I’ve been making a point to fill in the “gaps” in my film history lately. Yesterday I finally watched the John Cassavettes classic “A Woman Under the Influence” starring Gena Rowlands and Peter Falk. It is a fantastic film, with two incredible performances by the leads, but it is also emotionally exhausting as you watch an already strained woman entirely unravel. It’s the kind of movie that a modicum of chain smoking would probably make for easier viewing. I broke it into two separate sittings.
Nobody needs a new review of a 50 year old film- Roger Ebert already covered it ably, but there is reason to see it with fresh eyes. The principal word used to describle Mabel (played by Rowlands in a jaw dropping performance) is “crazy”. A least one person refers to her as anxious, but insanity is the general catch-all concept.
When you watch it now, though, you see a woman who would likely be be diagnosed with some variation of bipolar disorder, triggered by social anxiety. If she were to grow up today the observation of repeated physical “ticks” might have been associated with Tourettes or identified as the physical coping mechanisms of a child on the autism spectrum dealing with an avalanche of indecipherable social cues. I don’t actually know – the character is fictional and I am not a psychiatric professional. The point is that there are social, medical, and educational mechanisms in place to help a greater variety of people thrive. Maybe it’s just that we recognize a richer set of personal attributes and diversity of personalities than prior decades. There are handles for a person to grab on to before their life spins out of control.
There exists a sentiment that maybe we’ve gone too far, that we’re overdiagnosing, over- compartmenalizing, and over-accomodating a variety of behaviors as mental illness or disorder. And I can see the logic sometimes. But I think we’ve come so far that we can sometimes lose sight of the incredible value of the progress made. There are easily thousands, likely millions, of people who would have in prior generations been expected to endure a life of quiet misery or, barring that, be pushed sufficiently to the periphery that their suffering was just out of earshot. Instead they are provided language to understand themselves and communicate their needs to others, and sometimes the tools to optimize within their diverse set of needs and constraints. That’s much better.
Nirvana fallacies abound, especially when nostalgia paints over the obviously inferior parts of our personal histories. The present is taken for granted, it’s flaws drawn in sharp relief against an imagined perfect future rather than vastly inferior past. There is little to be looked back upon fondly in the formal and informal institutions of mental health. Better to have progressed an overly diagnosed and indulgent inch passed the unknowable social optimum than regress to a past where ignorance obstructed our empathy.
Economist Writing Every Day 