I attended my first counseling session at 21. I was newly married, starting my Clinical Mental Health Graduate Program and life was just not going as I planned. I loved my graduate program, and loved my partner very much, however I felt like I could not escape my anxiety enough to feel any of this joy. I was experiencing chronic anxiety, suffering from constant thoughts and fears of something happening to my family, and because of this I was barely sleeping at night and experiencing crying fits. It was a really hard time for me and I thought maybe it’s time I seek counseling. I was hesitant at first due to cost and/or time restraints. I was afraid that people would say I was, “crazy,” if I let it slip that I had mental health concerns, or that future jobs, if they somehow discovered I was in counseling, would think I was unstable. Obviously I have grown a lot since that time, and now openly talk about my counseling experiences and encourage all my friends and family members to seek counseling as well. However, I still find it interesting that, even as a beginning graduate student in mental health, I still held all these negative stereotypes about mental health. I have spent much time wondering where these ideas came from, and have recently come to the conclusion that a lot of these stereotypes have been learned from media and movies, particularly horror movies. 

A brief horror movie history

In a previous blog installment (read here) I sang the praises of horror movies, discussing how they can help mental health and anxiety. I am dedicated, however, to accurately discussing horror movies, and can recognize the harm they have done to mental health communities. I am about to walk you through a brief(ish) history of mental health depiction in horror movies to give you a better understanding of the systemic nature of this issue. On this note, I am going to be talking about a lot of movies, and therefore a SPOILER WARNING is now in effect.  If concerned about movie endings being ruined, go ahead and skip to the next subheading. With that out of the way, let’s buckle up and get ready for a tour of horror by someone who has seen way too many movies. 

The stereotype depicted in horror movies about mental health dates back to the 1920s, with the German movie, The Cabinet of Dr. Caligari. This movie depicts a mad scientist who is attacking people and a heroic protagonist who is trying to stop him and save the day. As always, there is a twist ending and we realize that our protagonist is actually an inmate at an asylum, and imagining the whole plot of the movie. This was the first movie to set the standard that those who have mental health concerns are untrustworthy and have violent fantasies, and set a trope that has been repeated various times throughout the past century. This same idea has been repeated in movies such as Shutter Island, Memento, and Donnie Darko

Moving forward in the timeline to 1960, we see another troupe start to emerge – the use of dissociative identity disorder (DID; often sensationalized and called, “multiple personality disorder,” in media) as the disorder of choice in horror movies. We can trace this stereotype back to the father of slasher movies, Alfred Hitchcock’s Psych. In Psycho, we meet Norman Bates, a meek motel owner who has a troubling relationship with his mother, who seems to be a killer. As with many horror movies, there is a twist at the end, and we discover Norman Bates is actually his mother, and has been dressing up as his mother to commit multiple murders. The movie Psycho, from a modern lens, has a lot wrong with it, including damaging depictions and outdated notions of gender identities. Furthermore, it also started the troupe that those with DID are dangerous, violent, and bound to become killers. This simply isn’t true – DID is a heartbreaking diagnosis that stems from immense trauma and suffering. It is a serious diagnosis that can lead to depression, self harm, and suicide. Statistically, those with DID are more a danger to themself than anyone else, with 72% of those with DID having attempted suicide at some point. Although these are the facts of the situation, Psycho has started a troubling trend where horror movies use DID as a reason for violent behavior, and depicts those struggling with DID as dangerous. This can be seen in more modern movies as well, including Split (2016), Hide and Seek (2005), Secret Window (2004), and many, many, more. 

Another stereotype related to mental health that is important to mention is related to a particular group of people – those who are 50+. In horror movies elderly folks, especially those experiencing mental health concerns that come with old age (such as confusion, Alzheimer’s, and Dementia), are violent, dangerous, and scary simply because of their age. There are various movies guilty for perpetuating this stereotype. Including The Taking of Deborah Logan (2014) and The Amusement Park (1973). The most egregious example of this is the 2015 film The Visit. In this movie, two children go to visit their grandparents and soon find out their grandparents are not who they say they are and are dangerous people. The grandparents in this movie are depicted as having mental health concerns related to old age, as well as maybe Schizophrenia, and are shown abusing and attempting to kill the children. The movie confirms the stereotype that the elderly are dangerous, and was even listed as the worst depiction of mental illness in any movie by the mental health advocacy organization Resources to Recovery. 

There are more stereotypes about mental health concerns depicted in horror movies  than I can list here without making this blog into a thesis.  However, what is important to note is that, regardless of the horror movie, the story is usually the same – those with mental health concerns are dangerous, untrustworthy, violent, and should be avoided at all costs. This depiction of those who are seeking help for mental health concerns has impacted all of us, and have led many of us (myself included)  to be afraid to seek help. 

Replacing Stereotypes 

At this point, I hope I have you a bit worked up at the injustice of how mental health has been depicted in horror movies. You might be at the point of wanting to scream, “Just stop depicting mental health in horror movies!” This is a natural reaction, however maybe not the best course of action for solving the problem. Think of it this way – a persistent problem in movies is the stereotypical depiction of women. The answer is not and was not to stop having women in movies – instead, it was to develop female characters that were more well rounded, more realistic, and more human. The same is true for depictions of those with mental health concerns. Of course, it is progress to have it where not every villain in horror movies are those with mental health concerns. However, it is just as important for horror movies to show realistic and accurate depictions of mental health, so that this population does not become ignored. If you haven’t figured it out by now, I have seen a lot of horror movies. Below I have listed some of my favorite horror movies that either don’t include mental health or, if they do, (I feel) have a realistic representation of it. As always, PLEASE look up these movies and their trigger warning before watching them – just because there aren’t stereotypical descriptions of mental health in these movies doesn’t mean that there aren’t other elements that some audiences may find triggering. Check out, “Does the Dog Die,”  (https://www.doesthedogdie.com/) for a list of movies and their triggers. Neither I nor Hey Emma endorse the views expressed in these movies. 

 

  1. Fear Street Series (2021) – no mental health depictions, Rated R
  2. A Quiet Place (2018) – no mental health depictions, Rated PG-13
  3. Scary Stories to Tell in the Dark (2019) – brief mental health depictions, Rated PG-13
  4. M3GAN (2022) – depictions of grief and childhood trauma, Rated PG-13
  5. The Babadook (2014) – depictions of depression, grief, anxiety, Not Rated
  6. Oculus (2013) – depictions of childhood trauma and unprocessed grief, Rated R 
  7. The Night House (2020) – depictions of grief, depression, and suicide, Rated R
  8. Buffy the Vampire Slayer (1992) – no mental health depictions, Rated PG – 13
  9. Poltergeist (1982) – no mental health depictions, Rated PG-13
  10. Insidious (2010) – no mental health depictions, Rated PG-13 
Overcoming Stigma

What movies, including horror movies, have done to mental health communities is unforgivable. However, now is our chance to change how the public sees mental health and change the narrative. Part of how we do that is choose to watch movies that don’t depict mental health this way, sending a message to creators that this is not what we want. Another way we do this is to overcome the stigma, and seek help from a professional counselor when we need it. 

A lot of times, when you first attend counseling, there are alot of emotions and questions flooding through your head. You may be scared, anxious, insecure, but also slightly excited and hopeful. You might be thinking, “What are they going to ask me?” “Are they going to ask me to recount traumatic memories in this first session?” “Are they going to judge me for what I say?” “Are they going to think I am crazy?” Some of my favorite clients that I see are first time counseling attendees – I love helping to quiet some of these racing thoughts and soothe some of these emotions. If your first session in counseling happens at Hey Emma, the first session will look fairly similar regardless of which of our wonderful counselors you see. We will start by going through informed consent. In informed consent, we will discuss the length of session, when we charge for session, cancellation policies, and confidentiality and its limitations.  Then, we will tell you a little bit about Hey Emma, including our mission statement and vision. From there, we will describe what the counseling process looks like, and what to expect from the next few sessions. During this process, the floor will be open for any and all questions you have. Once the technical aspects are discussed fully, we turn the session over to you and what you want to discuss. Some common elements we may discuss include timing (Why is now the right time to seek therapy?),  your experiences to date, and what your feelings about counseling are. 

As a person centered therapist, my main goal for the first session is to validate your experiences, gain an understanding of you and your story, and begin building our relationship as counselor and client. There is no pressure in this first session (or in counseling in general) – we just want to get to know you as a person, and you only have to share as much as you are comfortable with.