Introduction Madness and the Human Condition In Shakespeares great tragedy, Prince Hamlet pretends to be mad to learn the

truth of his fathers, the kings, death. Hamlet knows that in the sixteenth century, as in centuries past, people will disregard the words and actions of a madman. Nor will they consider him capable of plotting and executing revenge. Hamlets pretense is the perfect cover for his intentions. By feigning madness, he becomes, in a sense, invisible to those in the court whom he distrusts. Disarmed by his insanity, they reveal their wrongdoing and guilt. Polonius, the lord chamberlain, suspects as much when he says of Hamlets behavior, Though this be madness . . . there is method int (II, ii, 203204). Shakespeares use of the madman, or the fool, in Hamlet, King Lear, and other plays appealed wildly to the vast numbers of illiterate and uneducated who attended the theater. Hamlets disheveled looks, rude manners, and bawdy puns enjoyed a raucous response from the pit. One might say that Shakespeare exploited the figure of the deranged mind for its theatricality. In plot, character, and theme, however, Hamlet revolves on this central image and theme of madness. The outward signs of madness can be easily mimicked, but the complexity of Hamlets condition cannot be so easily articulated. The prince scolds his one-time friends Rosencrantz and Guildenstern for thinking that they can pluck out the heart of his mystery (III, ii, 351352)easily identify the cause and nature of his condition, be it derangement or something else. The appearance of madness makes visible Hamlets inner turmoil, but it cannot identify or explain it. Madness is part of the human condition, not separate from it. Shakespeares use of madness in Hamlet is effective because the character is more than the outward appearance of madness, more than what is so often a stereotype. Ultimately, Shakespeares play is concerned with the human condition and with the shared plight of humans who can feel small and powerless. Always, Shakespeare brings the audience back to the humanity of the character, whether sane or insane, and his commonality with all other humans. It should be no surprise that madness has also been a popular subject of American movies. In film as on the stage, madness can be exquisitely visible. Consequently, the mentally disturbed person has been a frequent object of exploitation in the movies. In appearance, gesture, and speech, the insane person has been portrayed as an outsider and, at the worst, an alien who fascinates and horrifies the audience. Some critics even say that the majority of American movies that depict mental illness exploit it. Otto F. Wahl in Media Madness: Public Images of Mental Illness acknowledges that films about mental illness . . . have included many well-crafted and critically acclaimed . . . ventures (4), but he concludes that media images of mental illness do not measure up well (1213). Mental health advocate Rosalynn Carter makes the following assessment in her 1998 Helping Someone with Mental Illness: Of the hundreds of movies in which psychiatrists or psychiatric hospitals have been depicted, we need

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only think of One Flew over the Cuckoos Nest to understand how negatively they can be characterized (230). Although the hospital and the staff are portrayed negatively in Milos Formans 1975 film, those portrayals do not support Carters larger claim that the movie depicts mental illness and psychiatry inaccurately and insensitively. In fact, since the 1940s, when the first notable American movies about mental illness were produced, numerous films, including One Flew over the Cuckoos Nest, have created honest, memorable images of the internal chaos experienced with schizophrenia, paranoia, depression, and a variety of other conditions. Even some early films, such as The Snake Pit (1948), Dont Bother to Knock (1952), and Fear Strikes Out (1957), present their central characters sympathetically, albeit trapped in stereotypes or victimized by doctors, nurses, and institutions ill equipped to help them. The best movies have also explored the complexity of mental illness, the mystery of it, to use Hamlets word. Like Hamlet, some movies have succeeded in getting beyond the outward appearance and portraying the underlying humanity of the character who is severely mentally ill. Ron Howards A Beautiful Mind manages just that by representing the voices a person with schizophrenia hears as imaginary characters on screen. A number of films have explored the very nature of madness, examining, as Sidney Lumets Equus does, the relationship of madness to passion or, as Norman Jewisons Agnes of God does, its kinship to ecstasy or rapture. Other films, such as John Cassavetess A Woman under the Influence, consider the difficulty of defining madness and understanding its relationship to perception. These and other movies not only reject the stereotypes associated with mental illness.1 They also question the labels, approaches, and treatments applied by the established medical community. People who suffer from schizophrenia, paranoia, and other serious mental illnesses often exhibit an otherness. They do not fit the norm, either in their speech patterns, their facial expressions, the way they dress, or a combination of features and aspects. Formans film captures this differentness in R. P. McMurphy and the other patients on the ward masterfully, without exploiting it. Instead, One Flew over the Cuckoos Nest seeks to uncover the relationship of the otherness to sanity, or the norm, and thereby to contribute to an understanding not only of madness but of the human condition. In its depiction of the iron-willed Nurse Ratched and the mannequin-like hospital attendants, for example, One Flew over the Cuckoos Nest showcases both the general populations fear of mental patients as aliens and the need to control or overpower them, sometimes disguised, whether knowingly or unknowingly, as caregiving. In this book I am concerned not with the hundreds of movies that exploit certain myths and stereotypes of the mentally ill, although I will identify and discuss some of those false notions. I will not discuss the movies that exploit the subject for horror or violence. I am concerned instead with American films that treat the subject honestly, increase the audiences understanding of the subject, and challenge viewers assumptions and attitudes. Whether they are dramas, thrillers, or comedies, American movies that portray mental illness intelligently tell moviegoers not only about the way Intro-2

the person suffering with schizophrenia or paranoia, even simple neurosis, sees reality and relates to it, but also about the way the so-called normal person perceives and interprets the mentally ill person and defines reality. Mental illness is, first, exactly thatillnessand the discussions in People Like Ourselves: Portrayals of Mental Illness in the Movies take into account current medical knowledge and treatment of severe mental illnesses, such as schizophrenia and depression. The diagnoses and causes of mental illness, it must be recognized, are myriad and complex. Mental illness can have social and psychological elements, such as upbringing and traumatic events, as sources or as contributing factors. Many major illnesses, such as schizophrenia, are now known to be linked to physiological factors. In any patient, etiology might involve all of these categories of causes. Diagnosis is similarly complex. The symptoms of one person who is diagnosed as having bipolar disease are not identical to those of another person who has this illness. The concern of People Like Ourselves is not with diagnosis and etiologythose are the concerns of psychiatrists and research scientists. Mental illness is, in addition to illness, a part of the human condition. According to the U. S. Surgeon Generals 1999 report on mental health, severe mental disorders afflict about one in five Americans (report overview). Increasingly, even Americans who do not experience severe illness seek counseling and medication for stress, anxiety, and other emotional problems. The concern of People like Ourselves, therefore, is with commonality. This book explores the themes that unite the mentally ill with people everywhere. These common themes dramatically demonstrate that people who suffer from serious mental illness, like people with heart disease and cancer, are people like ourselves. Madness, insanity, mental illnesswhatever the general term usedit remains a mystery in many aspects. Although much progress has been made in recent decades in understanding mental illness and improving treatments, much remains to be known. As in Hamlet, mental illness often manifests visually dramatic signs. Prince Hamlet chides his friends for thinking that by these signs they can understand his derangement. They might better understand his illness by first knowing his human predicament. As a number of the best movies demonstrate, a recognition of the shared human experience that underlies mental illness can illuminate this too often misunderstood condition.

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