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Bipolar Disorder

31 Knights of Halloween: "The Phantom Carriage"

Viewing the Swedish Legend of the Phantom Carriage Through a Psychiatrist's Lens


The Phantom Carriage is a 1921 Swedish film based on the novel Thy Soul Shall Bear Witness! that influenced the films of Ingmar Bergman and Stanley Kubrick’s The Shining. It tells of a legend that the last person to die each year has to drive Death’s carriage and collect the souls of everybody who dies the following year. The film depicts a dying sister Edit whose last wish is to speak to the enigmatic David Holm. Of the many factors that link the two is that Edit has contracted tuberculosis (TB) from David, a condition from which she is now dying.

How it relates to the field of psychiatry

Davis Holm is afflicted with Alcohol Use Disorder (AUD) as we are first introduced to him sitting in a graveyard telling his two “drinking buddies” about the legend. His drinking is revealed to have caused clinically significant impairment when (seen through a flashback) David is jailed for public intoxication. The rest of the unfolding plot details the many hardships David’s drinking has on his interpersonal relationships including those with his estranged wife, children, and Edit. The author also portrays the heritability of AUD in that David’s brother was sentenced to life in prison for killing a man while drunk.

Another theme presented in The Phantom Carriage is the formulation of TB as a biopsychosocial illness. While healthcare providers accurately view TB as an infectious (biological) disease, to fully understand its impact on wellness one needs to appreciate not only the biological sequelae of the infection but also its psychosocial consequences. As such, The Phantom Carriage parallels other films such as The Black Monk (Bongiorno Productions, 2017).

The Black Monk is a film inspired by the Anton Chekhov short story of the same name about a documentary filmmaker from Newark, NJ who encounters a legendary monk upon reuniting with the woman he loves. While the film depicts psychotic features in the context of mood (Bipolar Affective Disorder) and anxiety (Posttraumatic Stress Disorder) states, it further reminds us of the influence that TB had on the career of its author (2). While TB motivates Edit to fulfill her last wish, so too did it impact Chekhov’s life’s work.


Bongiorno Productions,…

Tim Parks, Writing to Death, NYR Daily, The New York Review of Books, 2018.

About the Author
Anthony Tobia, M.D.

Anthony Tobia, M.D., currently holds titles of Professor of Psychiatry and Clinical Professor of Internal Medicine at Rutgers Robert Wood Johnson Medical School.

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