David Conway examins how obsessive compulsive disorder is represented on the big screen, and the misconceptions involved.

Whimsical music plays as Melvin Udall (Jack Nicholson) struggles to complete his daily routine in 1997’s As Good As It Gets. He turns lights on and off in a ritual of five, doing the same on his locks. He removes soap from a cupboard of perfectly aligned bars, washes his hands in boiling hot water, and then immediately chucks the bar away, replacing it with a new one.

It’s a great little comedy sequence in its own right, portraying the rigid and limiting routine of someone who suffers with OCD. But as a thorough, accurate portrayal of the disorder, I’m not sure the film’s entirely representative.

Obsessive Compulsive Disorder, or OCD for short, is often wrapped in misconceptions. Dogged by misguided clichés that it’s the quirk of eccentrics, or simply a symptom of being a ‘clean freak’, the truth is far more serious. OCD can in fact manifest itself in a wide variety of life-altering ways, and currently affects around three-quarters of a million people living in the UK, according to current estimates quoted on the website of the OCDUK charity.

As someone who suffered and overcame it during my teenage years, it’s been a passion and interest of mine to see how the disorder is reflected on the big screen. To put a very complex subject at its most basic, OCD involves a sufferer being driven to anxiety by intrusive obsessional thoughts and fears, and going to extreme lengths to stop them. These lengths are compulsions, often manifesting as rituals which give the sufferer temporary comfort, but which can be utterly debilitating.

OCDUK sums up the cycle a sufferer goes through as: triggers, avoidance and reassurance.

In some ways, As Good As It Gets understands the disorder. It limits its lead’s everyday life, makes relationships a challenge, and is something he fights against. However, it’s told within the framework of a romantic dramedy, and so ends up becoming tangled in the genre’s narrative clichés. Often, it’s treated in a comedic way, and it seems more charmingly quirky than debilitating. Similarly, as Melvin learns compassion and love, growing as a character, his symptoms begin to loosen and fade, a very romantic view of recovery.

Compulsive may be the second word in OCD, but the compulsions are by far the most prominent area portrayed in film. In some ways, this is understandable. They’re naturally cinematic, their dependence on ritual and structure working well as a mini-narrative. But as a result, the obsessions – the painful, torturous reasons the compulsions happen – are left to one side.

Examples

Take Matchstick Men, a 2003 thriller from Ridley Scott. Though we understand that the lead character Roy (Nicolas Cage) has many compulsions, such as pronounced blinking, ‘one, two, three’ rituals, and cleaning the house, we never really get under the surface of what the obsession is.

Martin Scorsese’s The Aviator is a marked improvement in this regard. Scorsese smartly uses a more internal approach to show Howard Hughes’s obsessive personality. Implicitly, this is suggested at the start through his adamant insistence on getting his film made, despite everyone warning him otherwise. As the film goes on, his obsessions increase, with his germaphobia becoming more and more apparent.

The repeated spelling out of the word ‘quarantine’ as a motif represents the thought process of a sufferer, simulating the way in which an intrusive thought is latched onto. When we see the compulsion in all its paralysing power, we also have an understanding of the thought process behind it.

Like As Good As It Gets, The Aviator has a scene set in a bathroom to show Hughes’s compulsions. But it understands the serious, debilitating nature of the condition, and treats it as such. Hughes washes his hands to the point of bleeding, and then can’t even bring himself to open a door, lest he get germs from the handle. This later descends into him locking himself away from the world to avoid germs, the ultimate culmination of a powerful obsession driving him to absurdly convoluted, painful compulsions.

Cleanliness is just one obsession of many however, and that’s something that cinema often seems to forget.

While a 2005 NICE report singles out 37.8% of sufferers as having obsessions around germs and 26.5% with cleaning compulsions, that’s also a huge proportion more who don’t. Obsessions can vary from person to person – they could be worries about academic ability, to fear of worrying sexual thoughts – basically any intrusive thought that could induce anxiety, which sufferers just can’t shake off.

It’s rare to see any other obsessions covered in films, though. While television is doing wonders helping to understand the disorder with the superb Pure, cinema seems to stick to the same routine of cleanliness rituals. However, there is a brief moment in gentle 2015 indie flick The Road Within, which does something different. Though the character of Alex in the film is portrayed as being obsessed with neatness and cleanliness, some other obsessions are looked at.

One instance is a sequence where he is driving a car with two other characters after escaping their behavioural institute. However, after hitting a pothole, he has to stop the car to get out and check, thinking he’s hit someone, his panic escalating. I’ve got friends who’ve spoken of similar obsessions, which makes driving for them almost impossible, so seeing this was refreshing. The use of behavioural therapy as a key tool in combating the disorder is also a positive; often films lead the therapy or recovery to the wayside.

Requests

If we look at the release dates of the films I’ve mentioned, we can see a steady progression in understanding. But future representations still need to take heed of two things in particular.

Most importantly, that the spectrum of obsession is huge – sufferers are often not bothered by untidiness at all, their obsessions and compulsions being much more personal or obscure.

My second request seems a little odd on the surface – for characters to be more mundane. This isn’t to suggest making them uninteresting, far from it. But OCD is often confined exclusively to eccentrics or broad roles played by performers like Nic Cage and Jack Nicholson. It creates an impression that it’s a symptom of being kooky, separate from the everyday. We need to instead normalise the discourse around it, make it known that it could affect anyone.

The reality of OCD can be frightening and life altering, but the more accurately we see it reflected on the silver screen, the more people will understand how common it is. And maybe as a result, sufferers won’t feel like they’re alone in their plight.

You can find our more about OCD at the OCDUK website, here.

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