- The Washington Times - Thursday, December 30, 2004

Hollywood is mad about madness. It just can’t make up its mind about what causes it.

In Martin Scorsese’s “The Aviator,” Howard Hughes’ obsessive-compulsive disorder and other eccentricities are linked to a demonic mother who fed him a steady diet of paranoia and germ phobias. But Leonardo DiCaprio, who plays Hughes, has said in interviews that he believes OCD is hard-wired into the brain and not easily cured.

While researching the role, Mr. DiCaprio got to “spend three or four days with a patient,” he told the Los Angeles Daily News recently. “I found out what a daily routine for them was like and how you’re constantly playing mind games with yourself.”

Just as bad as the confusion over root causes, say critics, is Hollywood’s tendency to mock mental illness as well as sentimentalize it.

The latter is why Dr. Sally Satel, a D.C.-based psychiatrist, avoids movies that depict mental illness.

It’s bad enough to watch mentally ill characters being mistreated by others or by the mental health profession, she says; it’s even worse when “those episodes of mistreatment are often used as an artistically cheap way to manipulate the audience.

“Directors or writers often use it as a shortcut to generate sympathy without fully developing the character.”

Recent examples of Hollywood’s penchant for mental illness are plentiful.

OCD-related tics were a punchline in Jack Nicholson’s Oscar-winning turn in “As Good as It Gets” and in “Matchstick Men,” which starred Nicholas Cage.

Schizophrenia and multiple-personality disorder were conflated in the Jim Carrey comedy “Me, Myself & Irene.” Novelist Virginia Woolf’s struggle with depression was a heroic storyline in “The Hours.” Insanity was weirdly entangled with seduction in “Girl, Interrupted.”

On TV, it has been depicted in such shows as “Monk” and Sally Field’s six-episode arc on “ER.”

In “The Aviator,” the mental decline of Howard Hughes is more than hinted at, but it is treated sparingly; Mr. Scorsese and screenwriter John Logan focus on the Texan industrialist at his most vital.

But there are scenes of Mr. Hughes hitting himself with a bar of soap, which he carries everywhere; holed up in a projection room, naked, unkempt and urinating in a meticulously arranged row of milk jars; and repeating phrases until they sound perfect to his deranged ear.

The movie opens with what the filmmakers posit as the basis for Mr. Hughes’ disorders: a scene in which his mother creepily inculcates a sense of safety and cleanliness in separateness from others — the godly state of isolation, or “quarantine,” a word he spells aloud when under stress.

“My mother made me this way,” also a favorite theme in “The Hours,” is bad neuroscience. The “society is sick — not the patients” trope of “One Flew Over the Cuckoo’s Nest” has also been discarded.

The past 20 years of research supports a view that Mr. DiCaprio appears to share: that mental illness is biochemical in nature and can often be better treated with drugs than with Freudian therapy talk.

But here’s the likely problem: Biochemistry isn’t dramatic.

As TV writer and OCD sufferer Jonathan Solomon wrote in the Long Island newspaper Newsday: “Presenting OCD with complete accuracy would be quite dull. Everybody turns on and off light switches; we just do it over and over.”

The environmental alternative of tracing an illness to childhood — whether to a parent or a traumatic incident — is a handy way to compress a life story and shape a character for a two-hour movie.

And it need not be mental illness that’s being explained. The device also turned up in the Ray Charles biopic “Ray,” with the soul legend’s ambitions and excesses radiating from a tough-loving mother and the sight of his brother drowning in a washtub.

Storytelling economy aside, critics such as Mr. Solomon are galled by one thing in particular: pessimism about recovery. “Worse,” he said, in reference to the profusion of OCD in movies and TV shows, is that “none of the characters takes responsibility for the fact that he or she must recover.”

On both points, Ron Howard’s “A Beautiful Mind” stands out. The Academy Award-winning drama about Princeton game theorist John Nash’s battle with schizophrenic delusions and hallucinations won praise for its accuracy and its realism about recovery (possible, but enormously difficult).

“It is a sensitive, compassionate portrayal, based on facts,” wrote Jacqueline Shannon, former president of the National Alliance for the Mentally Ill.

Unlike so many movies in which the mentally ill have propensities for bloodshed — statistics show they’re more likely to be victims than perpetrators — the John Nash of “A Beautiful Mind” was a “hero.”

Howard Hughes, of course, never recovered. Instead, he retreated.

Such isolation is the fate that most worries mental health activists. In cases where the mentally ill don’t come in from the cold, because of stigma or severity, the debate over the environment vs. the genome becomes strictly academic.

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