Spoiler Warning: This post contains spoilers for the movies Shutter Island and Stonehearst Asylum. Regarding Shutter Island, the cinematography foreshadows the surprise ending from the beginning, so it really is better to watch it (or read the book) unspoiled first.
United States Marshals Teddy Daniels and Chuck Aule arrive at the Ashecliffe Hospital For The Criminally Insane, located on Shutter Island (2010, Leonardo DiCaprio). Patient Rachel Solando has disappeared without trace and is expected to still be somewhere on the Boston Harbor island.
Not far into the film it’s demonstrated that Deputy Marshal Daniels is not entirely emotionally stable, himself. Daniels was a front-line WWII veteran who participated in the liberation of the Dachau concentration camp and is prone to flashbacks. In contrast to the story of Stonehearst Asylum (2014, Kate Beckinsale) which doesn’t focus at all on Dr. Newgate’s (Jim Sturgess) inner demons, rather on the mysteries of its Gothic setting, Shutter Island in contrast, is a more personal story that speaks to not just the imposing fortifications of a mental facility, but on the internal struggles of Deputy Daniels and how the investigation affects him the deeper he probes into the fate of Solando.
And then it turns out that Daniels is crazy. He’s even one of the inpatients.
To be fair, this presents a satisfactory reveal for Shutter Island. But still, it does reinforce the Hollywood myth that insanity is Boolean. True or False. Either you’re insane, which case you’re nutzo and you qualify for a padded cell and regular Thorozine doses. Or you’re not, and you’re completely stable, and you qualify for a proper job (at least as a custodian or a laborer if you’re not educated enough to have a trade or a profession).*
Both asylums have their less cuckoo inpatients. Eliza Graves (Beckinsale) presents herself as a proper highborn and demonstrates her high-functionality as an accomplished pianist. Still, she is diagnosed with female hysteria and cringes when touched inappropriately. (Other patients in Stonehearst are noted for comedic effect for diagnoses that would be disregarded in the twenty-first century, including homosexuality, compulsive masturbation and the heir to a railroad empire with a complete disinterest in trains). Bridget Kearns (Robin Bartlett) is alert, aware, communicative and polite. Kearns recognizes right and wrong, and is cognizant of how her crimes landed her permanent incarceration at Ashecliffe. She doesn’t ask for or expect forgiveness, and yet recognizes that the circumstances in which she acted were exceptional, and debatably justified, even if morally wrong. And yet both women recognize they belong where they are. Asylum inpatient and crazy are part of their identity. Functionality doesn’t matter. Cognizance doesn’t matter. Crazy is who they are.
A professor at the real-world McAuley Institute (San Francisco) explained to me once a spectrum of mental dysfunction based on the degree abnormality of the brain: Healthy, flawless brains are actually unusual. Neuroses and personality disorders are commonplace within the population. Then come brains that suffer from psychosis. Then schizo-effective disorders. Then autists. And yet, my professor pointed out, this model based on physical abnormality does not correlate to functionality (the ability to interact appropriately, to find and do work, to take care of survival matters such as food preparation, hygiene and paying bills.) Nor does this model correlate to the danger a patient presents to the public. The most dangerous people tend to have mere personality disorders such as Borderline Personality Disorder (BPD) or Antisocial Personality Disorder (APD, aka Sociopathy). Psychotics and Schizoids tend to be far more docile on average.
This was something Shutter Island did represent well: The most dangerous patient at Ashecliffe was not a psychotic or a sociopath or an axe crazy cinema slasher. He was dangerous because his experience as a veteran made him a skilled and disciplined solder and killer, and his paranoia and delusions (some visual or auditory) made it impossible for him to differentiate between friend and foe. All the good intentions and fire-restraint matter very little when your brain is telling you is that a given target is the enemy and an imminent threat.
I think the stories of Shutter Island and Stonehearst Asylum would be a tad more palatable if there were also stories without the twist. Imagine a functional, if preoccupied, Deputy Daniels discovered that the course for Rachel Solando’s fate agitated the ghosts of his own past, much the way that a riverboat trip in Joseph Conrad’s Heart of Darkness exacted its toll on anyone who would take the journey. This mirrors the real-world legend of Bethlem Royal Hospital (from which we get the word bedlam) in which a visiting doctor observed that conditions within the hospital were appalling enough to make lunatics of sane men. And it was folly to try to heal the afflicted in such a place.
In real life, most of us are looney-tunes. We all have issues. Problems. Personal demons. In contemporary (post-90s) psychology, you require treatment when your issues prevent you from functioning appropriately in society. And you’re involuntarily committed only when you are a significant danger to yourself or others. Neither of these are clear, delineated thresholds, but decided by the assessment of an experienced doctor.
And at this point, it’s problematic that society — and Hollywood — treat crazy as if it were a switch turned on or off.
* Hollywood does have room for people who are only a little crazy (that is, high functioning enough to hold a job and manage themselves yet a few pixels short of a display), but these fall into eccentrics and weirdos and people who wear bunny-ears to their professional jobs because reasons. Look under crazy-eccentric to see some of what Hollywood sees as not-too-wierd-for-society.