Using Movies in Psychiatric Education

 Oddur Bjarnason

Movies are an effective artistic medium. A good movie can affect us profoundly, and we may perceive the experience as if we are participants. We are drawn into the story and the experiences and emotions of the characters and can relate to them emotionally and intellectually.

There exist a large number of movies with main characters with severe mental disorders. They can effectively be used in teaching psychiatry to medical students and medical residents and are used in some medical schools and psychiatric departments. I did that when teaching in the psychiatric hospitals of the University of Iceland and University of Bergen, and found that the students showed great interest in the movies and in discussing them. The author is convinced that the courses increased the students’ knowledge and understanding of psychiatric patients and their disorders.

Courses can be arranged presenting movies with characters that have severe mental problems or mental disorders.  They should have relevance to teaching about these disorders and should have high artistic value. The following link gives access to a network database with information about such movies, their characters, and their mental disorders:

 Movie Information

A movie course allows learning to make a diagnosis/differential diagnosis and to discuss a mental problem/disorder within the disease-psychodynamic-cognitive/behavioral-social frame of reference and which aspect of that model is most relevant to the mental problem/disorder exemplified by a character in a movie. In this context, the author should like to direct the reader’s attention to the excellent book “Models for Mental Disorders” by Peter Tyrer. Mental disorders may also be discussed relative to other theoretical frames of reference. In this regard, it would be advantageous to invite other professional groups, e.g. psychologists, social workers, to course sessions.

I shall use Medea by Evripides and Lars von Trier as examples of using plays and movies in teaching psychiatry.

The Myth of Medea

A Guide to Euripides’ Medea

 Medea before Corinth

Medea helped Jason, leader of the Argonauts, to obtain the Golden Fleece from her father, King Aeëtes of Colchis. She married Jason and fled with him pursued by Aeëtes. Jason, in conspiracy with Medea, cut her brother Apsyrtus to pieces and threw him into the sea to delay the pursuit.

They then went to Jason’s hereditary kingdom of Iolcus, where his uncle Pelias had usurped the throne. To get rid of him, Medea convinced his daughters that to restore his youth, he would have to be killed, cut to pieces, then put together and restored to youth by Medea’s magic, which she, however, withheld. After this, Jason and Medea, together with their two children, were forced into exile and fled to Corinth.

 Medea in Corinth

King Creon of Corinth wants to secure his throne. To do this, he wants to marry the victorious warrior Jason to his daughter Glauce. Jason accepts although he is already married to Medea. Creon decides to banish Medea and her two boys from the city. She entreats him to let her stay, but he gives her only one day to secure the needs of the two boys.

Medea agrees with Aegeus, the king of Athens, that she can come to live in Athens under his protection. She then murders both Glauce and Creon and her children to punish Jason for his betrayal.

 Medea after Corinth

Medea became the wife of Aegeus, who later drove her away after her unsuccessful attempt to poison his son Theseus.

 The following are some of the questions that course participants might ask and discuss:

1.    Is the play/movie of high artistic quality?

2.    Do the symptoms portrayed by the main character correspond realistically to symptoms of a mental disorder?

3.    How would a performance/showing of Medea by Evripides or Lars von Trier be experienced and understood by:

a. an ancient Greek 

b. a contemporary person without a mental health education

c. a contemporary mental health professional, psychiatrist, Freudian or Jungian analyst,  a cognitive or behavioral psychologist, a social worker, a psychiatric nurse?

4.    What is the significance of the social, cultural and historical context in shaping representations of mental illness

The application of DSM5 to the symptoms Medea demonstrated by her words and deeds during her sojourn in Corinth shows that she fulfills all the criteria for General Personality Disorder and at least five of nine criteria for Borderline Personality Disorder. She does not fulfill the criteria for any other personality disorder. According to ICD-11, she has a Personality disorder, Severe, Borderline pattern.

Some people have argued that her actions can be understood as a normal reaction to Jasons’ betrayal. However, when we take Medea’s actions throughout her life into account, there is not a shadow of a doubt that she has a Borderline personality disorder and at least traits from other personality disorders. She exhibits symptoms long before Jason betrays her.

 Other important questions that we might discuss during a course section are for example:

1.    Does the application of psychiatric diagnostic criteria and the assignment of a diagnosis enhance the experience and understanding of Medea derived from attending a performance/showing of Medea?

2.    What is the primary purpose of applying psychiatric diagnostic criteria to Medea and other characters, as well as psychiatric patients?

 Conclusion

Because of the intense emotional and intellectual effect of movies of high artistic quality, they may be used for teaching psychiatry to medical students and medical residents. They can increase their knowledge and understanding of psychiatric patients and their disorders.