Terry McMahon’s second feature (after 2011’s Charlie Casanova) is about Patrick, a young man being treated for schizophrenia in an Irish psychiatric institution who falls in love with a woman he meets during the St. Patrick’s Day celebrations in Dublin, but whose mother intervenes in the interest of his protection. We spoke to Terry about suffering, art and control and the making of this moving film.
I understand you have a background in psychiatric care: why do you think psychiatric hospitals exist?
I’m sure for noble intentions. But despite noble intentions, they are often turned into ugly places, which are mechanisms of control, mechanisms to protect so-called normal people or protect people in power. Too often, a psychiatric institution that was designed to help or to humanistically engage with people who are ill, ends up dehumanising them and controlling them. So, like many hospitals, and like many government policies that observe those hospitals, the very thing that was once noble is too often rendered ignoble.
Do you believe that it is useful for us to have terminology such as ‘mentally ill’?
I think we’ve bashed about language to such a degree, and we’re so politically correct about everything, that we use terms like ‘mental health’ which, for me, negates the actuality and the complexity of what it means to be mentally ill. So I can understand why so many people want to use a language that normalises things that are deemed to be abnormal, but the idea of a reductionist diagnosis being a cover-all for a person or for a group of people — I think that’s damaging. So while I understand the necessity of clarity in the use of language, I think the reductionist use of it can be damaging.
I’m thinking back over the last couple of years in Irish society, and Irish cinema, and it seems like we’re talking a little bit more about these issues, and I would argue the content of this talk is still reductionist and oppressive, regardless of its quantity. I’m thinking about Frank: have you seen that film?
Yeah, I thought it was stunning.
In the final sequence of that film, we have Frank’s parents reasserting conventional attitudes about mental illness as innate fact, but with Patrick’s Day I perceive a bit more ambivalence in the treatment of that discourse: do you see your film as a sort of antidote to reductionism?
I think so, yeah. Even Patrick’s mother, she uses the word ‘retarded’ in the film. But she’s using the word deliberately, because she understands the connotations of that word, and she’s using it to cause fear in her son’s lover. But this woman is more than capable of using a diagnostic word in the same, painful way. I do believe that too often we exist in a situation where we are sort of nanny-conditioned, where we are so vulnerable that we seek help from people who may not necessarily have our best interests at heart. And as an obvious metaphor for the larger narrative of our culture, I believe that our own government, in their moral certitude, have convinced themselves that what they are doing is right, when in fact their actions are causing untold damage. Just because an act is not an act of malice, does not mean that it cannot be a profoundly damaging act. The conversation about using love or using ‘protection’ as a mask for control is one we need to have on a much broader issue. So yeah, it’s not an abreaction, but it’s definitely a reaction against reductionist notions of mental health and so-called regular health.
You mention Patrick’s mother. To me she seems the villain of the piece, if such exists in the narrative. Do you believe that family relations provide the basic shape of all later suffering?
Well, there are some claims that back up that idea, and some that counter it. But she’s not intended to be the villain. We lie to our children from day one. We lie to our children about fairies and Santa Claus, and then we progress to lying to our children about other things for which we have no proof, like God. We convince them of these things and their existence because for that time frame we believe it will benefit them, and give them the moral tools required for being a decent person. But imagine if your child had a mental illness to such a degree that you feared that love, romantic love, could break their sense of normality to such a degree that it caused them damage, would you reach out and try to protect them with a delusion? That’s what the mother is doing; she’s not a villain. It is her belief that she’s doing the right thing.
The roots of schizophrenic thinking are such that we split off those aspects of reality that we find unbearable, to be replaced by a blank space, or perhaps a delusion. Now, when you say that Patrick’s mother is not necessarily the villain of the piece, we see that very early on, her fostering of a delusion, insofar as it related to a material and emotional reality (her lying about the death of Patrick’s dog when he was a child, then claiming that the dog never existed), could quite easily have sown the seeds of later delusional thinking. Do you not think that this is the case?
It’s certainly possible, but it’s not presented as simplistic fact in the film. Everything we do facilitates something, and engaging with fantasy and delusion is something that becomes habitual, and something that occasionally becomes addictive, whether we’re normal or deemed to be abnormal. The second point of it is the idea of what we’re willing to do to our children, or for our children, as parents: very often we believe we’re doing the right thing but we’re causing untold damage. And the third thing is the idea of what it means to be mentally ill and what it means to be incapable of dealing with reality… there are people every day, sadly and heartbreakingly, in our culture who fear reality to such a degree that they take their own lives. Those people are not deemed to be mentally ill; those people are deemed to be having a reaction to a cultural, social and economic cancer that is in our society. The reality of what it means to be mentally ill versus what it means to be a sensitive human being — it’s often a very thin line between the two, and it depends on who’s manipulating your perception to tell you who you are, what you do and why.
I wonder about this. I spoke to Lenny Abrahamson after the release of Frank and, despite that film’s often quite nuanced treatment of its subject, he still remarked that he believes that mental illness is something which exists. So we have this philosophical argument for the innate existence, of something which I would argue is a discourse which exists within, and as a result of, extant power relations — those of the state, the disciplines of medicine and psychiatry — that then determine what is ‘sick’ or ‘healthy’. So, in talking about a politics of human freedom, is using that binary of ‘sick’ and ‘healthy’, handed to us from above, not somewhat self-defeating?
I agree, and beautifully and eloquently phrased. I think the actuality of who defines what we are is one we need to address before we even question the idea of mental illness. And the kind of people who are defining who we are are very often corrupted, and from the outside — our education system, our economic system, our religious system and then, of course, our familial system.
Very often the constructs that are put in place, before we have the opportunity to define who we want to be, are already killing us. The nature of mental illness is such a controversial subject in itself that I’m sure in Lenny Abrahamson’s case, and many other cases, that people are just trying to be delicate in a profoundly sensitive conversation. But sometimes that delicacy unintentionally propagates and protects the same system. Whereas I think we need to address head-on the reality that we have a system that in too many cases not only doesn’t work, but causes untold damage. And the final thing is the pharmaceutical industry: its only interest is keeping you on drugs from the cradle to the grave. It has no interest in any shape or form in curing, or the process of helping someone towards a humanistic engagement with their reality. Its only interest is the financial benefit of keeping you on drugs for as long as you live.
The use of electro-convulsive therapy is widespread in Irish psychiatric institutions. We are either aware of this, or perhaps wilfully unaware of it. Do you think, then, that we live in a society that lacks compassion?
It’s extraordinary because I don’t think it’s wilful, but people are genuinely staggered when they learn that ECT is not just still used, but is increasing in its use. So I don’t think it’s a deliberate ignorance, I don’t think it’s a deliberate malice on the part of administrators. I do think that there are people who believe that ECT is the only effective method that has worked for them, and there are others who believe that it is barbaric beyond measure — it depends on who you talk to. I don’t believe that the doctors who administer it believe that it is wrong.
But no evil ever understands itself as wrong. Is it not fair to say that any doctor administering ECT lacks the ethical capacity to make a useful distinction between right and wrong?
Yes, you’re right that nobody is going to determine their own actions as immoral when they are acting from a moral perspective. Do I believe it to be right or wrong? I think that’s one of the central questions of the film, so my individual position is irrelevant. But I do think that the reaction from the audiences that have witnessed it — and we’ve screened around the world — we’ve heard the guttural sobs come during that scene [which features ECT], I think that’s coming from a primal place that transcends our limited morality. We’re seeing a human being going through something that is a living, breathing nightmare. I don’t want to be divisive in the wrong way: I want to generate a visceral reaction.
We only see the terminology of mental illness emerge in relatively quite recent history. In the last hundred years or so, as you say, we have forfeited our understanding of human suffering — of madness, even — to the institutions of medicine, psychiatry and, as you quite rightly say, the pharmaceutical industry: do you think there’s any way back from this?
I think art is one of the most sublime examples of the control of madness. So yes, in terms of a cultural abreaction to reductionist engagement, when we have humanistic art, in the form of film, music, painting — all forms of art — all of those are engaging with the realm of possibility that transcends our limitations.
Patrick’s Day is out now.
Words: Oisín Murphy-Hall