Accessibility Page Navigation
Style sheets must be enabled to view this page as it was intended.
The Royal College of Psychiatrists Improving the lives of people with mental illness

A Song for Martin



Introduction

Based on a book by Ulla Isaksson about her own relationship with her husband, this film, in Swedish with English subtitles, was scripted and directed by Billie August. It is interesting to note that the two actors in the main roles, Viveka Seldahl (Barbara) and Sven Wollter (Martin) were married in real life, giving some added poignancy to the film. Sadly, Viveka Seldahl died from cancer shortly after the film was released in 2001. Both actors won the equivalent of a Swedish Academy Award for their performance in A Song for Martin.

A Song for Martin

 

Unusually for ‘Minds on Film’, which normally focuses on readily available films, this DVD is only available as a Region 1 disc and as such can only be played on a multi-region DVD player. However, I have chosen to discuss it because it presents a very good portrait of Alzheimer’s Disease and the challenges that face any caregiver.
 
A Song for Martin is also a film of mid-life romance and second marriage, which is blighted a few years later by the onset of Alzheimer’s Disease. It portrays the reality of living with, and caring for, a loved one over several years, who is suffering from a neurodegenerative disorder. 

The Film

The film opens with the rehearsal of an orchestral work composed by Martin, who is conducting the orchestra in which Barbara plays first violin. They are obviously attracted to each other, despite both of them being married, and we watch in the following scenes as they fall madly in love, separate from their respective spouses and embark on a loving, intellectually stimulating and truly satisfactory second marriage. We see them on honeymoon, rejoicing in this late found romantic happiness despite this being tinged with guilt for Barbara. In a significant scene, the viewer witnesses them promise to be open and honest with each other whatever the future brings.

 

A few years later, settled in their new home, we watch Barbara and Martin at work together, with her contributing to his composing, and we are shown the complex skills that are required for his work. The first hint of problematic change occurs when Martin struggles to remember the name of his manager and later calls Barbara ‘Alice’, which was the name of his ex-wife. They think nothing of these slips until Martin experiences a frightening lapse of memory whilst shaving one morning and is unable to recognize the bedroom. He fears that he has suffered a cerebral haemorrhage, but a visit to his doctor fails to detect a problem and the episode is attributed to overwork. A family gathering a little later shows him playing the piano and interacting with his grandchildren very capably.

 

The real problems begin as Martin is conducting the first public performance of his new concerto, live on television, when he freezes in the opening bars, confused and unable to focus on the task. This leads to a CT brain scan and assessment by a specialist who delivers the diagnosis of early Alzheimer’s Disease. He is encouraged to carry on as normally as possible with his work and family life. As a result, Barbara attempts to support him in completing his next major project, which is to compose an opera.

 

From this point on, A Song for Martin follows the relationship between Barbara and Martin closely over a number of years as his disease gradually progresses. We witness Barbara struggling to ‘do the right thing’ but being unable to contain her own needs and frustrations at times. Martin’s perplexity is brilliantly portrayed when he is trying to grasp a situation that should be familiar, but isn’t any longer recognizable to him. It is painful to watch when Barbara’s decision to revisit their honeymoon destination for a much-needed holiday almost ends in tragedy and clearly indicates the next stage of his illness.

 

With his increasing dependence on Barbara for his personal care, Martin develops some difficult behavioral symptoms, which end up leading to him being assessed in hospital, confirming significant deterioration and resulting in the recommendation for long term institutional care. My only gripe with the film comes at this point when the specialist suggests that Barbara should “forget he is your husband…he is not the man you married”, advice Barbara certainly doesn’t follow. That apart, the film poignantly explores Barbara’s guilt at ‘giving up as a caregiver’ and brilliantly illustrates her loneliness when she returns to an empty home from hospital, exhausted after years of caring. The film ends with us seeing Barbara make a gradual return to a more normal life and managing a lovely good bye to the husband she adored, despite the fact that he remains in full time care, no longer able to recognise her.

 

Relevance to the field of Mental Health

A Song for Martin tracks the development of Martin’s Alzheimer’s Disease from its earliest signs to his final move into care, providing us with a potted clinical history. It also convincingly represents the emotional strain that his wife Barbara suffers throughout the various stages of his illness. There are situations that Barbara chooses to manage in a certain way that may make some viewers want to shout out ”don’t say that” or “don’t do that”. But for anyone who is involved in Old Age Psychiatry, there will surely be numerous points in the film that bring back memories of a real clinical situation, in which real people in difficulty don’t always do or say the right thing.

There is excellent information for dementia sufferers and caregivers about the disease at the Alzheimer’s Society website and I can highly recommend the Alzheimer’s Association’s ’10 signs of Alzheimer’s’ detection checklist, that could be read in conjunction with a viewing of the film, to aid learning about the diagnosis of Alzheimer’s Disease. The film does not shy away from portraying several difficult to manage behavioral problems, in the later stages of Martin’s dementia, and could definitely serve as an excellent starting point for a discussion about the stresses of care giving. This can be further explored using the excellent page on the Alzheimer’s Society website called Carers: looking after yourself.

 

The film illustrates the positive encouragement given to Martin, at the time of diagnosis, to maintain as normal a life as possible, for as long as possible, although it also manages to highlight just how much this depends on the stamina and capability of his wife. Martin is encouraged to continue composing, giving him a sense of purpose and worth, long after he has lost his previous level of ability.

 

There is an increasing awareness of the need to maintain a positive approach to dementia care wherever possible, encouraging the individual personality of the dementia sufferer to be recognized throughout their illness. The book entitled “I’m still here”, by American sociologist John Zeisal, Ph.D (2009; Published by Avery, a member of the Penguin Group (USA) Inc.), explores the non-pharmacological treatment of Alzheimer’s and takes a decidedly ‘glass half full ‘ look at the disease. Zeisal is a founder of the Artists for Alzheimer’s™ programme in the USA, which has enabled thousands of people living 
with Alzheimer’s disease to have cultural opportunities and artistic experiences.

 

Recognition of the need to reduce anti-psychotic medication use for the behavioral and psychiatric symptoms in dementia, outlined in the independently commissioned report produced by Professor Sube Banerjee for the Department of Health, in 2009, has led to an exploration of various different non-pharmacological strategies, such as the use of sensory rooms and aromatherapy massage. A few other initiatives, which have been reported in the UK media in recent months include a reminiscence room set up at a care home in Wiltshire, UK, or the recent project developed by Middlesex lecturer, Trish Hafford-Letchfield, who made a short ‘mockumentary’ film of a royal visit to a day centre for dementia sufferers in north London (with the aim of involving people with dementia in the education of social workers and nurses).

 

A Song for Martin gives the viewer an opportunity to experience, close up, a life and an intimate relationship affected by Alzheimer’s Disease. The film offers a good starting point for anyone wishing to teach students, from a variety of professional backgrounds, about dementia, with a particular focus on the progression of the illness and its effect on the main caregiver. I would certainly recommend it to anyone wanting a career in Old Age Psychiatry.

 

  • More information about A Song for Martin can be found at IMDB.
  • The Region 1 DVD is available on amazon.co.uk.

 

Subscribe to this post's comments using RSS

Comments

Add a Comment
  • Security Verification:
    Type the numbers you see in the picture below.
    Type the numbers you see in this picture.
     

 

Login
Make a Donation

 

About this blog

 

Minds on Film is a monthly 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.