Media Column The Life Stories of Children and Adolescents Using Commercial Films as Teaching Aids Adrian Sondheimer, M.D. Commercial films have been used by educators as helpful components in the psychiatry training process. Professional literature describing cinema focusing on children, adoles- cents, and their families, however, has been conspicuous by its absence. A solicitation from child and adolescent psychiatry members of the Association for Academic Psychiatry re- sulted in a compilation of 97 substantial and relevant commercial films, with each accom- panied by a single-sentence annotated description. The author proposes a teaching approach and suggests questions to assist educators in the utilization of these films during the train- ing of residents about child and adolescent themes and issues. A description of this ap- proach is illustrated using two representative films. (Academic Psychiatry; 2000:214–224) tone (1) asserts: “life is a moral [read psycholog- the reader is more likely to experience interruptions Sical, behavioral, and ethical] adventure.” That is, and discontinuities. It is no accident, therefore, that human beings live, and tell, their stories. These sto- films have been used in the education of sundry ries becomes texts. Often these texts are the print or health professionals (6–8), and specifically that of film descriptions of an individual’s moral adven- medical students, general house staff, and, more to tures, and it is via these media that readers, viewers, the point, psychiatry residents (9,10). and professionals can more closely examine situa- tions, contents, and themes. Both print and video media have the power to CINEMA AND PSYCHIATRY harness the attention and emotions of students and trainees in a manner that unadorned, reductionistic Cinema has longcaptured the attention and interest professional case descriptions often do not. As with of psychiatric professionals, who have devoted con- the use of fiction literature by psychiatric educators siderable effort to movie analysis (11–13). Commer- (2–5), commercial film is similarly used for teaching cial films have been used to illustrate numerous psy- purposes. Engaging films, viewed with a suspension chiatric concerns, includingdiagnosticconsiderations of disbelief, usually evoke an unfolding, enveloping, (14), psychopathologic manifestations (15–18), and and uninterrupted atmosphere for the duration of the differingtreatment approaches (19). For example, As story. The experience of this medium contrasts with Good as it Gets, The Man with the Golden Arm, Play Misty for Me, and Klute represent films that, respec- that of print literature, duringthe readingof which tively, do good jobs of depicting manifestations of ob- sessive– compulsive disorder, substance abuse, bor- Dr. Sondheimer is Associate Professor of Psychiatry and derline personality disorder, and therapeutic TrainingDirector of Child and Adolescent Psychiatry at the Di- technique. Somewhat less tangible, but nonetheless vision of Child and Adolescent Psychiatry, University of Medi- cine and Dentistry of New Jersey (UMDNJ)–New Jersey Medical important, concepts, such as countertransference (20) School, Newark, NJ. Address reprint requests to Dr. Sondheimer, and stigma (21) have similarly been portrayed. Rep- Division of Child and Adolescent Psychiatry, UMDNJ–New Jer- resentations of charged attractions between arche- sey Medical School, 215 South Orange Avenue, Newark, NJ 07103. e-mail: [email protected] typal characters, as commonly occurs in the genre of Copyright ᭧ 2000 Academic Psychiatry. film noir, have promoted insights into the interper- 214 Academic Psychiatry, 24:4, Winter 2000 SONDHEIMER sonal dynamics of ordinary individuals (22). Com- familial functioning. Consequently, the portrayal of mercial film portrayals of physicians (23), psychia- cognitive functions, interpersonal dynamics, devel- trists, and psychiatric practice have received opmental tasks, interests, and responses to stressors extensive description as well (24–26). The bulk of the will vary with the protagonists’ developmental psychiatric professional literature concerningfilms, stages. For example, Ponette deals with the life of a 4- however, as it relates to mental health concepts, prac- year-old child, whereas Clueless focuses on adolescent tice, and education, has dealt largely with adult be- shenanigans. The films also approach their subject haviors and manifestations. By contrast, the cine- matter in differingways—with humor (comedy: e.g., matic worlds inhabited by children and adolescents Caddyshack, Hairspray), seriousness (drama: e.g., Dead await larger exposure and more professional atten- Poets Society, Los Olvidados), a combination of the two tion. (tragicomedy: e.g., Matilda, Say Anything), affection (e.g., Peppermint Soda, The White Balloon) and/or aus- Film Selection Process terity (e.g., Sleepers, The Sweet Hereafter). Some films focus largely on single themes, for example, chil- In March 1998, to address that need, the child and dren’s responses to abuse (Radio Flyer, This Boy’s Life), adolescent psychiatry members of the Association for loss (Careful, He Might Hear You, House of Cards), or Academic Psychiatry received a letter solicitingthe war (Europa Europa, Forbidden Games); others focus on titles, and one-sentence descriptors, of engaging and the varied manifestations of a developmental stage, thought-provoking popular films depicting “impor- for example, sexual interests, conflicts with parents, tant facets of child and adolescent development, pa- and inter-peer dynamics amongadolescents ( The thology, and/or responses to the environment.” It Breakfast Club, Dazed and Confused, Sixteen Candles). was intended that the proposed compilation be used Rarely, a film will depict children and/or adolescents by psychiatric educators to portray, for teaching with clear-cut psychiatric disorders (e.g., David and purposes in general and/or child and adolescent psy- Lisa). More commonly, the delineation between nor- chiatry residency trainingsettings,the developmen- mative and pathologic, when that issue arises at all, tal stages of childhood and adolescence and associ- is hazy. ated psychological phenomena. Over a 2-year period, 112 titles were submitted, FILM DESCRIPTIONS/EDITORIAL DECISIONS and 97 were included. Fictional screenplays, several documentaries, and the occasional animated film The descriptions of the selected films include the comprise those selected. Excluded from the compi- country in which the film was produced (for example, lation were films focusingprimarily on adults as sub- France) and, by implication, the language spoken jects, as well as those produced specifically as teach- (French); the nature of the approach (i.e., comedy, ingvehicles with explicit didactic foci, for example, tragedy, drama, fable, fantasy, thriller), and year of treatment approaches for designated psychopathol- release. The brief descriptions are written in the ogies; school-based discussions of non-majority sex- words of the contributingpsychiatrist, identified in ual lifestyles, or druguse, etc. Clearly, such educa- parentheses, with editingof the submission in order tional tools have great value, and relevant lists can be to improve clarity. The number of contributors and obtained from a variety of educational video produc- the wide variety of film subjects and approaches is ers and distributors. The focus of this effort, however, confirmation of the range of tastes and interests is on the world of evocative, visually-based, cine- amongchild and adolescent psychiatrists. matic imagination. The request to avoid popular productions in fa- vor of substantive ones was the single limitation Child and Adolescent Themes posed for the contributors. A ratingof 0–4 stars, de- rived from an industry-respected work that rates the The cinema compilation (see Appendix) has been perceived qualities of thousands of individual films parsed into a variety of categories, and the films are (27), may possibly help guide instructor choices. It is listed in alphabetical order by title. Individual films certain, however, that determinations of quality most focus primarily on child and/or adolescent and/or accurately reflect the tastes that exist in the eyes of Academic Psychiatry, 24:4, Winter 2000 215 MEDIA COLUMN the beholder. For example, whereas the majority of quate; what vulnerabilities and assets do the children the selected films are rated 3 stars or better, repre- possess; and to what extent do the sociocultural in- 1 senting“fine (* * *), memorable (* * * ⁄2), or masterful fluences of gender, ethnicity, class, religion, and/or (****)cinematic expression,” both Brooks (Blue La- other environmental contexts shape or determine the 1 goon; no rating) and Sondheimer (Milk Money,* ⁄2) protagonists’ behaviors? Later in the discussion, staunchly defend their recommendations. Not to in- speculation commonly develops concerninghow the clude parental guidance (MPAA) ratings for this pro- possession of psychiatric knowledge and/or the pro- ject was another editorial decision. Apart from sin- vision of psychiatric input might have affected the cere differences between professionals about their course of the portrayed behaviors and their out- value and their potential for misuse via the exercise comes. of censorship, it is assumed that all medical and psy- chiatry trainees are of sufficient maturity to be ex- Two Illustrative Films posed to each of the films included in the attached list. To briefly illustrate the use of films as potential teachingtools,