Magazine article Clinical Psychiatry News

Suffering Fools Gladly (When the Joke's on Us)

Magazine article Clinical Psychiatry News

Suffering Fools Gladly (When the Joke's on Us)

Article excerpt

Early in my career, I seethed while watching psychiatrists portrayed as nincompoops in the movies. Like Rodney Dangerfield, I thought we got no respect. Over the years I seem to have shed this defensiveness, perhaps as a function of feeling more secure in my work (or reconciled to my foibles). These days I can enjoy satirical takes on our profession and, indeed, find that the comical exaggeration of countertransference and boundary issues, when well conceived, can resonate with clinical experience. The best among such films can serve as useful teaching tools.

Picking Winners

Before sharing my favorite comedies about psychiatrists, here's a word on how I chose them. The movie has to be funny, pretty much from start to finish: a tough and shamelessly subjective criterion. Some people loved "What About Bob?" featuring Bill Murray as the neurotic patient from hell and Richard Dreyfuss as his pompous psychiatrist. Their superficial, stereotypic portrayals would have made a hilarious half-hour sketch, but 90+ minutes of their antics got too tiresome for me.

Even if the featured psychiatrist is a cipher, there should be some redeeming qualities with which we can sympathize. If the portrayal is purely negative, it is merely a slur on our profession and usually bad theater as well. That was the case in "The Couch Trip," in which an antisocial patient (Dan Aykroyd) impersonates his own psychiatrist (an indifferent bumpkin) in order to make money filling in for another psychiatrist (a narcissistic jerk) who doles out advice on a radio talk show.

Worthwhile satire is rooted in clever, knowing ridicule of our real foibles. Uninformed or superficial silliness won't do, as demonstrated in films like "What's New Pussycat?" or "Beyond Therapy." Other disqualifiers for me are films where the psychiatrist role is a mere cameo, however funny, like Alan Arkin as the terrified doctor treating a hit man in "Grosse Pointe Blank," or where the psychiatrist morphs into some other character entirely, as Billy Crystal did, becoming a Mafia lieutenant for his crime lord patient in "Analyze This." So here's my short list of winning comedies.

Who's Treating Whom?

How often do we benefit from some element in the therapeutic relationship with a patient? Carl Jung and Irvin Yalom are among those who have written that in an authentic therapy relationship, this should always be a possibility. This theme is explored in "Don Juan DeMarco," a 1995 film directed by Jeremy Leven, who also wrote the screenplay. Leven was trained as a clinical psychologist, and his background shows in this clever farce.

Marlon Brando plays Dr. Jack Mickler, a public hospital psychiatrist on the threshold of retirement, who chooses to treat the title character, a grandiose, presumably psychotic young man (Johnny Depp), who has adopted an alias and boasts that he is a reincarnation of Lord Byron's legendary lover. As bright manic patients often do, the facile DeMarco discerns exactly which buttons to push to provoke and manipulate his therapist's vulnerabilities, in this instance Dr. Mickler's demoralization at the prospect of growing old.

Mickler is especially troubled by the flagging passion in his marriage (to Faye Dun-away). "I see as clear as day," the courtly DeMarco says in an early therapy session, "that this great edifice [the hospital] in which we find ourselves is your villa. It is your home and as for you, Don Octavio DeFlores (DeMarco's name for Mickler), you are a great lover like myself, even though you may have lost your way and your accent. Shall I continue?"

Charmed by DeMarco's libidinal swagger, Mickler lets himself be swept into identifying with his young patient, a process that arouses the good doctor from his torpor. Dr. Mickler, however, is no simpleton; by permitting DeMarco to play out his invented persona, Mickler is able to influence his patient enough to make a difference. …

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