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April 2012 Posts

03/04/2012 09:43:04

Control

Introduction

Control is a biographical film, directed by Anton Corbijn, about Ian Curtis, the lead singer of the post-punk band called Joy Division, whose life ended in suicide at the age of 23. The screenplay by Matt Greenhalgh was based on the book Touching from a Distance, written by Curtis’ widow Deborah. Control was shot in black and white and released in 2007. Corbijn is a Dutch photographer, known for his work in black and white, who had met and photographed Joy Division before Curtis’ death in 1980. The film won several awards at Cannes Film Festival, five British Independent Film Awards and a British Academy Film Award, as well as being named Best Film at the 2007 Evening Standard British Film Awards.

 

Control

It tells the story of Ian Curtis throughout the formative years of Joy Division, but also focuses on the difficulties in his marriage, his affair with another woman and his struggle to cope with recurrent seizures and later depression, which results in his tragic death. As a very human portrait of epilepsy in a young adult, Control offers much to students of psychiatry as it presents so many important issues concerning medication (both compliance and side effects), the influence of stressors, the role that substance abuse may play in altering the seizure threshold and the psychological effect of fear and of stigma. I am sure I will not be alone, as a spectator who is a mental health professional, in wanting to ‘intervene’ at many stages of this film and change the course of events. 


The Film

We first meet Ian Curtis (Sam Riley) at school, as a day dreamer interested in poetry. He falls for his close friend’s girlfriend, Debbie (Samantha Morton), and they soon become engaged. In 1975, they marry when Ian is just 19 and Debbie is 18. However, Ian struggles to share in domestic life and prefers to write poetry alone in a room of the house. At this time, he is working as an employment agent at the local job centre, where he deals with a young woman, called Corrine, who suffers from epilepsy. She attends the appointment wearing a protective helmet and Ian witnesses her having a seizure at his desk. By 1977, Ian and fellow band members Peter Hook, Bernard Sumner and Stephen Morris formally debut as Joy Division and Ian & Debbie provide the finance for the band’s first record.

As the band’s success grows, their manager gets them their first gig in London in 1978, and it is after this event, on the way back home that Ian experiences his first grand mal seizure. The diagnosis of epilepsy is followed by a recommendation to take several antiepileptic drugs, which cause significant drowsiness and soon threaten his ability to work at the employment agency. It is at this time that he hears of the sudden death from epilepsy of Corinne. Giving up his job just after the birth of their daughter Natalie in 1979, Ian chooses to focus on his career in Joy Division, leaving Debbie to look after their daughter and earn some money whilst he goes on tour. In a gloomy mood, feeling that his marriage was a mistake, he starts an affair with a Belgian journalist, called Annik, who is reporting on Joy Division’s 1980 European tour. On his return home, Ian tells Debbie that he probably doesn’t love her anymore and not long after this she finds evidence of his affair and confronts him. Telling Debbie that the affair is finished, he continues to see Annik, who is present at a concert when he has a seizure on stage, and so is able to comfort him as he regains consciousness, whilst telling him she loves him.

Once he gets back home, Ian makes a suicide attempt by taking an overdose of his medication, leaving a note for Debbie, but also telling her before collapsing. A brief scene in hospital, just before his discharge, shows no psychiatric assessment or intervention despite it being very clear that his mood is significantly depressed. As the band prepare for their first tour in the USA, they perform at a small local venue, where Ian finds himself unable to perform onstage, walking off after only one verse of a song. Racked with guilt, he expresses the view that he has lost control of his life. As the affair with Annik continues, Debbie asks him for a divorce, and asks him to leave. He first moves in with band member Bernard, who offers him help using hypnotherapy tapes, and then with his parents. He writes to Annik of his fear that epilepsy will kill him and that he loves her. But nothing relieves his distress and he returns home to Debbie, pleading for her not to divorce him. When she refuses, he becomes angry, asking her to leave and he sits alone drinking until he has a seizure. On waking from the floor the next morning he hangs himself in the kitchen.

Relevance to the field of Mental Health

Control offers the opportunity to consider an important mental health issue, namely the relationship between depression, suicidal behaviour and epilepsy.

An article published in 2011, in Advances in Psychiatric Treatment entitled Epilepsy and neuropsychiatric comorbidities by Niruj Agrawal & Suren Govender (2011, vol 17, 44-53), provides an excellent introduction to epilepsy in its various forms and discusses its association with depression, anxiety and psychosis. The abstract makes clear that the wide range of neuropsychiatric comorbidities has only recently been truly appreciated and the full article provides a thorough consideration of the relationship between epilepsy and depression. The article states that there is also a strong association between the risk of suicide and the onset of epilepsy at an early age, especially during adolescence.

A population based case-control study by Christensen et al in 2007 (Lancet Neurology 6:693-8) suggested that the risk of suicide is 32 times higher in those with epilepsy and depression than in the general population, as opposed to 2.4 times higher in those with epilepsy alone (link to the abstract). Antiepileptic medications can also have depressive effects as well as having a possible influence on suicidal behaviour. In the recently revised book entitled The Neuropsychiatry of Epilepsy, edited by Michael R. Trimble and Bettina Schmitz, published by Cambridge University Press 2011, there is a chapter on Antiepileptic drugs and suicide by Trimble, which is accessible online at Google Books, in which the author discusses the neurochemistry of affective disorders, suicidal behaviour and antiepileptic medications.

A viewing of Control, alongside a reading of these articles and the chapter, would form the basis of an excellent introduction to the psychiatric aspects of epilepsy for mental health professionals. But this film can also give all viewers some understanding of the personal and social implications of suffering from recurrent seizures.

To quote from a review of this film on the Disability Now website:

Control is of huge benefit to people with epilepsy. As a hidden disability, it has little profile. People who have seizures on the street continue to terrify the population. Control gets the issue out there.

Written by Clair Chapwell, who has had epilepsy since she was 14.

This film would be especially beneficial to medical students and psychiatric trainees and I strongly recommend it.

•  More information about Control can be found at IMDB as can a short trailer

•  The DVD can be purchased at amazon.co.uk

•  Minds on Film is written by Consultant Psychiatrist, Dr Joyce Almeida.

 

 

 

 

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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.

 


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