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July 2012 Posts

02/07/2012 09:02:20



Tyrannosaur was written and directed by the actor Paddy Considine. It is his first full-length film as a director and was released in 2011. It stars Peter Mullen (who plays Joseph), Olivia Colman (Hannah) and Eddie Marsan (James) whose excellent performances make this powerful drama so unforgettable. Tyrannosaur has been very well reviewed, and won several awards, including three British Independent Film Awards in 2011 (Best Actress, Best British Independent Film and Best Debut Director) and a BAFTA in 2012 for Outstanding Debut for a British Writer, Director or Producer. It is set in an unnamed town in Northern England and was actually filmed on location in Leeds and Wakefield, using local residents as extras.



The Film

The film opens with a most distressing scene of unbridled rage as widowed ex-prisoner Joseph destroys the only thing he really loves. This deeply unpleasant vision sets the tempo for what follows as we are drawn in to his world of anger, aggression and conflict, only occasionally relieved by some lighter, humorous moments. It demonstrates the well-recognised close association between love and hatred, so often present when things go wrong within relationships, that frequently becomes a focus of psychoanalytic psychotherapy sessions. Why do we hurt the ones we love? That is the fundamental question that this film poses.

After a pub brawl, Joseph takes refuge in a charity shop where he encounters a volunteer sales assistant, Hannah, who tries to reach out to him in his obvious distress, buoyed up and driven by her Christian beliefs. Joseph initially responds in his characteristic way, by being hurtful and abusive to Hannah and humiliating her for attempting to be kind. However, it soon becomes clear that all is not what it seems in her suburban middle class marriage to James and this draws Joseph closer to her, perhaps united by their shared unhappiness and despair. The viewer soon learnss that she is struggling to survive emotional and physical abuse perpetrated by her husband James, which is portrayed in harrowing scenes that pull no punches. As Joseph and Hannah’s friendship forms and then deepens, the cracks in Hannah’s marriage develop and spread, with ultimately disastrous consequences. 

Relevance to the field of Mental Health

Tyrannosaur is a film about anger and violence that is portrayed in a painfully realistic way. This anger is embodied both by an individual, Joseph, who is consumed by rage, and by a couple, Hannah and James, whose middle class marriage is destroyed catastrophically by domestic violence. The film eloquently makes the point that physical and emotional abuse can be found in all areas of society. Anger is something that will certainly be encountered by those working in the field of mental health at some time in their career, if not throughout it, but anger also affects those working in many other areas of healthcare, including in general practice. Tyrannosaur gives the viewer the opportunity to experience, at close hand, anger that is out of control and in particular gives insight in to the important issue of intimate partner violence, often hidden from view in apparently satisfactory relationships.

Those employed in the health and social care professions are often the first port of call for victims of domestic violence and it is crucial that professionals are vigilant about the possibility, and ask the right questions of an individual who may be subject to partner abuse. A recent editorial in the British Medical Journal in March 2012, called Responding to domestic violence in primary care (BMJ 2012;344:e757), highlighted the need for clinicians in primary care to routinely enquire about intimate partner violence in order to increase its detection. Further consideration was given to the topic in an earlier article in the BMJ entitled Violence between intimate partners: working with the whole family (BMJ 2008; 337 doi: 10.1136/bmj.a839). The Department of Health published a document, in 2005, containing guidance on managing domestic violence (Responding to domestic abuse: a handbook for healthcare professionals) that can be accessed and downloaded from the following link.

A viewing of Tyrannosaur alongside a reading of these articles and guidance would provide a very good platform for discussion and learning about the very important issue of domestic violence. But perhaps the film can also give an understanding to viewers who have grown up in circumstances largely free of anger and violence, what it might be like to live in such an environment. For medical students, lacking a first hand experience of violence, who may find themselves treating people from a wide variety of unfamiliar backgrounds, this film may offer invaluable insights in to some of those foreign territories.

Be warned, this is not an easy film to watch, but it is well worth the challenge.

•  More information about Tyrannosaur is available at IMDB as is a short trailer.

•  The DVD can be purchased at

•  Minds on Film is written by consultant psychiatrist Dr Joyce Almeida.


31/07/2012 12:16:57

El or This Strange Passion


Directed by Luis Buñuel and released in 1953, this black and white film, in Spanish with English subtitles, tells the story of the jealous relationship between Francisco and his wife Gloria. Filmed in only three weeks, during Buñuel’s years in Mexico, it is based on the memoir of an abused wife. Buñuel is quoted as saying “It may be the film I put the most of myself into”, identifying himself with the protagonist Francisco, something that is confirmed by his wife Jeanne, who in her own memoirs wrote about her husband’s jealousy. Later in his life, Buñuel was friends with the psychoanalyst Jacques Lacan, who is said to have shown El to his training analysts in order to teach them about paranoia (This and further information can be found in the book Luis Buñuel The Complete Films by Bill Krohn/Paul Duncan Ed. Published by Taschen).

El or This Strange Passion


The Film

The film opens in church where Francisco, a rich bachelor, is the water bearer for a priest who is washing the feet of a line of boys. During a moment of distraction, Francisco finds himself focusing on the feet of a woman, who we find out is Gloria as the camera pans up to her face slowly. Francisco becomes instantly attracted to her, chasing her out of the church in an attempt at conversation but failing to meet her until another visit to church brings the opportunity to talk. Gloria’s lack of interest in Francisco is clear and she tells him that they cannot speak again. However, he follows her to a restaurant, where he sees her meet with a friend of his called Raúl. When Francisco subsequently meets with Raúl, he learns that Raúl and Gloria are engaged to be married. This appears to increase Francisco’s determination to woo Gloria and so he arranges a party to which the couple are both invited. Although Gloria is initially wary, she finally falls for his charm and we next find out that Francisco and she are married at some time in the future. We then observe Raúl driving through the city streets where he meets a distraught Gloria, who gets in to his car in panic and recounts the story of her unhappy marriage. It is this ‘flashback’ that forms the next part of the film.

During their honeymoon Francisco takes Gloria to see some property, once owned by his family, that he believes should still rightfully belong to him. We learn that Francisco is fighting a lawsuit to regain the property, but is struggling to find a lawyer willing to take on his case and defend his view that he is being wronged. This is the first sight that we are given of his paranoia. At this early stage in their marriage, Gloria remains calm and non-judgmental, even when she begins to experience Francisco's jealousy on the honeymoon when she meets an old male friend. From this point on, Francisco’s suspicions that Gloria is behaving in an over familiar manner with other men grow and he begins to accuse her in a critical and unreasonable way. She feels misunderstood by others, who continue to view Francisco as an upstanding member of the community and becomes increasingly isolated. After he finds out that she has spoken with the priest about the matter, Francisco is angry and decides to frighten her in to submission by firing a gun with blank bullets at her.

`After further escalating threats and then actual aggression, Gloria finally runs away. It is at this point that she encounters Raúl driving through the city. He suggests that she must leave Francisco, but she returns once again to her marital home, not realising that Francisco has seen Raúl bring her home. That night, Francisco enters her room as she sleeps, carrying rope and sewing implements, possibly to bind her and stitch her up so that no one can enter her, or perhaps to murder her. Whatever his intention, she wakes in time to scream and escape from the house. Francisco sets off in pursuit with a gun, mistaking other people for Raúl and Gloria, but is unable to find her. When he reaches the church where his friend the priest is delivering a service, he experiences some frightening paranoid visual hallucinations that suggest the whole congregation is laughing at him. Suffering from an acute paranoid psychotic episode, he tries to attack the priest and is restrained by the crowd. Some period of time later, we see Gloria, Raúl and their young son visiting a monastery, where Francisco now lives in the care of monks.

Relevance to the field of Mental Health

This film provides a brilliant opportunity to consider the topic of morbid jealousy, a symptom rather than a diagnosis, related to a number of underlying mental disorders and often co-existing with substance abuse. Morbid jealousy refers to the abnormal preoccupation that a partner is being sexually unfaithful. The strength of this belief may take the form of an obsessional rumination, an overvalued idea or a delusion. This may arise de novo as a delusional disorder or it may be associated with an underlying mental disorder such as schizophrenia, depression, and substance misuse or arise in the context of a personality disorder. The temporal relationship between the symptoms of morbid jealousy and any other illness are crucial in determining the cause and thereby informing the treatment.

As in the case of Francisco and Gloria, the symptom of morbid jealousy usually carries significant risk of violence to the partner suspected of infidelity or to the third person accused of involvement with them, but there is also a risk of suicide. It is for this reason that forensic psychiatrists are often involved in the management of such patients.

An excellent review article entitled Aspects of morbid jealousy, by forensic psychiatrists Michael Kingham and Harvey Gordon, is available in full in the journal Advances in Psychiatric Treatments (Advances in Psychiatric Treatment (2004)10: 207-215). A reading of this alongside a viewing of El would provide a very good foundation for learning about this very important symptom.

Of additional value to students learning about mental health is the scene near the end of the film when Francisco experiences terrifying paranoid visual hallucinations in the church. Buñuel manages to recreate the experience for viewers of the fear and confusion that those suffering from such paranoid psychotic symptoms might feel, by using point of view camera shots.

Although this film is more difficult to obtain than my usual recommendations, I highly recommend a viewing for anyone interested in working in the field of forensic psychiatry.

•  More information about El can be found at IMDB.

•  Unfortunately, the DVD is more expensive to buy. Several copies are currently available on marketplace.

•  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.


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