A Beautiful Mind
...reviewed for those interested more
in schizophrenia than just a good movie

By Linda Quinet and Peter Weiden, M.D.

Movie critics look at plot, acting, screenplay, costumery, sets and the basic ingredients that go into a cinematic work of art. Those of us concerned with mental illness will look at this movie for other things:

• Does the movie stigmatize mental illness?
• Does it show the symptoms accurately?
• Is it too upsetting to see if you have schizophrenia, or someone in your family has schizophrenia?

For more than 30 years mathematician John Forbes Nash Jr. wrestled with paranoid schizophrenia. It's a compelling story, the perfect vehicle for telling one person's experience with schizophrenia in a way that that is interesting to the general public. Although it's an exceptional story because Nash, unlike most of us, received a Nobel Prize, many universal aspects of the illness are there. Viewers gets a firsthand look at how ordinary perceptions turn into horrifying nightmares. We can understand how hard it is to recognize brain malfunctioning. Nash is the last one to realize that his torture is coming from within his mind rather than from the outside world. The film vividly and accurately shows the devastation schizophrenia causes in a person's life, the terror of living through psychotic experiences that are so real, the agony it causes him and his loved ones, the struggle involved in recovery.

Those in the audience not knowledgeable about brain disorders will still see a good movie. Actually, the film medium's limitations will be important in the story's overall popular success. It can't help but oversimplify the complexity of mental illness. Glossed over are the years of struggle and daily uncertainty. Another example is how Nash's psychiatrist is always available, no matter what time of day or night. The continued devotion of Nash's wife shown gazing starry-eyed at Nash as he accepts his Nobel Prize is as much fantasy to some of us as Nash's delusions. This movie—no matter how well done—can't help but be a cameo appearance in the long-term struggle with the illness. This cameo just happens to be extremely powerful.

This may be the best depiction of what it's like to be delusional since Mark Vonnegut's book, The Eden Express. The film does an awesome job dealing with what the repercussions are for those who love the afflicted person—whether after he is sick or as they knew him at another time. Russell Crowe is superb as Nash, as is Akiva Goldsman who did the screenplay. The antisocial person that Nash was comes across loud and clear as does the shuffle in his walk he develops as a side effect of the medication.

One fear is that a misconception may result about how treatable schizophrenia is. At the time of the story, schizophrenia was considered progressively degenerative and incurable. Nash's psychiatrist is very up front about this—so much so that this could be an idea that lingers. Nash's own recovery disproves this theory, as he sticks to treatment and medication and learns to deal with his delusions by doing reality testing. As advocates, we have to hope that Nash's recovery is a stronger message to the audience than the mistaken idea in the '60s that schizophrenia is a "deteriorating illness" where "no one" recovers. John and Alicia Nash wisely rejected this grim prognosis, and their struggle for recovery is an example of how even severe schizophrenia can get better with time and proper treatment, along with love and caring from family and community.

Times have changed considerably. We know that with advances in medication and treatment, many people with schizophrenia go about their lives successfully. Is this promising too much for someone who is struggling with schizophrenia? The movie was accurate about schizophrenia in the sense that John Nash's illness was not "cured." His recovery came when he could control his symptoms instead of his symptoms controlling him. This film may not be easy for someone with schizophrenia to sit through. It might be a reminder of past symptoms and traumatic experiences. But, A Beautiful Mind offers hope and shows how a person can have schizophrenia and still be loved, appreciated and in the end, live a successful life. No, the illness doesn't go away, but the debilitating stigmatizing side effect should and can once more is known about mental illnesses. This movie will help.

One major component in Nash's recovery that perhaps too subtle for the general public to appreciate is the community that supported him. It is obvious that Nash's friends and family played an important part in allowing him to recognize and fight off his delusions. The fact that he was allowed to stay around Princeton, problematic as it was at times, was instrumental in his ability to gain a grip on reality. All too often, the story line is that the ill person loses his friends, community, and sense of belonging. The major part the campus community's acceptance plays in Nash's story is still the exception for most people struggling with schizophrenia. If what Princeton did for Nash could be done for more is a powerful message.

Would a schizophrenic person want to see it, or should you encourage him/her to see it? One consumer who had been in the military and taking a class in mathematics at the time of onset of his schizophrenia said it brought back strong memories and caused him to relive certain experiences—not that they were all bad—but it's something to consider. He does expect to go to the movie again with other consumers. Other consumers who have seen the movie highly recommend going to see it. It can generate meaningful discussion about what the person is experiencing versus how the illness was portrayed in the movie. It's not an issue that should be forced. It's very much an individual thing. Where is the person in relation to the illness? Usually the person will know whether he wants to see it or not. Respect that. If in doubt about whether to encourage seeing it, approach the subject with something like, "I heard about this movie, A Beautiful Mind about a man who has schizophrenia and how he deals with it. It might be a good thing to see together. Do you have any interest in going?"

Fortunately, you leave this movie knowing more about schizophrenia than game theory, the basis for Nash's Nobel Prize. Director Ron Howard does a yeoman's job of blurring the lines of perceived reality. As we watch the film, we come to experience Nash's hallucinations from another perspective. As we follow him into psychosis, we can understand how he got there. We were with him. We stay in tune with Nash's perspective. The film's laudable accomplishment is that it is entertainment that helps others understand what it would be like to have schizophrenia.

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