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Psy-feld: Why There’s Plenty Wrong with That

When using media to understand mental illness doesn’t work

A story blazing through the Associated Press and Twitter this week tells of psychiatrist Anthony Tobia’s didactic in which medical students at Rutgers University’s Robert Wood Johnson Medical School are taught about psychiatric disorders by watching and analyzing reruns of the popular Seinfeld television show. Tobia created a database of teaching points from the show’s 180 episodes. Third-and fourth-year medical students are assigned to watch two episodes a week and then discuss the psychopathology demonstrated in each. Students learn of Jerry’s obsessive-compulsive traits, Kramer’s schizoid traits, Elaine’s inability to forge meaningful relationships and George’s egocentricity. Newman, Tobia contends, is “very sick.”

Are you kidding me?

To be sure, medical students can learn much about mental illness from television shows and films. Homeland’s Carrie Mathison teaches the pain of bipolar disorder. Foxcatcher’s John Du Pont shows the destructiveness of paranoid schizophrenia. Parenthood’s Max instructs about the challenges of autism. By providing honest and compassionate views of serious brain disorders, these shows teach people about mental illnesses and help break the stigma of mental illness.

Not so with Seinfeld. This award winning comedy was meant to make us laugh. And it did. We chuckled at the mix of stand-up comedy routines and idiosyncratic, conversational scenes focusing on insecurities such as “shrinkage” and wearing a puffy shirt. We giggled as Jerry and Elaine complained about bad dates and we snickered as George tried to fit in at work. The show was filled with humor, superficial conflict, and peculiar personalities.

Many episodes revolved around quirky characters whose involvement with one another often had predictably disastrous results. The eccentricities depicted in Seinfeld are stereotypical exaggerations meant to make us laugh at ourselves. While some of the exaggerated personality characteristics portrayed in the show may resemble those associated with psychiatric disorders, they are a far cry from these illnesses.

Seinfeld teaches us as much about mental illness as The Three Stooges does about intellectual deficiencies.

Certainly using the Seinfeld characters to teach about disorders such as obsessive-compulsive disorder and schizoid personality is engaging for the medical students. Not surprisingly, in published work, Dr. Tobia and his colleagues demonstrated that students found Psy-feld enjoyable and preferred it to more traditional forms of teaching such as large group lectures. 1 But medical schools should have loftier goals than entertaining its students – how about sensitizing our future doctors to the real pain people with mental illness experience?

Watching Seinfeld with an eye toward learning about psychological disorders minimizes the serious nature of these disorders and perpetuates stigma about mental illnesses. It encourages people to laugh at what can be highly debilitating conditions.

Let’s watch Seinfeld for the “show about nothing” that its creators wanted it to be. Let’s giggle about “double-dipping” and “re-gifting.”

But let’s find better ways to teach medical students about psychiatric disorders.

1. Tobia, A., Bisen, V., Zimmerman, A., Trenton, A., Dix, E., & Dobkin, R. (2014). Psy-feld: An innovative didactic using the TV show Seinfeld to teach delusional disorder subtypes. Academic Psychiatry. doi: 10.1007/s40596-014-0239-z

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