David O. Russell’s Silver Linings Playbook, nominated for eight Oscars, is hardly the first movie to find critical acclaim with a searing portrait of the impact of mental illness. But unlike many films, which portray people who suffer from mental health issues as either saintly or pitiable, Silver Linings Playbook, about Pat Solitano (Bradley Cooper), a former high school teacher who is returning home from eight months at a mental hospital after he beat his wife’s lover and was diagnosed with bipolar disorder, is savagely funny and often disarmingly sweet. It’s also a subtle vehicle for larger ideas about mental health care in America, ranging from the damage done by late-in-life diagnoses of mental illnesses, to the fact that for some people, treatment comes only after they come into contact with the criminal justice system, to training about mental health that could help everyone from teachers to cops do their jobs better.
I spoke with Bradley Cooper, who was nominated for an Academy Award for Best Actor, and Dr. Barbara Van Dahlen, the president of Give An Hour, which coordinates with volunteer mental health providers to get free treatment to American veterans, about the stigma around mental illness, the intersection of mental health care and law enforcement, and what kinds of conversations they hope Silver Linings Playbook can start. Our conversation has been edited for clarity and length:
I wanted to ask you about the structural story of the movie, because the real tragedy of Silver Linings Playbook is that Pat’s biploar disorder doesn’t get diagnosed until it’s completely unmanageable. It’s awful that it gets to this point, but it’s also a way that he finally gets care, and that’s not a story we see very often.
Cooper: But reflective of what’s happening. I mean, that’s the whole point. Patrick Kennedy, he likens it to a diagnosis which happens at stage four of cancer. When that’s occurring, it’s a bleak horizon. The whole idea is to have it be diagnosed before he makes a plea bargain with the courts after he beat the hell out of a guy. That’s the only reason he even went to a hospital in the first place and was diagnosed there. But, if somebody recognized, or he had a venue when he was a teenager, to talk about the fact that his brain is working in such a way that make him feel like an outsider, like he’s not belonging, then maybe that would have been prevented, then maybe he wouldn’t have had to serve time and had a 500-yard restraining order out against him, and have no job.
At the same time, the movie treats the ongoing law enforcement involvement in Pat’s life—a local police officer is assigned to check up on him and respond to calls about him—as a good thing in Pat’s life. He doesn’t have a case worker, he has his therapist appointment once or twice a week, but the cops are actually doing a fairly good job of dealing with him.
Van Dahlen: That’s an unusual situation. The issue is having people in someone’s life who are consistent, who care. The police officer in this story was somebody who actually was willing to try when he could to be helpful, rather than just “Okay, I’m taking you back in.” And unfortunately, that’s not often the case in communities, nor is it the case that we’ve got teacher who have the knowledge, even though they care about the kids, they may not understand. So they’re not going to be the one that says “Maybe something else is going on here.” It’s educating all the way down the line in our communities so these folks are identified and have access and it’s part of our normal conversation. It should not be the case that someone has to keep feeling like “I’m going to try to keep it together, I’m going to try to keep it together.” We see this obviously with the service members, that whole culture, trying to keep it together when they can’t. Our society, unfortunately, puts a tremendous amount of pressure on people, and sometimes, they blow.
Cooper: The police officer for our story in the movie, he serves the same way that his friend Ronnie serves, his brother Jake and his parents, who say “You look great. Just adhere to the rules and you’ll be fine.” There’s no investigation into what’s going on. The cop doesn’t pull him aside at the movie theater and say “Explain to me what happens.” He goes “The restraining order. You want to go back to Baltimore?” Those aren’t ways of actually understanding the situation. And that’s the device we use in the movie to then introduce Tiffany Maxwell, who is Jennifer [Lawrence], and that’s the whole idea of somebody understanding him. And that’s where we can then use this movie in terms of spreading an awareness of people actually needing to investigate, and to inquire in what’s going on, so people feel free to share, instead of adhering to a set of rules, and that’s the way it is.
Van Dahlen: That’s a great point. It does a great job of showing, especially with young people, having both of those elements, the structure, like the psychiatrist said, “You’re going to have to figure this out.” That is a reality. We went through a phase in the mental health community where people got into navel-gazing, and it was all about understanding, and we do need to help people—
Cooper: A strategy. As he says in the diner.
Van Dahlen: Gotta have a strategy, gotta have a structure. And with that, have that understanding, so people can take that within that structure and have a healthy life.
I was struck by that element of the movie. Trying to find small victories, the silver linings, the idea that we can build up one step at a time has always seemed really important. It seems like Pat’s parents, not knowing very much about mental illness, don’t seem to understand that there’s a space in between him being in a mental hospital and him being completely well that is a good target for Pat to get to.
Van Dahlen: The other thing, too, and this happens to veterans, civilians, if you have something, as if we all don’t have something, is if you have something that becomes identified, bipolar, depression, everyone lumps all of your behavior into that. We’ll sit and talk to these veterans, and they’ll say “I got angry, and that’s my PTSD.” And I’ll say, “No, wait a second, it sounds to me like you had reasons to be angry.” And we have to do a better job with that element, too.
When it comes to the stigma around mental illness, I was struck by the intergenerational tension in the movie is interesting. It seems like Pat, Sr. has fairly serious undiagnosed issues, whether it’s OCD, he has the same kinds of tantrums that Pat has.
Cooper: He’s been banned from Vets Stadium.
Van Dahlen: It’s a pretty big tantrum.
It seems like a story about how we can brand getting treatment. The pills aren’t just going to turn you off. It can give you access to things that make you happy again.
Cooper: And also that it’s not the other. This is a regular guy. This is a sort of slice of life, looking at these people who are in the prime of their life. He’s a young guy, and this is what happened to him. You look at his neighbor, John Oritz, is talking about how he goes into his basement and smashes his fists against the wall to Metallica. He’s supposed to be the normal one. So it is sort of an attempt to show, let’s just not just judge, let’s look into ourselves.
Van Dahlen: Life events, if life delivered him a serious blow. It’s what happens to you that determines what others are going to call your behavior.