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This volume examines the shift toward positive and more accurate portrayals
of mental illness in entertainment media, asking where these succeed and
considering where more needs to be done. With studies that identify and analyze
the characters, viewpoints, and experiences of mental illness across film and
television, it considers the messages conveyed about mental illness and reflects
on how the different texts reflect, reinforce, or challenge sociocultural notions
regarding mental illness. Presenting chapters that explore a range of texts from
film and television, covering a variety of mental health conditions, including
autism, post-traumatic stress disorder (PTSD), depression, and more, this book
will appeal to scholars of sociology, cultural and media studies, and mental health.
Acknowledgments ix
List of tables x
List of contributors xi
Index 212
Acknowledgments
Malynnda wishes to thank Jessica Benham for her ability to inspire and edu-
cate others about neurodiversity. Jessica is doing incredible frontline work and
has forever impacted Malynnda’s life. Christopher wishes to thank his partner,
CarrieLynn D. Reinhard, for her love, support, and assistance throughout the pro-
cess of putting this anthology together. As always, I would not be where I am
today without you, and I am forever grateful to have you by my side. Finally, we
would both like to thank Neil Jordan at Routledge for helping us take this project
from dream to reality.
Tables
Villains in various media have long been portrayed as “mad.” Looking closely at
depictions of the classic villain reveals numerous mental illnesses on display. The
use of characteristics such as wild eyes, unpredictable shifts in behavior, incessant
muttering, or hiding away from people for long periods of time in cold dark caves
invokes fear in the audience as they know what will happen next.
Beyond the media, the medical establishment itself has traditionally focused
on mental illness as one end of a binary concept: a subject is either mentally ill
or mentally healthy (Keyes, 2005). However, a far more nuanced approach to
understanding how mental illness and health interact is necessary, both from a
clinical perspective and from a media representation perspective. Such perspec-
tives are vital given that an individual’s perceptions about any illness or health
condition have tremendous impact not only on their own life but also on the lives
of others. If a person believes that they are at risk for contracting an illness, they
may choose not to engage in a behavior or to seek out preventative options. In the
same way, understanding susceptibility to an illness, or health condition, impacts
an individual’s behaviors. Yet a person’s beliefs and opinions about an illness also
influence how they treat others. Often, when we can see the health condition a
person is facing, feelings of empathy and compassion arise. We open doors for the
girl with a broken leg. We reach out and grab the box on the top shelf for the man
in a wheelchair. However, this is not the case for illnesses or other conditions that
are misunderstood or invisible to the eye.
Illnesses resulting from personal choices (lung cancer, HIV, STIs, and cirrhosis
of the liver) are often met with far less compassion and eagerness to help. Peo-
ple living with conditions that are less talked about or seen in person (alopecia,
vitiligo, and dwarfism) are stared at and/or questioned, if not avoided altogether
for fear of “catching” something. Yet each of these health concerns can often be
treated, explained, and accepted by the general population. For those living with
mental, emotional, and developmental disabilities, however, the ease of treatment,
explanation, or acceptance is far less common.
The fear, stigma, and dehumanization surrounding mental health is partly due
to the complex and often invisible nature of these conditions (Parker, Monteith, &
South, 2020). To those unable or unwilling to understand, a person incapable of
getting out of bed due to depression just seems to be “not trying hard enough.”
2 Malynnda Johnson and Tara Walker
Because of such misconception, onlookers may believe it is possible to just “push
through the sadness” and “get on with life.” However, for the one embedded in
the experience of depression, it may appear there is nothing to push toward and
no light at the end of the tunnel. The thought process for anyone facing a mental
health condition is simply different than those who are not, but this difference
remains largely invisible. There are numerous explanations and possible causes
of mental illnesses or developmental disabilities, including biochemical imbal-
ance, trauma, or genetic and environmental factors. Yet, despite this diversity in
thinking, there is little variance in portrayals and discussions of mental health
and illness.
Perhaps it is because many mental health conditions remain largely invisible
that media depictions are often exaggerated; media representations work to help
audiences visualize an experience that is not always visual. Nevertheless, media
depictions of mental health conditions have historically relied on stereotypes and
misinformation. For example, media often use mental illness as an explanation for
crime and villainous behavior as in many crime dramas and nightly news shows
(McGinty, Webster, Jarlenski, & Barry, 2014; Ma, 2017). Furthermore, Granello
and Gibbs (2016) highlight the importance of terminology: referring to people as
“the mentally ill” has a much more stigmatizing effect than saying “people with
mental illness.” The former associates the person fully with their disorder, while
the latter cites the disorder as just one characteristic that makes up an individual’s
experience. Yet it is not only the words used when discussing mental health that
shape the way people think but also the representations and frames themselves. As
such, people living with, and often struggling with, mental health issues continue
to be stigmatized and therefore avoid seeking help.
Thankfully, throughout the past decade numerous books, movies, and televi-
sion shows have featured characters that offer new and more accurate viewpoints
of mental health lifestyles. These characters often speak openly about the strug-
gles of living with depression, panic attacks, even autism. Each of these characters
and storylines offers audiences the opportunity to see and hear what it feels like to
live with a mind that works differently. As the chapters in this book demonstrate,
while entertainment media still have a long way to go in terms of representation,
significant strides are being taken to provide audiences with a far more realistic
and less dramatized view of mental health. Many of the portrayals discussed in
the chapters that follow offer complex and nuanced characters that have populated
the screen more recently. These characters illustrate to audiences that people cop-
ing with mental, emotional, and/or developmental disabilities need not be labeled
“mentally ill.”
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Trauma & Dissociation, 5(2), 61–87. https://doi.org/10.1300/J229v05n02_04
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in health news stories. Journal of health communication, 16(9), 941-954. https://doi.org/
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Cook, P. (2007). The cinema book. British Film Institute.
Corrigan, P. W., Powell, K. J., & Michaels, P. J. (2013). The effects of news stories on the
stigma of mental illness. The Journal of Nervous and Mental Disease, 201(3), 179–182.
https://doi.org/10.1097/nmd.0b013e3182848c24
Davidson, J. (2017, January 20). More than 20,000 people are boycotting “Split” for
the way it portrays mental illness. The Mighty. Retrieved from https://themighty.
com/2017/01/m-night-shyamalans-split-boycotted-for-mental-illness-portrayal/
Derrick, J. L., Gabriel, S., & Hugenberg, K. (2009). Social surrogacy: How favored tel-
evision programs provide the experience of belonging. Journal of Experimental Social
Psychology, 45(2), 352–362. https://doi.org/10.1016/j.jesp.2008.12.003
Entman, R. (1993). Framing: Toward clarification of a fractured paradigm. Journal of
Communication, 43(4), 51–58. https://doi.org/10.1111/j.1460-2466.1993.tb01304.x
Gerbner, G., & Gross, L. (1976). Living with television: The violence profile. Journal of
Communication, 26(2), 173–199. https://doi.org/10.1111/j.1460-2466.1976.tb01397.x
Gilman, S. (1988). Disease and representation: Images of illness from madness to AIDS.
Cornell University Press.
Goodwin, J. (2014). The horror of stigma: Psychosis and mental health care environments
in twenty-first-century horror film (part II). Perspectives in psychiatric care, 50(4), 224–
234. https://doi.org/10.1111/ppc.12044
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Goffman, E. (1974). Frame analysis: An essay on the organization of experience. North-
eastern University Press.
Goodwin, J., & Tajjudin, I. (2016). “What do you think I am? Crazy?”: The Joker and
stigmatizing representations of mental ill-health. The Journal of Popular Culture, 49(2),
385–402. https://doi.org/10.1111/jpcu.12402
Granello, D. H., & Gibbs, T. A. (2016). The power of language and labels: “The mentally
ill” versus “people with mental illnesses.” Journal of Counseling and Development,
94(1), 31–40. https://doi.org/10.1002/jcad.12059
Harper, S. (2009) Madness, power and the media. Palgrave Macmillan.
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2 “Remember what Dr. Lopez said”
Portrayals of mental health care in
Nickelodeon’s The Loud House
Jerralyn Moudry
“Making the Case” Clyde Clyde calls Dr. Lopez from a cell phone
(S1E2) and says, “Hello Dr. Lopez, I know that
I am not supposed to call you at home,
but it is a Lori emergency.”
“Overnight Harold and Harold tells Howard, “. . . remember what
Success” Howard Dr. Lopez said about letting go. Now
(S1E12) let go.”
“Two Boys and a Clyde and Lincoln While babysitting Lincoln’s baby
Baby” sister, Clyde applies the lessons in
(S1E15) child-rearing that he learned from the
(fictional) books Food for Tots, Oopsie,
My Baby Made a Poopsie, NapQuest,
The Impossible Journey, and Take a
Walk on the Child Side while waiting in
Dr. Lopez’ waiting room.
“Save the Date” Clyde Clyde calls Dr. Lopez at home and leaves
(S1E16) a message saying that he knows he
is not supposed to call but it is an
emergency.
“11 Louds a Harold and “Now Howie, you remember what
Leapin’” Howard Dr. Lopez said about . . . Oh forget
(S2E2) Dr. Lopez. This is the most wonderful
thing I’ve ever seen.”
“Brawl in the Clyde and Lincoln Clyde models a therapy session
Family” interviewing Lincoln about his sisters’
(S2E3) fighting.
“The Whole Clyde and Lincoln Clyde quotes Dr. Lopez: “The first step
Picture” in healing is to honor your feelings”;
(S2E5) although the boys ignore this and go
straight to “Denial; that is actually a
step backward.”
“Making the Clyde Clyde is forced to move to a different seat
Grade” in the classroom and calls Dr. Lopez
(S2E6) asking, “Dr. Lopez. Do you have any
openings this week? I’m having trouble
accepting change again.”
“Out of the Picture” Clyde and Coach Clyde models a therapy session
(S2E12) interviewing his coach and helping him
resolve childhood issues.
“Back Out There” Clyde, Lincoln, Clyde tries to help Lincoln get over the
(S2E13) and a group of 3 fact that the girl that Lincoln liked has
friends moved away using advice gleaned from
reading pamphlets (with titles, such
as Shame Theory, Not Guilty, and Am
I Misunderstood?) about PBB, Post
Breakup Blues while in Dr. Lopez’s
waiting room.
“Remember what Dr. Lopez said” 15
(Continued)
16 Jerralyn Moudry
Table 2.1 (Continued)
fainting and he frequently idealizes being a “man’s man,” even though the boys
usually learn a more nuanced lesson about masculinity in the end (Sales, 2019).
One might argue that Clyde’s portrayal as a secondary character would decrease
the impact of his perspectives. However, he appears frequently, and as can be seen
in Table 2.1 the other characters treat his relationship with Dr. Lopez and her
advice with such sincerity and pragmatism that the message is quite powerful.
Lincoln is shown frequently taking advice from Dr. Lopez through Clyde, who
talks about how useful therapy is, and even interacts with Dr. Lopez on the phone
to solicit help for Clyde in one episode. The following sections delve into how
this content can reduce the stigma of mental health care and model modes and
methods of therapy.
Public stigma
Corrigan and Watson (2002) define public stigma as the way that the general
population negatively reacts to mental illness. They describe that the general pub-
lic often holds stigmatizing perspectives that mentally ill individuals are danger-
ous or incompetent and should, therefore, be feared or avoided. This leads to
peer group stigmatization for both adults and youth (Corrigan & Shapiro, 2010;
“Remember what Dr. Lopez said” 17
Goffman, 1963; Heary, Hennessy, Swords, & Corrigan, 2017). Studies reveal that
negative attitudes about mental health treatment are prevalent among youth, with
young male adults holding the most negative attitudes of all demographic groups
(González, Alegría, & Prihoda, 2005). Thus, it is important that the subject of the
portrayals of therapeutic care in The Loud House is a preteen male. Socialization
theory regarding norms in general and in health practice specifically predicts that
positive portrayals in very popular children’s programs should lead to a percep-
tion that these behaviors are “normal” and beneficial (Signorielli, 1990).
When Clyde interacts with friends and family, he often unashamedly applies
psychological advice from his therapy sessions. For example, after fighting with
Lincoln, Clyde tells the Loud sisters that, “I should go and make up with him. Dr.
Lopez taught me a lot about conflict resolution” (“Overnight Success,” S1E12).
Dr. Lopez is also quoted as having advice on healing: “The first step in healing is
to honor your feelings” (“The Whole Picture,” S2E5); making mistakes: “Every
‘Uh Oh’ is a Chance to Grow” (“What Wood Lincoln Do?”, S3E13); and not
dwelling on the past: “[Clyde] can’t move forward if [he is] always looking in the
rearview mirror” (“Deal Me Out,” S3E10).
In the episode “Back Out There” (S2E13), Clyde takes the lead and guides a
group comprised of Lincoln plus three of their male friends from school in an all-
day mental health improvement outing to try help Lincoln get over the fact that
the girl that Lincoln liked has moved away. Through multiple venues the boys
use advice gleaned from reading pamphlets with titles such as Shame Theory, Not
Guilty, PBB, Post Breakup Blues, and Am I Misunderstood? while in Dr. Lopez’s
waiting room. The boys all listen to and support their application of different
therapeutic methods.
Additionally, one of the most subtle but significant examples of how the pro-
gram’s tone proves beneficial is found in an episode in which Dr. Lopez is not
mentioned by name. In “Lynner Takes All” (S2E19), Lincoln’s competitive ath-
letic sister asks, “Hey, I was just wondering. Do you guys know of any good
therapists?” In the story, she is baiting her siblings because she says they will need
a therapist to deal with losing to her. However, Lincoln matter-of-factly replies
“Well, Clyde recommends . . .” before Lynn cuts him off. Although her name is
cut off, Lincoln’s tone of voice clearly indicates that he sees Dr. Lopez as a valu-
able therapist and is unashamed to publicly recommend her.
Hinshaw (2005) argues that to decrease stigmatization, one thing that the media
needs to do is increase “promotion of poignant and realistic disclosures by chil-
dren and families who deal with mental illness on a daily basis” (p. 729). These
positive portrayals from The Loud House have the potential to increase the will-
ingness of children to attend psychotherapy and provide a positive model for how
friends of youth who utilize mental health care and are supportive of their peers.
Self-stigma
Stigmatization directed at individuals by others is often the only type that is con-
sidered, but Corrigan and Watson (2002) emphasize that when individuals with
a mental illness live in a society that stigmatizes them, they can “turn against
18 Jerralyn Moudry
themselves” (p. 16) and hold prejudiced viewpoints about their own identities.
They explain that these can include diminished self-esteem/self-efficacy, right-
eous anger, or relative indifference. To help mitigate a sense of low self-efficacy,
individuals need to see themselves as capable, powerful, and competent.
One way that The Loud House portrays Clyde as powerful is that he is shown to
be in control of his therapeutic care. Clyde himself calls Dr. Lopez in five of the
episodes. For example, in “Making the Grade” (S2E6), Clyde is forced to move
to a different seat in the classroom farther from Lincoln. He then calls Dr. Lopez
from the 5th grade classroom and asks, “Dr. Lopez. Do you have any openings
this week? I’m having trouble accepting change again.” Later, when he is plan-
ning to go to a haunted house, he attempts to call Dr. Lopez but only gets voice-
mail (“Jeers for Fears,” S3E20a). A running joke of the series is that Dr. Lopez is
often unavailable when Clyde calls, and this is most often due to the fact that he
calls at inappropriate times, as in “Making the Case” (S1E2), when he calls and
says, “Hello Dr. Lopez, I know that I am not supposed to call you at home, but it
is a Lori emergency”; “Save the Date” (S1E16), when he calls Dr. Lopez outside
of office hours; and “Predict Ability” (S3E23), when Clyde sneaks out of class to
call Dr. Lopez stating, “I know you are in Aruba, but I am really starting to spiral
right now.” Although these calls are often played for humorous effect, they do
show a child powerfully requesting care, even against the rules of an authority
figure, when he needs it.
Clyde powerfully conveys belief in the efficacy of his therapy sessions and is
willing to share it with anyone and in any situation. Another example of a scene
that has subtle but significant impact is found in “Tea Tale Heart” (S3E20b), Lin-
coln’s sister, Lola, asks him why he is not hanging out with Clyde and he responds
that “Clyde’s at his weekly therapy appointment. He invited me, but . . .” before
being interrupted. Clyde is so confident in sharing his mental illness and mental
health care that he even invites his friend to participate.
Hinshaw argues that to reduce stigmatization “compassion [must] replace
blame and silence” (p. 730). Children who currently visit a therapist can see on
The Loud House a child who confidently manages his care and shares it with oth-
ers. Ideally, this will reduce any feelings of indifference, low self-esteem, or lack
of self-efficacy.
Children’s television content is often critiqued for doing harm and leading to
violence and other antisocial behaviors in the youth who view the programs, but
research has shown that television’s potential for pro-social messages is equally as
powerful (Mares & Woodard, 2005). In The Loud House, Clyde, his friends, and
his parents often endorse therapy in general and Dr. Lopez specifically. Research
indicates that children aged 6–12 inhabit a unique developmental phase for gain-
ing an interpretive understanding of the mind (Hansen Lagatutta et al., 2015), so
these lessons in psychology are fitting. This is the phase in which children form
their understanding of the motivation of others, the reasons for their emotions,
and the diversity between people. Programs such as The Loud House that provide
accurate instruction to youth about psychological constructs at this age are power-
ful in helping frame their future relationships.
“Remember what Dr. Lopez said” 19
Modeling modes and methods of psychotherapy
Negative perceptions of mental health services constitute a significant barrier to
accessing and utilizing mental health care (González et al., 2005; Owens, Hoag-
wood, Kellam, & Ialongo, 2002). While The Loud House never actually shows
Dr. Lopez, the audience builds a relationship with her and her advice, and the
message about psychotherapy is that it is valuable and applicable. In addition to
the potential, the positive tone of the content has for reducing the stigma of men-
tal illness and mental health care, a second theme found in the content is more
pragmatic: the show models how therapy is conducted. This is impactful in many
ways, but the two that will be highlighted here are modeling therapeutic sessions
and family involvement in therapy.
While individual therapy is most common and usually combined with whole fam-
ily therapy (WFT), research does show that WFT “affords the best understanding
of the system involved in a given problem . . . helps members solve problems by
releasing the family’s own underutilized resources . . . [and] builds family resil-
iency” (Breunlin & Jacobsen, 2014). In addition to normalizing Clyde’s therapy
with Dr. Lopez, The Loud House also indicates that his parents attend therapy
individually with Dr. Lopez and that they attend as a family.
At least one of Clyde’s fathers is portrayed in seven of the episodes, and in four
of those (57%) Dr. Lopez is mentioned. Clyde and his parents endorse and apply
therapy in “Snow Way Down” (S2E26), in which Lincoln, Clyde, and Clyde’s
dads travel to a cabin in the snowy mountains. The parents engage in over-the-
top protective practices (e.g., bubble wrapping Clyde, cooling his hot chocolate),
prompting Clyde to tell them that they must let him grow up:
Although this interaction does not lead to a whole-family session, the parents and
child are all given a voice in therapeutic decisions and discuss how best to apply
the advice that they have been given in the past.
Clyde’s parents also discuss advice Dr. Lopez gives them on parenting. In
“Overnight Success” (S1E12), Harold tells Howard, “Remember what Dr. Lopez
said about letting go. Now let go.” Howard is then able to let Clyde sleep over at
Lincoln’s house. They also seek her advice in “ARGGH! You for Real” (S2E17),
when Clyde worries that everyone lies to him and his parents feel he is “having
an episode.” Howard runs off crying saying, “That’s it, I’m calling Dr. Lopez.”
In addition to portraying the importance of whole-family therapeutic interven-
tion, in these portrayals Clyde is respectful of his parents and their time com-
municating with each other in and about visits to Dr. Lopez. These depictions
model open communication for the youth in the audience. Harold is also shown
respecting Clyde’s input and wishes, which is essential to a child’s acceptance and
compliance with medical care.
Conclusion
The Loud House provides an example of how a modern children’s cartoon can portray
seeing a therapist and applying her advice as commonplace and provide the children
who view the show the opportunity to understand mental illness and mental health
care through a positive lens. Clyde’s overt acceptance of Dr. Lopez and “Therapy
Thursday” (“Game Boys,” S3E17) is integrated into his life choices and interactions
with others and is a welcome break from past portrayals of mentally ill people in chil-
dren’s programs as rare, negative, untreated, and open to ridicule (Wahl et al., 2007).
Public and self-stigmatization are two of the greatest challenges facing the
mentally ill and a substantial barrier to participation in mental health treatment
(Corrigan, 2004; Corrigan & Watson, 2002). The Loud House facilitates overcom-
ing public stigmatization by depicting a middle school-aged boy who is open and
unashamed about receiving therapy, discusses and applies therapeutic strategies
with his male friends, and recommends his therapist to others. Additionally, it
helps reduce self-stigmatization in that Clyde is depicted having good self-esteem
and self-efficacy while in control of his care.
Additionally, the program models positive practices in psychotherapy includ-
ing WFT and therapeutic listening sessions. These can positively influence youth
by preparing them for and supporting them through their mental health care and
maintenance. In “Brawl in the Family” (S2E3), Clyde says, “When I take my
problems to Dr. Lopez, this is how she helps me.” More children’s programming
should aspire to this type of constructive portrayal of mental health care.
22 Jerralyn Moudry
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3 “And I suffer from short-term
memory loss”
Understanding presentations of
mental health in Pixar’s Finding
Nemo and Finding Dory through
communication theory of identity
Hayley T. Markovich
Method
Klinger (1997) proposed a new addition to the academic area of reception stud-
ies called histoire totale, or total history, which aims to put the film(s) studied in
larger cultural contexts. This is accomplished in either a synchronic or diachronic
method. A synchronic focus believes the object of interest has multiple histo-
ries. Specifically, this is studied in three zones: cinematic practices, intertextual
zones, and the social and historical contexts (Klinger, 1997). Cinematic practices
are “primarily all of the practices associated with film production, distribution
and exhibition that shape the film the audience finally sees” (Klinger, 1997,
p. 115). Intertextual zones are focused on the influences between film and prac-
tices outside the film industry in other media and businesses. Lastly, the social and
historical context looks at the social processes that can impact what a film means
publicly. Diachronic studies look at the film’s total life span through revivals and
retrospectives, reviews, academic theory, criticism and history, television, video
and laserdisc reproduction, fan culture, biographical legend, and cross-cultural
reception (Klinger, 1997). While not the only way to study film, total history pro-
vides a way of engaging with the film to understand its role as a cultural object.
Cultural texts, such as films, are inherently polysemic resulting in multiple
meanings. As such, this study will employ Klinger (1997)’s diachronic total
history. Under total history, there are three zones: (1) cinematic practices, (2)
intertextual zones, and (3) social and historical contexts. These zones were
explored through applying Hecht’s CTI to provide a more detailed understand-
ing of how Finding Nemo and Finding Dory depict neurodiversity through the
character of Dory.
To complete this study, the author watched and transcribed each of the two
films, specifically looking for instances in which Dory’s lived mental health expe-
riences were present in the films. The bonus feature content on both the DVD
and Blu-ray discs was also watched and transcribed for moments that focused on
28 Hayley T. Markovich
Dory’s character and specifically her mental health. To better understand the films
and their reception, the author also collected reviews from major newspapers and
YouTube videos reviewing the films. The videos were found by searching the
terms “Finding Dory Reviews Verified” on YouTube. Videos were included for
this part of the analysis if they came from verified channels on the platform.
The analysis focused on the four levels of Hecht’s CTI. After watching the
films and the bonus features and reading through the reviews and watching the
review videos, the author coded the data by highlighting the transcripts and cat-
egorizing them into the four levels of CTI they corresponded to.
Results
Instances in the films were found to correspond to all four levels of CTI. The indi-
vidual, relational, and enacted levels were present in the films themselves. The
communal level was found in the bonus features and film reviews.
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