Out of Order: The Problematic Portrayal of Obsessive Compulsive Disorder in Film
Written for my Media History course in fall 2024.
Obsessive Compulsive Disorder (OCD) has been ranked one of the ten most disabling illnesses of any kind by the World Health Organization. However, many people have an incomplete or inaccurate understanding of what OCD looks like in reality. According to the Mayo Clinic, Obsessive Compulsive Disorder is a psychological disorder that compels the sufferer to repeat actions, or compulsions, to ease the anxiety that amounts as a result of unwanted thoughts, fears, and images, also called obsessions. These compulsions can range from physical actions one must complete, such as knocking a certain number of times or washing one’s hands repeatedly. It can also come in the form of rumination, a repeated focus on and analysis of the reasons for the presence of the intrusive thoughts. While engaging in compulsions can ease the often extreme distress people with OCD feel as a result of their obsessions, the relief does not last long, and the intrusive thoughts return, worsening the cycle. The themes of one’s intrusive thoughts can appear irrational, even to the sufferer, and may often center around distressing topics like losing control, violence, and inappropriate sexual thoughts. While the subject of people’s obsessions may seem frightening, it’s important to acknowledge that the reason why these thoughts distress the sufferer is because they often directly oppose their core values, and that their fears do not represent who they actually are. For instance, a mother who loves and centers her life around her children might have intrusive thoughts about harming them, or a man who takes pride in his faith may have obsessive thoughts about being possessed by the devil. The mother might then develop an avoidance compulsion where she avoids being alone with her children out of fear she might harm them, and the man might feel the need to mutter a silent prayer under his breath every hour to “keep the devil away.” It may seem clear to an outsider that this mother would never hurt her kids, and that this man is not at risk of being possessed, but the fear feels real to them, and might even become debilitating. It’s this anxiety-based nature of the disorder that makes negative depiction in the media so significant, impacting not only public perception, but their own perception of themselves and their disorder.
Now, with an understanding of what the disorder actually is, we can begin to examine a potential cause of its widespread misunderstood nature. The purpose of this paper is to determine what successful representations of people with OCD might look like in cinema and how the portrayal of the disorder has shifted over the course of 30 years by exploring existing research and three film case studies. OCD in itself has existed since at least the 14th century, when the earliest detailed record of the disorder was documented. Despite this, there are limited examples of OCD’s representation in media, particularly in U.S. mainstream cinema. Some of the earliest examples of movies that centered exclusively around OCD, meaning the disorder was the sole mental illness depicted, were released in the early 1990s. To examine the cultural sentiment surrounding the disorder, we can look at its history in media. Before exploring the disorder’s representation in media, though, we must examine the importance of mental illness representation as a whole. In a study titled “OCD In The Media” by Dana Fennell and Michael Boyd, they wrote, “The media is one way in which conceptions of mental illness are created and reinforced. [...] The mass media is sometimes a person's primary source of information about mental disorders, even potentially superseding information from direct experience.” Essentially, consumed media can become so convincing to the point that it becomes just as reliable as a legitimate experience. Seeing these repeated only reinforces the beliefs one might garner from watching a movie with a poor portrayal.
This idea is only furthered by Joachim Kimmerle and Ulrike Cress’s work, titled “The Effects of TV Exposure on Knowledge About and Attitudes Towards Mental Disorders.” Through two studies, they found that, not only did people who watched more movies and television have less knowledge about OCD, but also, “The less people knew about OCD or [Major Depressive Disorder], the more they believed that affected persons were violent.” According to the Anxiety and Depression Association of America, those with OCD, even with harm-related themes, are no more likely to be violent than the average person. The belief that people with OCD are dangerous is a stigma that is commonly perpetrated by movies, and can become ingrained in one’s ideas about people with OCD, just as Fennell and Boyd discussed. Finally, we must examine the results of Yasemin Özkent’s study, “The Effect of Psychological Disease Portrayals in TV Series on Internet Searches: A Google Trends-Based Analysis.” Here, Özkent found her results to indicate “that the themes of psychological illness in TV series trigger internet search interest,” and that “this relationship supports the view that the media can influence societal attitudes, awareness, and attention to diverse social and individual issues.” She proves here that media related to mental illness does have an impact on what people think about those with OCD, and what research people might do on the disorder. It is important that the initial representation be accurate, not only to ensure people develop an opinion on the disorder from legitimate information, but to also prompt helpful, legitimate research from a place of curiosity rather than fear. However, much of OCD-related media does not portray the disorder accurately.
In almost any film that includes characters with OCD, you can find the common archetypes that the writers and directors rely on. The first category is a character portrayed as overly neat and orderly; while this can be a compulsion people experience, it is not the only manifestation of OCD, and its overexposure in media makes it seem as though it is the main symptom. That is, however, when characters with OCD are not depicted as violent. This is the second archetype. Characters with the disorder are often shown to be abusive or violent, somehow compelled by their mental illness to kill or hurt others illogically and sporadically. The first archetype is often played for laughs, imploring the audience or other characters to laugh at the absurdity of the character’s actions. The second, on the other hand, almost exclusively is used for villainous characters in thrillers or horror movies. Neither stereotype is properly explored or explained, and the movies portray the reasoning behind each compulsion as overly simplified. The explanation for any action is almost always that the character “just has OCD,” with no clear indication of what their obsessions might look like or how it affects their psyche. By examining what pitfalls movies might fall into while exploring OCD, we can determine what a proper representation of the disorder might look like. Thus, a successful representation of OCD would include either an inciting incident, such as the first time the disorder was triggered, or an exploration of the motivation behind a particular compulsion. Additionally, it would show the varied nature of the disorder and the complexities that accompany its navigation and treatment.
To examine how OCD has been portrayed in cinema throughout the past thirty years, the movies As Good As It Gets (1997), Trap (2024), and The Aviator (2004) will serve as case studies. Each of the three films were released in different decades, and each explore different facets of the representation of people with OCD. The case studies have been considered some of the best and worst portrayals of OCD in film, according to a number of therapy or OCD-specific organizations, including Choosing Therapy and NOCD. As Good As It Gets has found its way onto both the “best and worst” lists.
As Good As It Gets was released in 1997 and explores the journey of the character Melvin Udall’s struggle with OCD, alongside his bitterness and resentment of the world around him. Melvin is shown to struggle with germophobia, and falls mainly into the first archetype of a character with OCD. He brings plastic utensils with him to restaurants, wears plastic gloves, and avoids being touched by anyone while out in public. While this does somewhat perpetuate the idea of OCD being solely centered around germophobia, through those examples, the film does examine the lengths those with the disorder might go to while engaging with their compulsions. Much of the critique As Good As It Gets received was a result of Melvin’s detestable actions in the first part of the film: He puts a dog down a garbage shoot and is rude to everyone he meets, even calling his neighbor slurs. As he grows as a person and his OCD improves, he also becomes kinder, potentially suggesting that rudeness and OCD are interlinked. It could also be said that the comedic portrayal of his compulsions make light of the disorder, although there is an argument to be made that the comedy is to more so lighten the mood than to trivialize people’s experiences. The film ends with Melvin accepting treatment through medication, as his newfound love inspires him to “be a better man.” He experiences personal growth, relies on his community, and his life is able to exceed what he previously thought would be “as good as it gets.” Although not the perfect representation of the disorder, the film offers a comedic take on what the life of someone with contamination OCD might look like, and how things can improve.
In contrast, in M. Night Shyamalan’s 2024 movie Trap, the main character, Cooper, largely falls into the second category, while still exhibiting the stereotypical cleanliness of the first. The film follows Cooper and his daughter attending a concert which has been set up by the FBI as a trap for a known serial killer. It’s revealed that Cooper is the killer, and we follow along as he attempts to escape the trap without being caught by the authorities or alerting his daughter, manipulating and murdering people along the way. Cooper, who is explicitly said to have Obsessive Compulsive Disorder, is shown repeatedly tidying things up, something that has become a clear insignia for filmmakers trying to demonstrate a character has OCD. Unlike As Good As It Gets, wherein Melvin’s more negative attributes seem somewhat separate from his disorder, it’s made very clear that Cooper’s OCD is a significant part of what drives him to kill people. He repeatedly states that the only way to defeat “the monster” is if he were to commit suicide, an extraordinarily harmful message to send to an audience. To those unacquainted with the disorder, it portrays sufferers as dangerous and out of control. For those with OCD, it’s even worse; people potentially struggling with harm-related OCD may already be so afraid of hurting someone that hearing and internalizing this message may make them a potential danger to themselves. This is further complicated by a lack of explanation behind Cooper’s seeming compulsion to kill people. In reality, if someone with OCD felt driven to kill someone, it would be either “justified” or “required” by their obsession in some way, and we see no such indication of this in Cooper. Additionally, this is not M. Night Shyamalan’s only movie that vilifies mental illness, as Split and its sequels have done a similar thing to Dissociative Identity Disorder (DID). There is fan speculation that these two movies are meant to take place within the same universe, carrying the thread between the two misinformed works. Either way, Trap does an extraordinarily poor job of representing OCD.
The Aviator, released in 2004, follows the biography of Howard Hughes, a famous pilot who suffered from OCD. Whether it’s a result of the movie’s basis in reality or because of more informed writing and directing, The Aviator’s representation is drastically more realistic than both Trap and As Good As It Gets. While technically Howard’s OCD fits most in line with the first archetype, it does not attempt to pass the disorder off as a form of comedic relief. Instead, it shows the disorder for what it often is: Debilitating. There are scenes where Howard is unable to leave the house, isolating himself in a germ-free environment for months, and the film shows his disorder worsening, making him even more paranoid. The movie also shows where Howard’s contamination OCD might have begun, opening with a focus on the cholera outbreak in his childhood. The movie does not shy away from showing how much of Howard’s life was impacted by his disorder, and, as a result, it feels much more authentic than both other case studies. Where As Good As It Gets provides a hopeful ending, showing that remission is possible, The Aviator is brutally honest, showing Howard’s struggle to the end of his life. In comparison to Trap, both endings are successful, but obviously vary in their aims.
Through examining these three case studies, it seems as though there has not been extraordinary progress in the on-screen representation of Obsessive Compulsive Disorder; the most recently-released example analyzed, Trap, was the poorest of all. It frames OCD as a dangerous and violent disorder, providing no rationale behind its main character’s motivation, and taking every opportunity it can to laugh at the compulsions it seems to consider “quirks.” As Good As It Gets does a better job, showing the journey a man takes to recover from his disorder, but still paints a somewhat one-dimensional portrait of what OCD looks like in reality. The Aviator succeeds more so where As Good As It Gets fails, not shying away from the bleaker side of the disorder. The examination of other academic research makes clear the need for accurate representation of people with OCD within movies, as the media people consume influences their perception of what’s important, the people around them, and the world as a whole. Movies successful in their display of OCD outside of The Aviator include Turtles All The Way Down (2024) and the documentary Unstuck (2017). Both of these examples focus on the disorder as a significant portion or the central fixture of their story rather than a throwaway “quirk,” and focus on accurately representing a complex disorder. Accurate portrayal of the disorder in a non-comedic setting allows the audience to build understanding and empathy, as argued by Sam Martin in his thesis, “Madness in the Media: Demystifying the Emergence of an OCD Trope in Television.” The trivialization and minimization of a potentially devastating disorder in the media only allows for the continued spread of misinformation. Looking to the past and using movies that potentially misrepresent the disorder allows for us to improve and make changes that will result in an accurate and equitable media landscape in the future.
Works Cited:
As Good as It Gets. Directed by James Brooks, Sony Pictures, 1997.
Boudin, Melissa. “The 15 Best Shows & Movies about OCD Behaviors.” ChoosingTherapy.com, medically reviewed by Heidi Moawad, 2023, www.choosingtherapy.com/movies-about-ocd/.
Fennell, Dana, and Michael Boyd. “Obsessive-Compulsive Disorder in the Media.” Deviant Behavior, vol. 35, no. 9, Jan. 2014, pp. 669–86. EBSCOhost, https://doi.org/10.1080/01639625.2013.872526.
Hirner, Liana. “OCD Representation on Screen Should Encompass All Facets of the Mental Illness.” Calvin University Chimes, 12 Feb. 2024, calvinchimes.org/2024/02/12/ocd-representation-on-screen-should-encompass-all-facets-of-the-mental-illness/.
Kimmerle, Joachim, and Cress, Ulrike. “The Effects of Tv and Film Exposure on Knowledge about and Attitudes toward Mental Disorders.” Journal of Community Psychology, vol. 41, no. 8, Nov. 2013, pp. 931–43. EBSCOhost, https://doi.org/10.1002/jcop.21581.
Martin, Sam, "Madness in the Media: Demystifying the Emergence of an OCD Trope in Television" (2017). All Theses. 2724. https://open.clemson.edu/cgi/viewcontent.cgi?article=3731&context=all_theses.
Mayo Clinic. “Obsessive-Compulsive Disorder (OCD).” Mayo Clinic, Mayo Clinic, 21 Dec. 2023, www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432.
OCD-UK. “The History of OCD.” Ocduk.org, 2018, www.ocduk.org/ocd/history-of-ocd/.
Özkent, Yasemin. “The Effect of Psychological Disease Portrayals in TV Series on Internet Searches: A Google Trends-Based Analysis.” Journal of Communication Theory & Research / Iletisim Kuram ve Arastirma Dergisi, vol. 63, Sept. 2023, pp. 36–55. EBSCOhost, https://doi.org/10.47998/ikad.1159182.
Reddick, Tracie. “Trap - Tracie Reddick - Medium.” Medium, 23 Aug. 2024, traciereddick.medium.com/trap-c92813db16ca.
“Rumination OCD - Symptoms and Treatment | the Gateway Institute.” Www.gatewayocd.com, 16 Oct. 2017, www.gatewayocd.com/rumination-ocd-symptoms-and-treatment/.
Shah, Yusra. “The Worst Representations of OCD in TV and Movies.” NOCD, NOCD, 13 Sept. 2024, www.treatmyocd.com/blog/the-worst-representations-of-ocd-in-tv-and-movies.
The Aviator. Directed by Martin Scorsese, Miramax Films, 2004.
Trap. Directed by Shyamalan M. Night, Warner Bros. Pictures, 2024.
Cover photo courtesy of Janine on Flickr.