The Snake Pit (1948)

Exploitation vs. Representation: An Analysis of Mental Illness in 20th Century Film

Written by Audrey Liepsna Gray | May 8th, 2021

It’s no secret to anyone that mental illness is a complicated subject to portray in the media— and often a difficult conversation to have in general. The topic is broad, and the term ‘mental illness’ is always meant to encompass all kinds of disorders and conditions that don’t necessarily have any related symptoms or behaviours. Schizophrenia, depression, antisocial personality disorder; these are just a few of the mental disorders beloved by mainstream film media, repeated and recycled again and again in the form of stereotyped characters and narratives. Sometimes these stories claim to truly represent the experience of the ill through their depiction, but others make no such attempt and rather use illnesses as concepts to be milked of all theoretical artistic value before they fail to shock audiences. Early to mid-20th-century film may be the most egregious source of these exploitative narratives, rooted in a history of ignorance towards people different from America’s expected norm. 

From the conception of the moving picture in the late 1800s onward, film grew into a quickly developing art form and business. Silent films came first, turning actors like Buster Keaton, Clara Bow, and many more into superstars. The silent films of the early 20th century had their fair share of glaringly problematic tropes and plots. Rife with racist imagery and caricatured portrayals, early movies showed the first signs of the film industry’s obsession with the unfamiliar, unknown, and ‘exotic.’ Ernst Lubitsch’s One Arabian Night (1920), starring Pola Negri, shows off an orientalist imitation of Arabian culture through its dramatic and completely stereotyped plot of harems, barbaric sheikhs, and glittery dress. 

This wasn’t an unusual occurrence. Cultural misrepresentation was handed around just like the cash in the industry, and didn’t move away with the rise of talking pictures. The film industry’s fascination with exoticism was never rooted in a desire to understand foreign societies or arts— it simply came from the novelty of the strange and unfamiliar. In a time of a singularly rigid, conservative, and straight-laced path being the most desirable and culturally celebrated life in America, we can begin to see the emergence of depictions of mental illness in film as another form of this preoccupation with subjects poorly understood in that era.

Much like foreign cultures dissimilar to America at the time, mental illness in the early 20th century was surrounded by much mystique and stigma, and was misunderstood by most. With the public generally not seeing mental illness as legitimate sickness caused by the factors we know of today, it maintained itself as a mostly unexplored field. Thus, it was characterised mainly by the observed behaviours of patients. Medical researchers and psychologists began, in the early years of the 20th century, to attempt to determine the causes of odd and erratic behaviour, emotions, and thoughts that general opinion of the time would dictate as “madness,” but the source of mental illness as a complex combination of chemical imbalances, genes, and outside influences went misunderstood in medical fields. Because of this lack of medical knowledge about mental illness, the topic was often even worse perceived among the general public. This began to be seen in films developed during the same period, which usually portrayed mental illnesses the same way they’d historically been seen by the public; unpredictable, irregular madness, present in people that were just different than most. 

Stigma surrounding mental illness arose most notably throughout the 20th century, not just in the early decades, through a combination of media playing upon these widely-held fears of mental disorders and the separation of mental health treatment from general healthcare. The manifestations of stigma relating to the topic were drastic, expressed over time through decreased research in various circles and the defunding of mental health institutions. Public opinion usually saw mental institutions as creepy cesspools for the depraved and psychopathic, rather than essential medical facilities. We can see quite obviously the source of much of these public fears in the early days of the slasher subgenre of horror in films. 

These movies were often influenced by films like Alfred Hitchcock’s iconic Psycho (1960), which featured the character Norman Bates, a deranged murderer with dangerous delusions about reality. Over time, connections of mental health to threatening and dangerous characters became even more clearly defined as the trope of an unhinged mental asylum escapee proved itself to be popular throughout the horror genre. One of the most famous examples of this trend is the character of Michael Myers from the popular Halloween horror franchise, a serial killer who escaped from the sanitarium in which he was institutionalised in order to go on a killing spree.

Norman Bates, portrayed by Anthony Perkins in Psycho (1960)

But even before slasher films began to worsen the stigma around mental disorders and propagate societal prejudices of the mentally ill as dangerous and hostile, there were many depictions of mental illness and the people who suffered from it in the field of film. Mixed in attitude and approach, many of these films took the path that later horror films did, although to a lesser extent. Public views of mental illness as unpredictable and frightening were utilised in various ways throughout the history of movies related to the subject, exploiting the concept of illness in order to evoke these fears, emotional responses, and curiosity about the unfamiliar in viewers. This trend in culture brings up a greatly important question for consumers and critics of film: where is the line between media that legitimately represents mental illness versus exploits it, and how is it identified?

There’s no easy answer to this question. When discussing it a plethora of factors come into play, including but not limited to characterisation, cinematography, and thematic elements used throughout a film. Through these lenses, one can refer back to films portraying mental illness and begin to analyse them. One of the most important things to study the use of on this subject is perspective. It’s one of the key elements that comprises the difference between exploitation and representation in most subjects, and is especially important when considering what a substantially misunderstood topic mental illness is. 

Through the element of perspective, we can see the ways in which the portrayal of people with mental illnesses in media also feels similar to the representation of women in film throughout the 20th century. The experiences of women and the subject of femininity itself were both historically used even more frequently as key selling points for film than mental illness, and were usually expressed similarly; since stories that turned mental illness and femininity into attractions were usually viewed through the eyes of an outsider (a man in the case of the female experience, and someone unfamiliar with mental illness), the main characters of stories regarding both of these topics were usually unqualified to pass their vision off as representative of real groups, but often still attempted to do so anyway.

Take Lilith (1964), directed by Robert Rossen, starring Jean Seberg and Warren Beatty. The film follows Vincent Bruce, a young man who gets a job at a private mental institution and falls in love with one of the patients, a beautiful but unstable woman named Lilith. They begin an affair of, it’s worth noting, somewhat dubious moral support considering his status as one of the caretakers in the facility in which she’s institutionalised. Throughout the film Vincent gradually becomes more and more obsessed with Lilith and her behaviour until finally, at the end, he’s reached such a level of mania that he comes to the institution for help with his own mental health. 

The film is framed around Vincent’s perspective of the events occurring, focusing on his emotional and psychological journey throughout the story and his own view of Lilith’s condition and behaviour. He approaches the film’s mental institution and its patients as an outsider, one unfamiliar with the patients, their conditions, and the experience of suffering from a mental disorder. Because of his status as a foreigner to this place, his perspective is unrepresentative of the experiences of any of the patients, whose individual points of view or inner lives are never revealed. Vincent’s perspective doesn’t accurately represent Lilith’s character, either, but instead represents an interpretation of her formed from the film’s use of an angle of an enigma. She’s consistently portrayed throughout the film as unpredictable, unstable, and often with mysterious motivations that are never revealed to the viewers. Because of this, it’s natural that she and her mental struggle are seen by the audience only how she’s depicted in the context of Vincent’s character development, and we’re never made aware of many of her more personal experiences. 

The disconnect Lilith has from the woman it forms a narrative around is essential to the film’s purpose, to use societal sentiments towards a poorly understood topic like mental illness in order to engage viewers’ curiosity. For efforts to exploit representation of mental illness, the less development an afflicted character receives in their personal experiences, the better, because more development provides the audience with a greater sense of empathy toward the character and thus removes their status as an object meant to be ogled for the concept of their illness.

Warren Beatty and Jean Seberg in Lilith (1964)

The use of perspective in Lilith also serves the keen purpose of a device meant to explore the concepts usually associated with mental illness in artistic settings, like passion and deep emotional volatility. Because relationships rely heavily upon emotional connection, the romantic relationships that someone emotionally unpredictable and unstable has don’t always fit within generally accepted views of a “normal” relationship, especially within narrative and thematic purposes. Lilith’s mental disorder and the instability that comes with it are thus not only used within the story as fuel for the fiery and unconventional romance she has with Vincent, but also as an unspoken justification throughout the storyline for toxic and misogynistic behaviours he exhibits towards her. Lilith is portrayed throughout the course of the film as unpredictable and flighty, and doesn’t adhere to Vincent’s ideas of normal relationship dynamics. Relationship dynamics, it’s worth noting, that involve her being docile and passive in his treatment of her. 

The narrative fully recognises this disagreement of values— in fact, it relies on it for the tension between Vincent and Lilith, and to be used to showcase Lilith’s inclination towards behaviours and opinions unconventional to the time that marked her as “different” and the presumed driving force behind her unhealthy relationship with Vincent, when in fact it was his own misogynistic values that turned their relationship destructive and detrimental to both parties. 


It’s also important to recognise the biblical significance of the name Lilith, a demonic figure that appears in medieval Jewish mythology as the first wife of Adam, the first man. According to some stories, Lilith refused to submit to Adam as his inferior and pronounced the name of God, gaining the power to fly and leave the Garden of Eden. She was known as a seductress and possessor of dark wiles, committing dangerous and destructive acts in various legends. Lilith’s character from the 1964 film mirrors the origins of her name, through the film’s representation of the mythological figure’s qualities of independence and nonconformity— in, however, the context of mental illness and an institutionalised patient. In this way, her behaviours within the film, and sometimes her symptoms, are identified with those of a biblical demon in ways that aren’t meant to be subtle at all. They’re meant to actively encourage the film’s perspective of mental illness from that of an outside, conservatively valued society, and develop the audience’s identification with this perspective through the use of a well-known mythological figure.

Lilith is a good example of a piece of media that displays exploitative tendencies towards mental illness, especially when viewed through this lens of perspective. The idea of the outsider’s view of a certain topic can sometimes work to explore new ways of thinking about the world through artistic exploration. But this perspective is neither relevant or representative when the topic is already stigmatised and viewed in unfairly negative lights by the general public, and the narrative simply enforces this view without providing any new stances. 

In a topic like mental health that’s been historically defined by those unfamiliar with it, it’s especially important for the perspectives in film to explore the voices and experiences of those suffering from mental illness in order to decrease stigma regarding the topic and encourage more understanding among those who have never experienced it. When this approach to perspective is used correctly in art, it’s called legitimate representation, representation dictated by those who know how to accurately portray it. A film that contrasts with Lilith in its use of perspective to tell a story about mental illness is The Snake Pit (1948), directed by Anatole Litvak and starring Olivia de Havilland. 

The film was based off of a novel of the same name by Mary Jane Ward, which drew acclaim for drawing critical attention to the troubles of patients in mental institutions and addressing issues of mental health, which were very rarely portrayed in art or discussed openly in society at the time. The film follows a woman named Virginia Cunningham, who finds herself a patient at a mental institution with no memory of how she arrived there or of her mental disorder in general. Throughout the course of the movie, she receives treatment and therapy for her disorder, and details of her life that contributed to the development of her illness are slowly revealed through flashbacks. 

One can see in the plot the obvious differences in perspective the film has with Lilith. The film entirely follows Virginia and her journey, and seeks to understand and show her emotional and psychological state rather than exploit the misunderstood parts of her illness simply for tone or theoretical artistic exploration. It’s a very different story than Lilith; based on a semi-autobiographical book that was inspired by the author’s own experience with institutionalisation and mental health, it differs in both tone and content from the eloquent, artistic Lilith. The Snake Pit proves to be a much more straightforward, reflective, and biographical-feeling experience. 

Olivia de Havilland and Leo Genn in The Snake Pit (1948)

This difference in style isn’t necessarily what makes it a more representative story, though— it’s the intention throughout the story to explore the realities of mental illness, rather than a romanticised idea of it or contrived, assumed concepts. Virginia’s emotions are felt by the audience through her interaction with her own mental health. We understand her panic, her calm, and her journey towards beginning to understand herself, because the narrative stays connected to a strong intent of representation and description throughout the film and doesn’t stray from the realities her character faces. In this way, The Snake Pit shows the narrative power that portraying mental illness through real experiences possesses. Done correctly, it creates a story that’s more open about the topic it’s discussing, facilitates a greater emotional connection in the audience, and proves to be more useful in moving away from stigma and mystery surrounding the subject. 

When it comes to mental illness and mental health, there’s a growing obligation in our social climate today to engage in conversation on the subject more openly and with greater acceptance. Openness on the public discussion of this topic is vitally important for the future; with the rising medical understanding of mental health, an equally important social understanding of it as another facet to the human experience needs to come into discussion. With this comes enormous responsibility within art to move away from stigmatic representation of mental illness and those who suffer from it. 

Artists and consumers alike should begin to deconstruct and analyse the stigma and stereotypes associated with mental illness in order to create an environment for greater understanding. This task isn’t always black and white; mental health is a complex, multi-faceted subject. There’s not always one clear way to represent it in art effectively, but this is part of what makes the topic so important to approach from a variety of unique stories— the more experiences that are out there portrayed in media, the more people are able to realise that no one’s mental health journey deserves to be ignored. With this understanding, more steps can begin to be taken that help our society begin to reject the old-fashioned ideas of mental illness that prompted the original exploitation of it.

Audrey Liepsna Gray is 15 years old and a student at Shorewood High School. She’s currently a member of the Penguin Advisory Council and a writer for the TeenTix Press Corps. Audrey loves writing, both creatively and analytically, and is always excited to delve deep into new subjects and find different perspectives to explore media from in her writing.

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