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October 2012 Posts

01/10/2012 13:09:55

A Separation

Introduction

A Separation is an Iranian film, with English subtitles, written and directed by Asghar Farhadi. It was released in March 2011. It won several international awards including a British Independent Film Award for Best Foreign Independent Film in 2011 and several at the 2011 Berlin International Film Festival. In 2012 it won an Oscar and a Golden Globe for the Best Foreign Language Film of the Year. A Separation has gathered much critical acclaim and is the first Iranian film to win an Oscar. The film deals with marital breakup in a middle class Iranian family made up of husband Nader, his wife Simin, their daughter Termeh and Nader’s aging father, who lives with them and is suffering from Alzheimer’s Disease. The director’s real life daughter plays the eleven year-old Termeh.

A Separation

The Film

The film begins with a long single camera shot in which Nader and Simin are at the divorce court putting their respective cases to an unseen judge. Simin is petitioning for divorce on the grounds that her husband will not agree to leave Iran with her and their daughter to begin a new life in another country, where she and her daughter would have better opportunities to work and study as women. Nader explains that he cannot leave Iran as he is duty bound to care for his elderly father who is suffering from Alzheimer’s Disease and who needs twenty four hour care and supervision. Simin does not find satisfaction in the court and so moves out of the family home leaving Nader to care for their daughter and his father. As Nader must work, he is suddenly plunged into a dilemma about how to care for his father, daughter and the home without his wife to help. Reluctantly, he employs a devout working class woman, Razieh, from a distant part of town who needs to bring her own young daughter with her as she takes on the role of housekeeper and carer for Nader’s father. Razieh is desperate for money as her husband has lost his job and she finds herself haggling to negotiate her wages as Nader tries to pay her as little as he can. Both finally reach an agreement and Razieh gets the job, however she is not wholly prepared for what the job actually involves. A Separation presents an interesting dilemma for Razieh as she suddenly encounters the need to give intimate personal care to Nader’s father after an episode of incontinence whilst still obeying her religious guidelines. Razieh, unsure of how to proceed, decides to phone her Imam to consult on whether she can go ahead and change the elderly man in her role as his carer.

 

At this point the scene is set for the main theme of the film to be developed when a clash occurs between the increasingly stressed Nader and his struggling employee Razieh, in an angry spur of the moment incident, which results in both families ending up in court. As viewers we are invited to be observers of the evidence and to form our own judgement as we join the studiously watchful daughter Termeh as she tries to work out whether her father is telling the truth or not. Termeh is forced to learn a lot more about the complexities of the adult world than she would wish at her age. I do not want to reveal any more details about the plot because this is a film to watch without preformed ideas. As it unfolds, it invites viewers to reach their own conclusions about all of the major characters within the drama.

 

Relevance to the field of Mental Health

This film cleverly involves the viewer from its outset as an observer and a judge of what is right or wrong in a variety of different situations. It poses more questions than it gives us answers and invites us to decide where we stand on a range of familiar and unfamiliar issues, given that the film is set in Iran, which is a theocracy. From the opening scene in the Iranian courtroom when both Nader and Simin put their case to camera, in lieu of the judge, we are intimately involved in the dilemmas of all of the main characters. Attempting to understand the struggles that other people are having in their lives, separating truth from untruth in people’s accounts, and identifying which events have acted as triggers for an episode of mental ill health, are often at the core of our work in psychiatry and psychotherapy assessments and can be especially challenging in our increasingly multicultural society. A Separation offers an incredibly rich experience that shows us the universality of suffering and mental turmoil in a culture that may be unfamiliar to many non-Iranian viewers. The effect of parental separation on an eleven year-old girl, brilliantly portrayed here, and the strain within a family of caring for an elderly relative suffering from dementia, are shown to be no different in this Muslim middle class family than in one beyond Iran.

 

As a platform for discussion about the effects of stressful life events on mental health and well being, A Separation is compelling from beginning to end and the presence of subtitles is soon forgotten as the viewer is drawn in to its excellent psychological drama. I would highly recommend this film for anyone involved in working in mental health, especially those working with ethnically diverse communities.

 

•  More information about A Separation is available at IMDB and a short trailer is available here.

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

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

 
31/10/2012 14:55:55

The Soloist

Introduction

The Soloist is a film based upon the true story of Nathaniel Ayers, a musician who suffers from schizophrenia, and Steve Lopez a journalist for the Los Angeles Times, who befriended the then homeless Ayers when he was living on the streets of LA. Lopez was a journalist in need of a story, but soon became drawn in to a closer involvement with Ayers, fascinated by how mental illness had affected the life of such a talented musician. In the process Lopez wrote a regular column in the newspaper about his encounters with Ayers and subsequently published a book called The Soloist: A Lost Dream, An Unlikely Friendship, and the Redemptive Power of Music. These form the basis of the film. The background to their meeting and friendship is told in a short documentary made for CBS in America in 2009.

The Soloist was directed by British filmmaker Joe Wright (who had previously made the very different Pride and Prejudice and Atonement) and was released in 2009. Robert Downey Jr. and Jamie Foxx play the parts of Lopez and Ayers respectively and their real life counterparts have publically appreciated their performances.  The film presents a realistic portrait of schizophrenia and the associated problems of homelessness. Using a significant number of the mentally ill homeless population of Los Angeles as extras gives the film an authenticity that is unusual for a Hollywood production.

The Soloist

The Film

The film opens with journalist Steve Lopez falling off his bicycle and sustaining nasty grazes to his face. Wounded and in need of a story for his newspaper column he encounters Nathaniel Ayers in a Los Angeles park, beside a statue of Beethoven, playing a violin with only two strings on it. As they start to talk it becomes clear to Lopez that all is not well in the mind of Ayers but he also hears from him that he was once a student at Juilliard, the highly prestigious New York music school. After some research and further meetings with Ayers on the streets of LA, Lopez begins to write a regular newspaper column detailing their encounters and their growing friendship. This attracts much interest from the public who send in musical instruments for Ayers to play. Lopez uses the lure of a cello, given by a member of the public, to persuade a reluctant Ayers to abandon his homeless location in the road tunnels of LA for a room in the sheltered LAMP community. Lopez begins to make an effort to connect Ayers with the classical music community based at the Disney Concert Hall in LA and they go together to see a rehearsal. During this visit, when listening to the orchestra, Ayers experiences a marked increase in the voices that he hears, affecting his ability to concentrate on the music. The film uses flashbacks to tell us more about Ayers’ childhood and his huge potential as a musician, leading up to the point at which he develops schizophrenia at Juilliard and drops out.

Lopez also tracks down Ayer’s sister, long time estranged from him, and eventually succeeds in getting her to visit her brother in LA. As the ties of friendship and family increase, Ayers seems to respond positively, although his lack of insight about his illness remains. This provokes an incident of aggression toward Lopez when he brings some legal documents for Ayers to sign, which state that he has a diagnosis of schizophrenia. It is then that Lopez truly realises that schizophrenia cannot be cured by friendship alone; although he sees that stable human connections can provide the opportunity for some progress toward social recovery.

 

Relevance to the field of Mental Health

The Soloist, with its basis in a real life story, offers a tremendous opportunity to examine a number of very important issues in the long-term management of schizophrenia. The film gives us a good example of the effect the illness can have on the words, thoughts, perceptions and behaviour of sufferers and highlights the fluctuations that occur naturally in the disorder. It also raises the topic of treatment and the individual’s right to choose whether or not to take medication. As a teaching tool, this film could provide a wonderful starting point for a discussion about when the use of the Mental Health Act (in the UK) becomes appropriate and when we must respect a person’s right to choose their treatment options.

At its core this film also explores the role of kindness and compassion in the treatment of those suffering from chronic psychotic illnesses and the power of the social environment to aid recovery in such disorders. The Soloist examines the effect of a stable, consistent friendship in supporting and promoting recovery in an individual with schizophrenia. It shows that a trusting relationship must be developed before any attempts can be made to engage Ayers in any treatment services (in this case the acceptance of shelter rather than living on the streets). The film highlights Ayers’ loss of contact with his family when he became unwell, his relocation far away from the family home, and the subsequent alienation he experienced. But more than anything this film focuses our attention on the reality that it is individuals within societies who suffer from schizophrenia and that each of them has a personal story. If we can see someone who has schizophrenia as a person not a disease, society might begin to lessen some of the stigma of mental illness that is so often present.

It is interesting to note that Ayers and Lopez are still friends several years after their first meeting and now campaign for better housing for the mentally ill in America (as seen in this short video made in 2011). As mentioned in that short video, Ayers was invited to play for President Obama in 2010 to commemorate the 20th anniversary of the Americans with Disabilities Act at the White House.

In broader terms The Soloist challenges the viewer to consider mental health as an important public health issue, consistently associated with low income, unemployment, and poor physical health. I have previously discussed the topic of homelessness and mental illness in an earlier Minds on Film blog about the film The Christmas Choir. But for a greater understanding of the more general topic of public mental health there is the recent editorial in Advances in Psychiatric Treatment by Professor Sir Michael Marmot, entitled Health inequalities and mental life (APT (2012)18: 320-322). In addition, a detailed   position statement by The Royal College of Psychiatrists, published in October 2010, is available to read on the website by following the link to No health without public mental health.

 

•  More information about The Soloist is available at IMDB as well as a short trailer.

•  The film 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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