Porphyria? Indian Cinema and Mental Illness
Sometimes, a film appears as if out of the blue and leaves you shaken. It is not for the film per se or for its creative excellence but for the subject it deals with - some form of mental affliction. Kuheli, a new Bengali film directed by Debarati Gupta has tackled a rare mental affliction in one of its two protagonists head-on, leaving the audience both puzzled and informed.
‘Puzzled’ because the audience has probably not even heard of the affliction before. ‘Informed’ because the film provides a reasonably credible and well-researched update of this disease called Porphyria.
What is Porphyria? Stated simply, Porphyria is a group of diseases in which substances called porphyrins build up within one’s system affecting the skin and/or the nervous system of the afflicted person. It is also known to be an inherited disease passed from parents to children.
In Kuheli, Amrita is a patient of acute Porphyria and cannot tolerate sunlight. So, she remains at home during the day and keeps away from socialising. Sayak is one of the most loving husbands one has witnessed on the Indian screen who takes extremely good care of her and keeps her away from company and from sunlight. He cooks breakfast, takes a glass of red juice from the juicer every morning, wakes her up and insists that she take her pills alongside the breakfast. However, though the film deals with the medicinal aspects of the disease, it does not even suggest a possible cure either through the two characters or within the narrative.
Porphyria is also said to be related to the mysterious legends surrounding the Vampire and the werewolf which means that the patient might be addicted to human blood! King George III, some of his descendants and later, painter Vincent Van Gogh is known to have suffered from Porphyria.
This brings across the myriad mental illnesses Indian cinema has been dealing with over the years. Are they authentically depicted ailments backed by medical expertise the filmmakers relied on? Or are they rather a romanticised depiction of the disease used either as a cinematic strategy to draw audience empathy or to fulfil the demands of a given actor who wished to explore this disease via his/her performance or as a plea to get the box office rocking.
So, most Indian films dealing with some kind of mental disease do not really throw light on the sickness as it happens in real life and is therefore, filled not only with logical loopholes but often, and this is more tragic, with misinformation.
One classic example in point is the way the boy Ishaan Asthana in Amir Khan’s Taare Zamin Par who is a dyslexic child bracketed with other films that depict mental illness. This is gross misinformation that does more injustice than draws empathy towards a genetic case of dyslexia. Dyslexia is a learning disability and not, repeat NOT a mental affliction in any way.
Ishaan suffers from what, in medical terms is called “developmental learning disability.” It was a no-holds barred commercial film designed to tug at the tear glands of the audience and rake in the big bucks. But it did one good thing – it introduced the Indian masses to a new term and added this to their limited vocabulary of learning disabilities – dyslexia.
Dyslexia covers a range of symptoms and learning difficulties related to the written word. As such, no single cause for dyslexia has been pinpointed. The nation woke up to Ishaan Asthana’s pain that began with the basic ignorance of his parents and teachers about this little-known but grave learning disorder called dyslexia. But for most of us, Ishaan’s problem was read as a mental ailment.
Artists like Michelangelo and Rodin, scientists like Einstein and Edison, great orators like President Roosevelt and General Patton, and even entertainers like Tom Cruise and Cher are supposed to have been dyslexic. They are generally found to excel in areas that do not involve the "written word" to a great extent. They were able to make the best of their skills and overcome their dyslexic problems to excel in their chosen fields.
Prof. Dinesh Bhugra of the Royal College of Psychiatry in his well-researched paper, Mad Tales from Bollywood – The impact of social, political, and economic climate on the portrayal of mental illness in Hindi films points out “The way mental illness is used in the narrative of the film is determined by the state of the society (at what level of political maturity the society has reached) and the reflection of political and economic factors which are prevalent at a specific time in the history of the culture and society.”
Among the many examples he cites, one is Khamoshi (1960) that unfolds the story of a nurse who cures a patient through psychoanalysis and falls in love with him as part of the counter-transference which is never resolved. After he is discharged, she initially refuses to take on another similar patient. Under changed circumstances, she does so and in this case he falls in love with her within the transference and she becomes psychotic in turn.
“The trauma of failure in love is shown as the cause of the psychosis in two of the protagonists. As a nurse, the heroine deals with patients as difficult children and it is clear that she has no support system of her own as her close confidant is only her diary,” says Dr. Bhugra. But nowhere in the film is the precise disease the first patient suffers from is mentioned, nor is the audience explained the psychological reality called “transference.” This reduces the film more to the tragic love story of a committed nurse trained in England than remain a film that mainly deals with a mental illness.
Other than its backdrop of terrorism set in the US and the love story of a Muslim boy and a Hindu girl, My Name is Khan, another point of emphasis the film zeroes in on is that the hero, Rizwan Khan, portrayed by Shahrukh, suffers from Asperger syndrome. Asperger syndrome is an autism spectrum disorder, and people with it therefore show significant difficulties in social interaction, along with restricted and repetitive patterns of behavior and interests.
It differs from other autism spectrum disorders by its relative preservation of linguistic and cognitive development. Such people are often physically clumsy use atypical language. There is no single treatment, and the effectiveness of particular interventions is supported by only limited data. Intervention is aimed at improving symptoms and function. The mainstay of management is behavioural therapy that focusses on specific deficits to address poor communication skills, obsessive or repetitive routines, and physical clumsiness.
The onset of Alzheimer’s is dealt with delicately and touchingly by Sanjay Leela Bhansali in Black said to be a celluloid representation of the growing up years of Hellen Keller with multiple handicaps and her teacher, male in the film, portrayed by Amitabh Bachchan. Debraj Sahay is an incurable alcoholic who is appointed at the behest of his earlier boss to coach Michelle McNally who is deaf and blind and has other problems too. Debraj’s sudden loss of memory comes in phases, slowly but surely in what the common man might be convinced to be clinically authentic.
Black evoked the wrath of medical specialists for its misrepresentation of Alzheimers which, they insist is incurable. This incurable, degenerative and terminal disease was first described by German psychiatrist and neuropathologist Alois Alzhemier in 1906 and was named after him. Black suggests in its closing scene that Sahay is perhaps regaining his lost memory. This is medically wrong. There is no cure for this disease which worsens as it progresses and eventually leads to death.
Amir Khan’s representation of Anterograde Amnesia in Ghajini is not a patch on what one expected it to be – a psychological thriller inspired/ motivated by the radically different Memento directed by Christopher Nolan. Anterograde Amnesia stands for loss of memory of what happens after the event that caused the amnesia. It is different from 'Retrograde amnesia' where memories prior to the event are forgotten.
What is scary is that till date, anterograde amnesia remains a mysterious ailment a cure for which is yet to be found.
In Ghajini, Sanjay Singhania does not remember anything that happened more than 15 minutes back. Sanjay Singhania’s managers leave him alone in the hospital knowing that he is always in danger from himself. He does not refer to the reverse tattoos to jog his memory in the large mirror set up for this specific purpose. Nor does he take the help of his detailed diaries while others find easy access to them. The 15-minute memory span fluctuates at the convenience of the script.
Medical experts are not happy. Dr. Harish Shetty, along with Maitri took the initiative of exposing through the Human Rights Commission (application no. 964/13, 2005-2006) the fraudulent depiction of both illness and treatment in cinema.
Bangalore-based consulting psychiatrist Ajit Bhide was so angered by the misrepresentation of mental illness in the Ajay Devgun film Main Aisa Hi Hoon plagiarized from the Sean Penn film I am Sam, he wrote a scathing piece in the Karnataka edition of The Indian Psychiatric Society. “The director remains totally unclear about the condition of the hero, the exact handicap(s) he has, and does a great disservice by confusing autism with mental retardation,” he wrote.
Prof. Dinesh Bhugra's Mad Tales of Bollywood is an exhaustive study of the representation of mental disorder in Hindi cinema. Among other works are Psychoanalysis and Film and Psychiatry and the Cinema by Prof. Glen Gabbard.
The approximations to real representations of mental illness in Indian cinema are so wide and varied that nothing come out of these interpretations. Often, in Indian films, many mental ailments are placed within umbrella terms like “depression”, “schizophrenia”, “suicidal tendencies” which are ambivalent, ambiguous and misinformative.
According to Farah Nah Khan, an internal medicine resident at Emory University, in A Look at the Many Ways Bollywood Mishandles Mental Health in The Aerogram (April 9, 2014),“In a country with a population of 1.2 billion citizens, there are a mere 4,000 psychiatrists — compared to the roughly 50,000 psychiatrists in America.
In 2012, The Lancet published a nationally representative survey of India that demonstrated suicide as the second leading cause of death among Indians between the ages of 15 and 29. Unfortunately, the country’s largest film industry’s portrayal of mental health issues usually leaves much to be desired.”