A few weeks ago, I went to see the film Silver Linings Playbook with a friend. I was looking forward to it, because I’d heard such good things about its treatment of bipolar. However, about ten minutes in I began to feel distinctly uncomfortable, and by the end I was horrified that anyone could consider it a helpful depiction of bipolar. Since then, I have seen the movie lauded over and over again for its depiction of bipolar and the way it “challenges stigma”, with even Stephen Fry declaring it “perhaps the best example of mainstream film and mental health I’ve seen”. Yet a small minority of bipolars seem to share my concerns, so I thought it was worth setting them out.
A detailed synopsis of the plot can be found here, which I recommend you read if you haven’t see the film or need a refresher before reading on.
As the synopsis shows, absolutely key to the plot is that Pat has ended up an inpatient because he beat his wife’s lover to a bloody pulp, and that he wishes to breach his Restraining Order (this being much of his initial motivation for entering the dance contest with Tiffany). OK, so here’s my problem: I don’t see a bipolar man “losing it” in this film. I see a domestically violent man who happens to be bipolar.
Now, I’m not for one minute trying to deny that some people with bipolar are sometimes violent as a result of their condition – especially when they are undiagnosed and untreated. I have done many things of which I am deeply ashamed when unwell, including some incidents of violence and destructiveness. But to attribute a person’s violent or controlling behaviour to their bipolar, there must be a correlation between mood state and the behaviour. In other words, if a person is violent and/or controlling when they are high, but not when they are euthymic (of normal mood), it’s fair enough to see the behaviour as symptomatic of the disorder. If, however, they continue to display any behaviour of this nature when they are euthymic, it’s indicative of an entrenched pattern of thinking and behaviour which will continue regardless of mood state.
There are, of course, more types of violence than simply physical assault. Programmes for domestic violence perpetrators try to get them to understand and admit that they make use of a range of power and control techniques in their relationships. Psychological violence can take many forms, but a common example that police and probation have to carefully monitor is the deliberate breaching of Court orders such as Restraining Orders, Injunctions and Exclusion Requirements. The perpetrator usually justifies the breach on the grounds that he loves his partner or knows she wants to see him; the actual message to the partner is that even the law cannot keep her safe. As those who work in the field will tell you, it’s a tactic which we know is positively associated with a risk of future physical assault of the perpetrator’s partner. Pat emerges from hospital full of plans for cheerfully breaching his Restraining Order – which prevents him going to his wife Nikki’s home of workplace or seeking to contact her, and from having contact with the victim – and this quickly borders on stalking-type behaviour. And his obsessive attempts to contact Nikki continue after he has started complying with his medication regimen, when appears to be generally calmer, and is able to commit to regular, serious dance practice with Tiffany. In other words, his worrying behaviour around the RO continues when he is otherwise well, and is therefore not dependent on his mood state.
So if Pat’s controlling and aggressive mindset doesn’t stem from being manic or depressed, where does it come from? Well, there is plenty of evidence that Pat’s behaviour is learned and intergenerational, rather than impulsive and linked to bipolar mood swings. He has clearly grown up in a violent home; his dad doesn’t hesitate to pitch in and punch Pat repeatedly in the face after Pat pushes his mother to the ground, and later we learn that Pat Sr is unable to join his son at the big football game as he is barred from the stadium due to his previous violence there.
If you went into a cinema to see Silver Linings Playbook with no knowledge at all of bipolar and how it affects those with the condition, what would you take away from the movie?
– That bipolar meds aren’t particularly pleasant. No quibble there.
– That some people judge you because you have a mental health condition and/or have been an inpatient. Again, no problems.
– That anger, violence and bipolar are closely linked. This is seriously problematic. In fact, study after study has shown that once you control for the impact of substance misuse, those with serious mental illnesses (including bipolar) are no more likely to be violent than the general population.
– That domestic violence (including “jealousy” violence towards other men) is something some with an illness like bipolar just can’t help. This something the vast majority of DV perpetrators I have worked with wanted to be true. It’s easier to cope with your own behaviour if you tell yourself and those around you that you have an illness or “anger management” problems. That means, hey, it’s not really you.
Are those the messages we really want people to internalise about bipolar?
So much for challenging stigma.