Jeremy Clyman Psy.D.

Reel Therapy

Tully: A Movie About Parental Stress

Read on to find out what drives the parental distress...

Posted May 15, 2018

“Tully” is the third and most recent collaboration between writer Diablo Cody (“Juno”) and director Jason Reitman (“Up in the Air”). While the (4 out of 5 stars) film is obviously about motherhood, the narrative delves into what I'll oversimplistically term pathological parenting.

So, what type of pathological parenting or diagnosis is the movie talking about when it comes to Marlo, the main character and married mother of three?

To me, Marlo (played by a magnetic Charlize Theron) is firmly established as a high-functioning, exceedingly capable individual operating within a reasonably supportive home environment (e.g. a loving, hardworking husband played by an understated Ron Livingston).

But there’s also a very strong external “stress load” to Marlo’s life setup; she is a full-time stay at-home parent, grappling with the daily childcare demands of two grade schoolers, one of whom is clearly Autistic, and a third newborn child named Mia. What happens next, as Marlo navigates through the formulaic chapters of adversity and growth, is a relative picture of resilience.

With the high stress load in Marlo’s life, I expected the plot to orbit around a theme of mid-life crisis or post-partum depression. And despite what some critics (and, at times, the movie itself) interpreted, Marlo never, at any point in the film, showed minimally sufficient signs and symptoms of this DSM-V diagnosis, namely impaired general functioning and mother-infant rapport building.

In short, she’s too high-functioning; Marlo moves through the plot well-connected with her newborn, skillfully coping with life phase changes like the relentless breast feeding process, and even finding the energy to effectively advocate for her son’s Autism challenges.

At the same time, since the stress load of Marlo’s third fourth-trimester is so high, some mildly depressed mood, self-doubt, and existential angst occurs, which strikes me as a clinically common phenomenon, if not unavoidable. 

As Marlo becomes predictably exhausted by uniquely high childcare demands, she develops a relationship with a night nurse named Tully, and a comedic and entertaining female bro-mance ensues with Tully providing a palpable and sorely needed injection of energy, optimism, and unconditional affection into Marlo’s daily life.

MAJOR PLOT TWIST BELOW (if you have not seen the movie, I’d advise waiting to finish this blog post)

What we as an audience learn during the final chapter of the film is that Tully has been Marlo’s fabrication. Technically speaking, but really more as a dramatic and comedic conceit, Tully represented a delusion. There’s a fun “Six Sense” feel to the ending when you realize that indeed none of the other character’s in Marlo’s life (and throughout the film) showed explicit recognition to the character we all thought was real.

In the end, there is a crisis moment in which Marlo, exhausted and showing sleep-deprived bad judgement in driving while exhausted and hungover, crashed her car in fatal-looking fashion.

Fortunately, Marlo comes out of the car accident with non-significant injuries. She also gains further clarity about her internal distress.

The insight, and the most apt clinical diagnosis for Marlo is that she has been the silent sufferer of caretaker burnout.

Caretaker burnout - a somewhat unofficial but hot-topic in the field of clinical psychology - is approximate to overworking (as a default life mode), which can be just as harmful as under-working (e.g. clinically dependent), though much less obvious.  

In fact, we learn retrospectively that Marlo, at peak escalation of overworked distress, had stayed up all night cleaning and baking on top of her all-consuming daily parenting routine. Marlo’s husband and co-parent was framed by the movie as unsupportive to the point of disengaged. And while it might be fair to say that a pre-established setup of genuinely equal and balanced co-parenting might have nipped Marlo’s ripple effect of depression, insomnia, and, ultimately, caretaker burnout in the bud, Marlo’s pathology (and necessary self-insight) was that she never asked for her husband's help.

Marlo never asked. 

And while the husband’s evenings spent overly engaged in video games was certainly under-supportive, if not obnoxious (he should have reasonably deduced that his wife and co-parent needed more help than he was habitually giving), Marlo co-constructed this unhealthy dynamic by desperately wanting to do it all, control it all. At various times throughout the film, and in objectively bad judgement, she dismissed and rejected options and overtures for help and support, fixated on the notion she could and should do it all.

In the end, Marlo is observed to be duly acknowledging and accepting the ever-reasonable and now-necessary support and help of her husband and others. Self-care and a somewhat less imbalanced work-life routine was re-established. This incrementally more efficient path toward recovery, replenishment and return-to-(psychological)baseline was triggered by crisis, but would need to be cemented, moving forward, with a cognitive-behavioral therapy process - modification of internal dialogue and implicit beliefs.

In this case, to fully re-stabilize as a happy and healthy individual, Marlo would need to “lower the bar” on her internal standards for parental perfection, and reality-check her confused principle that help is undeserved or somehow equates to failure.

While I initially thought the car accident and hospitalized bedside scenes at the end were melodramatic, there’s a kernel of reality and an important takeaway – if a loved one is objectively overworking and self-sacrificing, then there is a high risk for chronic sleep deprivation which, in turn, legitimately raises the risk for clinical depression, temporarily impaired cognitive performance and “accidents,” and (presuming a predisposition) delusions/psychosis, if left unchecked over the long-term.

So, to end on a note of mental healthy advocacy, if you suspect there is an overburdened caretaker in your family, then unilateral and proactive support is the best measure (don’t expect the caregiver to ask for it directly, or even accept it easily)!

And if you suspect you are the overburdened and burnt out caretaker in your family, then you’ve already taken the first step. The next step is to explore why asking for help feels so aversive and, more importantly, to start forcing the request for help as a healthy re-training of bad habits!

This film is recommended as a particularly useful and relevant springboard of clinically rich discussion between new and adapting co-parent/romantic partners (be advised, conflict is a risk).