SHINE
The second Kampala Mental Health Film Club showed the Oscar winning film Shine, a dramatic biopic based on the life of David Helfgott, an Australian pianist who developed a manic or schizoaffective illness in his twenties.
About 80 people attended the film, including several members of the Ugandan National Association for the Deaf, who had been rehearsing a performance at the National Theater when I had gone to check the acoustics of the Auditorium earlier in the day. The previous Film Club had been marred by difficulties with sound, so we had played the film with subtitles. Even though we were able to resolve the difficulties with sound, we realized that keeping subtitles with allow us to include and involve those who were hard of hearing.
Discussion
After the film, about 30 people remained for a discussion. One member asked what the function of the film club was and who were the target audience. The function is to entertain, to educate and to promote dialogue and discussion, thought and reflection. The target audience is ultimately everyone: service users and patients, carers and mental health staff and members of the public. The co-ordinator of Heartsounds, the community based mental health service user group, reiterated that the function of the film club was to allow everyone to learn, including psychiatrists, who don’t know everything about mental illness.
The Film Club audience at the national Theatre
One member thanked the Film Club for bringing mental health to the forefront and unashamedly into the public domain, by hosting the event at the National Theatre. Another member acknowledged the moving and sensitive treatment and destigmatising approach to mental health but was concerned about the modest audience size: the film could have a role in education and awareness raising and suggested that the Film Club should liaise with the UNAD to get ideas about advertising the event more widely. Other members suggested audiences that would benefit from seeing the film, including university students, the forces (where mental health issues are a big problem) and police (who have the task of bringing acutely disturbed patients to hospital when community cant manage them).
Lost in Translation
One member’s contribution to the discussion in Lugandan was simultaneously translated by man from Deaf Association, leading on to an observation about ability to translate and comments at the last MHFC about trying to translate the film into Luganda. The representative from the UNDA was happy to get involved but had concerns about the fidelity of any translation: he wondered whether it was more important to get an exact translation or whether the main meaning was adequate. The content of the speech of a manic or psychotic patient is sometimes dismissed by psychiatrists as being irrelevant compared to the form: the characteristic rapid fire speech, changing topics, associations between words based on sound or on ideas, mark a symptom of a mental illness that moves the clinician closer towards diagnostic certainty. Thus attempts at understanding the content of the speech of a patient with a manic psychosis have at times been dismissed as being futile. However, far from being un-understandable, the content of Helfgott’s speech is laden with references and allusions to emotionally charged events pivotal in the development both of his personality and in the events that conspired alongside a vulnerable personality to result in a breakdown. While it would be good to get a high quality translation that captured the symbolism, alliteration and richness of his speech, from a practical point of view, a translation based on meaning alone would be better than nothing.
Translating films again led to a discussion of Jingo films, Hollywood blockbusters translated into Lugandan and shown at small local theatre shacks in Kampala. They are called Jingo, after the man who has made himself famous for his gonzo translations of all the dialogue (male and female) of popular blockbusters into Lugandan, injecting his own characteristic humour into the translation to the delight of his audiences (some say he even improves the films!). Other members suggested showing the film on a community film bus, that could goto a market place, show the film at the close of the market and have promote discussion after the presentation.
Recovery
A member of the Deaf Association stated that there needed to be no discussion of the meaning of the film as it had been very clearly presented in the film. However, he identified the importance of hope, and that like deafness, people with mental health difficulties don’t necessarily get cured but learn to live with their difficulties. Another member emphasized the importance of meaningful activity in recovery from mental health difficulties and the central role given in the film to David’s piano playing in helping him to adapt to his difficulties. One member acknowledged both an exceptional story, and exceptional talent, who was able to find acceptance and elicited a welcoming attitude from people around him. She wondered how would it be for those who do not have such exceptional gifts. Another member picked up on this concern: David’s infectious good humour, popularity and talents protected him and allowed him to be supported by his community, people responded to him well and he thrived despite his mental health difficulties. But this is a movie, and in real life and in Uganda, manic episodes often are not well tolerated by the community and can lead to assaults upon those who are mentally unwell. Education about mental health difficulties to the community and to the police, often called in to deal with mental health crises, is urgently necessary.
One member noted that whatever happens in an individuals life, there is still hope for recovery and improved functioning. In this film, it can also be seen that behind the mental illness, there are events in Helfgott’s early life, as portrayed in this film, that contribute to the development of the illness. Another member noted the role of stress and pressure in contributing to breakdown was noted.
Testimony
Several members were moved by the film, the accepting audience and the discussion to give testimony of their own experiences of mental health difficulties. One member talked of his diagnosis with insomnia long ago took away a message to message to accept taking medication and to accept and to love our children. Another member spoke of a person he knew in Northern Uganda, where mental health problems are a big issue, who just disappeared one day, leaving those left behind uncertain of his fate. One member, a teacher, gave testimony that a few years ago, he had woken up one day to find that he was in Butabika. He had never taken alcohol or drugs and had no personal or family history of mental illness, leaving him with an existential question: how did I end up in Butabika? The lack of an adequate answer to this question continues to worry him: “dealing with the reality of being mad keeps on haunting you because you think that today I may break down”. He also spoke movingly of his fear of talking about his difficulties,”going out and telling people that you have had mental illness is the scariest thing that you can do”, and so he had kept silent, even to close friends an colleagues. Another member advised him to break his silence, as being open and honest can be the most liberating act, taking away the power of a feared secret.
Messages from the film
Ali-Young children, the longer that you take imposing the attitude that you can manage this, the more it can lead to a breakdown. But thank god, he maintained his talent and even got married.
Medication
One member questioned whether his rapid speech suggested that he was compliant in taking his medication, but another member indicated that, if anything, Helfgott’s rapid speech suggested the characteristic pressured speech of mania, his speech snatching at his thoughts which have already moved on. This led to a discussion about whether Helfgott was taking his medication in the film, and one member concluded that it was unclear, and that people could get the wrong message from the film.
Service user involvement
Not enough community involvement, only medication- CRT, psychologists and OTs bringing non-pharmaceutical approaches to mental ehalth distress, Heartsounds supporting each other and PSW project.
Jim- ackowledge how far things had progressed since Heartsounds tour, 2008. HVG advert
Elizabeth thought on the last film for a week
Dave Baillie
About 80 people attended the film, including several members of the Ugandan National Association for the Deaf, who had been rehearsing a performance at the National Theater when I had gone to check the acoustics of the Auditorium earlier in the day. The previous Film Club had been marred by difficulties with sound, so we had played the film with subtitles. Even though we were able to resolve the difficulties with sound, we realized that keeping subtitles with allow us to include and involve those who were hard of hearing.
Discussion
After the film, about 30 people remained for a discussion. One member asked what the function of the film club was and who were the target audience. The function is to entertain, to educate and to promote dialogue and discussion, thought and reflection. The target audience is ultimately everyone: service users and patients, carers and mental health staff and members of the public. The co-ordinator of Heartsounds, the community based mental health service user group, reiterated that the function of the film club was to allow everyone to learn, including psychiatrists, who don’t know everything about mental illness.
The Film Club audience at the national Theatre
One member thanked the Film Club for bringing mental health to the forefront and unashamedly into the public domain, by hosting the event at the National Theatre. Another member acknowledged the moving and sensitive treatment and destigmatising approach to mental health but was concerned about the modest audience size: the film could have a role in education and awareness raising and suggested that the Film Club should liaise with the UNAD to get ideas about advertising the event more widely. Other members suggested audiences that would benefit from seeing the film, including university students, the forces (where mental health issues are a big problem) and police (who have the task of bringing acutely disturbed patients to hospital when community cant manage them).
Lost in Translation
One member’s contribution to the discussion in Lugandan was simultaneously translated by man from Deaf Association, leading on to an observation about ability to translate and comments at the last MHFC about trying to translate the film into Luganda. The representative from the UNDA was happy to get involved but had concerns about the fidelity of any translation: he wondered whether it was more important to get an exact translation or whether the main meaning was adequate. The content of the speech of a manic or psychotic patient is sometimes dismissed by psychiatrists as being irrelevant compared to the form: the characteristic rapid fire speech, changing topics, associations between words based on sound or on ideas, mark a symptom of a mental illness that moves the clinician closer towards diagnostic certainty. Thus attempts at understanding the content of the speech of a patient with a manic psychosis have at times been dismissed as being futile. However, far from being un-understandable, the content of Helfgott’s speech is laden with references and allusions to emotionally charged events pivotal in the development both of his personality and in the events that conspired alongside a vulnerable personality to result in a breakdown. While it would be good to get a high quality translation that captured the symbolism, alliteration and richness of his speech, from a practical point of view, a translation based on meaning alone would be better than nothing.
Translating films again led to a discussion of Jingo films, Hollywood blockbusters translated into Lugandan and shown at small local theatre shacks in Kampala. They are called Jingo, after the man who has made himself famous for his gonzo translations of all the dialogue (male and female) of popular blockbusters into Lugandan, injecting his own characteristic humour into the translation to the delight of his audiences (some say he even improves the films!). Other members suggested showing the film on a community film bus, that could goto a market place, show the film at the close of the market and have promote discussion after the presentation.
Recovery
A member of the Deaf Association stated that there needed to be no discussion of the meaning of the film as it had been very clearly presented in the film. However, he identified the importance of hope, and that like deafness, people with mental health difficulties don’t necessarily get cured but learn to live with their difficulties. Another member emphasized the importance of meaningful activity in recovery from mental health difficulties and the central role given in the film to David’s piano playing in helping him to adapt to his difficulties. One member acknowledged both an exceptional story, and exceptional talent, who was able to find acceptance and elicited a welcoming attitude from people around him. She wondered how would it be for those who do not have such exceptional gifts. Another member picked up on this concern: David’s infectious good humour, popularity and talents protected him and allowed him to be supported by his community, people responded to him well and he thrived despite his mental health difficulties. But this is a movie, and in real life and in Uganda, manic episodes often are not well tolerated by the community and can lead to assaults upon those who are mentally unwell. Education about mental health difficulties to the community and to the police, often called in to deal with mental health crises, is urgently necessary.
One member noted that whatever happens in an individuals life, there is still hope for recovery and improved functioning. In this film, it can also be seen that behind the mental illness, there are events in Helfgott’s early life, as portrayed in this film, that contribute to the development of the illness. Another member noted the role of stress and pressure in contributing to breakdown was noted.
Testimony
Several members were moved by the film, the accepting audience and the discussion to give testimony of their own experiences of mental health difficulties. One member talked of his diagnosis with insomnia long ago took away a message to message to accept taking medication and to accept and to love our children. Another member spoke of a person he knew in Northern Uganda, where mental health problems are a big issue, who just disappeared one day, leaving those left behind uncertain of his fate. One member, a teacher, gave testimony that a few years ago, he had woken up one day to find that he was in Butabika. He had never taken alcohol or drugs and had no personal or family history of mental illness, leaving him with an existential question: how did I end up in Butabika? The lack of an adequate answer to this question continues to worry him: “dealing with the reality of being mad keeps on haunting you because you think that today I may break down”. He also spoke movingly of his fear of talking about his difficulties,”going out and telling people that you have had mental illness is the scariest thing that you can do”, and so he had kept silent, even to close friends an colleagues. Another member advised him to break his silence, as being open and honest can be the most liberating act, taking away the power of a feared secret.
Messages from the film
Ali-Young children, the longer that you take imposing the attitude that you can manage this, the more it can lead to a breakdown. But thank god, he maintained his talent and even got married.
Medication
One member questioned whether his rapid speech suggested that he was compliant in taking his medication, but another member indicated that, if anything, Helfgott’s rapid speech suggested the characteristic pressured speech of mania, his speech snatching at his thoughts which have already moved on. This led to a discussion about whether Helfgott was taking his medication in the film, and one member concluded that it was unclear, and that people could get the wrong message from the film.
Service user involvement
Not enough community involvement, only medication- CRT, psychologists and OTs bringing non-pharmaceutical approaches to mental ehalth distress, Heartsounds supporting each other and PSW project.
Jim- ackowledge how far things had progressed since Heartsounds tour, 2008. HVG advert
Elizabeth thought on the last film for a week
Dave Baillie
SHINE: THE FILM
Isolation of mental illness
The film opens with a scene focusing on David Helfgott’s head, symbolising the isolation that characterises the separation from others that people experience as they go through an episode of mental illness. Isolated by the private and internal nature of their distress and inhibited the access to support and sympathy of others by their symptoms which intefere with their ability to communicate their distress: racing thoughts, rapid, incoherent and barely audible speech, apparently directed at no-one other than himself. Isolated, alone and cut off in his experience, his psychic energy is turned inwards, narcisisitic and self regarding and oblivious to the outside world: he is a head in isolation, cut off from the wider community.
The meaning of mental illness
The scene following the credits shows many of the characteristic features of a manic episode: filled with an abundance of energy, he is running through the streets; his thoughts cascading through his mind, his speech snatching at his thoughts which have already moved on; he is intrusive, forcing his way into the restaurant; inappropriate, overfamiliar and disinihibited with staff but infectious in his enthusiasm and energy, endearing him to the waitress. His speech and behaviour initially appear to be the un-understandable speech and disorganized behaviour of the madman, but as the narrative of the film unfold and as we develop a greater understanding of his background and early experiences, his speech and behaviour become more understandable. The content of his speech reflects many of the precipitating factors of his illness and in listening to his speech, we can begin to see some of the life events that contributed towards and marked his descent into madness.
The content of the speech of a manic or psychotic patient is sometimes dismissed by psychiatrists as being irrelevant compared to the form: the characteristic rapid fire speech, changing topics, associations between words based on sound or on ideas, mark a symptom of a mental illness that moves the clinician closer towards diagnostic certainty. Thus attempts at understanding the content of the speech of a patient with a manic psychosis have at times been dismissed as being futile.
However, far from being un-understandable, the content of his speech is laden with references and allusions to emotionally charged events pivotal in Helfgott’s development both of his personality and in the events that conspired alongside a vulnerable personality to result in a breakdown.
1. The rain which Helfgott observes is coming down in cats and dogs leads to Helfgott to think of cats, pussycats and lions, and recalls his overpowering and tyrannical father, whose influence loomed large over Helfgotts development and early years. In one scene, Peter Helfgott was experienced by young David as an angry lion, his sister attempted to reassure David by dismissing their father as a pussycat.
2. He describes himself as callous, the word used by his father when young David decides to disobey his father and pursue his dream and move to London.
Family factors and expressed emotion
Families play an important role in the development and the treatment of mental disorder. Early research in the 1950’s conceptualised types of family relationships that directly led to the development of mental illness, with its height in vitriolic attacks on the family institution from David Cooper and RD Laing. Subsequent research moved away from blaming the family but research has noted the role of certain types of family relationships that can be unhelpful in people with mental illness. Expressed emotion describes relationships characterised by overinvolved, enmeshed or extremely critical relationships, and research in London has shown that reducing the amount of time that people spend in such pressured relationships, combined with sensitive family interventions based on a non-blaming psychoeducation, can improve outcome.
In the narrative of the film, Peter Helfgott’s overbearing presence dominates Davids early life experiences. David’s fathers cherished violin was destroyed by his own father, his family destroyed by the overwhelming horror of the holocaust, and these events translate into his burning drive that his son succeeds where he could not in music and that his family should remain intact whatever the cost, even to the detriment of the emotional and professional development of his children.
(As an aside, Armin Mueller-Stahl, the actor playing Peter Helfgott, chooses to communicate his characters despotic and dictatorial anger when throwing David’s acceptance letter to the American music school in the fire by evoking the mannerisms of the most tyrannical and brutal dictators, whose policies so affected the Helfgott family).
Childhood abuse, both sexual and physical, is increasingly recognized as a risk factor for psychotic symptoms and illness later in life, and in the film, David is presented as being exposed to both physical and chronic emotional abuse. The echoes of the verbal abuse, the actual words that his father used to control him, still ring in his ears years later as he is overwhelmed by his manic psychosis.
Triggers
BPAD is described as having a strongly genetic component, famously the most heritable of the mental illnesses, and in real life, two paternal relatives had severe mental illness. However, stress can play a precipitating, triggering and maintaining role in the development of episodes. For David, we see the increasing stress that he is put under, and the insoluble conflict presented by his deep conflicting impulses, to excel in his music and to obey his fathers will.
In classic cognitive theory, depression is considered to be associated with events that involve loss, of a loved one, of a job, of a relationship, of self esteem, of an opportunity. Psychodynamic theory postulates the possibility of a manic defence against loss, to protect against the psychological distress of depression, by instead undertaking a distracting and liberating flight from accepting the loss, in a “triumphantly scornful” rejection of reality.
In the film, David experiences an accumulation of losses in the year leading upto his first episode, including the loss of the scholarship to the American Music academy, the loss of the national music competition, the loss of his family and his father, the loss of Katherine
The film presents further triggers for his breakdown: the overwhelming stress of the Rach 3, symbolic for a herculean and near impossible task, that would stress the finest pianists; the familiar narrative of the creative genius, precariously walking the fine line between creative genus and madness. As his teacher states, “you have to be mad to attempt the Rach 3,”, “Am I mad enough, professor?” David asks. Rach 3 then becomes the grail that can be achieved but at a catastrophic personal cost, causing considerable mental strain that the mind cannot cope and collapses into madness: the dramatic collapse at the end of the recital of Rach 3.
Treatment and Institutionalisation
David’s treatment is only touched on briefly, but shows ECT, now only a treatment for depression but then used for a variety of mental illnesses, including psychotic episodes. He is then shown in a rather depressing ward, with heavily sedated patients, shuffling about. He is rescued by a well meaning fan, but she cannot cope with his chaotic and disinhibited behaviour and she eventually finds supported accommodation for him. However, in the absence of caring and careful ongoing support, and with the loss of the semblance of a supportive family environment, he lapses into a depression, lying on his floor, staring at the TV.
Recovery
His recovery takes a long time, and an important milestone is shown when he returns to play the piano publicly. The narrative identifies two important components in his recovery: deciding to challenge his doctors prohibition of playing the piano, and the evolving relationship with the astrologer, Gillian Murray, who is charmed, seduced and ultimately captivated by his eccentric behaviour.
His return to playing piano symbolically demonstrates him overcoming some of the stresses that were catalytic in his first breakdown, returning to the activities that gave him a sense of purpose and esteem, and probably gave him enjoyment. His mental illness reduced him to a state of helplessness that his father. In the film, tried but ultimately failed to achieve. Being able to overcome his demons, and return to the piano, is a concrete endorsement of how he has changed and conquered his old nemesis.
Tension between biographical accuracy and a movie created fantasy
Many stereotypes of mental illness are portrayed in film- a disrupted childhood, a driven father, a monomaniacal obsession, overwhelming stress, mental collapse, institutionalisation and hopelessness, someone notices the glimmer of hope beneath the hopelessness, the recovery and relapse before a mental illness swept aside by the curative and healing powers of love. These Hollywood staples help to create a narrative in which his mental distress is understood and categorised….
Shine is presented as biographical and presents a very moving account of a man, subjected to childhood abuse and driven by stress to a mental breakdown, before slowly recovering to be able to perform to public acclaim. However, both David
Helfgott’s skills as a pianist and the accuracy of the film as a true biographical account have been severely criticized and attacked.
Criticisms of his piano playing
The film’s portrayal of David Helfgott as a musical genius has clearly irritated music critics, apparently provoked by the attention that Helfgott gets as a result of the Shine film. Dennis Dutton has written extensively about what he would see as Helfgott’s shortcomings as a musician and his criticism of individual pieces of music. He complains that the only fans of his music are not true music aficionados but merely people unlikely to have attended a musical concert, if they hadn’t seen the film or heard of his reputation. Critics have complained that the reverance of Helfgott is exploitative, with cynical promoters taking advantage of his fame from the film, Shine. However, those moved by his public performances describe “observing a triumph of the human spirit” and are inspired by a “deep sense of human communication”, reconnecting with something of Foucault’s Renaissance concept of madness where the madman is considered to have knowledge of the limits of human experience. Dutton concedes that ultimately to criticize the shortcomings of Helfgott’s piano playing might be to miss the point: maybe his performances herald a new “cinematic/musical/media aesthetic event”; the perception of the performed music shaped by an understanding of the background of the performer, and shaped by preconceptions delivered by film and myth.
Criticisms of the accuracy of the biographical story
Helfgott’s mother is on record as saying that the film Shine “haunts me day and night, an evil has been done.” His sister, Margaret, co-wrote a book with a journalist, “Out of Tune: the myth of David Helfgott and Shine”, in which she attempted to address the “derogatory and insulting” portrayal of her father. She makes a number of statements that are in stark contrast to the details of the film:
1. Peter never struck his son
2. Peter’s refusal to let David go to America at the age of 14 was more a reasonable decision that his son was not yet ready for such independence
3. No letters were burned
4. The family remained in touh and treasured his letters from London
5. David won the Danreuther prize for his performance of Rachmaninoff’s Piano Concerto No. 3, ? in 1969, but although showing signs of his first episode of mental illness in London, was not hospitalized until after his return to Ausralia, at least a year later.
6. When it became clear to the family that he was becoming unwell, his father urged him to return to Australia
7. He was welcomed by his whole family on his return to Australia
8. He contintued to play both publicly and privately despite repeated hospitalizations
9. He stayed with his father when his first marriage broke down
10. Despite the emphasis on his fathers mistreatment of him, David had a strong family history of mental illness, with a paternal aunt and a paternal great aunt both suffering from mental illness.
11. When living in the halfway house, he had an active social life and was popular with other residents
12. His brother found him the job working at the local wine bar.
Hollywood vs Real Life
There is always tension between the fantasy, myth making and Hollywoodisation of a co-called true story, where the onus is to develop a nice clean story arc that explains everything, show an archetypal struggle against a disadvantaged hero against all the odds, triumphing by a combination of inner resources and the love of a good woman, with a rousing and emotionally manipulative soundtrack. Back in the real world, life is more complicated and less pleasingly and reassuringly simple but far more rich, inconsistent and complicated. But maybe this simplicity is one of the attractions of film: to develop a clear narrative and a framework of understanding to make sense of a complex phenomenon.
So what of the film is relevant to the Ugandan context?
- Probably the presentation of a manic or schizoaffective psychosis;
- the value of attempting to make sense of an episode of mental illness, by developing a coherent narrative that patient, family and clinician can recognize;
- episodes of acute mental illness are often characterized by a breakdown in a persons capacity to communicate.
Recovery can be facilitated and supported by
- developing a working relationship with medication and mental health services
- nurturing and supportive relationships and
- through meaningful activity
Ultimately, the understanding and narrative of a particular persons relationship with their mental health difficulties will vary according to the individuals personal and professional perspective, a biological psychiatrist may interpret their difficulties as due to a dysfunction of transmitters; a traditional healer may see the influence of witchcraft or a failure to appease spirits; a spiritual healer will point to spiritual causes; the patient will have their own individual explanation. The same patient may have several different stories about their difficulties but a story gives meaning, understanding, hope and a framework on which to build their recovery.
Dave Baillie
Isolation of mental illness
The film opens with a scene focusing on David Helfgott’s head, symbolising the isolation that characterises the separation from others that people experience as they go through an episode of mental illness. Isolated by the private and internal nature of their distress and inhibited the access to support and sympathy of others by their symptoms which intefere with their ability to communicate their distress: racing thoughts, rapid, incoherent and barely audible speech, apparently directed at no-one other than himself. Isolated, alone and cut off in his experience, his psychic energy is turned inwards, narcisisitic and self regarding and oblivious to the outside world: he is a head in isolation, cut off from the wider community.
The meaning of mental illness
The scene following the credits shows many of the characteristic features of a manic episode: filled with an abundance of energy, he is running through the streets; his thoughts cascading through his mind, his speech snatching at his thoughts which have already moved on; he is intrusive, forcing his way into the restaurant; inappropriate, overfamiliar and disinihibited with staff but infectious in his enthusiasm and energy, endearing him to the waitress. His speech and behaviour initially appear to be the un-understandable speech and disorganized behaviour of the madman, but as the narrative of the film unfold and as we develop a greater understanding of his background and early experiences, his speech and behaviour become more understandable. The content of his speech reflects many of the precipitating factors of his illness and in listening to his speech, we can begin to see some of the life events that contributed towards and marked his descent into madness.
The content of the speech of a manic or psychotic patient is sometimes dismissed by psychiatrists as being irrelevant compared to the form: the characteristic rapid fire speech, changing topics, associations between words based on sound or on ideas, mark a symptom of a mental illness that moves the clinician closer towards diagnostic certainty. Thus attempts at understanding the content of the speech of a patient with a manic psychosis have at times been dismissed as being futile.
However, far from being un-understandable, the content of his speech is laden with references and allusions to emotionally charged events pivotal in Helfgott’s development both of his personality and in the events that conspired alongside a vulnerable personality to result in a breakdown.
1. The rain which Helfgott observes is coming down in cats and dogs leads to Helfgott to think of cats, pussycats and lions, and recalls his overpowering and tyrannical father, whose influence loomed large over Helfgotts development and early years. In one scene, Peter Helfgott was experienced by young David as an angry lion, his sister attempted to reassure David by dismissing their father as a pussycat.
2. He describes himself as callous, the word used by his father when young David decides to disobey his father and pursue his dream and move to London.
Family factors and expressed emotion
Families play an important role in the development and the treatment of mental disorder. Early research in the 1950’s conceptualised types of family relationships that directly led to the development of mental illness, with its height in vitriolic attacks on the family institution from David Cooper and RD Laing. Subsequent research moved away from blaming the family but research has noted the role of certain types of family relationships that can be unhelpful in people with mental illness. Expressed emotion describes relationships characterised by overinvolved, enmeshed or extremely critical relationships, and research in London has shown that reducing the amount of time that people spend in such pressured relationships, combined with sensitive family interventions based on a non-blaming psychoeducation, can improve outcome.
In the narrative of the film, Peter Helfgott’s overbearing presence dominates Davids early life experiences. David’s fathers cherished violin was destroyed by his own father, his family destroyed by the overwhelming horror of the holocaust, and these events translate into his burning drive that his son succeeds where he could not in music and that his family should remain intact whatever the cost, even to the detriment of the emotional and professional development of his children.
(As an aside, Armin Mueller-Stahl, the actor playing Peter Helfgott, chooses to communicate his characters despotic and dictatorial anger when throwing David’s acceptance letter to the American music school in the fire by evoking the mannerisms of the most tyrannical and brutal dictators, whose policies so affected the Helfgott family).
Childhood abuse, both sexual and physical, is increasingly recognized as a risk factor for psychotic symptoms and illness later in life, and in the film, David is presented as being exposed to both physical and chronic emotional abuse. The echoes of the verbal abuse, the actual words that his father used to control him, still ring in his ears years later as he is overwhelmed by his manic psychosis.
Triggers
BPAD is described as having a strongly genetic component, famously the most heritable of the mental illnesses, and in real life, two paternal relatives had severe mental illness. However, stress can play a precipitating, triggering and maintaining role in the development of episodes. For David, we see the increasing stress that he is put under, and the insoluble conflict presented by his deep conflicting impulses, to excel in his music and to obey his fathers will.
In classic cognitive theory, depression is considered to be associated with events that involve loss, of a loved one, of a job, of a relationship, of self esteem, of an opportunity. Psychodynamic theory postulates the possibility of a manic defence against loss, to protect against the psychological distress of depression, by instead undertaking a distracting and liberating flight from accepting the loss, in a “triumphantly scornful” rejection of reality.
In the film, David experiences an accumulation of losses in the year leading upto his first episode, including the loss of the scholarship to the American Music academy, the loss of the national music competition, the loss of his family and his father, the loss of Katherine
The film presents further triggers for his breakdown: the overwhelming stress of the Rach 3, symbolic for a herculean and near impossible task, that would stress the finest pianists; the familiar narrative of the creative genius, precariously walking the fine line between creative genus and madness. As his teacher states, “you have to be mad to attempt the Rach 3,”, “Am I mad enough, professor?” David asks. Rach 3 then becomes the grail that can be achieved but at a catastrophic personal cost, causing considerable mental strain that the mind cannot cope and collapses into madness: the dramatic collapse at the end of the recital of Rach 3.
Treatment and Institutionalisation
David’s treatment is only touched on briefly, but shows ECT, now only a treatment for depression but then used for a variety of mental illnesses, including psychotic episodes. He is then shown in a rather depressing ward, with heavily sedated patients, shuffling about. He is rescued by a well meaning fan, but she cannot cope with his chaotic and disinhibited behaviour and she eventually finds supported accommodation for him. However, in the absence of caring and careful ongoing support, and with the loss of the semblance of a supportive family environment, he lapses into a depression, lying on his floor, staring at the TV.
Recovery
His recovery takes a long time, and an important milestone is shown when he returns to play the piano publicly. The narrative identifies two important components in his recovery: deciding to challenge his doctors prohibition of playing the piano, and the evolving relationship with the astrologer, Gillian Murray, who is charmed, seduced and ultimately captivated by his eccentric behaviour.
His return to playing piano symbolically demonstrates him overcoming some of the stresses that were catalytic in his first breakdown, returning to the activities that gave him a sense of purpose and esteem, and probably gave him enjoyment. His mental illness reduced him to a state of helplessness that his father. In the film, tried but ultimately failed to achieve. Being able to overcome his demons, and return to the piano, is a concrete endorsement of how he has changed and conquered his old nemesis.
Tension between biographical accuracy and a movie created fantasy
Many stereotypes of mental illness are portrayed in film- a disrupted childhood, a driven father, a monomaniacal obsession, overwhelming stress, mental collapse, institutionalisation and hopelessness, someone notices the glimmer of hope beneath the hopelessness, the recovery and relapse before a mental illness swept aside by the curative and healing powers of love. These Hollywood staples help to create a narrative in which his mental distress is understood and categorised….
Shine is presented as biographical and presents a very moving account of a man, subjected to childhood abuse and driven by stress to a mental breakdown, before slowly recovering to be able to perform to public acclaim. However, both David
Helfgott’s skills as a pianist and the accuracy of the film as a true biographical account have been severely criticized and attacked.
Criticisms of his piano playing
The film’s portrayal of David Helfgott as a musical genius has clearly irritated music critics, apparently provoked by the attention that Helfgott gets as a result of the Shine film. Dennis Dutton has written extensively about what he would see as Helfgott’s shortcomings as a musician and his criticism of individual pieces of music. He complains that the only fans of his music are not true music aficionados but merely people unlikely to have attended a musical concert, if they hadn’t seen the film or heard of his reputation. Critics have complained that the reverance of Helfgott is exploitative, with cynical promoters taking advantage of his fame from the film, Shine. However, those moved by his public performances describe “observing a triumph of the human spirit” and are inspired by a “deep sense of human communication”, reconnecting with something of Foucault’s Renaissance concept of madness where the madman is considered to have knowledge of the limits of human experience. Dutton concedes that ultimately to criticize the shortcomings of Helfgott’s piano playing might be to miss the point: maybe his performances herald a new “cinematic/musical/media aesthetic event”; the perception of the performed music shaped by an understanding of the background of the performer, and shaped by preconceptions delivered by film and myth.
Criticisms of the accuracy of the biographical story
Helfgott’s mother is on record as saying that the film Shine “haunts me day and night, an evil has been done.” His sister, Margaret, co-wrote a book with a journalist, “Out of Tune: the myth of David Helfgott and Shine”, in which she attempted to address the “derogatory and insulting” portrayal of her father. She makes a number of statements that are in stark contrast to the details of the film:
1. Peter never struck his son
2. Peter’s refusal to let David go to America at the age of 14 was more a reasonable decision that his son was not yet ready for such independence
3. No letters were burned
4. The family remained in touh and treasured his letters from London
5. David won the Danreuther prize for his performance of Rachmaninoff’s Piano Concerto No. 3, ? in 1969, but although showing signs of his first episode of mental illness in London, was not hospitalized until after his return to Ausralia, at least a year later.
6. When it became clear to the family that he was becoming unwell, his father urged him to return to Australia
7. He was welcomed by his whole family on his return to Australia
8. He contintued to play both publicly and privately despite repeated hospitalizations
9. He stayed with his father when his first marriage broke down
10. Despite the emphasis on his fathers mistreatment of him, David had a strong family history of mental illness, with a paternal aunt and a paternal great aunt both suffering from mental illness.
11. When living in the halfway house, he had an active social life and was popular with other residents
12. His brother found him the job working at the local wine bar.
Hollywood vs Real Life
There is always tension between the fantasy, myth making and Hollywoodisation of a co-called true story, where the onus is to develop a nice clean story arc that explains everything, show an archetypal struggle against a disadvantaged hero against all the odds, triumphing by a combination of inner resources and the love of a good woman, with a rousing and emotionally manipulative soundtrack. Back in the real world, life is more complicated and less pleasingly and reassuringly simple but far more rich, inconsistent and complicated. But maybe this simplicity is one of the attractions of film: to develop a clear narrative and a framework of understanding to make sense of a complex phenomenon.
So what of the film is relevant to the Ugandan context?
- Probably the presentation of a manic or schizoaffective psychosis;
- the value of attempting to make sense of an episode of mental illness, by developing a coherent narrative that patient, family and clinician can recognize;
- episodes of acute mental illness are often characterized by a breakdown in a persons capacity to communicate.
Recovery can be facilitated and supported by
- developing a working relationship with medication and mental health services
- nurturing and supportive relationships and
- through meaningful activity
Ultimately, the understanding and narrative of a particular persons relationship with their mental health difficulties will vary according to the individuals personal and professional perspective, a biological psychiatrist may interpret their difficulties as due to a dysfunction of transmitters; a traditional healer may see the influence of witchcraft or a failure to appease spirits; a spiritual healer will point to spiritual causes; the patient will have their own individual explanation. The same patient may have several different stories about their difficulties but a story gives meaning, understanding, hope and a framework on which to build their recovery.
Dave Baillie