TV Gets Into the Loony

Hollywood is into crazy. Mental illness, madness, obsessive behavior, multiple personalities, schizophrenia -- you name it, it's been depicted by nearly every big star, including Robert DeNiro, Sally Field, Leonardo DiCaprio, Anthony Hopkins and Barbra Streisand.

Every once in awhile, they get it right. But more often they get it terribly wrong. And the problem with that, experts say, is that it creates misconceptions and stigma for those afflicted.

Now that the small screen has gotten into madness, viewers can look forward to weekly visits of characters with some form of mental illness. Along with Tony Soprano's visits to the psychiatrist to delve into his demons, newer shows like TNT's "The Closer" and USA's "Monk" portray compulsive behavior with differing degrees of success.

In "The Closer," Kyra Sedgwick's character has something of a food obsession. As the credits roll and the case is solved, Sedgwick's Los Angeles police detective Brenda Johnson, lovingly devours a chocolate doughnut, more specifically, a Ring Ding, wrapped in foil. End scene.

The way the directors have decided to show the food obsession is to usually linger on a food item. There is no discussion about eating or obsessing over eating.

Tony Shalhoub's character Adrian Monk in "Monk" has obsessive compulsive disorder.

Both characters' obsessive behavior in some ways fuels their success. Monk's attention to detail helps him solve cases. Johnson's food obsession in some ways fills a void, something people with food obsessions and eating disorders often say.

"One of the things that film can do well is to capture visually the internal experience of someone with a mental illness," said Glen O. Gabbard, professor of psychiatry at Baylor College of Medicine in Houston.

OCD groups have taken on "Monk" as a kind of poster boy.

"His success is tied to his OCD and dependent upon it," noted Patricia Perkins, executive director of the Obsessive-Compulsive Foundation. "And I think the show is very funny."

Perkins, who has OCD, said the writers of the Emmy Award-winning show do a good job at giving Monk true OCD-style symptoms.

The disorder, characterized by superstitious beliefs, excessive worrying and doubts, manifests itself in extreme hand-washing, touching, counting, cleaning and straightening items out of order. It affects one in 50 adults in the United States, according to statistics compiled by the foundation.

"For entertainment purposes, they give him more symptoms than people normally would have," Perkins said. "But they do a very good job of using the symptoms in a way that doesn't offend."

Many times, though, the depictions are stereotypical and can be detrimental for people with a disorder, perpetuating stereotypes and stigmatizing those afflicted.

"There are so many countless times that we see it done badly," Gabbard says.

Gabbard, author of "Psychiatry and the Cinema" and "The Psychology of the Sopranos," says that, unfortunately, it's easier to name bad characterizations of disorders than good ones.

"The characterization of Howard Hughes' OCD in 'The Aviator' is an example of something that is totally over the top and unrealistic," he said. "The tendency to make it over the top is logical since it is more theatrical. But it does a disservice."

Negative stereotypes of patients with mental illness have a long history in Hollywood. Inaccurate portrayals have an underestimated negative effect on the perception of people with disorders -- by the public, legislators, families and patients themselves, Gabbard says.

"The problem is that you have to make mental illness and the treatment entertaining to keep people interested in film and television," Gabbard said.

It's not just harmless fun, either, Gabbard said.

"The distorted images make their way into a collective unconscious of society and influence the way we all regard the world around us, including the mentally ill," he said. Gabbard co-authored "Psychiatry and the Cinema" with his brother, Krin Gabbard, professor of comparative literature at the State University of New York at Stony Brook.

"The Closer" mimics what some people living with eating disorders or at least a fixation on food may look like when obsessing on their object of desire. But it may also perpetuate a stereotype of single women who use food to fulfill their "unfulfilled desires."

"People become preoccupied with food,"said Walter Kaye, professor of psychiatry at the University of Pittsburgh School of Medicine. "It does sometimes become an issue of self-control and that's certainly why sometimes someone may focus on the object."

In the show's pilot, Johnson eyes a box of full of doughnuts on another cop's desk. Cameras focus on the box while the detectives discuss the case. Johnson nearly takes one but then changes her mind. Finally she carries one back to her office and leaves it on her desk, uneaten.

"It's typical behavior for people who are obsessed with food to also not eat their object of obsession," Kay says. "Also, these people may collect cookbooks but never cook."

We are led to believe that the food obsession fulfills something in the single, middle-aged life of the salty-tongued Johnson.

"For anorexia nervosa it's fairly straightforward," Kay said. "People often don't see themselves as having a problem. They see themselves as fat, and half of them restrict their eating. The other half binge and purge. And many of them say it's about control. This control one feels like they lose sometimes during middle age could be addressed this way. But that's also simplistic."

Listing films that have done a decent job in portraying mental illness is not all that time-consuming, unfortunately, Gabbard said.

He named "A Beautiful Mind," however, as a film that does depict mental illness and its recovery in a fair way.

" 'A Beautiful Mind' does help an audience see how one becomes paranoid," Gabbard said. "The tendency to go over the top is of course still there but they do at least attempt to portray the treatment."

While "Monk" sometimes tends to go for the laugh in its OCD portrayal, overall, it does a good job, too, Gabbard said.

Storytelling economy aside, critics say that the one thing that is most irritating about portrayals of mental illness is pessimism about recovery.

Even Perkins wishes "Monk" would discuss the proper treatment. Instead of going to therapy, which she says does not curb OCD behavior, she wishes the show would talk about medication.

"It's the only treatment that works," she said.

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