For the first several years of teaching Movies & Madness, I began the semester with Milos Forman’s classic One Flew over the Cuckoo’s Nest (1975). This tradition ended when a student who had taken the class sent me an email with a link to the trailer for a film due to be released in the coming months. In her message, she said that she and her friends were out at the movies and, when she saw the trailer for Shutter Island (Scorsese, 2010), she knew I would be interested. After watching the film (my husband and I had a rare date night after which he said, “Next time, can we have a date where you’re not working?”), Cuckoo’s Nest was replaced as the opening film for the class.
My current group of students will be watching Shutter Island this evening. Shutter Island was directed by Martin Scorsese and stars Leonardo DiCaprio. The film is based on the novel of the same name by Dennis Lehane (Gone Baby Gone, Mystic River). Their instructions will be to watch the film mindfully and intentionally. Their charge will be to answer this question: What does this film communicate to the audience about people with mental illness and mental health care providers?
Chuck: All I know is that it’s a mental hospital.
Teddy: For the criminally insane.
Chuck: Yeah, if it’s just folks runnin’ around hearing voices and chasin’ after butterflies they wouldn’t need us.
The story is set in the 1950’s and begins with U.S. Marshals Teddy Daniels (Leonardo DiCaprio) and Chuck Aule (Mark Ruffalo) arriving at Ashecliffe Hospital on Shutter Island to investigate the disappearance of one the patients. The woman (Rachel Solando) they are looking for murdered her own children but lives in a delusional world where she believes that they are still alive. The appearance of the island as they approach is menacing and the music dark. As they walk up to the gates, Teddy and Chuck are met by the Deputy Warden (John Carroll Lynch) who takes their firearms before allowing them to enter. He states that they “only take the most dangerous, damaged patients” making it clear to the audience that they are walking into a very, very dangerous place.
In many ways, Shutter Island is a typical “asylum” thriller involving a number of common elements including a series of “zoo” scenes which serve to introduce the main characters and the audience to the patients and the facilities. In Shutter Island this first occurs as Teddy and Chuck approach the hospital building after entering the gates. The first patient encountered greets them with a silly, childlike grin and wave. He is manacled and is raking the lawn. The next man is older, also manacled, and he stares blankly as the men walk by. His clothes are faded and old. Some patients appear to by attended by individual staff who shepherd them around and monitor them as they work. The most memorable patient shown prior to their entry into the building is a woman whose image was heavily used in promotional material for the film. She is manacled, emaciated, much of her hair is missing, her eyes are darkly clouded, and her teeth black and decayed. She initially communicates a warning (“Shhh”) but then switches to coquettish flirting.
The hospital/prison is highly secured with locked gates, electrified fencing, and alarms. Patient rooms are barren and lack personalization. The day room includes patients smoking, playing cards, and otherwise engaging in either bizarre or purposeless activities. Later, two more patients are interviewed. One is a young man dressed a tattered sweater vest with a boyish hair style. He committed a very violent crime but he has an aggressive tantrum when pushed. The second is an older woman who murdered her abusive husband. She is composed and calm at first but becomes frightened and agitated by the end of the interview. Finally, viewers are introduced to the Ward C patients who are male, violent, and frequently very bizarre in appearance. Several are naked. One is tearing at his skin and marking the wall in blood. The physical space of Ward C is wet, dark and industrial. It is a haunted house of horrors.
In his book Media Madness (1995), Otto Wahl argues that people with mental illness in the mass media tend to be presented with certain, stereotypical attributes: Dangerous/Unpredictable, Childlike/Incompetent, Blameworthy/Malingering, and Contagious/Untreatable.
Throughout the film, the patients are presented as dangerous and unpredictable while simultaneously being childish and incapable of caring for themselves. In addition, their crimes are morally reprehensible. This serves to enhance their blameworthiness and underscore the belief that no treatments will work.
The characteristics outlined by Wahl are especially obvious in the central character of the film. It eventually becomes clear that Teddy Daniels is actually Andrew Laeddis. Andrew is no longer a U.S. Marshal and is a patient at Ashecliffe. He is there as a result of murdering his wife because she killed their three children. He no longer acknowledges his identity as Laeddis instead adopting the complex delusion that he is the hero Teddy Daniels. Even before the audience knows who he really is, he is violent, unpredictable, unstable, and obviously stressed. He is shown experiencing hallucinations, delusions, flashbacks, nightmares, and headaches. He becomes increasingly paranoid as the story unfolds. The audience finds out along the way that Andrew is a decorated war veteran who may have committed atrocities of his own while liberating Dachau. It is more than implied that he has been traumatized by his wartime experiences and may be suffering from PTSD. It is also suggested that he is an alcoholic. In one character, the audience sees a man who has suffered multiple traumas, is an addict, has a wife who has bipolar disorder which he ignored, whose wife drowned their three children while psychotic, and he murdered his wife because of what she did.
As is the case in many films in this genre, the idea that mental illness is contagious (or at least contaminating) is communicated in Shutter Island in terms of the transformation endured by the film’s main character. As was the case in One Flew over the Cuckoo’s Nest, the protagonist enters the hospital in street clothes with a strong sense of identity. As the film progresses, the relatively colorful suit and tie are stripped away and replaced by a white orderly uniform. In the final scene, he is wearing the same greys and blues as the other patients and is submitting himself to an identity erasing procedure.
Dr. John Cawley (Ben Kingsley) seems sincere and caring but also deceptive and guarded. He presents a philosophy that is actually quite progressive. He says that he has “…this radical idea that if you treat a patient with respect, listen to him, try and understand, you just might reach him.” He argues against pharmaceuticals, psychosurgery, and harsh treatments. He argues on behalf of the patients as the storm approaches. And, as the film concludes, he is shown to have gone to extreme lengths professionally and personally to treat individual patients regardless of their crimes. As he states, “My job is to treat my patients not their victims. I’m not here to judge.” At the same time, the elaborate treatment he has designed for Andrew is at best unethical.
Dr. Jeremiah Naehring (Max von Sydow) is presented as a stereotypical, European, psychoanalyst. He asks Teddy questions which are intensely personal and in some ways threatening. Invoking the image of a German doctor is intended associate psychiatry with the acts of the Nazi’s in WWII concentration camps. Naehring is decidedly more harsh and controlling in his approach to treatment. He is “Dr. Evil” in contrast to Cawley’s “Dr. Wonderful.” When they are introduced, Naehring pushes Teddy/Andrew to see himself as a man of violence tainted by trauma.
Dr. Jeremiah Naehring: Did you know that the word trauma comes from the Greek for wound? What is the German word for dream? Traüme. Ein ist traüme. Words cannot create monsters. You…you are wounded, Marshal. Wouldn’t you agree, when you see a monster you must stop it?
Teddy Daniels: Yeah. I agree.
The nursing and support staff at times appear professional and engaged while at others disinterested or disdainful. The following is one memorable interchange:
Teddy: Huh. Anything unusual occur?
Nurse: Define unusual.
Teddy: Excuse me?
Nurse: This is a mental institution, Marshal, for the criminally insane. Usual isn’t a big part of our day.
The guards are generally authoritative and apparently competent but menacing music often accompanies their arrival in scenes. The Warden (Ted Levine of The Silence of the Lambs and Monk) while not appearing in many scenes in the film, has an interchange with Teddy/Andrew during which he makes essentially the same argument as Naehring but in more colorful language.
Teddy: I’m not violent.
Warden: Yes, you are. You’re as violent as they come. I know this, because I’m as violent as they come. If the constraints of society were lifted, and I was all that stood between you and a meal, you would crack my skull with a rock and eat my meaty parts. Wouldn’t you?
Ultimately, the Warden has a great deal of control over Teddy/Andrew’s fate.
Finally, Dr. Sheehan (Chuck Aule) has been playing multiple roles in Andrew’s treatment. As Sheehan, he is his primary doctor directing his treatment. As Chuck, he is Teddy’s new partner. In both roles, he is compassionate and supportive.
Psychic Damage and Unforgivable Sins
The theme that is revisited repeatedly throughout the film is that madness is caused by trauma and violence is an inevitable extension of madness. Wrapped around this causal pathway is the suggestion that people’s choices, their mistakes, their sins, make them deserving of both trauma and madness. For Andrew, he carries guilt from his behavior at Dachau. Even more importantly, however, is the guilt stemming from the death of his children. He knew his wife was ill but he failed to take action and, worse, left his children alone with her. As Sheehan puts it he drank and he stayed away. In essence he is as responsible for their deaths as he is for shooting his wife.
As happens so often in the “asylum” genre, the conclusion to the film reinforces the idea that there is no treatment that will work. The best, the only option is annihilation of the self. Similar to the ending in Cuckoo’s Nest, the lobotomy plays a pivotal role. In this case, Andrew chooses obliteration to life with the full knowledge of his past.
Teddy: You know, this place makes me wonder.
Sheehan: Yeah. What’s that, boss?
Teddy: Which would be worse, to live as a monster or to die as a good man?
[Teddy gets up and walks towards Cawley and the orderlies]
What does the naive viewer take away? Primarily, viewers receive a heavy dose of reinforcement for the stereotypes they probably already believe to be true about people with mental illness and those who treat them. People with mental illness are seen as dangerous, violent, unpredictable, untreatable, and contagious while treatment providers are either brutal and controlling or simply impotent. I’m left wondering how many times the same tired story needs to be told leaving real people with mental illness to be victims of prejudice and discrimination in the real world outside the theater.