Script(ing) treatment: representations of recovery from addiction in Hollywood film doc

Contemporary Drug Problems 32/Fall 2005 467 Script(ing) treatment: representations of recovery from addiction in Hollywood film BY CURT HERSEY American films and television programs increasingly feature characters recovering from addiction. These representations are based on previous depictions and help create a cultural understanding of addicts. This study analyzes the depiction of addicts and addiction in three Hollywood films whose narratives are largely situated within a treatment center: Clean and Sober (1988), When a Man Loves a Woman (1994), and 28 Days (2000). It concludes that the films depict a stock experience of treatment that is surprisingly univocal, as well as unrealistic when compared with the availability and realities of real-life programs. In addition, the films limit their representations of successful recovery to white, upper-class individuals and offer only one conceptual framework for addiction. KEY WORDS: Addiction, film, recovery, treatment, representation. AUTHOR'S NOTE: / would like to thank Dr. Ted Friedman, Dr. Robin Room, Karen Hersey, and the journal reviewers for their suggestions and comments on this article. © 2005 by Federal Legal Publications, Inc. 468 SCRIPT(ING) TREATMENT Addiction and recovery have been topics of Hollywood films and movies of the week and are increasingly integrated into mainstream television shows through the inclusion of addicted characters. Now the producers of reality shows have entered the field with the new American television show Intervention, on the A&E channel. Intervention follows addicts (broadly defined to include substance abuse, as well as shopping and other addictive behaviors) through the progression of their addiction, and then confronts them with a choice between treatment or expulsion from the lives of their loved ones. Although there are myriad possible moral and clinical objections to such a show. Intervention seems to be the next step in a growing wave of media products using addiction and recovery as plot devices. Several recent American television shows, such as The Sopranos, Dawson's Creek, and Law and Order, include central characters seeking recovery from substance abuse through clinical treatment and support groups. Although new to the small screen, such television story lines tap into a narrative about institutional treatment that has been developing in Hollywood for the past several decades. Addiction has appeared on the movie screen since Edison's earliest films (Starks, 1982); however, the now familiar images of modem institutional treatment did not appear until the late 1980s. After a decade of American cultural backlash against addicts and drug treatment during the years of the Reagan administration, public opinion seemed to shift throughout the 1990s toward encouraging people with substance-abuse problems to get help (White, 1998). Since that time, Hollywood has released several works with narratives focused on institutional treatment of addiction. Through their representations of addicts, substance abuse, treatment centers and the experience of recovery, these films help construct for their audiences a common cultural understanding of addiction. They can be viewed as a discourse in a Foucaultian sense—creating meaning and marking off the boundaries of how filmgoers should view and understand treatment. 469 The representation of drug treatment in America can affect society in several ways, including stigmatization. Elizabeth Hirschman (1992), in her study of cocaine use in films, argues that "motion pictures which focus upon addiction can serve as instructive, semiotically-rich texts for communicating cultural knowledge about addiction" (p. 428). This communication is not simply one-way, though; it exists as a continual feedback loop, with movies "both reflect[ing] and shape[ing] individual and societal values, attitudes, and behavior" (Wedding, 2000, p. 3). Thus representations from cinema can become received knowledge, which is incorporated into societal views. These shifts may then be mirrored and reinforced in subsequent movies. Obviously, films are no "magic bullet" with the power to instantly change public perceptions and beliefs; however, as a part of the culture industry, Hollywood does participate in teaching us about ourselves. Films can speak to society as a whole, but they can also be instructive for individual groups. Previous research found that movies featuring substance abuse provide a strong point of identification for addicts (Hirschman & McGriff, 1995; Lalander, 2002). Films are part of a learning process about addiction, and the movie screen might be one of the few places where addicts can see their filmic counterparts receiving help. This study compares the depicted reality the films present to audiences with previous addiction cinema and with real-world economic and cultural conditions. Since films privilege certain viewpoints through representational strategies and by leaving out alternatives, I also examine the ideologies of the films and issues of textual silence. The study offers a critique of these issues in the spirit of other well-known ideological film studies, such as Ryan and Kellner's (1988) Camera Politica. In this article, I conduct a critical discourse/ideological analysis of the three major Hollywood films released since the 1980s that feature treatment as a major part of their 470 SCRIPT(ING) TREATMENT narratives. After researching literature on addiction and film, I chose the films for the study and viewed each one many times, specifically looking for socioeconomic representations of characters, treatment of different races, sexes, and sexual preferences, methods of production as they relate to addicted characters and drug usage, and the depiction of treatment/ self-help groups. I then outlined the narrative of each film and compared the uses and meanings brought to addicts, addiction, and substances. I found that these movies construct a fairly unified image of treatment. In the films, 12-step- based substance abuse treatment is readily available to middle-class, non-minority addicts. The economic realities of treatment are ignored, as are alternative paths to recovery. Minority addicts are similarly disregarded or stereotyped. Previous treatment film research During the late 1970s, some film scholars and researchers involved in social, scientific and medical research of alcoholism began studying the ideological implications of alcohol and alcoholics in film. A 1978 conference sponsored by the British Film Institute generated several papers about the representation of movie alcoholics, including the only study devoted to examining the depiction of treatment. In his paper, Bruce Ritson (1979) writes: "If I were worried that I was becoming an alcoholic and decided to seek help on the basis of the films about alcoholism which I had seen, I would know that I must avoid hospital[s] at all costs" (p. 51). He discusses how most movies ignore treatment altogether, but those that do, feature "a blur of needles, burly attendants, locked doors and terrifying screams" (p. 51). No further research on treatment depictions in film has been published since that time. When combined with the more general literature on addiction in films, Ritson's analysis provides a good starting point to question whether certain ideologies continue to appear in 471 substance-abuse cinema, and how recent treatment films rework older concepts. Much of this previous research specifically centered on alcoholism; however, modern treatment facilities and psychiatric models tend to focus less on particular substances and group them all under the heading "addiction" (White, 1998). I adopt the same language and use "addiction" in place of substance-specific terms. Treatment films Although many Hollywood films include depictions of addicts and addiction, only three recent movies have devoted considerable screen time to depicting substance-abuse treatment: Clean and Sober (1989), When a Man Loves a Woman (1994) and 28 Days (2000). The structure and plot of these films share a common debt to earlier movies about alcoholism. Denzin (1991) has labeled the mid-1940s to early 1960s the "classic" period of Hollywood alcoholism films. Bracketed by The Lost Weekend (1945) and Days of Wine and Roses (1962), this era also corresponds to the height of the social-realism movement. Social-problem films fell out of favor in Hollywood, but they found a home with the oft-maligned "made for TV" movie during the 1970s and 1980s. Although alcohol continued to appear in major film releases, "excessive drinking was not automatically connected to the problems that appeared in drinkers' lives" (p. 129). Addiction was no longer the focus, merely a subplot. The only major American motion pictures addressing substance abuse during the 1970s were either comedies, such as Cheech and Chong vehicles, or biographical stories like Lady Sings the Blues (1972). The 1980s signaled a return to the representation of addiction within a social-realist framework with Clean and Sober. The film follows an addict from drug abuse to treatment and back into society, with over half of the film occurring within a treatment facility. Since the release of Clean and Sober, many other movies have included characters entering treatment. 472 SCRIPT(ING) TREATMENT trying to quit using, or seeking out self-help groups; however, only two other films also include extended depictions of life inside a treatment facility and the methods used to get addicts clean: When a Man Loves a Woman (1994) and 28 Days (2000). These three movies present surprisingly similar narratives about drug treatment. Taken together, the films create a depicted reality of treatment for viewers who have never struggled with substance abuse or known addicts seeking help. In Clean and Sober, Daryl (Michael Keaton) is a real-estate broker who is unable to give up cocaine and alcohol. After embezzling company money and becoming implicated in a woman's overdose, Daryl checks into a treatment center to hide. While in treatment, he tries to get drugs and romantically pursues another patient named Charlie (Kathy Baker). After they are released from treatment, Charlie dies in a car wreck as she is trying to snort cocaine. The film ends with Daryl speaking in front of an Alcoholics Anonymous (AA) meeting. When a Man Loves a Woman chronicles the destruction addiction visits upon a family. Alice (Meg Ryan) and Michael (Andy Garcia) seem to be the perfect upper-middle-class couple, but Alice clearly drinks too much. While intoxicated, Alice hits her oldest child, Jess (Tina Majorino). She agrees to enter treatment and slowly begins to get her life back together. Michael finds it difficult to accept his wife's new friends and way of life, and he moves out. The film closes with Alice speaking at an AA meeting; Michael emerges from the crowd and they reconcile. In 28 Days, Gwen (Sandra Bullock) is a party girl who is unable to stop partying. She steals a limousine at her sister's wedding and drives it into a house. Subsequently she is court- ordered to enter a treatment program, where she rejects the feel- good camaraderie of the facility. However, after some initial escapes and drug episodes involving her boyfriend, Jasper 473 (Dominic West), Gwen begins to participate seriously in the activities at the treatment center. Once she is released, Gwen chooses to leave Jasper in order to pursue her new way of life. Representations of addicts I have divided my analysis into two main categories. First I examine how these films represent addicts and addiction, and what these representations suggest. I then discuss how treatment is depicted in the films, and analyze and compare their constructed reality with the real-world treatment field. The question of how addicts are portrayed is central to understanding the ideological positioning of addiction within these films. It is also instructive to compare these representations with earlier films to see how certain ideas reappear or become reworked by newer filmmakers. The familiar devices of the addict "hitting a bottom" and seeking out help remain. Likewise, the addicts who seek treatment in these newer movies continue to be upper-middle-class and white, as in the classical films. As we shall see, one of the major shifts between the classical Hollywood approach and contemporary approaches is a lessening of the stigma of using substances and being an addict. Like all cultural products, films traffic in stereotypes. Filmmakers develop and borrow easily recognizable "shorthand" devices that stand in for complex cultures and segments of society. Problems develop when these representations are seen as absolute, already existing boundaries that define a larger whole (Dyer, 1979). Such stereotypes also work to mask the power struggles lying behind all such naming and representational activities. Cape (2003) identifies four stereotypes of addicts appearing in drug cinema. All the main characters in these subject films fall within his "tragic hero" mold: a flawed yet "likeable, readily identifiable character" (p. 168). Many of the stereotypical 474 SCRIPT(ING) TREATMENT qualities identified in other substance-abuse cinema research also appear in treatment movies; however, representations within these three films do show some signs of departure, especially in their depiction of female addicts. I return to a discussion of gender within these films later. Films in the first half of the 20th century, as well as those in the 1970s and 1980s, often associate alcoholism with so- called creative professions, such as writing, acting, etc. (Room, 1989; Denzin, 1991). By the late 1980s, substance abuse on the screen diversified to include other walks of life, including portrayals from inside the world of corporate America and from the inner cities. The addicts in the films included in this study, like those in earlier movies, begin their stories firmly entrenched in an appealing, upper-middle-class lifestyle. In Clean and Sober, Daryl is a real-estate broker who works for a large company and makes very lucrative deals. In When a Man Loves a Woman, although Alice is a teacher (a profession not commonly associated with a glamorous life), she and Michael have a roomy, upscale townhouse in San Francisco and go on vacation in Mexico. 28 Days, by contrast, never mentions whether Gwen has a job. Her apartment is not especially luxurious; however, the film begins with her partying in a posh club. Although these films may present a less glamorous lifestyle than 1980s cocaine films such as Less Than Zero (1987), these addicts are still financially well off and living attractive lives prior to "hitting their bottom." They all have financial and social resources that prevent too hard a fall from their normal life of privilege. There are no scenes of living on the street or the desperation associated with the continual hunt for substances. These are most assuredly "upper-class addicts." In her comparison of 1920s and 1960s alcoholism films. Herd (1986) found that the movies shifted from portraying external causes for alcoholism to the (now familiar) assumption that internal factors cause alcoholism. Despite acceptance by the medical community and much of the public that addiction 475 comes from within, recent filmmakers still find it necessary to provide a necessitating external factor for a character's substance abuse. As is discussed later, this may be attributable to the AA concept of "hitting a bottom." Regardless, all three treatment films do offer precipitating events based on anxiety, stress, or failure for each character's addiction. Clean and Sober provides no pre-existing catise for Daryl's addiction. Daryl seems to be quite content with his lifestyle, until the police start pursuing him. He responds by increasing his drug use and then checks into a treatment program. Unlike Clean and Sober, both 28 Days and When a Man Loves a Woman link their characters' addiction to their family history. During detox, Gwen flashes back to scenes of her childhood with her sister and addicted mother. The sequences show how their mother put them into danger and eventually died from her using. Through the flashbacks and sequencing, Gwen's addiction is directly linked to her mother's substance abuse. The concept of addiction affecting entire families is endorsed by many self-help groups, particularly Adult Children of Alcoholics (ACOA), and it became incorporated into addiction films during the 1980s (Lynch, 1999; Denzin, 1991). This approach is even more evident in When a Man Loves a Woman. The film suggests several factors for Alice's addiction, including her father's drinking and Michael's controlling nature. Although these family issues could be seen as external factors, they are presented less as a cause of substance abuse than as links to an addiction-prone personality that, in turn, causes substance abuse. Beginning in the 1980s, an increasing number of films began to focus on addicts who use multiple substances. The classical social-realist films were almost exclusively inhabited by alcoholics; in current substance-abuse films alcoholics are almost a quaint exception. While Daryl splits time between alcohol and cocaine, Gwen is equally happy with pills or alcohol. When a Man Loves a Woman offers the sole 476 SCRIPT(ING) TREATMENT throwback to the classical alcoholism film in the character of Alice; however, the people Alice befriends in recovery admit to using a variety of substances. It almost seems that Alice's roles as mother and wife preclude all but the most socially acceptable substance abuse, feeding into ideologically conservative notions about women and motherhood. In her discussion of 1920s alcohol films, Denise Herd (1986) notes: "Romantic goals dominated the entire plot of the melodramatic film, thus creating the primary situational context of alcohol problems" (p. 216). This remains true for the treatment films under discussion here. Their increased focus on addiction therapy does nothing to diminish the importance of romance within their narratives. These relationships are easily explained away as a classical feature of Hollywood scriptwriting, but they do hold a deeper meaning within alcoholism films: "The resolution of his/her drinking becomes a symbol for the resolution of the problems of the relationship" (Denzin, 1991, p. 249). Thus the fate of the couple is tied to whether the addict will choose a life of sobriety or continue using. Since Gwen's fiance continues to use in 28 Days, Gwen's decision to stay clean is reinforced when she tells him, "Everything has to be different, and that includes us." After a brief kiss she bids him goodbye. Daryl is unwilling to let go of his girlfriend, even after he finds drugs in her purse. Her death allows him to resolve the situation within the classical alcoholism motif without having to actually choose staying clean over remaining in the relationship. By contrast, in When a Man Loves a Woman, Michael tries his best to be supportive of Alice, but he has to learn his limitations before they can reunite. These relationships are a central focus of all three films, and their resolution implies a direct correlation between the choices the characters have made about their addiction and their recoveries. There are other characteristics of addicts common to these three films that researchers have not generally identified with [...]... spots for the financially well off In addition to drastically altering the previous image of treatment centers in film, these movies also contradict the economic facts of the treatment profession In his chronicle of the history of addiction treatment, William White (1998) points out that an expansion of patients and posh facilities during the 1980s met with resistance from insurance companies The maximum... babysitter Denzin (1991) found the same problem with representation in his study, saying that films "systematically excluded certain classes and types of subjects," resulting in a "dominant middle-class ideology about who had this problem" (p 238) Hollywood perpetuates racist stereotypes by excluding minorities from these stories of redemption and then foregrounding them as addicted criminals and similar... stereotypical move of linking female using to relationship problems has a long history in addiction films (see Denzin, 1991; McCormack, 1986; Lynch, 1999) Such a move results in a loss of agency for these characters Viewers are given the impression that these women are truly victims, while Daryl is often incapable of inspiring the same pity Perhaps society is more comfortable with the figure of a helpless... time The images of treatment in these three films stand in stark contrast to the pre-1980s addiction movies Lewington (1979) wrote of "the image of the locked door or barred window" and the "sadistic or pessimistic male nurse"(p 28), but the facilities in these three films become progressively warmer and more lavish In Clean and Sober, Daryl walks through swinging doors into a swirl of activity and... cause of the problem Spouses, co-workers and friends drink and use drugs in these films For example, in When a Man Loves a Woman Michael usually drinks with Alice, but there is no suggestion he is an addict Instead, the films imply that the nature of addiction is found within the individual character rather than in specific substances—an approach familiar to treatment professionals The representations of. .. (2003) Addiction, stigma and movies Acta Psychiatrica Scandinavica, 107(3), 163-169 Denzin, N K (1991) Hollywood shot by shot: Alcoholism in American cinema New York: Aldine de Gruyter Denzin, N K (1987) The recovering alcoholic Newbury Park, CA: Sage Publications Dyer, R (1979) The role of stereotypes In J Cook & M Lewington (Eds.), Images of alcoholism (pp 51-56) London: British Film Institute 492 SCRIPT(ING). .. positions by becoming the point of contrast with the dangerous "Other" most minorities represent to mainstream audiences Although 28 Days does not include as troubling racial representations as the other two films, its depiction of the sole homosexual identified in any of the three movies is just as problematic Gerhardt (Alan Tudyk), speaks in a German accent (further setting him apart from the other... buffoon in the film The serious process of recovery in all 481 three films is associated only with white heterosexual characters, usually females While largely ignoring or marginalizing racial minorities, these films seem to overrepresent female addicts Three out of the four major addicted characters are women: Alice, Gwen, and Charlie During the early 1990s, women comprised 27% of addicts in treatment... social environment supportive of abstinence" (Wilcox, 1998, p 58) The jargon and trappings of AA have become adapted parts of the lexicon of these films The main characters in all three movies have a "sponsor" to help them Phrases and ideas featured in these films, such as "one day at a time" and "keep it simple," come directly from AA (Wilcox, 1998) The concept of "hitting a bottom" can also be attributed... neglecting to mention this aspect of AA, however, the films present an incomplete view of that organization Recent movies dramatically alter the face of substance-abuse treatment from its previous screen depictions Facilities shift from stark institutional interiors to sumptuous living and recreational quarters despite a real-life decrease in such facilities The films focus upon the successful treatment of . 467 Script(ing) treatment: representations of recovery from addiction in Hollywood film BY CURT HERSEY American films and television programs increasingly. Publications, Inc. 468 SCRIPT(ING) TREATMENT Addiction and recovery have been topics of Hollywood films and movies of the week and are increasingly integrated into mainstream