I have renamed my film Raw Vision, which I think represents better its theme of hallucination. This comes from Raw Vision magazine, specialising in Outsider Art, which has its roots from the art of people committed to mental asylums.
Studies show about one fifth of people who regularly have hallucinations are in control of the experience (1). My protagonist straddles this hazy boundary between stable and unstable behaviour. There have been other short films on this topic, including the obviously titled Hallucination, and it allows for interesting visual experimentation.
Inspiration comes from my previous occupation, where I came across the Critical Psychiatry Network, a group of hundreds of psychiatrists. Their concern is reflected in a Report by the United Nations (2013), that states forced psychiatric interventions in health care on basis of disability alone, are forms of torture and ill-treatment (2).
Shock, horror, but most of all: disbelief. How the hell is torture in healthcare possible in the 21st century? We’ve moved on from One Flew Over the Cuckoo’s Nest surely? Well, yes and no. I myself had a patient beg me to write to her psychiatrist to stop her involuntary injections, as she said this made her want to commit suicide.
Nevertheless, psychiatrists I have worked with have been lovely (to me). I was taught psychiatry at medical school. My conclusion then was that extreme altered mental states must be due to dysfunction residing in the brain, but now I realise that this belief was shaped by the remarkable absence of social contexts in psychiatric textbooks. It seems all too easy to sidestep the interface between an extreme thought/perception and its social world (3,4).
World Health Organisation studies found that patients with extreme altered mental states in developing countries experienced significantly longer periods of unimpaired functioning compared to the West, although only 16% of them were on continuous psychiatric medication (compared with 61% in developed countries). A WHO researcher stated: ‘A strong case can be made for a real pervasive influence of a powerful factor, which can be referred to as “culture” (5)’.
Yes, CULTURE. Films affects culture, and vice versa. In Real to Reel, Psychiatry at the Cinema, psychologist Ron Roberts notes of A Beautiful Mind: ‘The film is therefore premised on a lie, a gigantic one at that’. He refers to the portrayal of John Nash becoming functional and able to teach again due to continuing psychiatric medication, together with a review statement: ‘Without that there would be no film’ (6). In reality, Nash stated his function returned ‘ultimately without medicine’ (7).
Is this fear? Fear that such people off meds may destabilise and in the worst case scenario, kill? Yet WHO studies, and others, suggest something far more important than medication is necessary for stabilisation.
The 26th Congress of the World Federation for Mental Health noted that overwhelming negativity in Western societies, such as assumptions that these people are ‘insane’, immediate sick role typing, and covert rejection and social isolation, are cultural factors identified by researchers as increasing chronic disability (8). Dominance hierarchy models (9) suggest origins of these altered mental states may be linked to subordination or social exclusion of the individual (social defeat (10)), so cultural attitudes may create vicious circles.
To counter negative interpretations (linked to legally sanctioned coercive medical practices) my film presents hallucination in a positive light, but also as problem-solving, because:
Science and medicine don’t actually know what’s going on in these cases. One interpretation is that these people are ill. Other scientific interpretations include that, like a delirious person with a raging fever (the high and temporarily disabling temperature necessary to resist a virus/bacteria that may otherwise kill the person) extreme altered mental states form part of a healing process to trauma. If this process is interrupted or overwhelmed, supposedly this could increase risk of negative outcome (this concern led to Soteria Houses) (11, 12, 13,14).
The scene in my film where the spiritualist tells my protagonist: ‘We’re having a healing session today’, is derived from this idea. It is alluded to only, because indirect association is more representative of the dream-like altered states of consciousness that characterise these experiences (15).
Complex system interpretations describe forces pushing a system to tipping point, with amplification of the system’s behaviour to extreme and erratic values, whereby the system evolves creatively to a new, more stable state or collapses (16, 17). This is more popularly applied to climate change, in that we are approaching a climate tipping point now!
The variety of relationships/interconnections may increase the chance of a successful outcome. Could there be unknown consequences to our society if it is chronically disabling thousands of potentially creative individuals? That is a practical and ethical question which we ignore and deny.
The market for my film is young adults and people who have an interest in unusual/extreme perceptions. Following feedback, I have added a scene which highlights that while these experiences may have subjective meaning, such meaning may be culturally rejected.
Comparable films include Girl Interrupted (about extreme personalities) which won Jolie an Oscar, Ghost, a major box office hit (a man’s ghost helps his partner) and Donnie Darko, a cult hit (where Donnie’s apparent ‘schizophrenia’ turns out to really be a race to save the Universe!!)
References
(1) Jones SM (2012). Hearing Voices: The Histories, Causes and Meanings of Auditory Verbal Hallucinations. Cambridge University Press. p.187. (2) Mendez JE (2013). Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment. Human Rights Council, United Nations General Assembly A/HRC/22/53 (3) Tamimi S (2014). No more psychiatric labels. Why formal psychiatric diagnostic systems should be abolished. International Journal of Clinical and Health Psychology 14(3): 208-215 (4) Gunn (R), Bortolotti (L) (2018). Can delusions play a protective role? Phenomenology and the Cognitive Sciences 17, 813-833 (5) Jablensky A, Sartorius N (2008). What Did the WHO Studies Really Find? Schizophrenia Bulletin 34(2): 253-255 (6) Roberts R (2011). Real to Reel: Psychiatry at the Cinema. PCCS Books. (7) Naser S (2002). A Beautiful Mind. Faber and Faber. p.353 (8) Jilek WG (2001). Cultural Factors in Psychiatric Disorders. Paper presented at the 26th Congress of the World Federation for Mental Health. (9) Price J (1967). The Dominance Hierarchy and the Evolution of Mental Illness. The Lancet 290 (7509): 243-246 (10) Selton JP, van der Ven E, Cantour-Graae E (2013). The Social Defeat Hypothesis of Schizophrenia: An Update. Schizophrenia Bulletin 39(6): 1180-1186 (11) Epstein S (1979). Natural Healing Processes of the Mind I. Acute Schizophrenic Disorganisation. Schizophrenia Bulletin 5(2): 313-319 (12) Perry JW (1998). Trials of a Visionary Mind. SUNY Press. (13) Scheepers FE, Mul J, Boer F, Hoogendijk WJ (2018). Psychosis as an Evolutionary Adaptive Mechanism to Changing Environments. Frontiers in Psychiatry 9: 237 (14) T Calton , M Ferriter, N Huband N, H Spandler (2008). A systematic review of the Soteria paradigm for the treatment of people diagnosed with schizophrenia. Schizophrenia Bulletin 34 (1): 181-92 (15) Scarone S, Manzone ML, Gambini O, Kantzas I, Limosani I, D’Agostono A, Hobson JA (2008). The Dream as a Model for Psychosis: An Experimental Approach Using Bizarreness as a Cognitive Marker. Schizophrenia Bulletin 34(3): 515-522 (16) Hayes AM, Laurenceau JP, Strauss JL, Cardaciotto L (2007). Change is Not Always Linear: The Study of Nonlinear and Discontinuous Patterns of Change in Psychotherapy. Clinical Psychology Review 27(6): 715-723 (17) Lenton TM (2020). Tipping Positive Change. Philosophical Transactions of The Royal Society B, Biological Sciences 375:1784