Cinema and Therapy: The Use of Film in Clinical Practice

“Do you have any suggestions for movies I could watch that might help me? My previous counselor recommended films when we worked together.” This question arises from a new client towards the end of our first session. Several days later, a similar request is made by some of my students in our psychology class: Are there any films that depict the conditions we will be covering this semester?

During the past two decades, we have witnessed a growing use of film in mental health treatment (for example, Ballard, 2012; Bierman, Krieger, & Leifer, 2003; Gramaglia et al., 2011; Hankir et al., 2015; Heston & Kottman, 1997; Powell, Newgent, & Lee, 2006) in three specific domains. First, mental health professionals are increasingly using film as part of their practices, and one can easily find lists of films with reputed clinical value for myriad conditions, including PTSD, addiction, and depression. Those seeking mental health treatment may find themselves working with practitioners suggesting film as part of treatment. Second, film is suggested as a self-help approach, and there is a plethora of self-help books that direct people to specific films to address their idiosyncratic issues. Third, film is used in training programs for future clinicians, and this is the least addressed topic in the literature.

As a faculty member of a university psychology program, I recognize that many of my students do not have personal experiences with therapy and instead use media representations as templates. I myself encountered my first depiction of therapy in the 1980 film Dressed to Kill and used the seven-minute therapy session occurring early in the movie as a model for my nascent career. (Note that the rest of the plot involving Michael Caine as an analyst murdering patients who sexually arouse him was not part of my modeling process.)

A cursory review of the personal testimonials, websites, video blogs, and training certifications on the internet would lead many to believe that film therapy (a.k.a. cinema therapy; reel therapy) is a valid and recognized form of intervention for mental health issues. However, the research is scant. This is something we will examine in future posts. But as a starting point, I propose three considerations to guide decision-making as to whether interpolating film into treatment and academic training programs is justified:

1. Is cinema therapy effective when included in treatment and clinical training programs? Does it improve outcomes?
2. What is the best protocol for using film in treatment and training programs? Research is clear that simply watching a film has little clinical value.
3. How do we determine which films offer clinical benefits other than the naïve suggestion to watch a comedy when one is feeling down?

Unfortunately, great films dealing with psychological concerns are not inevitably beneficial in treatment. There were several films released recently that demonstrated a profound understanding of human psychology, but none, in my humble opinion, would be beneficial in the therapy process (though they may be of use in an academic training program). As exhibit one, Memoria is one of the most psychologically incisive films this past year. In the opening scene, Jessica (Tilda Swinton) is awakened from sleep by a loud explosion (that catapulted many audience members from their seats when I saw the film), and from that point on these explosions occur deafeningly, unpredictably, and frequently, both day and night. Nobody else though can hear these cacophonous booms. Jessica’s ability to sleep, concentrate, and interact with other people inexorably deteriorates; imagine trying to work or simply talk to others if one is continually distracted by thunderous eruptions.

The most agonizing scene of any film I saw recently occurred in Memoria: Jessica bravely but failingly attempts to enjoy a meal with her family, who are oblivious to the explosions pummeling her throughout the repast. During the course of over two hours, we watch as Jessica’s personality and life disintegrate; medicine, mental health treatment, indigenous healing, and alternative approaches fail her. As a metaphor for chronic mental illness and its ravages, this film is remarkable.

But is Memoria film therapy? As a film metaphorically dealing with the toll of chronic mental illness, including the bewildering fragmentation of one’s implicit templates for day-to-day living, Memoria is unparalleled recently. Yet the film’s length, slow pace (including long static shots), opaque plotting, and, most damaging for our purpose, a decidedly non-psychological explanation for the ordeal of the central character will leave many people scratching their heads and likely annoyed with the unwary professional who suggested it. However, I could cautiously see this film as part of the syllabus in an abnormal psych class for the topic of schizophrenia and other psychotic disorders; with guidance, reflection, and a written assignment the film could assist students to recognize the effects of chronic and unremitting mental health problems on patients and the families who care for them. Then again, many students would fall asleep and never make it to the end of the film.

Memoria is one of the best psychological character studies in recent times, but it is also one requiring much patience for courageous viewers. With this in mind, we can establish a preliminary precept for cinema therapy: No matter how psychologically profound a film may be, its presentation and style may deter viewers from engaging with it.

Therapy Essential Reads

What Did Carl Rogers Really Say About Therapy?

Therapy Is Supposed to Make You Happier

The next post will introduce research on cinema therapy as well as another of the four great psychological films from the past year to formulate additional precepts for cinema therapy.