Psychiatry and the “Worst Movie Ever Made”

REEL INSIGHTS

The history of cinema is replete with movies that feature mental health issues at the center of their narratives. Some of these films have garnered enduring critical praise, establishing their place in film canon as “good,” “great,” or even “classic.” Films such as M (1932), One Flew Over the Cuckoo’s Nest (1975), and Black Swan (2010) attempt to engage with social, cultural, and medical discourses around madness. Such films provide valuable opportunities for psychiatrists to engage with the public and each other regarding relevant psychiatric themes. But what of critical and commercial failures—in other words, bad films? For psychiatrists, can poorly made films (even ones without mental health as a central narrative element) contain themes worthy of analysis? We would suggest that in some ways they might be equally useful, not least because bad movies will frequently offer insight into the everyday, popular, quotidian cultural discourses around mental health in a way that is unselfconscious and thereby extremely enlightening.

As perhaps the Platonic ideal of a bad film, what could we say about The Room (2003)?¹ Written, directed, produced by, and starring Tommy Wiseau, The Room is considered by many to be the “worst movie ever made.”² Despite (or rather, because of) the film’s terrible reputation, it has taken on cult status, giving it a persistent cultural footprint. The Room is regularly screened in theaters around the world, a dramatization of the making of the film (The Disaster Artist) won a Golden Globe in 2017, and a remake of The Room was filmed in 2023 with release date pending.³ While not narratively focused on psychiatry, The Room peripherally engages with topics related to mental illness. This article examines 4 psychiatric themes in The Room: (1) psychiatric treatment, (2) psychopathology, (3) substance use disorders, and (4) suicide. We have selected 4 characters from the film that respectively illustrate each of these themes: Peter (Kyle Vogt), Lisa (Juliette Danielle), Mark (Greg Sestero), and Johnny (Tommy Wiseau).

Psychiatric Treatment: Peter

The Room has a simple story and a small cast: Johnny is engaged to Lisa, but when Lisa has an affair with Johnny’s best friend Mark, everyone’s lives are thrown into chaos. Partway through The Room, we are introduced to another of Johnny’s friends: Peter. During their first on-screen conversation, Johnny seeks Peter’s help in navigating Lisa’s infidelity: “You’re a psychologist, do you have some advice?” Later in that same scene, Johnny derides Peter, saying, “you always play psychologist with us.” Johnny’s statements are contradictory: initially he seeks Peter’s help as a psychologist, but then he calls Peter’s professional legitimacy into question, suggesting he only “plays” psychologist. Johnny’s comments illustrate the lack of respect mental health professionals experience in the real world. A 2010 study showed that many in the general public underestimate the education of psychiatrists and label them as “odd,” mentally ill, or abusive.⁴ Even among other health professionals, psychiatrists may be perceived as “not real doctors.”⁴ These facts demonstrate a persistent stigma that surrounds mental health professions.

Johnny asks Peter for “some advice,” phrasing that is echoed by Peter in a later scene with Mark (“You want my advice?”). Identifying Peter as a psychologist and then framing his role as advice giver suggests that psychotherapy is equivalent to advice-dispensing. This is a misunderstanding of the psychotherapeutic process: instead of depicting therapy as a shared work between therapist and client, the imagined advice-dispensing therapist simply tells the client what to do. Although giving advice may constitute a (typically small) part of psychotherapy, an overreliance on advice can actually hinder client collaboration.⁵ Unfortunately, The Room does not appear to understand that a therapist could do more than give advice, as much of Peter’s dialogue falls into the trap of cliches:

“The unexpected can happen. When it does, you’ve just got to deal with it.”

“You should tell her about your feelings.”

“People are people.”

“Sometimes life can get complicated, and you’ve got to be responsible.”

While Peter is never depicted as treating Johnny, Lisa, or Mark in a formal clinical setting, some of their interactions suggest that he is speaking from the position of psychotherapist. Peter first appears in Johnny’s den that, with its dark woods, bookshelf, and fireplace, evokes television and movie stereotypes of a traditional therapist’s office. Peter speaks with his friends using language commonly associated with the opening statements of a therapy appointment: “Tell me about your problems, Johnny,” and later, “Let’s just talk about your problem.” Peter behaving as friend-as-therapist is also shown by his use of clinical terminology, labelling Lisa as a “sociopath” and Mark as “depressed.” If Peter is in fact functioning as therapist for his friends, this illustrates a violation of generally accepted ethical principles. In mental health professions, trainees are instructed to avoid treating close relations because their objectivity in treatment can be impaired by the closeness of the relationship.⁶ There may be some flexibility with these boundaries in rural communities with limited access to mental health resources, but Johnny and Peter reside in San Francisco, a large city with abundant health care services.⁷

Psychopathology: Lisa

There are several characters in The Room whose behavior may illustrate psychopathology. Does Denny (Philip Haldiman), the man-child who appears to rely on Johnny and Lisa as parent figures, have Peter Pan syndrome? Does Mike (Mike Holmes), who engages in a sexual liaison with Michelle (Robyn Paris) in the middle of Johnny’s unlocked front room, have a paraphilic condition such as exhibitionistic disorder? Or perhaps Mike’s cataplectic loss of muscle tone after laughing and being lightly tapped by Mark with a football is evidence of narcolepsy? These characters are not explicitly pathologized within the narrative of the film: Denny’s childlike disposition gives Johnny a fatherly role, and Mike’s antics are comic relief. It is Lisa whose troublesome behavior is most worthy of diagnostic consideration. As mentioned previously, at one point Peter the psychologist dubs her a “sociopath—she only cares about herself, she can’t love anyone!”

Sociopathy is more commonly referred to in modern diagnostic terminology as antisocial personality disorder. To understand whether Lisa’s behavior in the film supports a diagnosis of antisocial personality disorder, its diagnostic criteria are summarized in the Table.⁸

Table. Cluster B Personality Disorders Criteria⁸

Lisa is deceitful throughout The Room: she misleads Johnny about her feelings, falsely tells Michelle that Johnny hit her, hides her ongoing affair with Mark, and lies to Johnny about her pregnancy. The intent of her deceptions appears to be for personal pleasure, as Lisa tells Michelle at one point: “I want it all… You have to take as much as you can. You have to live, live, live!” She seems impulsive in her decision-making, not thinking through the consequences of her deceptions. When Michelle points out that there is “no simple solution” to Lisa’s web of lies, Lisa responds with a blasé, “don’t worry!” Lisa demonstrates an impaired capacity for empathy and a lack of remorse. Michelle confronts Lisa about the pain that her actions will cause Johnny, but Lisa refuses to acknowledge that she is causing any harm. Michelle asks Lisa point blank, “You don’t feel guilty about this at all?” to which Lisa replies, “No.” At the end of the movie, Lisa briefly appears remorseful after Johnny’s suicide, sobbing uncontrollably for several minutes. However, this remorse is undercut by her self-serving declaration to Mark: “We’re free to be together.” Assembling the evidence, Lisa does appear to meet the required 3 symptoms of criterion A for antisocial personality disorder.

Even with these signs of sociopathy, other Cluster B personality disorders are part of the differential diagnosis for Lisa’s behavior (Table).⁸ Borderline personality disorder is a possibility. Lisa’s love triangle could be evidence of “a pattern of unstable and intense interpersonal relationships.”⁸ She is impulsive. Her plea to Mark after Johnny’s suicide, “I’ve lost him, but I still have you, right? Right?” may show her frantic efforts to avoid abandonment. Histrionic personality disorder is another consideration. Lisa appears to enjoy being the center of attention, such as at Johnny’s birthday party where an unnamed male partygoer comments to his date, “Lisa looks hot tonight.” Her style of speech is lacking in detail, frequently saying “don’t worry about it” and “I don’t want to talk about it.” Her interactions with Mark are sexually seductive. Early in the film Lisa appears to consider her relationship with Mark to be more intimate than it is. When she addresses Mark as “lover boy,” he replies with confusion: “What are you doing this for?”

It is worth noting that as a fictional character, Lisa is a representation of the ideas of her creator/author, Tommy Wiseau. Wiseau may be saying things through Lisa that express his own beliefs about women—let’s not forget that Lisa’s mother is also characterized as a ruthless and cold-hearted gold-digger—even in ways of which he is unaware. However, rather than attempting to dissect Wiseau’s mind, we are limiting ourselves to an examination of the character as presented in the text of the film. Lisa’s portrayal in The Room is consistent with a cluster B personality disorder, most likely antisocial personality disorder given her lack of empathy.

Substance Use Disorder: Mark

The subject of substance misuse arises throughout the film. While alcohol is innocuously present in many depicted social interactions, there is a critical moment when Lisa, having convinced teetotaler Johnny to drink, falsely claims that he physically abused her while drunk. Alcohol’s function in this case is to illustrate Lisa’s manipulative behavior.

Illicit drugs play a central role in 2 scenes. In the first, Denny is saved from a violent drug dealer to whom he is financially indebted. In the second,Mark is smoking a joint when Peter joins him on the roof terrace. As the scene progresses, Mark exhibits signs of possible problem cannabis use. Research has shown that cannabis use is associated with disturbances in mood, reality testing, and cognition. Problem use can manifest with impairments in social relationships, vocational obligations, and risky behaviors.⁹ Mark clearly does not see his cannabis use as problematic, as he states, “It’s good, bro.” However, Peter is worried: “You look depressed.” Mark admits that he fantasizes about escaping the consequences of his affair by “running” or dying by suicide. Peter expresses concern that cannabis is negatively impacting Mark’s mental state, describing cannabis as “crap,” and observing: “It’s no wonder you can’t think straight. It’s gonna screw with your head!” Mark’s impulse control is clearly impaired, as he briefly attempts to throw Peter off the rooftop before coming to his senses. The Room was released in 2003, during a time when the risks of cannabis use were more recognized and potential medicinal uses were not widely accepted. As cannabis has been legalized across the United States, the pendulum of public opinion has swung dramatically in the direction of accepting cannabis both medicinally and recreationally with a corresponding reduction in the perceived risks of cannabis use.^10,11 Mark’s possible cannabis-induced mental disruptions illustrate Tommy Wiseau’s understanding of marijuana, grounded in a time when cannabis use was largely perceived as dangerous.

Suicide: Johnny

The concluding scenes in The Room center around Johnny’s suicide. After confirming that she and Mark have had an affair, Lisa informs Johnny she is leaving him. Johnny, in tears, shouts and breaks random objects in his home. As he sits on his bedroom floor in shambles, Johnny reaches over to a small, unlocked case and pulls out a handgun. “It’s over,” he states before placing the gun into his mouth and pulling the trigger. He is later found by Lisa, Mark, and Denny lying in a pool of blood.

Johnny’s death illustrates some important points related to suicide prevention. First, it correctly demonstrates the importance of firearm safety. Firearms in the home are a significant risk factor for death by suicide.¹² If a firearm is kept in the home, keeping the gun locked, unloaded, and storing ammunition in a separate, locked location are steps with a demonstrable protective effect against suicide attempts.¹³ Johnny did not keep his firearm locked, resulting in less than 30 seconds of film time passing between pulling out the handgun and dying from a self-inflicted gunshot.

Johnny’s death is also consistent with the short-term, impulsive nature of many suicide attempts. The Room shows no evidence that Johnny had been contemplating suicide prior to the few minutes he spent trashing his apartment in a state of despair. This is an accurate depiction of how quickly suicidal thoughts can transition to a suicide attempt. One study found that nearly half of patients hospitalized after a suicide attempt reported that the time between their first thought of suicide and the attempt was 10 minutes or less.¹⁴ Such transient, impulsive attempts can be addressed using preventive strategies that delay the time between a person’s thought of suicide and their ability to fatally act on that thought. In Johnny’s case, keeping his firearm locked might have sufficiently delayed his ability to act on the thought of suicide and saved his life.

Concluding Thoughts

The Room may be the worst movie ever made. But how does it fare in its engagement with psychiatric themes? As pointed out in this article, The Room is a mixed bag. Regarding psychopathology, The Room provides a plausible diagnosis for the film’s primary antagonist. The depiction of substance use is notable for acknowledging risks associated with cannabis use which have been downplayed in recent public discourse. Johnny’s suicide accurately depicts the lethal results that can accompany an unsecured firearm and a temporary impulse. By contrast, The Room falters in its portrayal of Peter the psychologist. The film reinforces stigma against psychiatric treatment and misrepresents the function of mental health providers. Engaging with films, even bad films like The Room, reminds us of our ongoing duty to educate the general public about the vital work that goes on in clinical settings every day.

Dr Weber is adjunct assistant professor with the University of Utah School of Medicine and medical director for behavioral health at Intermountain Health Logan Psychiatry, Logan, UT. Dr Wall is a professor and director of the film studies minor at Utah State University, Logan, UT.

References

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3. Murphy JK. Bob Odenkirk will take on Tommy Wiseau’s ‘The Room’ role in new tribute film: ‘I tried my best to sell every line.’ Variety. March 8, 2023. Accessed October 18, 2024. https://variety.com/2023/film/news/bob-odenkirk-the-room-remake-tommy-wiseau-1235547708/

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