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

When a Man loves a Woman

Introduction

Directed by Luis Mandoki in 1994, When a Man loves a Woman stars Andy Garcia and Meg Ryan. It tells the story of an airline pilot, Michael Green, and his wife, Alice, a school counsellor, who seemingly have a wonderful life living with their daughters in San Fransisco, until the truth about her alcohol dependence reveals itself and threatens to destroy everything.

What is especially interesting about the film is that it is based on the actual experiences of one of the two writers, Al Franken, who is now a United States Senator from Minnesota. His wife struggled with alcohol dependency whilst their two children were young and he supported her through some very difficult times.  This was publically revealed in a campaign Ad made by Franken in 2008, which featured his wife talking about her addiction.

When a Man Loves a Woman

The Film

The film opens with a playful scene between Alice and her husband in a bar, clearly fuelled by the effects of alcohol on Alice. Soon afterwards, an anniversary dinner leads to some late night, disinhibited, public disorder as Alice eggs a car whose alarm keeps going off outside their home. In these various introductory sequences, we also see the role that Michael has within their relationship as the strong, capable partner, who often steps in and takes over, even in Alice’s role as mother to daughters Jess and Casey.

 

The problems first surface when Alice goes out for a drink after work with a friend who needs to talk, completely forgetting that Michael has a flight and must leave that evening. When confronted about this by him, her irritability soon dissolves into despair about the loneliness of her situation when Michael is away flying. Her secret drinking is soon uncovered and she confesses to having vodka bottles hidden in various places around the home. As Alice’s behaviour becomes more painfully disturbed and openly drunken, the effect on the children takes centre stage. This situation is brought to a dramatic head after she hits her eldest daughter shortly before falling through the plate glass shower cubicle in her bathroom, where she then lays unconscious on the floor. Her daughter Jess frantically calls her Dad, who is away at the time, to tell him that she thinks that Mummy is dead.  He finds himself organising emergency help from a distance in an extremely poignant scene. This episode leads directly to Alice being admitted, for ‘detox’, into an inpatient unit, where we follow her progress and that of the family.

The second part of the film focuses on Alice and the family after she has stopped drinking and is in recovery back home, attending regular Alcoholics Anonymous meetings. We watch the change in the balance of the marital relationship brought about by Alice’s new found ‘true self’ which threatens to tear them apart. The film illustrates the increasing emotional strain placed on Michael as he struggles to make sense of those changes and to understand his own part in their failing marriage whilst, at the same time, seeking some stability in his life again. The scenes between Michael and his daughters when he tells them that he is finally relocating to Detroit are a painful reminder of the effect that parental separation can have on children, and how the age of the child commonly determines their response.

The ending is not completely negative, but leaves open the possibility of something good ultimately developing between two individuals who have learned a lot about themselves and their relationship through an incredibly challenging experience. Although there is a more positive tone to the ending, When a Man loves a Woman succeeds in communicating the vulnerable situation experienced by every recovering alcoholic as they set out to live one day of their life at a time.

 

Relevance to the field of Mental Health

When a Man loves a Woman provides us with a platform to explore not only the general topic of alcohol addiction, but in particular the specific issues relating to women and alcohol. It reminds us that it is impossible to tell who may be drinking excessive amounts of alcohol in our communities and that we must always ask about alcohol consumption when taking a medical or psychiatric history. The BMJ has recently reviewed the NICE guidelines on Diagnosis, assessment and management of harmful drinking and alcohol dependence; Stephen Pilling et al (BMJ 2011; 342:d700) and alongside this, in the same issue of the journal, there is an account by a 78 year old man of his experience with alcoholism, written with his GP, Dr Adrian Raby, entitled  A Patient’s Journey: Alcoholism (BMJ 2011; 342:d956) that highlights, in particular, the effect that his excessive drinking had on his wife.

 

For similar reasons, I believe that this film is especially valuable in its portrayal of the effect that Alice’s alcohol addiction has on her marriage and on her children. The anguish, confusion and hurt that we observe in her older daughter, as she becomes aware of her mother’s problem, are at times almost too painful to watch. These scenes place us directly into the battleground so often described by families struggling to cope with a relative’s alcohol dependence. The effects on Alice’s marriage to Michael are also fully explored and a glimpse of their marital therapy help to remind us of the complex work that usually needs to be done by a couple struggling to make sense of the causes and to repair the damage that so often accompanies alcohol addiction. When a Man loves a Woman follows all members of Alice’s nuclear family closely, giving us a powerful reminder of the consequences that one person’s mental ill health can have on their loved ones, especially any dependent children.

 

As the film focuses on Alice’s journey through detoxification and on to Alcoholics Anonymous meetings, it highlights the important role of advice and support that individuals need to deal with their addiction. This might help to illuminate and support the argument being made in a recent report by Alcohol Concern that more alcohol health workers in hospitals and GP surgeries, offering counselling and advice, would ultimately save the NHS money. As alcohol misuse has created a steady rise in costs for the NHS through an increase in alcohol related illnesses, there is an urgent need to recognise it as a major health priority.

 

Recent media attention has highlighted the particular risks facing middle class, professional woman who seem to be consuming more alcohol on a regular basis than other females (The Telegraph, March 2011). The Institute of Alcohol Studies has produced a number of very informative factsheets about alcohol consumption in the UK and in particular one on women and alcohol, which may be interesting to read in conjunction with a viewing of this film. The NHS web pages on Alcohol and Drinking have a number of useful links (including to a downloadable Alcohol tracking app for iPhone or desktop) and a Carer’s story, written by a husband about his alcoholic wife, which provides an account which describes some similar issues to those portrayed in When a Man loves a Woman.

 

I would highly recommend this film for anyone seeking to work in the field of alcohol or addictions as well as for those involved in family therapy. But for a wider mental health audience, When a Man loves a Woman reminds us that alcohol dependency is no longer the preserve of any one particular group in our society alone.

 

Minds on Film is written by 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.