It’s in a Word, Or It’s In a Look: Mental Illness and Horror

For someone who would describe herself as a fan of horror, there are remarkably few titles I can actually list as favorites. Both in movies and books, I feel like I’m often disappointed when it comes to the available offerings. There are a few reasons for this – the perennial problem of the disappointing reveal is one. For instance, I was really enjoying the movie The Conjuring until the explanation came around. It probably says a lot that my favorite works are those that explain nothing – even as they leave me frustrated they’re also much scarier as a result (Caitlin R. Kiernan’s The Red Tree comes to mind – I’ll be talking about her more later on.). Another is what I’d call “great concept, lackluster execution” – where I can feel the seed of a good idea but the way it plays out is either cliche, or boring, or falls back on tropes I dislike.

But another thing I run into problems with on a relatively consistent basis is the relationship between horror as a genre and mental illness.

This blog post was shamelessly inspired by the op-ed that ran in the New York Times on October 26th, titled “Mental Illness is Not a Horror Show.” The author, Andrew Solomon, discusses a VR attraction that took place in an asylum, featuring “the world’s worst psychiatric patients”.

Oh, dear.

Of course, asylum-based horror is nothing new. Endless video games take place in asylums haunted by the ghosts of malevolent former inmates; the movie Grave Encounters featured ghost hunters who encountered evil inside an abandoned asylum. Some takes on this genre, to be fair, draw on the documented atrocities and cruelties perpetuated by staff of psychiatric institutions (some of which are far from solely historical) – but they also tend to feature inmates in starring roles as monsters.

Nor is this kind of role limited solely to asylum-based horror media.The specter of mental illness lurks in the “mad” monsters of many a horror movie – Michael Myers of Halloween is an escaped mental patient, and even movies that don’t make the connection explicit often do so by means of coding characters as insane, or linking (for example) demonic possession with mental illness.

So, what’s the problem with this? It is well documented that people with mental illnesses are on the whole more likely to be the victims of violence than the other way around. By portraying mental illness as linked to evil and violence, a stereotype is being perpetuated that designates the mentally ill as inherently more dangerous than others, predisposed to “snap” and murder people, more akin to demon than human. But I’m not just writing this article to castigate horror for the way it deals with mental illness – many others have dissected that connection. I’m here to think about alternatives.

Just as discussion of “feminist horror” has opened up, I’d like to talk some about a horror that doesn’t exploit the mentally ill and what that might look like. There’s one easy way to avoid it that maintains the spooky-scary feel of an abandoned asylum from the 19th century: pointing the horror in the other direction, where it isn’t about the inmates but about the system.

Solomon makes a point when he observes that one of the reasons mental illness is so scary is the permeability of its boundary – people are constantly aware that they, too, might be betrayed by their brains. The lack of understanding we have of the causes of mental illness only amplifies that fear, and by otherizing the mentally ill perhaps that fear can be assuaged, marking a clearer line between them and us, the healthy and sick. 

But why not direct that fear differently, looking instead at the long and true horrifying history of the treatment of the mentally ill? Instead of pointing at a group as an example of what people fear to become, why not point at what could happen to any one of the 57.7 million people (in the US alone) diagnosed with some kind of mental disorder? After all, if we fear losing our minds, how much more frightening is the idea of someone attacking you at your most vulnerable, or those who are meant to help turning on you instead?

But even more appealing than that alternative is a concept I think was best explored in two of my favorite pieces of horror media: The Babadook and The Red Tree by Caitlin R. Kiernan. In the former, Amelia, whose husband has recently died struggles to raise her son, Samuel. Amelia is exhausted and beleaguered, isolated and lonely, frustrated by her son’s erratic behavior – and haunted by the Babadook, a peculiar creature that seems to have emerged from a mysterious picture book.

The titular being could be seen as representative of a number of things, but one of the most resonant for me was the idea of the Babadook as a form of mental illness (right down to the ending – the Babadook lives in the basement, seemingly domesticated but still present, accepted and recognized.). Much of the horror in The Babadook relies on the fear of the unseen and Amelia’s uncertainty about what is happening, whether any of her experience is real or an artifact of her struggle to cope. It is exacerbated, too, by her lack of support from relatives and community.

Unlike other movies involving possession or mental illness (frequently dissociative identity disorder, sometimes called “schizophrenia”), we never lose sight of the fact that Amelia is the protagonist. Even when she is possessed by the Babadook, the viewer is as terrified for her as of what she might do. At one point, she even says to her son, “I’m sick, I need help,” acknowledging that she is aware of her own loss of control. Rather than turning to the trope of “and they themselves were the murderer the whole time!”, The Babadook keeps its sight on the idea that the Babadook is at once a part of Amelia (when she is possessed) but also a kind of external opponent. As the article linked at the end of this post explains:

With the Babadook being a reality within the film, we as the audience cannot dismiss it as fantasy. This is something that is key to much of Western society’s treatment of mental illness, particularly depression. It can, bizarrely, often be dismissed as fantasy because there are no physical symptoms, and sufferers expected to “man up” or “get a grip”. […] The Babadook using the monster to represent Amelia’s mental breakdown gives a fresh and realistic portrayal of mental illness, as within the film it hasn’t been “made up”, and is a tangible, frightening, and very real threat, despite its physical ambiguity.

In The Red Tree, writer Sarah Crowe moves to an isolated house after the suicide of her long term girlfriend, and becomes obsessed with a tree in the yard. The novel remains ambiguous throughout, even to the ending, about if there is anything truly supernatural going on or if it is rather a development of her trauma and loss. Is her obsession with the old oak a sign of its malevolent influence, or is she seeing malevolent influence as a way of externalizing her inner demons?

My experience of mental illness bears some similarity to both Sarah’s and Amelia’s, albeit with less supernatural strangeness. Sometimes it feels like my brain is trying to kill me, or that I can’t trust my own perception and beliefs. I can simultaneously know that something I’m thinking is incredibly distorted and also believe it with complete conviction; or anxiety kicks in and my heart pounds and I can’t breathe even as I know I’m completely safe. My thoughts seem unreliable and I’m not sure I can trust myself at all. It’s terrifying.

A horror that relies on this kind of uncertainty – the inability to trust one’s own perception, the gnawing anxiety that your experience may not be what you think it is – is where horror lives for me, and where I see potential for horror that doesn’t exploit the mentally ill but can still exploit the horror of mental illness. It puts the viewer in a position to create sympathy for those who might regularly experience that kind of instability, rather than provoking disgust or revulsion. It positions mental illness as a quality that need not be equated with evil or violence, and the mentally ill as potential protagonists rather than monsters or murderers.

It may not provide a convenient opponent for the hero to kill, but in my opinion it makes for a much scarier – and richer – story.

Note: The header image is from Neverending Nightmaresa horror game drawing on the creator’s experience with obsessive-compulsive disorder.

Further Reading: Mental Illness and ‘The Babadook’ by Hannah Spencer, Why is Mental Illness Scary? by Praveen R.Krambam, and Nobody Wins When Horror Games Stigmatize Mental Illness by Ian Mahar


6 thoughts on “It’s in a Word, Or It’s In a Look: Mental Illness and Horror

  1. YYYYEEEEEEEEEESSSSSSSSSSSSSSSS. omg PLEASE world give us more horror that explores mental illness as experienced by the protagonist. please.

    Another angle for this sort of thing is the way that people with mental illness are dismissed (or dare I say gaslighted) by onlookers, or paternalistically controlled, and thus there is an added layer of helplessness or powerlessness, which is key to horror. Like, such an obvious way to approach the topic IMO, and yet hardly any writers seem to think of it, because idk I guess “escaped mental patient villain” is easier?

    Did you ever play The Cat Lady? Surely I’ve demanded that you play it before…


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