Movies and Psychotherapy = Cinematherapy - Part 1

A man in his 30s reads a book and something about how a young college student panics when he learns that a girl he slept with, just once, at a frat party, very quickly, in the corner of the party room, is pregnant. The episode in the book strikes a deep, painful chord about something he hadn't thought about in years. Like the guy in the novel, he got a girl pregnant. He got scared, really scared, yelled at her to just get an abortion. Then he brushed her off, played hard to reach, and later learned that she left school, had an abortion, and was so humiliated that she never returned to the university. He never forgave himself for treating her so shabbily; for being so selfish. It wasn't how he thought of himself.

In therapy, he talks with the therapist about how all this might relate to his fears about getting his wife pregnant, sabotaging the chance at every possibility and never quite understanding why.

This, in capsule form, is what the technique of bibliotherapy is about. It entails the use of books, especially fictional works, and other written materials, to help patients further understand some psychological problems. It's been around for 75 years. Maybe more if we talk about counseling of all forms before psychotherapy officially made its debut. In other words, before Freud.

But bibliotherapy has moved to the back of the bus. A recent aid to traditional psychotherapy has emerged in the form of a specialization called, variously, cinema therapy, cinematherapy, or film therapy. It's generally abbreviated as CT.

Movies are capable, it is believed (a belief which I share as well) of providing a quicker access to suppressed, even repressed problem areas than either books or other printed material. Research shows that, in general, there is much greater affective arousal by films than by print. This arousal leads to greater attention to problem areas and possibly greater and quicker insights into these problems than were achieved by traditional talk therapy alone.

Cinematherapy is an area of growing public and journalistic interest. I've done perhaps a dozen media interviews on the subject over the years, especially with print and radio journalists. Mostly, I think, this is attributable to the cachet of motion pictures which are, for good or ill, the principal quoted "literature" beginning in the second half of the 20th century.

Given the innovation in availability of videos through rentals, purchases, VOD or PPV, recommending film is now so much easier than it was when you had to wait for revivals of a film or for it to appear on TV. It made recommending films to patients very iffy. That's one reason why so much more attention was paid to print as an aid in psychotherapy. Now, it's easier to rent a film than rent a book. Television, of course, also provides programming that serves purposes similar to that of film in using fiction to touch people where they emotionally live and sometimes emotionally hurt.

Movies constitute the premier popular culture form of the day in no small way because of the psychophysiological properties of the film medium; moreover, it does not require the ability to read-not an insignificant advantage. While film has been justly called an "emotion machine," it is also a multi-sensory medium. More than any other medium of entertainment and communication, movies richly represent the swirl of messages: flesh, mind, ideas, pain, pride and laughter, the symbols and images that define what we call "the human condition."

The value of movies to progress in therapy is in their capacity to deal with issues that patients can't or won't discuss because they are too painful or too frightening. Movies can bring down psychic-emotional barriers, penetrate the wall of resistance, both conscious and unconscious, oftentimes very deftly and then open up the issues aroused for discussion in therapy. When I had a private practice I tended to use movies that dealt with marital, addiction and other intra- and interpersonal relationship issues, something that Hollywood handles in film very well (when it wants to, and when it gives the writer his or her head.)

What is the magic of film here? Screenwriters tend to be very good at capturing the truths of so many aspects of the human condition. Good directors then take that material and, with the contribution of cinematographers, editors, lighting, music, etc., produce powerful effects on audiences and hit the full range of sensory experiences and emotions that are accomplished less quickly and less immersively, for the most part, by written material.

Therapists can use a movie, recent, earlier or classic, since it matters less the vintage of the film than the way in which the film touches or explores the problem or issues generated by the problem. One of the best films I ever saw was about the dissociative disorder known as a fugue state, where someone dramatically represses an entire period of one's life and starts a new life, with no recollection of the life in which the door was slammed shut. The Oscar-winning film, entitled Random Harvest, was made in 1942 and the students in every one of the sections of my class in The Psychological Impact of Film, was mesmerized by it. What's stranger is that IT IS IN BLACK AND WHITE!

In CT whole films are not required. A therapist or a patient can hone in on a scene or sequence in a film because the sequence dovetails exactly with a problem area the person is confronting in therapy - whether the patient realizes it or not - but is just a small part of an otherwise irrelevant film.

The patient might find it easier to confront his/her own issue after seeing how someone else handles or mishandles it, as in the movie Fearless, staring Jeff Bridges and Rosie Perez, which deals with PTSD; or the patient may have the realization that the manner of coping with drug addiction or alcoholism after detoxification, as Meg Ryan showed with her family in When A Man Loves a Woman, mirrors just what's causing problems in her own family life after rehab.

Often, is easier for patients to discuss problems when they are talking about a character in a movie and then gradually transition to talking about themselves. For example, males may be reluctant to confront their own mother-son relationships but can jump right in and examine the one portrayed in the dark comedy like, say, Mother, with Debbie Reynolds and Albert Brooks, or even find an odd identification with James Cagney's character of Cody Jarrett in the classic 40s film, White Heat ("Top of the world, Ma!").

Maybe a film provides a truly realistic portrayal of someone struggling unsuccessfully with drug addiction and they can discuss what's happening with Michael Keaton in the movie Clean and Sober more easily than they can discuss what's happening with themselves. Someone with a chronic or an acute bout of commitment-phobia might be opened up to the struggles and embarrassments by watching Jessica Lange, Michelle Pfeiffer and Jennifer Jason Leigh's performances in A Thousand Acres. Any such film experience, if handled properly, should serve as a segue into previously hard-to-broach problem areas.

Of course, the therapist need not be the only one to find relevant movies. Patients frequently come to therapists and talk about how a movie or TV show like Seinfeld affected them and brought up some "issues." TV series like the classic ThirtySomething were engines of stimulation for couples struggling with marriage and the small details which in a pointillist fashion make up the large picture of modern marriages.

Part 2 of this blog topic will provide a case study of cinematherapy, one done with curious radio journalists from the BBC, in the Hollywood Hills, right around Oscar time. Come back and enjoy the psychodrama.

About the Author

Stuart Fischoff, Ph.D.

Stuart Fischoff, Ph.D., was Senior Editor of the Journal of Media Psychology and Emeritus Professor of Media Psychology at Cal State, Los Angeles.

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