Cinema therapy

How some shrinks are using movies to help their clients cope with life and just feel better.


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Daniel Mangin
May 27, 1999 8:00PM (UTC)

During the early days of home video, psychoanalyst Foster Cline treated a woman whose wild and uncommunicative child resisted the slightest display of maternal affection. It occurred to the doctor that his patient might benefit from seeing how Anne Sullivan dealt with the similarly rebellious Helen Keller, so he asked her to pop "The Miracle Worker" into the VCR.

Arthur Penns 1962 film about Keller and her teacher didn't work a miracle but, according to Cline, "the client learned from it how to set limits with a difficult child and saw that some children need to be held whether they like it or not." He found the experiment so successful he began to assign "video homework" to patients on a regular basis. Today many other therapists and mental-health professionals do the same, and some suggest that videos can help you even if you're not in therapy.

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Will "Field of Dreams" see you through a midlife crisis? Can "Groundhog Day" help you visualize your way out of a rut? What with America's penchant for quick fixes, one can't help but look askance at a recipe for personal evolution incorporating a pastime as popular as movie watching. But what goes by the name "video work" and "cinema therapy" is not without precedent. Aristotle, after all, theorized that tragic plays have the capacity to purify the spirit and aid us in coping with those aspects of life that cannot be reconciled by rational thought. Applying the concept in the 20th century, psychoanalytic critics have postulated that films, because of their dreamlike quality, transmit ideas through emotion rather than intellect, in some cases neutralizing the instinct to repress. One illustration of this: Some people will cry buckets over a sentimental movie but rarely in real life, even under duress.

Cline, now semi-retired, describes video watching as an "immersive experience involving sound, sight and a positive outcome." He says "Films show how problem solving can be accomplished, and since many movies are fairly true to life, the situations often closely mirror a client's. I think 'Stepmom' is the best film I've ever seen about how a parent can handle his or her death for a child. A therapist could also use 'Stepmom' to illustrate the anger that takes place between birth and stepparents and how this can undermine any children involved. If I had people fussing and feuding over a kid I'd demand they see 'Stepmom' and ask each of them which character is most like you."

Another recent film about parent-child relationships Cline gives two thumbs up is "Life Is Beautiful": "The father makes being in a concentration camp a game, and the child survives the situation quite well. It's a psychiatric truth that kids handle situations about as well as the adults around them do."

Cline isn't aware of any studies tracking the effects of video watching in a therapeutic setting but says he doesn't need research to know this works. "With some things you just have to say they're obvious and you don't need hard proof. You just know if you get a client to watch a particular movie and the person 'gets' what's going on, you'll be able to make some progress."

As with any treatment that shows promise, some proponents of video healing make extravagant claims. Gary Solomon, a psychotherapist and the author of "The Motion Picture Prescription," a video guide top-heavy with simplistic works like "Beaches" and "Rocky," goes so far as to propose that "prison and jail administrators can show movies to the inmates that will change the way they think, feel and do things for the rest of their lives." Cathie Glenn Sturdevant, author of "The Laugh & Cry Movie Guide," would probably whip up the cons a batch of Jiffy Pop: "The touch, smell, and taste of popcorn on our fingers and in our mouths in conjunction with the sights and sounds of a film can open the doorway to a whole new realm of energizing possibilities," she writes in her book.

That the "The Mummy" or "Phantom Menace" -- with or without popcorn -- might alter a person's mental-health status seems beyond dubious, but before dismissing the healing potential of commercial cinema entirely, consider the case of Norman Cousins. The late author and editor wrote famously in his book "Anatomy of an Illness" about watching humorous films as part of his recovery from what had been diagnosed as terminal cancer. He found that "ten minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep." Sturdevant concludes in "Laugh & Cry" that Cousins "cured himself of a life-threatening illness by laughing at Marx Brothers movies," but this simplifies the matter: They were one component of a regimen that included vitamin C, dietary changes and other responses. Cousins' experience does hint, however, that beyond elevating mood, watching movies can, in tandem with psychotherapy or other treatments, be worthwhile.

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The key component in video work is dialogue, says John Hesley, a psychotherapist who co-wrote "Rent Two Films and Lets Talk in the Morning" with his wife, Jan, a social worker. The Hesleys both express skepticism that viewing even the most emotion- or thought-provoking film will in itself bring about significant change. "Think about it," says John. "Films have been out there a long time. If any unmediated healing was going to happen it would have already. Someone has to help draw out the emotions. If friends or family members talk about a film together, something positive could happen, connections being made to how a situation depicted in a film relates to something in real life. But you cant just jot down quick and easy ways to make a particular film 'work' and have that accomplish much." Written for therapists, the Hesleys' tome is the best of several with lists of films dealing with issues such as aging, death and parent-child relationships. Like the two guides mentioned above, it favors conventional works.

"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.'"

"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.

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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.

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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.


Daniel Mangin

Daniel Mangin is a writer and editor living in New York.

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