Andrew
Here is a note I am prepared to have you forward to Brian, assuming you accept the sentiments expressed in my note. Please do not forward this note until we have had a chance to discuss it on Tuesday. I also think that your mother and Dr Coplan should be aware of developing events.
Dr G
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Brian
I am Andrew’s psychotherapist. I have been working with him in weekly sessions for roughly 2 years. I am a psychiatrist and psychoanalyst interested in the psychological treatment of psychotic persons. Andrew also receives care from an expert colleague of mine (JC) who focuses on medication. In my view the idea of Andrew participating in a film about mental illness has pluses and minuses. It will require a judgement call, by Andrew, and by you and your crew, that conditions are right for your film. I sent this note to Andrew before sending it to you so he could forward it to you if he felt comfortable with the sentiments expressed.
Andrew was dealt a painful blow in middle school, where he was the object of persistent bullying. Although the etiology of his psychiatric problems is more complex than this, being bullied at a time in his life when he would naturally have developed the social skills necessary to succeed in life had a crippling effect on his development. After the onset of his psychotic illness in college, he was unable to get his life back on track. Not able to achieve solid self-esteem in interpersonal relationships and work, his illness led him to seek these supports in daydreams which at times take hold of him in a delusional grip. Unable to forge ahead in the real world, which looms hostile when he tries to enter it, he retreats to a daydream world where his future is secure if he only waits. For example, he believes himself to be a “comedic genius” who will be discovered by a celebrity like Taylor Swift or the Disney organization, who will at some point step forward from behind internet avatars with whom he dialogues to invite him to success, celebrity, and a secure independent life. One of my concerns about Andrew appearing in the film you contemplate is that, despite his being able to say that the film is not being sponsored by Taylor Swift and its not being the beginning of the celebrity he has for years imagined, he might nevertheless regard the film as the debut of the celebrity future he has been daydreaming about for years. I think it is almost inevitable that he would regard the film as his big “debut” moment, but this likelihood does not seem to me an absolute contraindication to making the film. If he were to consciously or unconsciously regard the film in this way, I think this conviction would come and go, as does his daydream. Films about people like Andrew must take them as they are. We need more films that show mentally ill people to be fundamentally human beings, as are we all.
One way to mitigate the risk of Andrew believing that his daydream has come true would be to make the film not just about him, but about Fountain House and several other Fountain House members, as your collaborator suggested. This approach might help Andrew to experience the film as less a long-awaited break into Hollywood but grounded in the real world of mental illness and the difficult struggle toward recovery. If Andrew were to gain some self-esteem from having contributed to a worthwhile real-world documentary, where he participated in a team effort that transcends his individual daydream world, it would be a plus for him. I think he would be a good person to include in the film – he is bright, imaginative, performative, expressive, creatively productive, and has a good sense of humor, though I have said to Andrew that I think he has a very good sense of humor that I am not sure rises to the stature of “comedic genius”.
Andrew has a natural interest in filmmaking and comedic writing. This interest is real, though it sometimes ends up as melodrama broadcast to an anonymous internet. About a year ago, knowing that it might encourage Andrew’s daydreaming, I suggested if he really wanted to make a statement, why not write a screenplay about his experience with mental illness that could be staged at Fountain House for starters, then if successful, might find a wider audience. It seemed to me that rather than encourage him to find an entry level job stocking shelves or working a Starbucks, which would bore him, he might be able to direct his creativity to a project to be staged in the real world. He has written over 50 pages of dialogue, funny and coherent, though he has been unable to shape his vignettes into a disciplined project. In these vignettes, among other content, he shows his insight into how mental illness can create compelling illusions. He has an unusual degree of intellectual insight into some of the psychotic mechanisms of his mind. So, another idea here. I think it would make an interesting documentary to make a film within a film, where you film Andrew and other Fountain House members working together to stage a play about their experiences with mental illness. This would probably be overly ambitious, but would be interesting, and quite different than other films made about mental illness.
As to the matter of informed consent to be filmed…. Although getting informed consent from Fountain House and several other Fountain House members would be the preferable way to go, getting institutional consent might be a challenge. If Andrew can really grasp that the film you want to make is not the film he has dreamed of staring in, I believe Andrew is a sufficiently competent adult to make a decision about whether he wants to participate. Because at present he is dependent on his mother’s support, I think his mother should be apprised regarding the film. I also think that his psychopharmacologists JC should have the opportunity to weigh in, if he wishes.
If including Fountain House proves unfeasible, I think it might be possible to make a film with Andrew alone, if the film were made with sensitivity to the above concerns. Another angle on the film, which may not synch with your intent, but I think would be interesting to audiences, would be to help Andrew produce the play he has written and film it. He could play himself in the film, and actors could play the other characters, eliminating the need for extended consents from psychiatric patients.
A film about mental illness you may already know, produced by a colleague of mine Alice Maher, MD can be found at http://thehotstoveproject.org/ Interestingly enough, one of the several people with mental illness in the film is actually trying to develop a career in stand-up comedy. He talks about this in the film.
From your emails you appear to be a genuine person who wants to make a meaningful film while being sensitive to Andrew’s situation, but unlike an academic curriculum vitae, which I know how to evaluate, I don’t know how to evaluate your film “credentials.” Can you help with that?
Michael Garrett, MD
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