‘Beautiful Mind’ Over the Usual Hollywood Matter

As Princeton University math professor John Nash, Russell Crowe plays a tormented genius who eventually triumphs over schizophrenia through medication and sheer determination to maintain a truce with the demons that haunted him as a younger man.

To a public whose curriculum on schizophrenia has been limited to Hollywood’s comedies or thrillers, “A Beautiful Mind” may seem like a fairy tale. But to mental health workers, academics and families of those afflicted with the disease, the Ron Howard film got it right--for once. “A Beautiful Mind” presents a rarely seen but common outcome of the disease: recovery, or, at least, high-level management of its symptomatic delusions and hallucinations.

The Universal Pictures/DreamWorks Pictures film, they say, is a welcome departure from mainstream depictions of the mentally ill which casts people with schizophrenia as either oddballs with “split personalities”--think Jim Carrey in “Me, Myself & Irene” or dangerous paranoids, such as Edward Norton in “Fight Club” (1999). Almost as bad, they say, the disease was always portrayed as a degenerative, lifelong illness.

“And that was never true,” said Sylvia Nasar, whose 1998 National Book Critics Circle Award-winning biography of Nash became the basis for “A Beautiful Mind.” “The news of that hasn’t gotten out in a big way. Partly, because the only time we read about someone with schizophrenia is if a couple of Capitol Hill officers are shot, or someone is pushed in front of a train. The amazing thing about the John Nash story is that it’s making people aware. It’s giving them an entirely new view of who these people are who suffer from these illnesses, and what the prospects are.”

While the film has been criticized for either eliminating or fictionalizing parts of Nash’s life, mental health experts praise its truthful portrait of his schizophrenia. Depictions of schizophrenia in popular culture have consistently perpetuated damaging misconceptions about the disease--for example, that schizophrenia causes personalities to cleave and multiply. In reality, the most common symptoms of schizophrenia are audible hallucinations--hearing voices. Schizophrenia is a neurological disorder most often treated with a combination of drugs and therapy.

Akiva Goldsman, who wrote the screenplay, said even basic terminology is incorrect in most movies and TV shows. “People are not schizophrenic,” he said. “They have schizophrenia. The misconceptions we have are rooted in older models of the disease.”

Goldsman, whose parents started a group home for emotionally disturbed children when he was young, realized how little he knew about the disease when he read Nasar’s book.

“I was stunned to learn about cases of schizophrenia that were in remission,” he said. “It is not at all the disease that people thought it was decades ago. I have learned that this notion that the disease is degenerative is not accurate. That’s a kind of period notion. That’s what people thought in the ‘50s and ‘60s, but it’s not accurate.”

Raquel E. Gur, director of neuropsychiatry at the University of Pennsylvania School of Medicine’s Schizophrenia Research Center, said more than half of the nonviolent individuals diagnosed with schizophrenia eventually function normally with the help of medication, therapy and a strong support system. But these “mainstreamers” have received almost no attention in the mass media as they are overshadowed by images of deranged criminals whose situation becomes more dire and dangerous with time.

Goldsman and director Ron Howard, who co-produced “A Beautiful Mind” with Brian Grazer, cite films such as “Silence of the Lambs” (1991) and “Primal Fear” (1996), about violent mentally ill people, as examples of the direction they didn’t want their film to take. As Goldsman put it, they wanted to avoid “taking audiences to the zoo.”

“That’s where there’s the mentally ill person and then there’s the healthy surrogate, pointing at the mentally ill person, and we get to watch,” he said. “We wanted this movie to be from the point of view of the person with the disease, so we couldn’t objectify them. We didn’t want the safe island of having the normal person leading us through.”

Audiences of “A Beautiful Mind” are placed squarely within Nash’s distorted reality. “We created a delusional system that was really intact, because that’s the way it feels--totally intact and fluid,” Goldsman said. For the sake of accurately portraying that “system,” Howard sacrificed significant parts of Nash’s biography. Critics say the result is a film that is often more cheery than comprehensive, with long stretches of Nash’s depression and a lengthy separation from his wife completely excised. Even the diagnosis of one of Nash’s sons with schizophrenia is ignored. But Nasar said her book was merely the basis for the movie, and Howard did not have to make “a public service announcement.”

Nasar, a former New York Times staff writer who now teaches at the Columbia Graduate School of Journalism, said even with Howard’s artistic license, the film has an essential truth.

“There are no villains. There’s no abusive father. No screaming wife. No one caused it. That’s so sophisticated,” Nasar said of the film. “For a long time, psychiatrists believed you never did recover. That was an artifact of institutionalizations. That was before drugs. People ended up in hospitals, and they didn’t reemerge.”

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Howard became fascinated with genius and mental illness several years ago when he got to know Yale Law professor Michael Lauder, who was diagnosed with schizophrenia in his early 20s. (About 1% of the U.S. population has been diagnosed with the disease, and men often exhibit symptoms earlier than women, experts say.) Lauder credited medications and a personal strategy with the ability to live in concert with his vivid delusions.

“He viewed life as a television screen, and he would move his delusional lives to the corners of the screen, but he would have up to four hallucinations going at the same time,” Howard said. “He began to trust what was in the center screen was real.”

But Lauder’s carefully constructed world fell apart after his father died in 1997 and he went off his medication. The following year he murdered his pregnant fiancee and was sentenced in July 2000 to a psychiatric institution. He was 37 years old.

“I learned a lot through my conversations with him, and that specific journey,” Howard said of Lauder’s ability to train himself to function in spite of his delusions--and the fragility of that arrangement.

By the time Howard read Goldsman’s screenplay, he was eager to refute pop culture mythology about the disease. He also recognized similarities in how Lauder and Nash confronted their delusions.

A trained mathematician, Nash developed the game theory of economics in his 27-page doctoral thesis. But in 1959, when he was just 31, he had a complete breakdown. He underwent intensive rounds of insulin shock treatments--a since discredited treatment--and therapy during a five- to eight-month commitment to New Jersey mental institutions. He was released under orders to continue treatments of antipsychotic drugs, but they numbed his senses, his affect and his sexual drive. The cure seemed almost as bad as the disease, and Nash was determined to logically “solve” the problem of his debilitating illness.

He is an example of a very select population, of geniuses who present their own exceptional manifestations of the disease, said Gur.

“He has a marked, elaborate, delusional system,” Gur said of Nash, whom she has met. “I evaluated the Unabomber (Theodore Kaczynski), and it is the same type of system, with elaborate details. These are geniuses and they think big, even in their delusions. It’s commensurate with their intelligence and what they were doing before they developed.”

Through sheer discipline, Nash began to ignore the cadre of hallucinations that had run his life for a decade. He worked around them, just as Lauder had.

“I began to intellectually reject some of the delusionally influenced lines of thinking which had been characteristic of my orientation,” Nash wrote in a 1994 biographical essay. (In the film, Crowe describes the strategy as “a diet of the mind.”) Nash currently keeps an office in the mathematics department at Princeton.

Nash’s approach came at a time when the pharmaceutical industry was coming out with more effective drugs whose side effects were milder than those he had initially been placed on. Thousands of those diagnosed with the disease benefited from these drugs starting in the 1970s, and they rejoined their original communities. Scientists were given a large population on which to launch longitudinal studies. In one, Nasar said, as many as 20% of those individuals showed significant improvement by the time they had reached their 50s.

So there was scientific data to suggest that Nash was part of a long-ignored group of individuals who had recovered from schizophrenia, a group whose story had never been told on film. Howard sent Goldsman’s screenplay to experts “for a vetting.” He hired a psychiatric consultant to come to the set. He also paid many impromptu visits to his neighbor, a psychiatrist, who would talk to him about the disease.

In the end, executives at Universal were so confident about the film’s accuracy that they gave a copy of the film to pharmaceutical giant, Pfizer Inc. Pfizer held a private screening of “A Beautiful Mind” on Jan. 3 in New York’s Tribeca Grand Hotel for 70 mental health organizations and professionals.

Among the guests at the Pfizer screening were Constance and Stephen Lieber. Their daughter was diagnosed with the illness 25 years ago, and she remains on medication and works as an assistant librarian in her father’s office.

“I think it’s a wonderful film,” said Constance Lieber, who founded the National Alliance for Research on Schizophrenia and Depression after their daughter was diagnosed. “This has inspired some debate among reviewers (for its simplified portrayal of Nash’s complicated life),” Lieber said, but noted that it brought to light an illness “ that has historically been shrouded in mystery and fear. It creates awareness about one of the most misunderstood diseases.”