The therapeutic process itself requires patients to challenge their paradigms, something many of the films recommended, though by no means all, do gently if at all. There's a danger in making things too tough on a client, but it's likely possible to make things too simple. Indeed, some artists believe it's only when confronted by new forms and formats that new ways of seeing or seeing oneself come about. This may be overstating the case, but much of popular cinema follows a trajectory so familiar that psychically it mightn't be all that much of a call to action. A film like Fellini's "8 1/2" wouldn't be for everyone, but might for some people suffering a crisis of confidence open more doors than titles like "Rocky" or "Field of Dreams." No book I came across even mentions "8 1/2," which comes to some of the same conclusions as the other two films but via a more introspective and provocative route.

As video work becomes more widespread -- the Hesleys recently made a presentation to 150 or so clinicians, most of whom already use video in their practices -- therapists might do well to team up with film scholars or cinéastes to fashion a broader palette. In the meantime, New York University's medical school has made a good start with a brief yet varied film/video database that lists everything from Hollywood titles like "Awakenings" and "The Doctor" to art-house fare like "Antonia's Line" and "Vanya on 42nd Street." The university's faculty uses the videos to acquaint future doctors with situations they or their patients might encounter, but many of the videos would be equally helpful for therapists or people seeking help on their own.

A few months ago I recommended "Marvin's Room," one of the database's more mainstream works, to a close friend who's his mother's primary caregiver. Completely paralyzed for the past five years, she's had senile dementia for more than a decade, and the enormity of attending to her day after day had finally gotten to him. A doctor he'd seen only twice diagnosed him as suffering from depression and prescribed Prozac, but my friend is wary of taking drugs, and reflecting on his circumstances we both wondered if he was depressed or simply exhausted. My friend isn't the type to consider therapy but really was distressed, so I hoped that "Marvin's Room," in which Diane Keaton sacrifices two decades of the prime of her life to care for her ailing father, might provide a new perspective.

The database review describes Keaton's character as "a model of loving care." The film's key achievement, though -- in artistic terms in addition to any therapeutic benefits -- is the way it portrays the Zenlike beauty of Keaton's selfless behavior. Her sacrifice is indeed a great one, but it's clear the experience enriches her as well. As with Foster Cline's client who watched "The Miracle Worker," the results were discernible if not spectacular and required some post-viewing discussion. My friend, who lives in a different city than I, mulled over the film's message for a few weeks, occasionally holding the bottle of Prozac in his hand, he told me later, trying to decide whether he'd really changed his outlook or needed the pills. He ended up not taking the pills, and that he'd undergone a minor transformation was transparent when I saw him next, not only in his improved attitude but also in the serenity with which he attended to his mother. Though "Marvin's Room" by no means cured him of depression, by his account it was indeed a catalyst: "I know nothing has changed about my situation and it still gets me down, but I do have a different relationship to it, and for that I give part of the credit to watching 'Marvin's Room.'"

The movies have been taking it on the chin these days for supposedly inciting violence and otherwise contaminating society's values. Lawsuits against "Natural Born Killers" and "The Basketball Diaries" accuse their creators of providing road maps to killers. The issues are more complex than the suits suggest, but that a court is hearing the cases at all is a recognition that there is some interplay between film messages and the conscious and unconscious mind. If movies are capable of doing great harm, though, it stands to reason they possess the potential to heal as well.
salon.com | May 27, 1999

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