Reel Therapy

Thanks for the heads up. I'd really rather not see another movie that enforces an already urealistic public image/idea of clinical psychology. It would have ruined my night. A shame though. Done right the plot seemed to have potential.

But what if Teddy was never delusional until the psychiatrists began using him as a guinea pig for the very experiments Teddy was trying to uncover? This is not so far-fetched. In the 50s, the CIA spent 10 million dollars studying mind control techniques learned from the communists. If Teddy really was just a victim of a secret brainwashing program that he was trying to expose, then the indictment on psychiatry is probably even worse than if he was just a mentally ill patient at the island.
I think Scorsese probably made the ending ambiguous on purpose so that viewers would spend alot of time trying to decide for themselves if Teddy was delusional from the start or if Teddy was singled out for mind control because of his plans to expose the island.
In the end of the film, supposedly Teddy has finally faced the truth, but starts to become delusional again so his partner (or psychiatrist depending on your interpretation) nods to the doctor. Does this mean that Teddy is relapsing into delusions or that the brainwashing has not worked and he must be lobotomized to preserve the secrets of the island?
Makes you think doesn't it? But in relation to the article, I would hope that people don't judge psychology as a whole because of it's portrayal in this movie. But if Teddy was just delusional, then it paints a nicer picture of psychology than if Teddy was a victim of brainwashing.

How could he not recognize the doctors and patients having spent 2 years there

the " nod " is what i just do not get. it suppose it is up the the person who watched the film. since it is a " psycho " film, i would think that he is " not there " but, why the needle? maybe, b/c he is not violent anymore. but rather, they knew the whole time that he would not " come around " , rather, only get better that he was. they did think they could make a break threw. But, the entire time knew that it was a good possibility that it would not happen. it was only till the end of the " session " that they would totally know what coarse to take. He knew that he was crazy at the end and took the non violent way out...

I disagree with your defense of psychiatry and psychology. Psychiatry and psychology, although they have made massive improvements regarding doing less harm, are still in the dark ages. They will be until they deal with consciousness, determinism vs free will and other more salient social/cultural issues, rather than naming symptom groupings that are made to sound like they come from an understanding of the etiology of disease. Most mental health patients do not have psychosis or delusions or the more debilitating forms of mental illness (some of which have been identified through hard science), but more the garden variety stuff that cause unhappiness and poor functioning (whose etiology is really a hodgepodge of guesswork that sounds like bullshit). I work in the mental health industry as a clinician and can assure that if someone came into the hospitals I have worked in who were actors, they could not only fool us despite varying their levels of functioning, but they could get the scripts they wanted when they went home. I liked what the hallucinated psychiatrist said about diagnosis. It is something every clinician should keep in mind as they treat their patients.

Jeremy, For me the line between fact and fiction still remains blurry, both in the film Shutter Island, and in the real-life realm of psychiatry. I think in your attempt to separate fact from fiction, you were too quick to conclude that the character "Teddy" in Shutter Island was delusional. Scorcese did a good job of keeping that line blurred. And in the final moments of the film, I think we are meant to still be questioning what is the true reality. It is not surprising, given your choice of profession, that you would come to your conclusion with such certainty.

In reality, Massachusetts did have an institution that conducted experiments on the mentally ill and mentally retarded in the 1920s as part of the Eugenics movement, a precursor to Nazi Germany - that facility is the Fernald in Waltham. That isn't so far removed from what the character Teddy believed to be going on at Shutter Island. As an audience, are we really expected to believe that a psychiatric institution, with well-intentioned doctors, would play such an elaborate and cruel role-play with a patient? Did Teddy really conjure up as part of his hallucinations the doctor version of Rachel Soldano in the cave, or was that part of the role-play setup by the psychiatrists to help cure Teddy/Andrew, or was that indeed a woman trying to escape the island? Was it all a figment of his imagination? Could anyone's senses, eyes and ears, really betray them to that extent, even in the depths of the worst bouts of mental illnes?

I have seen the inside of locked psychiatric units, but from the opposite side of the coin as you -- as a patient. You paint the picture of modern day psychiatry as vastly improved and removed from some of its darker origins, but the profession is still dim from my viewpoint. Doctors still judge and condescend, and have way too much power over the lives of their patients. Involuntary hospitalizations, and subsequent coerced medications are too easy for doctors to force on their patients. And, perhaps patients delusions, whatever form they may take, are real after all.

In my opinion the film was brilliant.

I greatly appreciate your comments, particularly about your experience as a "patient" (I prefer client, because "patient" is already initiating a power imbalance). I have worked in many inpatient settings and although I have not experienced this as a client, I have attained a thorough understanding of the prototypical inpatient experience - and it is not a good one. I agree that the inpatient experience is not as it should be. Psychiatrists (not psychologists) rule supreme, their training in psychology is not as thorough as it should be, their ability to fine-tune medications is hampered by poor background information and patients who are in crises and can only afford a short-term stay (average length of stay is 1-2 weeks). It is a culture of stabilization, of lets increase your meds because life was probably overwhelming before you came in and we don't really know what else to do....now obviously no patient leaves the hospital without a clear and structured outpatient plan, as put together by hard-working, underpaid social workers, but the fact remains that intensive treatment and progress are elements of the experience that clients rightly expect but rarely rerceive. I would say that "the darker" image of this world is not fair. Psychiatrists are all wanting to do what is best for patients, its just that sometimes they have too many patients for too little a period of time to be ideally comprehensive in their response, so "band aids" are administered. And although, on rare occassions, people are forced by a court order to take medications this is usually because they are endangering the lives of everyone around them, and involuntary admissions do happen but rarely last longer than 3 days (i think this is law).

As to the "ending" of the film. I am surprised and curious why so many seem to think that Teddy could have been the victim of brainwashing. Usually the last few scenes of a hitchcockian movie such as this contain the "truth." We are sent clear signals that the somewhat unreliable Teddy is no longer the protagonist, the director is, and his perspective is the "truth." Not only does the "intervention scene" in the lighthouse seem well-intentioned, but Teddy seems to have full opportunity to leave the facility if, in fact, his paranoid thinking ever lifts.

oK Just had one comment about the last scene. I dont think he reverted back to his insanity he just wanted to die because he rather die a good man than live a terrible life. that is why the guy stood up in the end because he realized that Andrew said something that was not in his usual conversations. just had to put that out there thanks!

I don't see the twist, rather how brain washing works - if you believe Leo was patient of the clinic since ever, you might be a at some point patient (if necessary) of this clinic too?

The regression at the end is fake. He is haunted by the horrors of war & of the tragic end to those he loves. He fakes regressing so that the procedure will be performed & he will not remember. Dr Cawley said he was repeatedly violent towards staff & patients then at the end he walks off calmly. He had decided that becoming a "ghost" would be better.

The question is whether his delusional state was of his own minds origin. Two possibilities 1)He had become delusional or dissociative because of the tragedy & was committed. After progress he was released. Unable to live with the memories he regresses & is worse off than at the first hospitalization. So drastic measures are taken to help him. Since he is brought back to sanity he pretends so they will give him the lobotomy Dr. Cawley said he would get if this role play was not effective. 2)When he was released he was unable to live with the memories & fakes regressing so that he will be given medications & treatment that will keep him delusional, make him forget or kill him. He's smart he probably became aware of what goes on there while he was in recovering & played the insanity card.

Jeremy, can you please provide me your email address? I am writing a paper on Shutter Island psychologically and I'd like to ask you a few questions.

You could make an equally good case for Dissociative Identity Disorder or Dissociative Fugue. Typically, people with Delusional Disorder don’t change identities (new name, new story). What this film does is the usual thing films of this type do; it mixes multiple personalities with symptoms of psychosis (delusions and hallucinations) and has the whole thing stemming from a horrible trauma (or in this case traumas)taking place in adulthood.

Jeremy,

You dismissed PTSD as a possible diagnosis fairly quickly.

Doesn't the DSM-IV list delusions as possible symptoms of PTSD? And couldn't this explain the coming and going of his coping mechanisms (as they're also referred to in the movie) and the lack of effect of psychotropic drugs? It would also describe how his delusions were a parallel of what actually happened.

Also, having some limited experience with working at state mental institutions, I would say this facility was more kind than most in that time (aside from the potential ghost experiments, hopefully). And, there are still some practices that are similar, such as treatment with drugs being the baseline for violent patients.

Just a couple of thoughts ... I would be curious of your response! :)

The last scene of Shutter Island might've been a bit confusing but in fact if you analyze Teddy's last words you will know what I mean. He says " I rather die as a hero than live as a monster." He fakes a delusional relapse because he no longer can live with the agony and pain of realizing he is the true killer, therefore he decides to become lobotomized so he doesn't live as a monster.

The last scene of Shutter Island might've been a bit confusing but in fact if you analyze Teddy's last words you will know what I mean. He says " I rather die as a hero than live as a monster." He fakes a delusional relapse because he no longer can live with the agony and pain of realizing he is the true killer, therefore he decides to become lobotomized so he doesn't live as a monster.

Interesting. If Teddy, in fact, says " I rather die as a hero than live as a monster," and he seems cogent while saying it, then it does seem logical to assume he was essentially committing suicide in the end. Yet another assumption in your response, and perhaps a safe one, is to say that Teddy wanted to commit suicide because he blamed himself for his wife's murdering-suicidal rampage. Yes, I think "rampage" adequately characterizes that quiet, horrific afternoon. Now, for Teddy to blame himself for her actions - no matter how "checked out" he was at home (and can you blame him for being checked out, I'm sure she was no prize to live with day-to-day)- is pathological. It's a distorted belief. He does not control her actions, he did all he could once he got home, etc. He is not responsible and should not be carrying the guilt of responsibility. So, perhaps the well-meaning psychiatrists took him far enough to see the delusional world he set up for himself, but not quite far enough in adequately processing the death of his family. It would be truly ironic if, after all that effort at helping Teddy to break his delusion (the elaborately staged weekend), he slips through their fingers with a suicide-lobotomy because he pathologically blamed himself...

Just wanted to chime in here. I am a nurse (do not work in mental health) taking a mental health class for continuing education. We have an assignment to write a paper on a media depiction of mental illness. I chose to use a Hollywood movie (for quick entertaiment value) and Shutter Island came highly recommended. I went into it completely blind, knowing nothing about it at all other than it was an acceptable choice by the instructor and that I in fact had to get this assignment done. My two cents of a review: While we are working very hard to overcome the stigmas of the past in psychology, an accurate portrayal of that time period is necessary. I was disappointed to read reviews that thought all the movie did was set all our progess in "stereotyping" psychology back a few centuries and exploiting them for cinematic value. I equate it to this, I personally get sick to my stomach when I see movies with slavery or the holocaust in them....but that feeling is ultimately necessary in understanding the events that took place in that time and vitally important to remind ourselves that they are our past, like it or not. While I found the images of "patients" shackled and portrayed as violent and murderous disturbing, I think they were necessary to show the era the movie takes place in as well as a sad but accurate depiciction of mental illness of the time.
My verict is still out as to whether I feel he was actually delusional or in fact brain washed as an experiement to see how they could conform his thinking as a trained professional with a traumatic past. I think the twist of he was possibly conforming to them for the suicidal-lobotomy is interesting too! Overall I found the movie entertaining and it kept my interest all the way through. From a student aspect, I also took away from it an important aspect of understanding how real the delusions are to the patient. Whether I saw what he was seeing or not (depending on if they were in fact delusions or just well planned scenes forced on him) they were very real to him and orchestrated is every move.

Jeremy, thanks for this article. It is great and the discussion posts that followed were very enjoyable as well.

I'm not in the psychology field, but after watching the film, I wanted to see what those in that field thought of this movie. I found it quite interesting, and I appreciate it.

Now, I hold a degree in Media Communications. That may seem ambiguous but suffice it to say I spent my four years of college learning how to pick movies apart so that I would know whether my own work was any good or not. That said, I have to disagree with a couple of things that were said in this article.

First off, I don't believe this film is in any way condemning the modern field of Psychology. For one thing, the doctor very clearly believes that the surgical approach to mental disorders is flat-out wrong. He's willing to hand the entire island over to a patient in order to help him find healing rather than perform a surgery. I can only imagine the kind of bureaucratic red tape that must have taken.

Lobotomies and other surgical methods are portrayed as something that's out-dated and wrong even in the film's time period - which I'm guessing is sometime in the mid 50's. Instead the doctor seems to prefer either drug therapy (pardon me, I know there is a more proper term for this, but I can't remember it at the moment. I would point out that they did in fact use the correct term in the movie though.) or talk/counseling. This entire drama of allowing Ted/Andrew to live out his delusion in an attempt break him out of it is obviously an attempt to heal him without even using drugs. This is something that I understand is being debated even today in the field of psychology - are drugs or talk therapy the more appropriate way to help people and which is best when.

So it seems to me that the portrayal of psychology and psychiatry in this film is clearly a condemnation of the ways which were practiced in the past, but a positive portrayal of a doctor who is attempting to use new methods to heal a patient.

That leads me to my other point, one that has been made in the comments previously. I don't believe Andrew regresses at the end of the movie. He says something at the end of the film about how when he looks at "this place" (Shutter Island) he wonders whether its better to live as a monster or die as a good man. The implication here seems to be that he's decided to "die as a good man". He doesn't want to or cannot live with the fact of the things he and/or his wife have done and he's going to trick the hospital into lobotomizing him so he won't have to live with it. The look on Chuck/Dr. Sheehan's face shows that he's realized this, or at least believes it's possible.

Finally, this article talks about how it's not possible/likely that a patient would play through a delusion, realize the truth and then regress over and over again. That would seem likely, and I'll bow to the professionals on this. I would point out however that the doctor in the movie clearly states that they had one breakthrough nine months ago. He's not saying that Ted/Andrew breaks through every time he finishes playing through his delusion. This is in fact apparently only the second time he's broken through in his entire 2 year stay. So, is that a little more possible in the realm of psychology?

Um.. first of all, i'm not a Psychologist,a psychiatrist or a graduate. But I'm a patient. Maybe you're a graduate, a clinical psychologist or anything. But it doesn't matter. I guarantee you no one in this world know anything about mind. The key to everything. You know as a patient with a little study of psychology, I fooled everyone, even doctors, psychologists, that I'm schizophrenic. I even let them think that I have split personalities. And even now they are treating me. But I passed my final exams even with my "maniac" situation. For instance take the story God. Why people believe him even when they didn't ever see him. That's the true delusion. And psychology still in its cradle, or dark age. There are many to be discovered yet. You believe a single chemical reaction in brain would cure mind. But the fact is mind is what controls the brain. Mind is not Brain. Even if you balanced the chemical activity in brain, soon the mind takes over. The only thing you can do is to convince patient during the balancing period. Even if you do that, still the patient can deny you. That's mind. It's a power beyond all imagining. And you are standing on your tails. You electrify us, tie us to beds and cells us when we are out of control. That's why people still call asylums "Dark". Mind has no limits. Anything you imagine is your reality. When one comes to the sublime state of imagination, he lives in his own world. That's what you call delusion. Even if you convinced him those are imaginary, he can rewind back to his "normal". To his "world", which he likes. Because he has the control over his mind, he can loop his mind whenever you told him the truth. So do not trust that "much" about psychology. They are still poking in darkness. Ask any Prof. They'll tell you what they are doing.

This is a well-made movie. Plot is so good that it conceal two subliminal messages it gives.
This movie is made to show psychiatry is good. I suspect big pharmaceutical companies are behind it. Recently, there have been some reactions to the psychiatry, documentaries such as Industry of Death.In such documentaries, psychiatrist are criticized for prescribing pills that have so many side effects so easily. But in Shutter island psychiatrists go to so extreme to help a patient, which is far from the reality. In reality, they listen to you for 15 minutes and proscribe an expensive pill that has severe side effects. If that doesn't work, another one or combination. they don't let you get off them easily either.
Second one is not so subliminal. Hollywood's perpetual obsession with Holocaust. they manage to put a line or two in a movies that has nothing to do with Holocaust.