As Princeton University math professor John Nash, actor Russell Crowe plays a tormented genius who eventually triumphs over schizophrenia through medication and sheer determination to maintain a truce with the demons who haunted him as a younger man.
To a public whose curriculum on schizophrenia has been limited to Hollywood's comedies or thrillers, A Beautiful Mind may seem like a fairy tale. But to many mental health workers, academics and others familiar with the disease, the Ron Howard film is the first to get it right.
A Beautiful Mind presents a rarely seen but common outcome of the disease: recovery, or, at least, high-level management of its symptomatic delusions and hallucinations.
The film, the experts say, is a welcome departure from mainstream depictions of the mentally ill that cast people with schizophrenia as either oddballs with "split personalities" -- think Jim Carrey in Me, Myself & Irene -- or dangerous paranoids, such as Edward Norton in Fight Club. Almost as bad, they say, the disease has always been portrayed as a degenerative, lifelong illness.
"And that was never true," said Sylvia Nasar, whose 1998 biography of Nash became the basis for A Beautiful Mind.
"The news of that hasn't gotten out in a big way," Nasar said. "Partly, because the only time we read about someone with schizophrenia is if a couple of Capitol Hill officers are shot, or someone is pushed in front of a train. The amazing thing about the John Nash story is that it's making people aware. It's giving them an entirely new view of who these people are who suffer from these illnesses, and what the prospects are."
A truthful portrayal
While the film has been criticized for either eliminating or fictionalizing parts of Nash's life, mental health professionals praise its truthful portrait of his schizophrenia.
Depictions of schizophrenia in popular culture have consistently perpetuated damaging misconceptions about the disease -- for example, that schizophrenia causes personalities to cleave and multiply. In reality, the most common symptoms of schizophrenia are audible hallucinations -- hearing voices. Schizophrenia is a neurological disorder most often treated with a combination of drugs and therapy.
Akiva Goldsman, who wrote the film's screenplay, said even basic terminology is incorrect in most movies and TV shows. "People are not schizophrenic," he said. "They have schizophrenia. The misconceptions we have are rooted in older models of the disease."
Goldsman, whose parents started a group home for emotionally disturbed children when he was young, realized how little he knew about the disease when he read Nasar's book.
"I was stunned to learn about cases of schizophrenia that were in remission," he said. "It is not at all the disease that people thought it was decades ago."
Raquel E. Gur, director of neuropsychiatry at the University of Pennsylvania School of Medicine's Schizophrenia Research Center, said more than half of the nonviolent individuals diagnosed with schizophrenia eventually function normally with the help of medication, therapy and a strong support system. But these "mainstreamers" have received almost no attention in the mass media because they are overshadowed by images of deranged criminals in films like The Silence of the Lambs.
While critics have complained that A Beautiful Mind is often more cheery than comprehensive, with long stretches of Nash's depression and a lengthy separation from his wife excised, Nasar said her book was merely the basis for the movie, and Howard did not have to make "a public service announcement."
She added that the film has an essential truth. "There are no villains. There's no abusive father. No screaming wife. No one caused it. That's so sophisticated. For a long time, psychiatrists believed you never did recover. That was an artifact of institutionalizations. That was before drugs. People ended up in hospitals, and they didn't reemerge."
Inspired to refute myths
Howard became fascinated with genius and mental illness several years ago when he got to know Yale Law professor Michael Lauder, who was diagnosed with schizophrenia in his early 20s. (About 1 percent of the U.S. population has been diagnosed with the disease, and men often exhibit symptoms earlier than women.) Lauder credited medications and a personal strategy with the ability to live in concert with his vivid delusions.
"He viewed life as a television screen, and he would move his delusional lives to the corners of the screen, but he would have up to four hallucinations going at the same time," Howard said. "He began to trust what was in the center screen was real."
But Lauder's carefully constructed world fell apart after his father died in 1997 and he went off his medication. The following year he murdered his pregnant fiancee and was sentenced in July 2000 to a psychiatric institution. He was 37 years old.
"I learned a lot through my conversations with him," Howard said. By the time he read Goldsman's screenplay, he was eager to refute pop-culture mythology about the disease.
A trained mathematician, Nash developed the game theory of economics in his 27-page doctoral thesis. But in 1959, when he was 31, he had a complete breakdown. He underwent intensive rounds of insulin shock treatments -- a since-discredited treatment -- and therapy during a five- to eight-month commitment to New Jersey mental institutions. He was released under orders to continue treatments of antipsychotic drugs, but they numbed his senses, his affect and his sexual drive. The cure seemed almost as bad as the disease, and Nash was determined to logically "solve" the problem of his debilitating illness.
He began to ignore the cadre of hallucinations that had run his life for a decade. He worked around them, just as Lauder had.
"I began to intellectually reject some of the delusionally influenced lines of thinking which had been characteristic of my orientation," Nash wrote in a 1994 biographical essay. In the film, Crowe describes the strategy as "a diet of the mind."
Dana Calvo is a reporter for the Los Angeles Times, a Tribune Publishing newspaper.
For more information about schizophrenia:
* NAMI Maryland: md.nami.org; 410-467-7100. The National Alliance for the Mentally Ill is an advocacy group for people with serious mental illnesses and for families of those with mental illnesses.
* www.schizophrenia.com contains a variety of information on schizophrenia. The nonprofit organization acts as an information, education and support network.