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News Outlets Perception of Mental Diseases As Illustrated By James L. Brooks in the Movie, James L. Brooks

Because mental illness is so prevalent today, the most impactful informer of mental illness, the media, must be evaluated and analyzed for accuracy. Careless characterizations of the mentally ill can further contribute to stigma surrounding mental illness, preventing those is need of help from seeking treatment and creating unfounded fear and social discomfort. To that end, the portrayal of a mental disorder in the 1997 film As Good As It Gets is examined to determine whether the main character, Melvin Udall, meets the criteria for an obsessive-compulsive or related disorder, and whether the film depicts a person struggling with mental illness in an accurate and true light. The film’s representation is also appraised to determine whether the movie further stigmatizes or combats stigma of mental illnesses.

Mental illness is a growing topic of interest for almost everyone, including medical professionals, pharmaceutical companies, various forms of news and media, and of course, those affected by a mental disorder. The lifetime prevalence of any mental illness is 50%, and the one-year prevalence is 25% (Sue, Sue, Sue, Sue, 2013). Therefore, in a given year, approximately 25% of adults have a diagnosable mental disorder, and 50% of adults will meet the criteria of a mental illness in their lifetime. It is highly likely that an individual has or will come into contact with mental illness in some form, such as through relationships with individuals who meet the criteria for a mental disorder, information from news or film media, through some other guise. However, the pervasiveness of mental illnesses is unharmonious with stigma and perceptions of it. Only 57% of American adults and 25% of American adults who display symptoms of mental illness view others as “caring and sympathetic” towards those described as having a mental disorder (“Stigma of Mental Illness,” 2011). Approximately 75% of both Americans and Europeans do not seek treatment for symptoms of mental illness, with stigma associated with mental illness being the major deterrent (Krans, 2014). Researchers have investigated the perpetuators of stigmatized forms of mental illness, and have found that the public derives the majority of its information concerning mental disorders from the media. In fact, one study concluded that depictions of mental illness in media are so influential that they can invalidate one’s own personal experiences of mental illness (Alexander, 2009, 31). Because of the media’s potent ability to shape and create stigma of mental illnesses, portrayals of mental disorders, such as those in films and movies, must be analyzed and evaluated to determine their accuracy in depicting humans with mental health conditions that may influence perception of those with mental disorders by the public.

Movie Introduction

Synopsis

As Good As It Gets is an example of the media’s portrayal of a mental illness. This film was released on the 25th of December 1997 and was directed by James L. Brooks. Mark Andrus was in charge of the story and worked with Brooks to develop the screenplay. Jack Nicholson stars at Melvin Udall, Helen Hunt as Carol Connelly, and Greg Kinnear as Simon Bishop. This film has thirty-seven nominations and has won forty-one awards, including two Oscars and three Golden Globes (As Good As It Gets).

Melvin Udall is a rude and bigoted author who suffers from Obsessive-Compulsive Disorder. This film depicts the relationships Udall has with Simon Bishop, a homosexual artist and Udall’s neighbor, and Carol Connelly, the only waitress who tolerated Udall at his favorite diner. The movie chronicles Udall’s changes from a mean-spirited and hurtful man to a kinder and helpful neighbor as he struggles to care for Verdell, Bishop’s dog after Bishop is attacked in his home and must be hospitalized, and how he helps pay for Carol’s son’s medical treatment after Carol leaves work to care for Spencer. As Good As It Gets depicts the relationship that develops between three individuals that does not conform to society’s typical definition of friendship, and how a mental illness impacts a person and his or her relationships with others.

Impact on Critics and Audiences and Public Reception

As Good As It Gets has 7.8 out of 10 stars on the Internet Movie Database and 4 out of 5 stars on Amazon.com. Because this movie was released in 1997, when movies did not always present mental illness in a favorable light at all, this film was viewed as almost the first of its kind. The first couple reviews on the Rotten Tomatoes website do not mention mental illness or obsessive-compulsive disorder at all, instead describe this movie as a comedy (while still rating it 7.8 out of 10 stars). A very enthusiastic reviewer comments Jack Nicholson’s acting, describing him as “simply phenomenal” and describing himself as being “mesmerized by Jack’s intricate facial expressions and inflections” (As Good As It Gets). Because the majority of the reviews are from the time the movie was released, when neutral or positive mental illness portrayals were rare, and individuals with mental disorders were not viewed as having functional relationships or the ability to change, this film was viewed as a breakthrough. However, because of increasing public knowledge of mental disorder and some of their characterizing features, I believe critics today would harshly review the film in its association of obsessive-compulsive disorder only to an unlikeable and barely lovable man.

Film Analysis

Editing

The editing of As Good As It Gets towards the beginning of the film pairs scenes that depict Melvin Udall as an insensitive and unpleasant man. The audience’s first impression of Udall is the disgusted look the elderly grandmother makes when she catches sight of Udall, who is off-camera. The audience’s first view of Udall himself is a violent one: he shoves the elevator door open, and verbally abuses a small dog, which he then pushes down the trash chute. This initial representation of Udall is strongly negative. He is depicted as being disliked by two characters viewers relate and sympathize with – a sweet grandmother figure and a small, cute dog. The editing of the film also stages a conflict between Simon Bishop and Melvin Udall. Simon, whose dog Udall has just thrown down the trash chute, asks Udall if he has seen Verdell. Udall lies to Bishop, making him appear untrustworthy and duplicitous to the audience. Later, after Verdell is returned to Bishop, Udall so continually and rudely interrupts Simon’s attempts to confront him that Frank Sachs, Bishop’s art dealer, must be physically held back from attacking Udall. The editing of this film persistently depicts Melvin Udall as the social outcast throughout the film by combining scenes that highlight Udall’s lack of sociability. Two scenes in which Udall makes homophobic and racist comments are presented early in the film; this characterization of Udall’s negative stereotypes and unsuccessful social interactions and reinforced throughout the film, in scenes where none of the waitresses wish to serve Udall, Udall is finally kicked out of the diner and the restaurant erupts in cheers, and the insensitive comments Udall makes about Carol’s son’s death. Because Udall is the only character in the film to display these socially undesirable traits, when the audience learns that he has obsessive-compulsive disorder, Udall’s personality is attributed to the mental illness. As Good As It Gets presents Melvin Udall, and the mental illness he represents, in such a strong, unfavorable light, that viewers may not be able to overcome their first impression of a person suffering from obsessive-compulsive disorder, no matter how much he may change.

Art Direction

Although Melvin Udall is portrayed in a light detrimental to those suffering from mental illness, the art direction balances the main character by creating an environment more comfortable to the audience. The film takes place in New York City, making Melvin Udall another eccentric New Yorker. Having Udall reside in a large and famous city makes him more relatable to the audience. If any viewer has visited New York, or any other densely populated city, he or she has likely come across someone who has a mental illness, although one may not immediately come to that conclusion if he or she has not been shoved aside by someone trying to avoid cracks in the sidewalks as Melvin does. Nonetheless, Melvin Udall lives in a city that is meant to symbolize America’s acceptance of differences, with Lady Liberty welcoming immigrants of all religions, races, and cultures in the back of the audiences’ minds. The auditory component of the film serves as a foil to Udall’s character as well. Although the opening scene closes with Verdall’s whimpering as she slides down the trash chute, the opening music is bright and cheerful. Later in the film, Udall plays an uplifting song on the piano, singing to himself to look at the bright side of life (29:51). Although the juxtaposed negative portrayal of Melvin Udall and the positive background music could further separate Melvin from the audience, the music serves to highlight the possibility of some goodness of Melvin shining through. Another auditory component that influences viewers’ perception of Melvin is his use of language. Melvin often shouts and hits the table at the diner, causing those around him to jump. These startling noises unsettle the audience, and oftentimes overshadows Melvin’s large and clean apartment, which shows his success as an author in New York City.

Narration

As Good As It Gets contains three perspectives. One follows Udall, another Bishop, and another Connelly. The narration in the film mirrors the relationship that grows between the three characters. Initially, each perspective only overlaps with one other at a time; as Udall, Bishop, and Connelly grow closer, the perspectives merge into one. Later in the film, the first time Bishop and Connelly’s perspectives overlap emphasizes Udall’s separation from the two, the final conflict of the film. The last perspective resolves this conflict when Udall and Connelly are shown together, as Melvin goes after Carol.

The narrative strategy throughout the film also serves to reinforce Udall’s character. Scenes in which Udall is viewed negatively by other characters in the film are shown one after another, emphasizing his distastefulness from multiple viewpoints. The editing sequence works with the narration’s choice of events the characterize Udall as obsessive-compulsive and offensive in the beginning and throughout the movie by pairing similar scenes one after another to barrage the viewer the film’s characterization of Melvin Udall, a man with obsessive-compulsive disorder.

Analysis of DSM-5 Criteria

DSM-5 Criteria

The Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) related Obsessive-Compulsive and related disorders closely to anxiety disorders. Disorders related to Obsessive-Compulsive Disorder include body dysmorphic disorder, hoarding disorder, trichotillomania (also known as hair-pulling disorder), excoriation (or skin-picking) disorder, substance or medication induced obsessive-compulsive and related disorder and other specified and unspecified obsessive-compulsive and related disorders (American Psychiatric Association, 2013, 235).

The diagnostic criteria for Obsessive-Compulsive Disorder include the presence of obsessions and/or compulsions. Obsessions are thoughts that occur repeatedly and continually which the individual views as undesired and disruptive, which are combatted through other thoughts and actions, that cause anxiety and distress. Compulsions are the repeated actions or mental steps the individual feels compelled to perform in response to obsessions. Repeated behaviors include washing of the hands, checking, and ordering, or mental acts, such as praying, counting, repeating words silently. Compulsions are intended to combat anxiety and distress, although they are not realistically related to the obsessions. Although obsessions and compulsions differ among individuals, the most common symptoms include cleaning (obsession with contamination and compulsions of cleaning), symmetry (obsession with symmetry ad compulsively repeating, ordering, and counting), banned or socially undesirable thoughts (obsessions with aggression, sexual actions, or religion and complimentary compulsions), and harm (obsessions with fears of harming oneself or others and associated checking compulsions) (American Psychiatric Association, 2013, 235-236).

The next criterion for obsessive-compulsive disorder is for the obsessions and/or compulsions to be time-consuming (taking an hour or more of each day) or causing distress or dysfunction in social, occupational, or other areas of function. The symptoms cannot be the physiological effect of a substance or some other medical condition. Finally, the symptoms of obsessive-compulsive disorder cannot be better explained by some other disorder (American Psychiatric Association, 2013, 237).

Analysis of Fulfillment of DSM-5 Criteria

Melvin Udall only partly fulfills the first diagnostic criterion of obsessive-compulsive disorder, the presence of obsessions and/or compulsions. The film As Good As It Gets does not characterize any obsessions. Viewers are not privy to Udall’s mental processes, but even so, Udall’s speech and actions do not appear significantly anxious or distressed. Because Melvin Udall appears to have no obsessions, the compulsions he displays are not responses to attempts to suppress obsessions. Although Melvin Udall does demonstrate examples of compulsions, such as his checking and locking of his apartment doors multiple times (3:46), counting to the number five repeatedly (3:55), turning on the lights five times (3:59), and using a new bar of soap after washing his hands repeatedly (4:42), and his avoidance of stepping on cracks on the sidewalk (10:30), these compulsions fulfill the behavioral aspect, but not the mental component. The compulsions are also not intended to reduce anxiety or stress or prevent situations or events from occurring because Melvin does not have obsessions that cause his anxiety or stress. Because Melvin Udall does half the criteria for compulsions, he may fulfill the first criteria for obsessive-compulsive disorder.

However, Melvin Udall’s compulsions do not appear to be excessively time-consuming. The editing of the film only spends a few minutes detailing Udalls’ compulsions, implying that they may not even consume a whole hour, especially because most of the compulsions are not excessively (if at all) obtrusive or distressing to Udall. Because Udall is a successful author who has published over sixty books, his work does not appear to be impaired. Although Udall is depicted as mean, rude, and disliked by others, other characters’ aversions to him do not overwhelmingly stem from his compulsions. His behavior is what causes others’ disapproval of him. However, his behavior is not motivated entirely by compulsive related distress; instead, he offends people with his perpetuation of stereotypes and harsh language, which are not clearly connected to an obsessive-compulsive disorder, but may indicate a personality disorder.

Because Melvin Udall does demonstrate any substance use or medical condition, his behaviors do fulfill this criterion for obsessive-compulsive disorder. However, because Udall has not undergone intensive psychiatric evaluation, the film does not address whether his symptoms may be better explained by some other disorder.

Although Melvin Udall does display compulsions, I do not believe he meets the criteria of an obsessive-compulsive or related disorder. Some form of personality disorder may better explain his symptoms and behavior instead.

Reflection

I believe that As Good As It Gets ultimately somewhat further stigmatizes mental disorders, despite its its attempts not to. Melvin Udall does not clearly nor definitely fall into a specific category of mental disorder, but the film only describes him as having obsessive-compulsive disorders, misinforming viewers who may have no knowledge of the symptoms of OCD. Viewers may attribute Udall’s personality characteristics to the disorder. Further, the character also perpetuates the stereotypes of unpredictability by his loud and socially unacceptable behavior at the diner and the inability to form meaningful relationships because he has no evident functional relationships other than the ones he has with Bishop and Connelly, who appear to “fix” and be the cause of change in Udall.

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