Psychiatrists Invited to Peer Inside ‘A Beautiful Mind’

The film that last month won moviedom’s top honor, the Academy Award as the best picture of 2001, is a rare breed for another reason as well. It is a mainstream Hollywood production that has garnered rave reviews from psychiatrists and mental health professionals for its compassionate and realistic portrayal of what it is like to suffer from a severe mental illness. Film devotees who want a second look and curious psychiatrists who missed it in theaters will have a chance to see “A Beautiful Mind” when it plays at this month’s APA annual meeting in Philadelphia.

“A Beautiful Mind” is based on the life of genius mathematician John Nash Jr. The film was adapted from a biography of Nash written by Sylvia Nasar.

Early in the film Nash is an arrogant, socially awkward mathematics graduate student at Princeton when he begins to experience delusions and hallucinations that are eventually diagnosed as symptoms of paranoid schizophrenia. (In real life, he actually developed his symptoms after leaving Princeton for a teaching position at M.I.T. in 1951 at age 30.)

The film, which also won Oscars for director Ron Howard and Jennifer Connelly, who played Nash’s wife, Alicia, convincingly portrays his paranoid delusions as they become more and more complex and increasingly interfere with his ability to function. For much of the movie viewers have difficulty telling which scenes depict real life and which depict his delusions.

Nash, portrayed by Russell Crowe, eventually became so psychiatrically disabled that he was hospitalized. The primary treatment he received was insulin coma therapy, which along with ECT was the only treatment that had demonstrated any impact on schizophrenia symptoms by the time of his illness. The treatment relieved his symptoms for a while, but the improvement was short lived. Nash rebelled at the insulin treatments and later the severe side effects he had to endure from medication, and he refused further treatment.

While he was able to solve astoundingly difficult math problems in the early years of his illness, it soon prevented him from holding a job. The film also shows his illness progressively compromising his ability to care for his infant son while his wife was at work.

The film dramatizes how Nash managed through willpower and the support of his wife to learn to ignore his delusions, though they still plague him 50 years later. He eventually regained enough contact with reality and control over the manifestations of his illness that he was able to return to Princeton to continue his research. In 1994 Nash won the Nobel Prize for Economics for his discoveries of the ways in which game theory determines economic cycles and events and controls other aspects of life.

Much of the praise for “A Beautiful Mind” comes from Howard’s directorial choices, which do not rely on any of the usual cliches Hollywood uses to depict mental illness. The film is instead the portrait of a brilliant but very sick man dealing with a debilitating illness that has made his life extraordinarily difficult.

Also important in the film’s positive reception by psychiatrists, patients, and advocates is that it avoids the typical happy Hollywood ending. Nash’s illness is something he will have to live with for the rest of his life.

The movie will be shown on Wednesday, May 22, at 2 p.m. in the Loews Hotel. The discussant will be Max Fink, M.D., who was a consultant to the filmmakers and the only psychiatrist credited at the end of the movie. Fink began his residency in 1952 at New York’s Hillside Hospital, a psychiatric facility that had a 22-bed insulin coma therapy unit. He headed that unit for six years. ▪