Dr. Greiner is a professor of psychiatry at the University of Nebraska Medical Center. He has participated in teaching Omaha police officers about individuals with mental illness and has a special interest in forensic psychiatry.
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Whether or not it wins the Oscar for best motion picture, Silver Linings Playbook can teach us a lot about coping with the challenges of mental illness.
Psychiatric illnesses are often presented with stigma – individuals with mental illness are referred to as “them” as opposed to “us.”
The film's cast gives a compassionate, yet unsentimental and realistic portrayal of coping with a serious psychiatric illness.
The main character, Pat, is bipolar and has been hospitalized after assaulting his wife's lover. While there, he develops an attitude of wanting to find the “silver linings” in his complicated life. Taking a risk, his mother removes him from the long-term hospital and brings him home.
Once there, Pat goes on midnight rants directed toward his family, destroys the home and physically fights his father. He's on medication for his the severe mood shifts and unpredictable behavior, but early in the film he's not taking his pills.
Pat's ultimate dilemma: Does he accept, manage and cope with his illness or face hospitalization yet again? Eventually, his psychiatrist advises him to develop a “strategy.” The film follows his gradual and uneven progress toward healing.
Pat's relationship with Tiffany is central in re-establishing his life. She has gone through a period of grief, too, and wants to get her life back on track. Initially, Pat and Tiffany struggle with the fruitless question of “who is crazier.”
Through their relationship, Pat learns how to make and keep commitments. They establish affection and trust. The film does a good job of not minimizing the anger, disruption and fear faced by Pat's family, his separated wife and the community.
There are so many mental health related lessons to be learned while watching this film.
Eight major points are illuminated:
• Alcohol and drug abuse can threaten one's hard-earned improvements.
• Family structure and activity can lead to healing. Although contemporary culture focuses on the issue of “dysfunction,” the film demonstrates the healing power of family rituals, like sporting celebrations.
• Compassion is a central virtue. Both the psychiatrist and the families care deeply about the future of the main characters. They want them to succeed.
• Accepting one's limitations is necessary. Pat has an illness that requires medication. Although he wants to fight it, Pat needs to be adherent with his medication to sustain his recovery.
• Having a legitimate commitment to another person is important in healing. Through those commitments, individuals develop a sense of meaning.
• Developing a strategy to address one's vulnerabilities is a universal need.
• Individuals without identified mental illness may have harsh struggles with marriage, financial problems and meaning. Pat and Tiffany go through struggles to eventually capture a meaningful relationship.
• In Pat's words, “Life is hard.” There is no easy solution to dealing with the adversity of daily living, especially in the case of mental illness.
Two areas were potentially misleading:
• Leaving a psychiatric hospital against medical advice should not be taken lightly. For those attempting to provide at-home care, don't underestimate the mental illness.
• In many cities, law enforcement takes special courses about handling the mentally ill. The policeman in the film does not do justice to the way an educated officer would have handled a similar situation.
The film's portrayal of recovery speaks true to the importance of peer relationships, family participation and professional treatment.
The gap between “us” and “them” is diminished. The value of compassion and finding the person beneath the illness are important lessons to share.