Reel Therapy

Using fiction as a clinical tool. Film and movies can be a form of therapy.

By John W. Hesley, published on January 01, 2000 - last reviewed on January 10, 2007

Shirley Hanson, of the School of Nursing at Oregon Health Sciences University, also uses film to encourage clients to muster up the courage for self-improvement. Hanson tells of counseling a terminally ill man who had been estranged from his family for many years. She asked him to view the film My Life, about a young man who is dying and making a videotape for his soon-to-be firstborn child. "The movie warmed him up and inspired him," Hanson says. "Our conversation about the film resulted in my patient persuading his aging parents to come to therapy with him so he could apologize for his arrogance and pride during his younger years. The reconciliation that followed was a beautiful sight to behold."

Many doctors have found that films can also help families rebuild after tragedy.

New Orleans-based marriage and family therapist John Dawson, treats a multiethnic population that is highly dependent on family for emotional support. Recently, five grieving adult children and their parents came to him for counseling following the death of the eldest child. But the session soon focused on sibling rivalry and parent and child relationships. Dawson recommended they watch Soul Food because of its parallel story line. Most of the family watched it, comparing themselves and each other to the characters, reflecting and learning about themselves.

One of my own patients, a verbally abusive father, was able to learn about himself and change his behavior after watching a film and discussing it with his wife in a therapy session. Since direct confrontation seemed ill-advised, I had asked him to watch the film The Great Santini, about an alcoholic Marine who was unaware of how his behavior troubled his family. In the following therapy session the man asked his wife, "Am I really as bad as that guy?" "Not quite as bad," she answered. "But close."

He stared out the window for a while, and then spoke quietly: "That was my old man in that movie. I said I'd never be like him; I don't want to be." Prior to the viewing he had always referred to his father as "stern but fair." Afterward he spoke more candidly not only about his father, but also about himself. Following this experience, he finally began to change for the better.

Another patient, John Bard, had lost his father when he was a baby. He told psychologist Mary Gregerson, Ph.D., of Alexandria, Virginia, that he was worried about becoming a new father himself because an example was never set for him. "We are using films to explore the roles and relationships between father and child. We are working at developing what I call `pre-verbal' guidance for him."

The use of films in therapy is likely to become even more commonplace as many next-generation therapists are being trained with the aid of films. Kit Johnson, at Florida's Barry University, uses movies to illustrate hard-to-grasp concepts to her students. She relies on Angel Baby—a film in which a schizophrenic young couple are expecting a baby—to underscore how discontinuing medication is often detrimental to a client's mental health. She believes that a movie's emotional power makes clinical material come alive in the classroom. She also encourages students to incorporate films into their own practice to motivate change in clients.

But film therapy does have limitations. Therapists should treat films as icebreakers; too much time discussing a movie leaves less time for the issues that brought a client into therapy. When choosing a film, therapists should be sensitive to the client's intensity threshold and his or her compatibility with particular characters.

Most important, not all movies feature healthy role models or realistic scenarios. A poetic film such as American Beauty shows a man liberate himself from a mundane, repressive life by dropping out of society—to the point of neglecting his teen-age daughter and ogling her friend—and then serendipitously happening upon enlightenment before his sudden demise. So don't take movies too literally. Take them carefully and thoughtfully. And call your therapist in the morning.