Disclaimer: Spoilers for the film Hereditary present throughout this piece!
I have seen hundreds of horror films; in fact, I even began my graduate school personal statement on the topic. As a shameless horror fan, I am often asked, with perplexed and disgusted looks, “Why?” I am fascinated by the psychological processes —decision making, sensory perception, emotion regulation, acute and chronic stress effects— being tested and explored within these films and the effects of the processes on the viewer — the ability to elicit an emotion such as fear or disgust through a set of quickly flashed images, despite the rational knowledge that you are safe in your home. I think that horror films and how we interpret them is closely tied to humanity’s history with and persistent views on mental health.
Many horror films craft characters that exhibit stereotypes of mental health illness — for example, the Babadook (major depressive disorder/prolonged grief), Donnie Darko (psychosis), The Visit (mental health facility escapees), Identity and Split (dissociative identity disorder). Regardless of accuracy, what does it mean when a film intentionally or unintentionally portrays clinical features? To consider this question, I will unpack a recent film, Hereditary.
There are many elements of this film that strike me, as a clinical psychology student:
- Early scenes describe the protagonist’s past relatives as being diagnosed with schizophrenia and bipolar disorder, suggesting a genetic vulnerability for psychopathology. It is even in the title! In fact, heritability of psychosis is estimated to be approximately 75%.
- The protagonist’s mother has been diagnosed with bipolar disorder, which we see has been at times unmanaged and has caused the film’s protagonist to have a very stressful early life experience.
- The protagonist excessively smokes marijuana, which places him at clinical high risk for developing psychosis.
- An unexpected and graphic tragedy renders the protagonist responsible for the death of his sister.
All of these risk factors culminate for the protagonist, setting off the remainder of the film, which to me was reminiscent of a first psychotic episode. The protagonist begins experiencing auditory hallucinations related to his traumatic experience, which cause him to question his reality and perceptions. Working with clients with psychosis and hearing their descriptions of their symptoms, this seemed like a very astute interpretation of what such an experience might be like.
Though the interpretation of psychosis seems to shine through – because I, as the interpreter, have biases and/or because the creators have established this uncertainty – the end of the film is resolved in absolute certainty. The family has an extensive generational involvement with Paimon, a demon god. Historically, Paimon is known, among other things, for creating visions and being a representation of art and science, which in itself reflects this tug-of war in mental health history between science, creativity, and mysticism.
Why is this ambiguity between mental illness and the occult so prominent throughout the film?
One reason may be a long cultural history of conflation between these concepts. When we do not yet have the tools to understand something, superstition can prevail. Historical responses to mental illness have included superstitious and ethically questionable treatment. For example, the diagnosis and treatment of hysteria (or the “wandering uterus”), which postulated that various common ailments (e.g., headaches, frailty, fatigue, depressive symptoms, etc.) were the result, in women, of her uterus physically moving throughout the body. “Treatments” focused on keeping the uterus in place and occupied, including the prescription of sex and continual pregnancy to prevent “wandering.” As you may imagine, misconceptions such as these can have significant implications for policy. The dark history associated with psychology continues to be projected up to today, partially through the loose connections people develop when watching films where mental health is very quickly associated with the supernatural and vice versa.
Instead, films like this provide us with a great opportunity to move forward. It’s easy to identify with the protagonist, to understand how his particular life experiences could lead to certain ways of viewing or coping with the world. And the truth is: mental health concerns can wreak havoc on a family; it can be dark, stressful, confusing, and scary. With understanding can come fear, but also with understanding can come compassion. Mostly, I hope films continue in this direction, to help reconcile the speculation and discrimination in our past and instead set us on a path of understanding and empathy.