Tuesday, November 26, 2013

A Beautiful Mind: A case study in why paternalistic lying isn't generally a good idea

Mad in America recently posted a video of John Nash, the subject of A Beautiful Mind (2001), discussing some of the movie’s inaccuracies.

In particular, he describes the suggestion made in the film – but, significantly, not in the book by Sylvia Nasar on which it was based – that his recovery was made possible by psychiatric drugs. Coincidentally, a couple of weeks earlier I’d posted a link at Dispatches from the Culture Wars to this article by Bruce Levine, in reply to a comment joking about “the famed Princeton School of Medicine. Located in the basement of Fine Hall, and overseen by John Nash (before the medication started to work).”

Levine describes the film’s falsehood:
The shame is that [director Ron] Howard, perhaps afraid of upsetting the mental health establishment, gave Russell Crowe's Nash a line which the real John Nash never said, a line which was untrue, a line which was unnecessary to move the story along, but a line which was completely necessary for the pharmaceutical industry and the institutions it financially supports -- including the American Psychiatric Association, the National Alliance for the Mentally Ill, and the drug-advertisement addicted media.

The line? In Howard's A Beautiful Mind, John Nash, when informed that he was being considered for the 1994 Nobel Prize, mentions, ‘I take the newer medications’. However, as the documentary A Brilliant Madness (broadcast on PBS’s “American Experience” in 2002) reported, ‘Nash had stopped taking medication in 1970’.
This is confirmed by Nash in the interview (beginning at around 3:45). He says that the line, which did not appear in the book and does not reflect reality, was included by the screenwriter, Akiva Goldsman. Goldsman is the son of child psychologists (not of a psychiatrist, as Nash suggests), and this milieu may have influenced his presentation of the matter. In any case, he felt it necessary to include this fateful line despite its falsehood. The reasoning behind doing so can be imagined: “If people think they can recover without them, they’ll be unlikely to start taking the drugs and might want to go off of them. These are necessary medications, and I don’t want my work to turn people away from them.” It’s the sort of condescending argument that leads some psychiatrists to knowingly lie to people about chemical imbalances so that they’ll take and believe in drugs.

The effects of the addition of this line can’t be overestimated. As the comment at Dispatches to which I was responding suggests, the film powerfully shaped people’s ideas about “mental illness” in favor of the brain disease-drug model. As Levine argues, “Howard's ‘newer medications’ line served, in effect, as a product placement not for a single company but for an entire drug-dependent mental health industry that would show its appreciation.”

As I’ve discussed extensively here on this blog, in the years since the film was made, the scientific evidence – Harrow, Wunderink, Moncrieff, Andreasen,… - has continued to show that the use of drugs long term is not only not necessary but ineffective and harmful.* More and more stories of suffering, illness, and death caused by the drugs appear,** as do more and more accounts, like Nash’s, of recovery without them. In this context, the consequences of including that line in A Beautiful Mind, well intended though it probably was, have been more suffering and death and the lost hope of recovery for millions of people.

I have to wonder if it ever occurred to Goldsman or Howard that Nash’s recovery itself might have indicated that the model was flawed. Regardless, this case speaks strongly to the responsibility of artists and intellectuals to tell the truth. At a minimum, it points to the serious problem with artistic falsehoods. It isn’t the writer’s or filmmaker’s job to tell the public what he or she thinks is best for them to hear. It’s their job to speak the truth and to expose lies.

* Much of this was known at the time, and was even included in Nasar’s book, which is quoted in Levine’s article:
Nash’s refusal take the antipsychotic drugs after 1970, and indeed during most of the periods when he wasn’t in the hospital in the 1960s, may have been fortuitous. Taken regularly, such drugs, in a high percentage of cases, produce horrible, persistent, symptom like tardive dyskinesia. . . and a mental fog, all of which would have made his gentle reentry into the world of mathematics a near impossibility.
** Regarding Zyprexa alone, Peter Gøtzsche estimates that “with that drug Eli Lilly has killed around 200,000 people.”

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