As the people who have been in my therapy groups will know, I am a video game player. So I was interested when one of my group members told me about a video game called Hellblade: Senua’s Sacrifice, a game in which the main character is portrayed as having psychosis, including hearing voices, seeing visions, having paranoia, and flashbacks. Intrigued, I read several reviews about how the game’s portrayal of psychosis was handled. (e.g. Distance, Critical, “Perspectives Differ on How ‘Hellblade’ Handles Mental Illness”, waypoint.vice.com; Lacina, Dia, “What Hellblade: Senua’s Sacrifice Gets Wrong About Mental Illness”, polygon.com; Lloyd, James, “How Hellblade: Senua’s Sacrifice Deals with Psychosis”, sciencefocus.com). Not surprisingly, the reactions were mixed, with some people praising the game’s sensitivity and insightfulness and others finding the portrayal invalidating and hollow. However, the fact is, it’s rare to see a character with psychosis being a nuanced character who isn’t evil or pathetic. It’s even more rare to find a positive main character with psychosis, be it a movie, book, or video game. I can come up with a handful—the movie “The Soloist,” the movie “A Beautiful Mind,” and now, this video game. (An argument could also be made for “Benny and Joon,” and I’m sure there are some newer ones I’m missing, but you get the idea.) I’m not saying that these are realistic characters, or that they’re handled perfectly, I’m noting that the idea of treating a main character with psychosis as a real person, who is neither a villain nor a pathetic object of pity, is a relatively rare one. I’m encouraged by this development, while at the same time still disappointed by the flaws in portrayals of characters with psychosis and by the slow progress of awareness/understanding of these symptoms. The primary reason for this appears to be stigma against mental illness, especially against people with psychotic symptoms.Stigma. “People with schizophrenia and their families have to live with an extraordinary amount of stigma. Schizophrenia is the modern-day equivalent of leprosy, and in the general population the level of ignorance about schizophrenia is appalling.” (Torrey, 2013, p. 356) Serious mental illness is often seen as worse than physical or intellectual disabilities, and, more dishearteningly, the fault of the person with the illness. (Corrigan and Lundin, 2001, p. 15) Stigmas are stereotypes, and with mental illness, they almost always affect the people with the illness in a negative way. Researchers have found three broad categories of stigma against people with mental illness: that they are dangerous and should be kept out of our communities; that they are irresponsible and others should make decisions for them; and that they are incompetent and need to be cared for as if they were children. (Corrigan and Lundin, 2001, p. 20) I would add, that in the media, both news and entertainment, there is an erasure of positive, realistic portrayals of people with psychosis. The vast majority of people with psychosis that are covered in the news or portrayed in movie/book/video game stories are negative. I joke with my clients sometimes about how the news would never air a story like, “Local woman takes her meds, symptoms are stable, enjoys her job, going to her grandchildren’s sports events, and playing the piano.” These are many of the people with a psychotic disorder, but for the layperson, people with psychosis are all scary or incompetent. Fortunately, as the video game discussed above shows, the public is slowly starting to be aware of people with psychosis in a more realistic way. Flawed, sure, like any person, but not a one-dimensional caricature.
This series of blog posts aims to 1. take a close look at stigma and how it affects those with schizophrenia, their families, and the public at large, 2. Study how stigma hurts society, and 3. Examine how all of us can fight stigma and move forward in the progression of understanding and helping people with psychosis have enjoyable lives and bring as much positivity to the world as they can. We are early on in the journey, but when it occurs to large video game companies to try to present a hero with psychosis as the main character in the game, this gives me heart. We are moving forward.
Corrigan, Patrick, and Lundin, Robert. (2001). Don’t Call Me Nuts! Coping with the Stigma of Mental Illness. Champaign, Illinois. Abana Press.
Torrey, E. Fuller. (2013). Surviving Schizophrenia: a Family Manual. New York. HarperCollins Publishers.