The “Evil Psychiatrist” Isn’t Helping Anybody

The “Evil Psychiatrist” Isn’t Helping Anybody

My dad and I are both big movie and TV lovers, and often discuss the stock Evil Psychiatrist character who seems to show up more and more in the shows and films we see. On screen, the psychiatrist is an ideal villain, often set in scary psychiatric wards with unchallenged power over their patients—that is, their victims. After practicing psychiatry for ten years, my dad can only laugh at the blatant errors in the entertainment media’s presentation of psychiatry.

To be clear, I’m not at all belittling or dismissing cases of real malpractice. I will not deny the history of misguided abuse to sick individuals in the name of curing and containing “the mad.” My argument, when it comes to TV, movies and this stock character, is that too often we see the psychiatrist not as a health care provider, but a control-mongering monster with unregulated tactics and ulterior motives. This distorted portrait is, obviously, frustrating and even embarrassing for actual psychiatrists. But the real issue is the damage it does to the public view of mental health care, its practitioners, and its patients. By eroding trust in specialists and the branch of medicine as a whole, TV and movies promote stigmas about mental health care facilities and, in turn, their patients.

My roommate and I have been watching American Horror Story, the precursor to American Horror Story: Asylum. Dr. Harmon in American Horror Story is more clueless than evil, though he still manages to do more harm than good for any of his patients. He treats them in his home (in an office across the hall from his teenage daughter’s bedroom), fails to report repeated homicide threats from a patient, and doesn’t bother with restraining orders or law enforcement when several patients  threaten to kill his family and stalk the outside of his house.

Showing a psychiatrist seeing patients in his home is completely inaccurate, per practitioner safety/confidentiality regulations—our family wasn’t even listed in the phone book (back when there were phone books). Removal from the appropriate hospital setting further enforces the false assumption that metal health care is not medical care, does not require special facilities and can be administered by any handsome white man from the armchair in his den. Of course, psychiatrists like Dr. Harmon always fail their patients, leading the viewer to believe that the patient was (1) not treatable and (2) better off without a doctor.

Despite massive strides in diagnosis and treatment, we still have much to discover about the brain and its functions. Unlike many “physical” illnesses, mental illness has symptoms that aren’t obvious. These can be—and often are—socially isolating, disturbing, and even dangerous to the ill and those around him/her. Most bystanders wouldn’t judge or shame a visibly ill person for vomiting in public, but the manic depressive panicking about aliens on the bus is much more imposing and scary. Public reaction in the form of disgust rather than sympathy, respect, or even simple aid is still socially acceptable. That is because we do not see that person as manic depressive, or even ill. We see them as crazy and dangerous, “probably on something,” or drunk.

“Mental illness” is separated from “physical illness,” thereby assigning a degree of control and choice to the sufferer. But the truth is that mental illness is physical illness. The brain, though more complex and mysterious, is as much a part of the body as the heart or liver or lungs are. Our fear of the unknown, in this case “what makes a person crazy,” is a workable foundation for countless horror entertainment—but when a set of sick people and their doctors are constantly portrayed as sinister, society suffers at large. Mental illness is more likely than other ailments to go untreated, and many mentally ill feel ashamed of their illness or worry about losing other’s trust or confidence. Mental health care often goes unfunded, as donors are more inclined to have their name associated with a new oncology wing than a psychiatric ward, or, as I am amazed to still hear it deemed, the “nut house.”

Certainly I have a bias, as my own dad was a psychiatrist, and I trust his judgment and motives. When we watched A Beautiful Mind together, I asked if he had ever administered electric shock therapy. “Of course, “he said. “Many times.” This disturbed me after watching Russell Crowe get fried in a sterile white room (though this was set in the 60’s when the procedure was less advanced). My dad told me he saw hundreds of patients, mostly severely depressed, improve from electroshock, which was delivered in safe, low voltage to a patient under anesthesia with few, temporary side effects. This is when I realized that the stock Evil Psychiatrist could discourage the mentally ill, or those who care for them, from pursuing medical treatment.

The mentally ill and the doctors who treat them exist outside of sexy thrillers and horror movies. They are not lunatics and villains, only ordinary people who need, more than anything, to be taken seriously.

– Katya Karaz