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Book Review   |    
Psychiatry and the Cinema, second edition
Michael Fleming, Ed.D.
Psychiatric Services 2000; doi: 10.1176/appi.ps.51.4.537
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by Glen O. Gabbard, M.D., and Krin Gabbard, Ph.D.; Washington, D.C., American Psychiatric Press, 1999, 408 pages, $26 hardcover, $19 softcover

The strength of the second edition of Psychiatry and the Cinema lies in its breadth of inquiry and encyclopedic knowledge of film. Its weakness lies in a methodology that is at best myopic. The authors state that "requests for a new edition of Psychiatry and the Cinema have come from colleagues in clinical practice as well as in colleges and universities." For these readers, the book, like the 1987 edition, will continue to offer bountiful insights into cinematic depictions of treaters and treated.

The discussion of the film portrayal of female psychotherapists, expanded in this edition to a separate chapter, presents some thought-provoking hypotheses about gender comparisons of sexual involvement between therapist and patient. Specific attention is given to the countertransferential issues in films in which a female therapist falls for a male patient. The same chapter also explores films in which male therapists effectively treat female patients and why it is that so few films—only two since 1900, the authors assert—portray female therapists successfully treating male patients. Linked to this chapter is a new one entitled "'Phallic' Women in the Contemporary Cinema."

Two other chapters have been significantly expanded. The first, "Clinical Implications," explores the influence of cinematic depictions of psychiatrists, their treatment, and their patients on their real-life counterparts. Is the portrayal of psychiatrists "accurate," do cinematic images of psychiatrists seriously influence patients' attitude toward current or future therapists, and do cinematic portrayals of psychiatrists affect medical students' career decisions? These provocative questions unfortunately receive too brief an investigation, given their centrality to the book, and the discussion is too much dominated by anecdotal vignettes. The authors have also notably expanded the chapter called "Methodology and Psychoanalytic Film Criticism" to incorporate some of the new trends in psychoanalytically oriented film theory.

The first half of the book is devoted to a historical inquiry of approximately 90 years of changing images of psychiatry in American film, of how the movies have looked at psychiatrists. The authors have no doubt seen every major film, and every minor film—such as Movie Star, American Style, or LSD, I Hate You (1966)—that even for a moment presented a "psychiatrist"; without too much concern or justification, they condense a great number of helping professions into this nomen. In the second part of the book, the authors look at movies with "psychiatrically informed eyes." They present their discussions of films in a very readable format and helpfully provide a lengthy filmography and chronology at the end of the book.

The major limitations of the work lie in the authors' conviction that the study of the cinema is best thought of in terms of psychoanalysis. "The best complement to a study of the cinema's methodology of psychiatry is a psychoanalytic inquiry into how movies actively play on the mind," they write. While the psychoanalytic vision may be a central one to Hollywood's depiction, there are others that the authors simply refuse to acknowledge (1).

Their lengthy investigation of Now, Voyager (1942) is a case in point. They admit that Now, Voyager "contains nothing reminiscent of psychoanalytic theory and technique." They go on to say that "the exact nature of Dr. Jaquith's treatment is uncertain since we never see him working with the patient." But the treatment provided by Dr. Jaquith is, in fact, shown and is quite reminiscent of the work of the American psychiatrist Adolf Meyer, who was enjoying popularity during the time period of the film. Meyer along with many other clinicians, such as Harry Stack Sullivan, believed that psychoanalysis was but one of many viable theories. The authors are so psychoanalytically imbued that they use Good Will Hunting as an exegetical springboard for Sandor Ferenczi.

Despite this myopia, Psychiatry and the Cinema remains an outstanding investigation, and an essential reference for those interested in the interaction of psychiatry and film.

Dr. Fleming is adjunct associate professor of psychology and psychiatry at Boston University, where he teaches a course on psychology and film, and is dual diagnosis program coordinator at the Quincy (Mass.) Mental Health Center.

Fleming M, Manvell R: Images of Madness: The Depiction of Insanity in the Feature Film. Cranbury, NJ, Associated University Presses, 1985


Fleming M, Manvell R: Images of Madness: The Depiction of Insanity in the Feature Film. Cranbury, NJ, Associated University Presses, 1985

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