Mama (2013): Are We Literally Afraid of Mental Illness?

Trigger Warning: Non-graphic references to suicide and acts of violence, no triggering images

Spoilers Lie Within

I should preface this by saying that Mama was absolutely terrifying, and one of the least terrible horror films I’ve seen in years. And I don’t say that lightly.

When two young girls with a troubled past are left in the care of Annabel (Jessica Chastain), she quickly becomes concerned that supernatural elements are at play.

As much as I enjoyed the jumping-from-my-seat experience of watching Mama, there was a naggingly distracting flaw in the story that I simply can’t ignore, and that I’ve seen countless times before. It was the choice to add mental illness as an element of the horror, without any real reason to do so.

Let me break it down for you: when a man’s business fails, he kills his estranged wife and two professional partners, and takes his two young daughters away from their destroyed home environment, ending up at an abandoned cabin. He’s killed by a mysterious specter of some sort, leaving his daughters alone and orphaned.

They’re found five years later, and have clearly suffered from the lack of social interaction. It’s quickly discovered that they’re talking to an unidentified figure known as Mama. She sings to them, comforts them, and loves them.

So, it turns out that Mama is the ghost (or something similar) of a woman who, after escaping a psychiatric hospital, murdered a nun and jumped from a high cliff with her baby in her arms. She has spent over a century searching for her baby’s body.

My problem is this: did we need to know that Mama was a woman who was, in her lifetime, perceived to have mental illness? The story could have been told without that element. For example, maybe Mama was a woman who lost her child in a storm and continues to search for him out of guilt. Maybe Mama and her baby died together of disease. Mama’s death isn’t a major plot element, and there’s no reason it couldn’t have been changed to prevent a needless perpetuating of stereotypes about people with mental illness.

Mama is portrayed as violent, unattractive, incapable of speech, and irrational in her behavior. These are all characteristics that make perfect sense applied to a horror film character, but are extremely problematic in a media portrayal of mental illness.

Like I said, it’s not the first time we’ve seen this. Mental illness is all too often a go-to in the horror genre. It’s so common that it’s easy not to question its presence when it does show up, and to forget the actual implications of what’s happening.

I can’t stress enough that seemingly innocent choices by the media don’t happen in a vacuum. Tacking mental illness onto the back story of a horror character without any other explanation or details maintains the one-dimensional perception that many have about mental health.

In a way, the proliferation of references to mental illness in the horror genre may be an indication that we fear mental illness on a very different level than we do physical illness. We fear the unknown, we fear the struggles of the future, and we fear that which is difficult to control. Mental illness represents all three of these, so it’s no surprise that it’s so long stood as a symbol of fear.

But “not surprising” does not mean “acceptable.” Ending the stigma around mental health will mean ensuring that fear is no longer considered the default, “natural” reaction to mental illness.

What do you think? Why do we see so many references to mental illness in horror films, and is it really that significant?

Mental Health in the News: January 21-27, 2013

Sports (Update): Royce White has been reinstated to the Houston Rockets after months of discord between the athlete and the team concerning White’s demands for accommodations for his mental health needs. According to reports, such a protocol may soon be added to White’s contract. (Sports Illustrated)

Cedar Rapids, IA: A young woman’s advocacy for others with schizophrenia sets the scene for a report on increased attention on mental illness in children. (Des Moines Register)

Syracuse, NY: Syracuse University is expanding its capacity for offering mental health services and expansion by moving into a formerly abandoned building and adding an outpatient center to St. Joseph’s Hospital Health Center for student training. (Syracuse Post-Standard)

Philadelphia, PA: CBS Philly is one of several outlets still reporting on the need to understand that mental illness and gun violence are not as inextricably linked as much post-Newtown discussion implies. (CBS Philly)

United States: The DSM-V is facing criticism for changes to definitions regarding alcohol use that would define binge drinking common in college-age groups as alcoholism. Critics of the decision emphasize that, according to several studies, most people who drink heavily in college do not become lifelong alcoholics. (CNN, via Time)

United States: A Denver clinical associate professor wrote a strange-but-well-meaning piece asking readers to stay on watch for dangerous individuals: “Your gut is a finely-tuned psychological assessment tool. People are inherently excellent armchair psychologists.” I hope my readers understand that while we should all be prepared to see the signs of mental health struggles in others, attempting to diagnose others or needlessly labeling anyone as “dangerous” outside of a situation where action needs to be taken is in no one’s best interest. (Huffington Post)

Aside

Oh, this is a good one. This is that movie that comes along every once in a while as a reminder that, when it comes to portraying mental illness, there are people who actually do know what they’re talking about. There are, in fact, writers and actors out there who care about this stuff, who are willing to commit to getting it right and create a meaningful piece of art.

Silver Linings Playbook asks the viewer to see the world through the eyes of mental illness, and understand that maybe we’re all just a little more similar than we’re willing to admit.

I’m not sure that I was prepared for how real this movie was. It’s unexpectedly dark. It doesn’t go down easily; it’s tense and uncomfortable. As uplifting as Silver Linings is, it’s also exhausting, and stressful. What David O. Russel presents in this film is an emotionally challenging viewing experience.

The movie’s portrayal of bipolar disorder and depression isn’t perfect, but this is, after all, just a movie, so we have to expect that. Certain elements were added or given more weight for the purpose of facilitating storytelling (Cooper’s character Pat Solitano being so triggered by hearing a song, for example, may be bending the reality of bipolar disorder a little at times), but a literate audience will understand.

Some of the dialogue might be just a little too transparent in its educational intent: a little too much talk about medication here, a little too much unrealistic dialogue about stigma. Don’t get me wrong; from a mental health advocacy, I was thrilled to find these little details in there. From a film viewer’s perspective, there’s something a little off in the writing.

I don’t think that anyone can walk away from this film without a better understanding of what it means to live with mental illness. The characters here aren’t “Other.” They’re us, and we know them and understand them. They show us shades of ourselves that exist in everyone, and to see them is a terrifying but necessary experience.

I’ll have more on Playbook as the Academy Awards ceremony on February 24 approaches.

Mental Health in the News: January 14-20, 2013

Canada – The Mental Health Commission of Canada is working to address mental health in the workplace with a newly-introduced initiative. They are proposing a national standard that would apply on a voluntary basis to organizations and employers seeking to “improve workplace psychological health and safety.” (CTV News)

New York StateThe NY SAFE Act, designed to protect from gun violence, is drawing some criticism for its changes to existing mental hygiene laws. Some professionals feel that making the laws stricter will prevent consumers of mental health services from being honest with their counselors and doctors, while others say that patient-professional confidentiality would not be changed by the law. (Huffington Post)

United StatesCBS reports on efforts to standardize nationwide limitations on gun ownership to people with certain mental health histories. (CBS News)

Canada – Medical experts call for more educated treatment and discussion of eating disorders, which currently tend to ignore men. (CMAJ)

Washington, DC – The Pentagon reports that the number of military deaths by suicide may have reached a record high this year, pending the investigation of over 100 undetermined deaths. Some support is currently in place for military personnel, but the numbers indicate that services are not always sufficient or accessible (CNN)

North Dakota – State Representative Larry Klemin came under fire this week for sending an email titled “Why Men Seldom Get Depressed” to colleagues this week. (Jezebel)

MusicA$AP Rocky spoke to MTV this week to talk about his depression and struggles with suicidal thoughts. The rapper included a line about suicide on a track on his new album. (Pop Crush)

SportsHBO will be airing a special on Royce White that will “shed new on the rookie forward’s dispute with the Rockets.” In an interview with Bryant Goldberg, White discusses the importance of adding a mental health protocol to his contract. (Sports Illustrated)

Story to Watch: American Idol’s Mariah Pulice

On Thursday’s (January 17) episode of that former entertainment juggernaut, American Idol, ­ auditioner Mariah Pulice, 19, of Chicago told the judges, and 16 million viewers, the story of her struggles with anorexia before a lovely performance of, perhaps appropriately, the Beatles classic “Let it Be.”

Mariah Pulice

Mariah’s audition was accompanied by interviews with her sister and parents, who described the emotional changes they had seen Mariah going through, saying that the joy and energy she had always exuded had left her during her darkest period.

According to Pulice, her disorder is something she has to cope with every day, but she’s confident that the worst is behind her. “This eating disorder did not beat me,” she said. “And it will not, it will not beat me.”

Moving stories of mental health are nothing new to the talent show, which last season ran the story of Shelby Tweten, a young woman who was diagnosed with bipolar disorder at 16. Tweten, like Pulice, impressed and touched the judges, moving on to the Hollywood Round of competition. She was eliminated from American Idol after reaching the top forty, and is now a speaker for Active Minds, a national non-profit devoted to changing the conversation about mental health on college campuses.

There is a certain level of debate about the appropriateness of openly disclosing one’s mental health struggles in an ultra-visible competition setting like American Idol. It’s no secret that a contestant’s personal saga is, to the producers, even more important than their vocal prowess in this early stage of the game. Many viewers criticize this aspect of the show, saying it encourages hopefuls to exploit, even exaggerate, their struggles for better success of the game.

I think we can all somewhat agree that American Idol is more about making compelling television than it is about finding the nation’s best talent these days, so the emphasis on story sort of comes with the territory. As long as that’s the case, I’m grateful that the stories being told are meaningful ones.

While I applaud both Shelby and Mariah for their courage and honesty, I do hope that Mariah is at a stage in their recovery where she’s prepared to open herself up like this. “Coming out” about mental health is an important step for anyone with a diagnosis, but it should happen over time, free from outside pressures. There’s a huge difference between talking to a few close friends about a mental illness and telling the audience of one of TV’s biggest hits, and I hope Mariah’s prepared for that.

We’ll see more of Mariah Pulice on American Idol in a few weeks. I wish her the best of luck.

“But You Don’t Look Crazy…”

Those are actual words that have been said to me on numerous occasions, usually, of course, upon coming out about my diagnosis. I know that it’s also been said to friends of mine in the community of persons with mental health diagnoses, and that the sentiment can take any number of forms: “You’ve always seemed so normal,” “You don’t seem like the crazy people I’ve seen on TV,” and “You don’t look like you belong here,” said to me by a fellow patient during one of my three stays in a hospital psych unit.

It’s meant, almost always, as a compliment. The speaker feels that having a mental illness as an ugly stain upon a person’s appearance, and says this as an assertion that the listener is without such a vestige.

It’s sometimes also meant, on some level, as a dismissal. “Forget what the doctor says,” they had might as well be saying. “In fact, forget what the medical community has spent decades finding out.” And, most importantly, “Forget everything you’ve been through for months, maybe years, maybe decades. You don’t look like what I think a crazy person looks like, therefore you are not one.” It’s about as trivializing as you can get, despite the good intentions behind it.

Stereotypes about gender and mental health can, and often do, interact.

There exists, obviously, and as I’ve said before, a gap between our cultural perceptions of what a person with mental illness is “supposed to” look like and act like, and how we actually do. We’re a diverse and vast community: mental illness can affect anyone, and the people living with it are our friends, neighbors, and classmates, colleagues, and family. But the media portrayals of people with mental illness that have surrounded us our whole lives have most people with no other source of information thinking otherwise.
People with mental illness are depicted as inept, childish, emotionally unreachable, and untrustworthy,

Seinfeld character “Crazy” Joe Davola is a classic example of a character based on these stereotypes.

among other undesirable qualities, often exploited for comic effect. In the media, people with mental illness are most often male, and are physically distinctive: they’re either very tall or very short, they’re unkempt and unshaven, are disheveled and have poor hygiene, have bad haircuts, dress poorly, have lopsided smiles, and, perhaps most commonly, have what have come to be known as “crazy eyes.”

There are some theories as to why “the mentally ill” have, as a group, become homogenized by the media, as Dr. Otto Wahl describes in his outstanding book, Media Madness. One possibility is that the stereotypes exist as a way of separating “Us” from “Them:” if we can see ourselves as physically (and thus, in our superficial world, fundamentally) different from people with mental illness, then we need not fear that we’re “one of them.” A second theory is that, because mental illness is not nearly so concrete as other characteristics, or even physical illness, it can’t easily be portrayed visually. That changes, though, if easily recognizable visual associations are made with mental illness.

The initial plan to cast actual patients in the Oregon State Hospital in supporting roles in One Flew Over the Cuckoo’s Nest were scratched because they did not meet the director’s expectations of what people in a psych unit should look like.

Whether or not media makers intend to perpetually assign undesirable associations with people living with mental illness, that’s exactly what they do when they rely on stereotyped portrayals. Not only that, but they’re limiting themselves as storytellers by choose to recycle stock characters rather than developing the more nuanced and accurate characters we’ve seen on shows like Degrassi: The Next Generation and Homeland in recent years. They also make it difficult for people who do have mental illness but don’t fit the stereotypes to have their difficulties be taken seriously by their peers.

The attitude that stereotypes are just stereotypes and don’t do any harm, especially when they’re so obviously untrue, is the kind of ignorance that the media are in a very powerful position to reduce, or even end. Not only would it be a beneficial opportunity for them to take, but it’s also a part of their duty as a powerful international institution.

Mental Health in the News: January 7-13, 2013

Washington, DC: “Michael J. Fitzpatrick , executive director of the National Alliance on Mental Illness (NAMI) met yesterday with Vice President Joseph Biden ‘s task force on gun control, along with other leaders of the mental health community, urging action to strengthen and expand mental health care services.” Biden’s task force is expected to report to President Barack Obama tomorrow (January 15) (NAMI Newsroom).

The UK: A blogger for The Guardian makes the case for awarding New Year Honours to people who people living with mental illness, those who care for them, and those who publicly stand up for them. The New Year Honours are awarded on January 1 to newly named members of the orders of chivalry. (The Guardian)

The US: Legislators struggle to write laws that balance civil liberties with the need to get help for people who pose a threat to themselves or others. (USA Today)

The US: The psychiatric community is not currently meeting the needs of people of Hispano-American, according to some. Minority populations are historically less inclined to use mental health services due to differing cultural attitudes toward seeking help outside of one’s own community. It is also difficult for Spanish speakers to find services offered in their primary language. (Huffington Post)

Kansas: The Kansas City Star was one of many publications this week to report (with varying levels of unintentionally stigmatizing language choices) on our flawed state mental health systems.

Minnesota: Citing concerns that the mental health needs of the incarcerated are not being met, State Senator Al Franken has introduced a bill that would provide federal funding for mental health programs in prisons and jails. (Atlanta Journal-Constitution)

“Classic” Stigma: Great Sitcoms of the 90s, Pt. 2

A few days ago, I published a post about an episode of Will & Grace, the premise and script of which were pretty stigmatizing to the mental health community. I broke down the plot points and dialogue that were particularly harmful, and attempted to explain the episode’s flaws within the context of the portrayal of mental health in comedy. Tonight, I do the same with an episode of another great show from the same era: Seinfeld.

All things considered, Seinfeld just might be the greatest cultural icon, ever. Like I said in my previous post, it changed the face of situation comedy. But, like most art from decades past, reveals some signs of being the product of a different cultural landscape. I bring you the season seven episode, “The Gum,” which aired December 14, 1995.

Stigma synopsis

About two minutes into the episode, we find out that Lloyd Braun, a childhood friend of George’s (Jason Alexander) and one of Elaine’s (Julia Louis-Dreyfus) many ex-boyfriends, has experienced a “nervous breakdown,” and had an extended stay in “an institution.” Kramer (Michael Richards) has now taken Braun on as something of a personal project. He urges his friends to support Braun and treat him as though nothing as happened.

Kramer assures Lloyd Braun that he is not “crazy.”

While Kramer over-indulges Braun out of misplaced friendly concern, George is fascinated with Braun’s mental state, taking a certain degree of joy in it. He wears a smile as he tells Elaine, “they had to lock him up.” Elaine is now worried that she was an impetus in Lloyd’s episode.

Jerry, like always, is content to stand back and quip about everyone else’s reactions, rather than actually get involved. He mocks George and Elaine with some typical mental illness jokes.

The plot thickens when George runs into another childhood friend, the lovely Deena, and tells her about Lloyd: “Speaking of crazy, did you hear about Lloyd Braun?… He’s completely bonkers!” It turns out that her grandfather had a similar experience. George becomes very concerned upon hearing this, because that same grandfather is working on George’s car as they speak.

Throughout the remainder of the episode, comedic mishaps lead Elaine to inadvertently hit on Lloyd several times. Kramer continues to over-protect Lloyd, comforting him with “you’re not crazy.” George experiences a series of coincidences involving a cashier on a horse and a car fire, confirming Deena’s concerns that he’s exhibiting the warning signs of a nervous breakdown. George objects, saying that he doesn’t belong in “the nut house,” but Deena is entirely sure that there’s something wrong when she catches him wearing a King Henry VIII costume. She runs away from him, and the storyline closes.

So What?

Unlike the Will & Grace episode in my prior post, this one doesn’t come across as a blanket condemnation of people with mental illness. Actually, Lloyd Braun and the grandfather character are both portrayed as likeable, rational, and intelligent, three qualities often eschewed in media portrayals of mental illness. On the negative side, Lloyd is shown socially inept and unintuitive, a far cry from his former self as portrayed in the season 5 episode “The Non-Fat Yogurt.” To be fair, he was being portrayed by a different actor this time (the original actor was not available for filming), but there was a vast disparity in the way the character was written and depicted. This signified to the viewer that we are to believe that people who have experienced mental health difficulties have major personality changes that are perceptible even after recovery. This is, it should go without saying, not the case.

Most of the jokes in the episode rely on the audience sharing certain beliefs about people with mental illness. For example, when we see George’s reaction to finding out that retired mechanic ‘Pop’ has had a nervous breakdown, the audience laughs because they, like George, are afraid that a mentally ill man will certainly damage his car.

The stereotype that people with mental illness are incompetent is, as you know, still around today. We see it in places like this 2009 ad online gambling ad, where a group of psych hospital patients, shown as childish and erratic, can’t even make it through a game of poker.

The premise of the episode also relies on the assumption that there is reason to be socially uncomfortable around people who have experienced mental illness. Actually, mental illness isn’t technically the issue at play; it’s the hypothetical concept of “mental imperfection,” that most people are in perfect mental health and that those who aren’t are lesser, when in reality, we all struggle with our mental health in some way.

All four main characters, possibly excluding Jerry, behave differently around Lloyd than they would around anyone else, because of his supposed mental imperfection. They actually exhibit pretty common reactions to a friend with mental illness: Elaine’s needless guilt, George’s schadenfreude, and Kramer’s over-protection are all archetypes for the way people really do often behave in that kind of situation. The episode almost seems to want us to believe that these are the right reactions.

Impressively, the episode is actually really funny, and as such serves as a light look at stigma in our world. Now that general understanding of mental illness is somewhat more nuanced than it was 1995, I wonder what this episode would look like it had been made today.

A Dark Day on Twitter

Content Warning: non-graphic description of self-harm, no images

Sometimes the diverse, powerful, and easily-abused forces of the Internet will concoct something so disturbing that even those of us who have never lived in a world without it can’t quite fathom what hath been wrought.

Today, that came in the form of a Twitter Trending Topic, and possibly the worst one of all time.

“cutforbieber,” which, as of the time of this writing, has been trending since a little before 2:00PM EST Monday, is a Twitter hashtag which supposedly originated as a campaign for Justin Bieber fans to harm themselves as a statement against the pop star’s alleged drug use.

Pop sensation Justin Bieber has long polarized music listeners. Because of this, he often finds himself at the center of controversies he never asked for.

Complex Magazine (linked page does not currently contain additional triggering content, but this is subject to change) broke the story that the trend was actually started as a hoax by 4Chan, a “bulletin board” site on the cruelest corner of the Internet. It’s unclear, though, how many people have actually self-harmed today as a direct or indirect result of this trending topic.

What disturbs me most was that the 4Chan member who originated the idea was actively and admittedly attempting to persuade young girls to self-harm. This kind of disregard for the seriousness of cutting and similar behaviors is astounding, and must be, albeit to lesser degrees, pretty widespread, for the topic to have reached the levels it did in the first place.

The trending topic is filled with tweets mocking cutting and people who cut, and others expressing anger, even hatred, for the girls who have ostensibly harmed themselves as part of the campaign. Their anger is dangerously misdirected, and exists in a contradictory culture where many young people express frustration with people who “cut for attention,” while just as many others romanticize and glorify images of self-harm on blogging sites like Tumblr.

The fact is that the ensuing attention is, for many, a factor that plays a major role in their self-harm. Their actions often serve as a signal to others that they are in desperate need of help when other methods haven’t worked. No actual self-harm should be immediately met  with outright disgust, especially when the psychological and emotional circumstances surrounding it are not known. Sometimes, like in this case, the cultural circumstances are the ones that merit our disgust.

But disgust, of course, it wasteful unless it’s accompanied with action. Action needs to be taken against the individuals who started the trend, and 4Chan needs to take responsibility about the dangers of allowing this kind of activity to take place. Justin Bieber and Twitter need to speak out about the topic. Please continue to educate yourself and others about the significance and seriousness of self-harm, and speak out when you hear ignorant speech about self-harm.

Mental Health in the News – December 31, 2012 – January 6, 2013

This is the first of what will be a weekly round-up of mental health-related stories from news sources around the country, and, occasionally, the world.

The week’s mental health headlines

MissouriThe Columbian printed profiles of a local man and woman in its report on mental health in the LGBTQ+ community. (The Columbian) Content warning: personal descriptions of eating disorders and physical abuse.

Connecticut“Gov. Dannel Malloy set a two-month deadline for a commission to address the state’s gun laws, mental health policies and public security issues.” Involvement from mental health experts has been strongly emphasized in addressing the aftermath of the Sandy Hook elementary tragedy. (CNN)

Wisconsin – Concerns that young people with mental health struggles often end up in the legal system have led to the formation of a community group called the Chippewa Health Improvement Partnership (CHIP). “CHIP is a volunteer group hosted through St. Joseph’s Hospital that provides an array of low-income care services in the area. Its volunteers include retired physicians, psychiatrists and other related fields.” Other groups local to the area take a preventative approach, through ensuring that children are raised in healthy home environments. These groups, including the United Way of the Greater Chippewa Valley, were, as described in the article, more interested in the environmental factors of mental health than the biological. (Chippewa Herald)

New York – My local news station has been one of a handful to report on mental health stigma in the past few weeks. They wrote: “He says defamatory media will shame and deter many from seeking help, though most can substantially recover from disabling conditions with personalized services. He and other advocates said [that] recent emphasis on 24-hour emergency phone lines, peer support, housing, family services, managed care and outreach are showing results.” (WWNY TV-7)

AmsterdamA study published in Archives of Neurology reports concludes that there may be a link between dementia and depression, though one does not cause the other. In a group of over two-thousand people over 65 years old, people with depression were more than twice as likely to have dementia. (Psych Central)

Philadelphia – As bipolar disorder becomes more visible, some wonder whether it has become “over-diagnosed.” (Philadelphia Inquirer)