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The Royal College of Psychiatrists Improving the lives of people with mental illness

Still Alice

Introduction

Still AliceStill Alice, directed by Richard Glatzer and Wash Westmoreland, was released in cinemas in the UK in February 2015. The film is based on a novel written in 2007 by Lisa Genova about a renowned linguistics professor diagnosed with early-onset Alzheimer’s disease as she struggles to hold on to the defining aspects of her self as her condition worsens. In the film, Dr Alice Howland is played by Julianne Moore in a truly poignant and empathic performance, which brought well deserved recognition in the form of an Oscar for Best Performance by an Actress in a Leading Role in the 2015 Academy Awards, a Golden Globe in 2015 and a BAFTA award for Best Leading Actress in 2015, to name but three of the thirty four awards the film collected. Moore is very well supported by the other cast members, in particular Alec Baldwin, who plays her husband John.

 

Still Alice has been very well received by critics and also by those with Alzheimer’s disease (this February 2015 article by Tom Seymour in The Guardian provides a verdict from those with dementia), making it of particular interest to all mental health professionals, carers and families of those with Alzheimer’s disease.

 

The Film

Still Alice opens with Professor of linguistics at Columbia University, Dr Alice Howland, giving a guest lecture, which one senses she has given before, on her particular research interest within the topic of developmental linguistics. She pauses, literally lost for a word, whilst in full flow, dismissing her stumble on having drunk too much champagne and the moment passes. She is fifty years of age. Back at home she jogs through Columbia University’s campus, where she teaches, and finds herself suddenly unsure of her direction. With blurry, shallow focus shots evoking the sense that she has no idea where she is, Alice becomes frightened and panicky until she begins to regain her orientation and is able to run home. She is visibly shaken by the experience and is aware that something is wrong but doesn’t share her concerns with her family at this stage.

Instead, Alice consults a neurologist who takes a history, carries out a basic cognitive test and suggests an MRI scan (which proves to be normal) followed by a PET scan, which shows signs confirming his suspicion that Alice may have early onset Alzheimer’s disease. The neurologist asks to see her husband, John, and confirms the diagnosis to them both. A genetic test follows to determine whether she has the heritable form of the disease. She tests positive for the gene and their children must be told. At a family meeting, Alice reveals her diagnosis and then explains the risk to her children. She tells them that she has been prescribed Aricept and that she is now using numerous strategies to maintain her health and cognitive function. Shortly after this, Alice hears from her eldest daughter Anna that she too is positive for the familial form of Alzheimer’s disease, Tom is negative and her youngest daughter Lydia has declined the test. After these revelations, Alice is confronted by her boss with negative student feedback that indicates Alice’s teaching has become increasingly disorganised and difficult to follow. She reveals her diagnosis to him and this results in the end of her job as an academic. Alice becomes involved with the Alzheimer’s Association and prepares a talk to deliver to an audience about her experience of living with the disease, using a typewritten script that she highlights as she reads out the sentences. She delivers an incredibly moving presentation, describing the struggle of trying to hold on to those aspects of her life that meant so much to her previously and that defined her as a person. With huge support from her husband, Alice is helped to manage at home.

One of the things that Alice decides to do is to continually test her knowledge of key personal data such as her address and the name of her eldest daughter using her smart phone. She then records a video file on her laptop with instructions to her future self that she should follow when she can no longer answer these key questions. However, when the time comes, and she finds the video file on her laptop by accident, Alice is actually unable to follow the instructions easily. Her constant need for supervision and support becomes apparent and she is not left alone from that point onward. Her daughter Lydia moves back from Los Angeles to be at home again as a main carer, in part because Alice’s husband has been offered an important job opportunity in another city about two hours away by plane. The film closes with Lydia reading some poetry to Alice and asking her if she understands the theme. Alice replies with one word ‘Love’.

 

Relevance to the Field of Mental Health

In researching the role, Julianne Moore spoke to a number of people with early onset Alzheimer’s disease to gain an intimate understanding of their feelings and functioning, which clearly informs the authenticity of her performance and makes it so valuable to watch. One of those people called Wendy Mitchell, who Moore thanked in her BAFTA speech, lives in the UK. Mitchell features in an interactive resource on the BBC website called Living at home with dementia, which provides an extremely useful accompaniment to the film. Mitchell, diagnosed at 57 with Alzheimer’s disease, is quoted as saying about Still Alice “It was a shockingly accurate reflection of my own experience.”

This film provides an incredibly intimate personal portrait of early onset Alzheimer’s disease that challenges the viewer to experience what it might feel like to lose certain cognitive functions, in particular memory, from a previous position of competent engagement in the world. That Alice is a middle class academic, who seems to be making sensible choices with regard to lifestyle (she is a non-smoker who eats a healthy diet and takes regular exercise), makes her intellectual decline all the more poignant as she struggles to come to terms with her diagnosis and subsequent loss of certain cognitive functions. This film encourages us to reflect on the nature of the self and what makes us who we are. It asks us how much cognitive function can we lose before we cease to be that person we once were. Is Alice Still Alice by the end of the film? This question might provide the platform for an interesting debate.

This is simply a film that must be watched.....by everyone.

  • More information about Still Alice can be found at IMDB, as can a short trailer.
  • Still Alice is available to pre-order on dvd from amazon.co.uk and it will be released on 6th July 2015.
  • Minds on Film is written by Consultant Psychiatrist, Dr Joyce Almeida.

 

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About this blog

 

Minds on Film is a blog that explores psychiatric conditions and mental health issues as portrayed in a selection of readily available films.

Please note that this blog may contain plot spoilers. Any views expressed are purely my own.

Dr Joyce Almeida
Dr Almeida is a consultant
psychiatrist working in the private sector in the UK.