Hektoen International

A Journal of Medical Humanities

Understanding so little: Cinema and mass shootings

Eelco Wijdicks
Rochester, Minnesota, United States

Young man with disheveled blond hair looking out car window as a man with a mustache in the blurred background behind him looks at him
Caleb Landry Jones in Nitram. IFC Films/Photofest. Used with permission.

The horrific 2012 shooting in Aurora, Colorado, during a screening of The Dark Knight Rises, was serendipitously preceded by a trailer for Gangster Squad, which showed a fictitious shooting of a movie theater audience. Filmmakers have revisited the topic of mass shootings and their aftermath in portrayals not only of the perpetrators, but also of the disruption to the social fabric and persistent trauma for survivors and the bereaved (Beautiful Boy, 2010; Mass, 2021).

The first film to deal with psychiatric aspects of crime was Fritz Lang’s M (1931, Germany). The protagonist Beckert (Peter Lorre) endures torment and admits, “I can’t help myself … always is this evil thing that’s inside me, I want to escape from myself, but it is impossible… I can’t remember anything about it.” Lang’s masterpiece was loosely based on several vile crimes in Germany in the 1920s. There are oblique references to psychiatry and graphologic proof “attesting to the strongly pathologic sexuality of this sex offender,” as well as the decision by a kangaroo court made up of gangsters to kill him because he would be free in ten to twenty years after an insanity diagnosis made by psychiatrists. In the US, Psycho (1960) had the greatest influence on the portrayal of violence in mainstream film. At the end of the film, in a longwinded monologue, a psychiatrist concludes it is a case of multiple personality disorder—a rare disorder in reality but a common trope in film—and adds a psychoanalytic explanation. In the end, Norman Bates is sent to an institution. Directors have continued to use psychoanalysis or other societal theories of mental dysfunction as an explanatory paradigm.

Recent films have shown the ambiguities of preventive recognition, casting doubt on the strategy to reduce mass shootings through improved mental healthcare without also restricting gun ownership. Nitram (2021), directed by Justin Kurzel, tells the story of Martin Bryant (portrayed by Caleb Landry Jones, see figure) and his involvement in the 1996 mass shooting in Port Arthur, Tasmania. Within two weeks after the shooting, Australia’s state and federal governments agreed to enact uniform gun control laws, which accelerated a decline in firearm deaths. Nitram shows the protagonist’s antisocial behavior before the shooting: pulling at the wheel of a car for fun, giving fireworks to young kids, and punching his depressed father nearly to death to make him get off the couch. In one scene, he visits an obtuse psychiatrist (Conrad Brandt), who only asks if he is taking his antidepressants.

Cinematic portrayals of school shootings started with Lindsay Anderson’s metaphorical If… (1969). In this film, there is no psychological insight into the shooting other than as a revolt against boarding school and perhaps questioning the threat level of daydreams. The psychiatrist is mentioned as the culprit in a speech: “It is a very sad thing that today it’s fashionable to belittle tradition. The old orders that make our nation a living force are for the most part scorned by modern psychiatrists, pundits of all sorts, but what have they got to put in their place?”

No films on school shootings exist in European cinema. In the US, several films were inspired by the Columbine shooting. In Gus van Sant’s Elephant (2003), there is an obvious, preconceived use of obscurity. Before the shooting, Alex and Eric skip school to sign for mail-order semi-automatic weapons delivered to their doorstep. Alex plays “Für Elise” on the piano while Eric looks for guns on the internet and shoots people in a video game. These elements are shown in order to be interpreted as forewarnings. But are they? When the mayhem comes, it is sterile and surgical.

In Lynne Ramsay’s We Need to Talk About Kevin (2011), a genetic predisposition is implied. Kevin cannot stop crying as a baby, and during play as a toddler, refuses to throw a ball back. As Kevin develops, he cannot be potty-trained, mocks his mother, and rejects her attempts at physical affection. In a brief rage, she tugs at his arm, causing a dislocation. The mother (Tilda Swinton) and Kevin (Ezra Miller) cannot find peace. After the school killings (with victims that include members of her family), every childhood incident and spat may have seemed like a forewarning of violence.

Cinematic renditions of mass murder often provide a simplistic narrative that reflects the thinking of many, i.e., that there must have been warnings and clues in the killer’s life. There is a quixotic urge for screenwriters to attempt to explain the incomprehensible. A persistent narrative is that of an innate defect, with previous episodes of violent behavior in troubled or intellectually challenged children with reduced coping skills. But no explanation is sufficient, and films may condition viewers (and policymakers) into thinking that “evil” can be recognized early and remediated in time. Outside the world of cinema, the shooter is often readily diagnosed with a psychiatric condition. Politicians apply labels such as “insane monster,” “deranged individual,” “wacko,” “crazy madman,” “homicidal maniac,” or, less histrionically, “lonely oddball.” But psychiatrists often encounter kids who are merely sullen, with no classifiable mental disorder, and who do not meet criteria for involuntary commitment. Some who enact revenge fantasies may give warnings before the act, but others do not. Some may commit suicide rather than carry out a mass shooting.

The continued misdirection of trying to seek a solution to mass shootings through mental healthcare alone is an unfortunate, long-lasting myth, possibly fed by the movie industry. Even the most stringent measures to reduce mass shootings cannot erase human susceptibility for committing acts of violence. Restrictions may only reduce both the severity and frequency. Filmmakers have shown interest in the topic of mass shootings, but it is country-specific and often prompted by actual events. The number of films is small, but the prestigious Cannes Film Festival awarded three Palme D’Or prizes to films on school shootings. In general, cinema has propagated a stereotype of psychiatric and genetic causality in the perpetrators of this extraordinary violence. Gus van Sant’s Elephant is a notable exception. He understood there is no satisfactory explanation, and we will likely never find one. The “elephant” in the room is bewilderment.

EELCO F. M. WIJDICKS, MD, PhD, is a Professor of Neurology and History of Medicine at Mayo Clinic College of Medicine. He established Neurocritical Care at Mayo Clinic and is consultant neurointensivist in the Neurosciences Intensive Care Unit at Saint Marys Hospital (Mayo Clinic Campus Rochester). He has published commentary and criticism on medical and neurologic portrayal in film, including Neurocinema: When Film Meets Neurology (CRC Press 2014), Neurocinema―The Sequel: A History of Neurology on Screen (CRC Press 2022) and Cinema, MD: A History of Medicine on Screen (OUP 2020).

Summer 2022



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