“Inside Out 2”: A Movie for Our Mental Health

PSYCHIATRIC VIEWS ON THE DAILY NEWS

In yesterday’s column, I mentioned feeling dazed and confused after the Presidential debate. Other colleagues have expressed some similar reactions: “a physical gut punch,” “devastatingly unbelievable,” “the stuff of nightmares” from one side, with more positive emotional reactions from the other side.

Thankfully, Al Simon, a new friend, came to my rescue. A week or 2 before, he strongly recommended I see “Inside Out 2,” thinking I would be interested in it as a psychiatrist and that he would like to know my reaction. One thing led to another, and we went yesterday with our spouses.

I had seen the original “Inside Out” when it came out, just about 9 years ago. In that Pixar animated film, a 9-year-old girl named Riley moves with her parents from Minnesota to San Francisco. Her core emotions become characters inside her animated head in the movie, a place called Headquarters: Joy, Sadness, Anger, Fear, and Disgust. It was a creative, insightful, empathic, and compassionate portrayal of how our emotions influence our relationships.

The title had also been intriguing to me because some years before that I had written a rare poem about being inside and outside our mind, a haiku. I think it was published in the Houston Psychiatric Society newsletter. I did clearly recall the lines:

A psychiatrist

Tries to transform the inside

Outside of our selves

The sequel, which also depicts changes in neurons and memories by rising lines and marbles (maybe as in “losing our marbles” mentally), has been an attendance bonanza. I would say that it is also a psychiatric success. Now Riley is 13, an age typically of increasing unhappiness as puberty roars in, but worsened in her case by having to start in a new high school separated from her 2 close friends. Keeping up with the times, these friends are of different cultures and the girls play a rough game of hockey.

New emotional core characters are added as the old emotions are temporally put in mental storage. They are Anxiety, Ennui, Envy, Nostalgia, and Embarrassment. As she tries to impress the older students, Anxiety takes over from Joy and she becomes more selfish and not such a good person. She has to grieve the past losses to eventually move on.

However, what I told my friend afterword, the emotion that seemed missing to me was Guilt. There is a dark place in her mind that seems to have some recollection of a bit of the trauma in her past, but it is a minor character. There is little explanation of how and why she took the turn to become a good person once again. There is no therapist handy.

I am left wondering where the guilt is—or was—in our presidential debate and in many of our politicians. Perhaps in our society more broadly, guilt has been disappearing. We know that it is missing in sociopathy and undue narcissism.

There are more parallels to real life. There is conflict that is worsening, not being resolved. Mental disorders are particularly escalating in teenagers, especially Black females. We are just starting to try to control cell phone overuse.

Sometimes in the movie, like in life, things go by so fast that you feel you cannot put it together. That left me wanting to see it again and perhaps again. In that regard, it may also benefit from group discussion afterwards, like our 2 couples did during a meal.

Although the target audience seems to be teenagers, their teachers, and their parents, it felt therapeutic to me. In that regard, it may be useful for patients, and perhaps they will want to discuss the movie with their therapist. Understanding our emotions and how much cognitive control we have over them is difficult.

We elders may also get benefits from watching the movie. We, too, are helped by grieving what we have lost and are losing, including people and our usual climate. We particularly remember emotionally strong memories, good and bad, as we put our lives together. But memories for some are lost in dementias. Perhaps eventually, sequels will get to our age when we are losing neurons, but hopefully getting new connections of wisdom.

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.