Fatalistic Attraction: Re-thinking Hollywood’s Influence on Borderline Pedagogy (essays from graduate school)

Fatal Attraction has been recognized as THE silver screen portrayal of borderline personality disorder (BPD). As one Psychology Today blogger notes about the movie, “Viewers watched Alex Forrest and began to link the behavior and inner life of this troubled figure with BPD in a process that continues to cement in the mainstream mindset to this day” (Clyman, 2012). The film’s impact on popular beliefs about BPD now extends beyond regular entertainment consumption and into clinical psychology practice, both indirectly through clinicians’ background cultural knowledge and directly by gaining acceptance and applause as a useful tool for teaching about BPD in the field. It is this pedagogical use of the film that this essay attempts to take a critical look at, considering the risks involved in using a Hollywood dramatization to teach about BPD.

​This essay begins what should be a much larger discussion on cinema pedagogy in clinical disciplines, outlining preliminary interpretations only and taking a brief, but closer look at our culturally situated viewer biases, especially toward sex/gender. The conclusion of the author is that using Fatal Attraction to teach clinicians about BPD may be highly problematic. In what seems to be a dramatically (pun intended) fatalistic lesson on BPD—mad women are bad women—what is being sold to a generation of developing clinicians is a missed opportunity to widen our empathy for BPD clients, the very thing we need to do in order to recognize, diagnose, and treat this disorder effectively.

Considering the short history of BPD as a mental health diagnosis (first introduced in 1980 in the DSM-III), it makes sense, in 2014, for clinicians to first ask to what degree viewer interpretation of this 1987 film drives the film’s available BPD analysis, as opposed to the film or psychological knowledge driving the analysis. As it turns out, the film’s “analysis” of BPD is almost non-existent, with little to no psychological content offered. Fatal Attraction’s fairly simple plot relies heavily on exaggerated affect and the dramatization of unknowable psychological undercurrents to move the story along. For much of the movie, the audience must guess at the emotional and rational states of the characters. Even when concrete information is presented (Dan finds out that Alex’s father did in fact die when Alex was young; Beth tells Alex to leave her family alone), interpreting how the characters, namely Alex, process the information is mostly a guessing game for the viewer. (What motivates Alex to lie about her father’s death? How does Alex feel after Dan tells Beth about the affair?) This interpretation-rich environment leaves ample room for bias that may already exists in the audience to contribute to how we make sense of the inner world of the film and its characters. As viewers of this drama, we bring all of our self-interest and conditioning to bear on our critique of Alex, and in turn, on our understanding of BPD via the Alex character.

Importantly, the considerable room the film leaves for audience bias matters as an initial indicator of just how much the viewer may be making up meaning about the characters based on prejudgment. Even the most basic elements of the storyline must be conveyed carefully so as not to distort the facts: Dan, a (happy? successful?) lawyer is married to Beth, a (stylish? attractive?) mother of one. Dan has an extra-marital affair with Alex, an (enchanting? unpredictable?) editor. When Dan (finally? angrily?) breaks things off with Alex, she displays a number of behaviors (ranging from annoying to frightening?), including—we must actually infer—killing Dan’s daughter’s bunny rabbit. The movie ends with Alex attacking Beth in her bathroom. Ultimately, Dan and Beth kill Alex. Any of the above parenthetical details might be considered important and good writing for advertising copy for the film in order to elicit interest from a known, culturally-situated audience so that we the consumers will be inclined to pay to watch it—“know your audience” as the adage goes. These same details if included but left unconsidered, could contribute to clouding the clinician’s ability to accurately recognize, diagnose, and understand BPD or to hold the empathy needed to treat a client with BPD. Indeed, with a little further digging, it becomes clear that the weight of our viewer bias is really quite heavy.

A specific area of potential viewer/therapist bias that deserves deep and broad ongoing critical attention is sex and gender. The critical step of considering sex and gender in Fatal Attraction, a Hollywood-ized depiction of mental illness, must be the responsibility of any professional using the film to speak accurately or usefully about BPD. To take this step, we must look closely at how the sexist and gendered filters available to viewers of the film—all of us—may be present in us when considering Alex as a case study for BPD and also how these filters may distort how we learn about BPD and how we approach BPD clinically, both for diagnosis and for treatment.

Despite the larger problem of viewer bias, in 2011, Francine Goldberg published the second edition of Borderline Personality Disorder: A Case Study of the Movie Fatal Attraction, which aims to map Alex’s character and behaviors in the film to “clues” and “evidence” for a teachable case of BPD. Goldberg’s lesson plan, now easily accessible on the Internet, has been lauded by the Employee Assistance Professionals Association (EAPA) as, “a unique teaching method that allows EA professionals and other clinicians to acquire clinical skills and earn PDHs and CEUs” (p. 1). The EAPA cites some evidence for the effectiveness of Goldberg’s work as a teaching tool, but offers no critical framework of Goldberg’s analysis. While it may be true, as the EAPA reports, that after seeing the movie and discussing it, “EA professionals had acquired a more sophisticated understanding of psychopathology and were more likely to refer individuals with psychiatric symptoms to a psychiatrist or a specialized counselor” (p. 2), at what cost do these gains come? Perhaps it is simply easier to keep graduating students, handing out certifications, and not looking too closely at this question—yet looking closely is certainly what clinicians must do.

In making her case for a BPD diagnosis in the Alex character, Goldberg (2011) asserts early on that, “People with BPD cannot tolerate being alone” (p. 12). Elaborating on this point, Goldberg cites Synopsis of psychiatry, behavioral sciences, clinical psychiatry: “To assuage loneliness, if only for brief periods, they accept a stranger as a friend or are promiscuous” (Kaplan & Sadock, 1991, p. 534). Goldberg’s mapping of Alex’s character to the DSM-IV’s criterion #4 for a BPD diagnosis, impulsivity, subsequently hinges largely on a prejudgment of Alex’s sexual behavior as “promiscuous.” Goldberg (2011) notes the following: in scene two, Alex shows, “interest in a man who is (a) married and (b) has not really expressed an interest in her which may be indicative of criterion #4, impulsivity” (p. 9); in scene three, “seducing a man that she barely knows and who is not available for a relationship with her may be indicative of criterion #4, impulsivity” (p. 11); and in scene eight, “the news that Alex is pregnant is additional evidence to support criterion #4. Not only did she have sex with an unavailable man that she does not know, the sex was unsafe” (p. 25). In all three instances, Goldberg’s conclusion that Alex is “promiscuous” is the central (and really only) argument for Alex meeting the DSM-IV’s criterion #4 of BPD, impulsivity. Consider Goldberg’s assessment again in sum: Alex, the potential BPD client, is interested in a married man, who does not overtly share back about his interest in her, seduces him anyway, even while she also barely knows him, but does know that he is already “taken,” and chooses unsafe, condom-less sex on top of it all. As Janet Wirth-Cauchon noted back in 2001, “No mention is made of Dan’s ‘impulsivity’ in doing the same with a woman that he barely knows” (p. 170). But beyond this one-sided view of the sex shared by Dan and Alex that Goldberg continues to espouse in 2011, notions such as female seduction, adultery, sexual ownership, and sex as a weapon (tricking a man into pregnancy) are deeply entrenched sexist attitudes that exist in contemporary cultures, including our own, and that have been relied on to control female sexuality and female choice. Surely, these attitudes in ourselves must be considered before applying them to criteria for diagnosing BPD in any client.

Indeed, it is unclear after uncovering the sexist trope of “promiscuity” so readily available to us, whether Alex having sex with Dan is impulsive behavior for Alex at all. Though that is exactly the inquiry that a clinician would need to make with a client before diagnosing BPD. We do know that in the seduction scene Alex offers that she is trying to make up her mind about sleeping with Dan, which could be a “clue” (using Goldberg’s system) that Alex is in fact strategic about choosing her sexual partners—the opposite of impulsive. Interestingly, Goldberg (2011) also notes that for a diagnosis of BPD, “the symptoms must be pervasive, not just in response to one relationship or one event” (p. 11). But from the film we know of no other lovers who Alex has “promiscuously” (read: “impulsively”) slept with.

It is also worth noting that the DSM-IV criteria for BPD, used by Goldberg, refer to sex only once; criterion #4 states, “impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)” (APA, 2000, p. 710). (The DSM-5 criteria for BPD do not mention sex at all.) The sexist trope of “promiscuity” that Goldberg relies on to demonstrate DSM-IV criterion #4 in Alex’s behavior, therefore, assumes that non-monogamous, casual sex is not only impulsive behavior, but is also unhealthy and maladaptive. Not only, then, must we ask if Alex’s sexual behavior is impulsive for Alex, but we must also consider what the potential her sexual behavior in fact creates for self-damage, or if this is also Goldberg’s prejudgment. To what degree the sexual tryst shared by Alex and Dan was an act of self-damage by Alex may also be an important question for the plot of the film. But let us not get those two inquiries confused!

Let’s look at Alex’s own words for a moment: “Because I won’t allow you to treat me like some slut you can just bang a couple of times and throw in the garbage? I’m gonna be the mother of your child. I want a little respect.” Is it worth at least considering that in a world where women are often left with impossible choices to make, they may face their non-rational circumstances with non-rational attempts to reclaim their power? Dan, having participated in the condom-less sex, offers no emotional support or legitimacy to Alex’s position upon learning about the pregnancy. Of course, by this point in the movie we wouldn’t expect him to do so. The movie has made a hard turn toward following Dan as the primary sympathetic character—it is Dan who we sweat with whenever the phone rings; it is Dan who we rush to the hospital with when Beth gets in a car accident; it is Dan who we beg with for help from the police. And Dan does not want Alex in his life, so neither do we. Though the movie stays close with Dan, is it at all possible for the clinician—for any of us—to imagine that Alex’s attacking behavior is not so much self-damaging, an element of BPD, as Goldberg argues, and rather a non-rational attempt by Alex to wrangle some power from her spiraling situation? And if we cannot consider this, why not?

Goldberg seems knowingly convinced that at every step in the entanglement and the unraveling of the affair that Alex is actually compelled to make choices that create situations that are harder on her. This is not relegated to her sexual behavior alone. Per Goldberg (2011), Alex displays, “undermining of self,” “recurrent self-injury,” “constant state of crisis,” and “self-mutilating behavior” (p. 4–6). All of this self-damaging behavior adds up to an overall inability to self-regulate. In fact, it is important for Goldberg’s case for a BPD diagnosis that we view Alex’s tendencies to self-damage as a strong indicator of a larger pattern of being emotionally out of control, aka hysterical. For Goldberg, in fact, the main evidence for a diagnosis of BPD is Alex’s “emotion dysregulation” (2011, p. 22), which Goldberg suggests may have its origins in Alex’s father’s death when she was very young. There is no further mining of the origin of Alex’s BPD, however, either by Goldberg or in the film. Instead, the film’s focus (and Goldberg’s) is on the reel-time execution of Alex’s “madness” in and after her affair with Dan. As Wirth-Cauchon (2001) notes: “The maneuver is the age-old one of dismissing righteous female wrath as hysteria, and by ignoring it, transforming it into actual hysteria” (p. 172). 

Perhaps further illuminating is the fact that, when trial screened, Fatal Attraction had a different ending.[1] The film’s first audiences were also left to grapple with Alex’s death, but in the original version she dies by her own hands, slashing her throat with a kitchen knife like the one she used previously to attack Dan. Dan is then arrested for Alex’s murder. The discomfited, even angry response from these first viewers, who having to deal with Alex’s suicide and Dan’s apparent punishment for his part in Alex’s downfall, however, may have prompted the producers to change the final scenes. Whatever the causes of the changes, the new ending ensures that at the final curtain the complex, nuanced experiences of BPD do not live and breathe in Hollywood’s captivating melodrama. In the end, the vast majority of Fatal Attraction’s viewers were given a more familiar, culturally relatable ending of sane, male good guy versus mad, female bad guy. As Wirth-Cauchon (2001) argues, this is “particularly disturbing” in that “a fictive and misogynist cultural image of a woman is presented as reality, and as an accurate picture of a woman with borderline personality disorder” (p. 171).

It is truly unfortunate that by using Fatal Attraction to teach about BPD, what we get is a dangerously static story about BPD, a story given to us first by the filmmakers as an option for understanding the character of Alex, and then endorsed and solidified by Goldberg (and others) as useful tool in working with BPD. Goldberg, ironically, is acutely aware that “clinicians often find themselves…judging rather than sympathizing” (2011, p. 39). But Goldberg does not extend this interpretive lens to herself by considering the potential for the sexist and gendered nature of the “clues” and “evidence” she gleans from the film. Nor does Goldberg turn a critical eye on the overly sympathetic position of Dan in the final version of the movie. After all, the movie does not ask us after confronting Alex’s madness to love her anyway; instead, we get to love Dan and Beth who—and maybe because of this—kill Alex. The mad person is stamped out, and Dan and Beth and their representation as peaceful and good members of “normal” society maintain a monopoly on the audience’s empathy.

Even though Goldberg warns her readers that clinicians must be careful to work with BPD clients to be empathetic and non-judgmental, perhaps the most alarming aspect of Goldberg’s case study is a failing to widen the reader’s capacity for empathy by failing to address sexism and gender-typing in the film. Goldberg gets it right when she keenly notes, “empathy is an essential ingredient in delivering mental health treatment successfully” (2011, p. 38). But if we continue to see people with BPD as villains, can we also see them as ill and deserving our empathy? At present, the best treatment known for BPD, dialectical behavior therapy (DBT), is built on the clinician’s capacity to empathize with the client. To be empathetic one must be able to “be with” someone else’s experience in a loving way. Fatal Attraction does not offer this experience to the viewer with Alex; if anything it offers us empathy with Dan. By missing out on critiquing sex/gender and other potential biases in Fatal Attraction, it is almost as if Goldberg is admitting defeat to what is possible for how deeply we can go with empathy for the BPD client—Hollywood does it good enough. For clinicians that is a catastrophic lesson.

If Fatal Attraction continues to be used to teach about BPD, it seems necessary at the very least to include additional attention to and information about the lenses of sexism, gender typing, and accurate, non-judgmental empathy for the client at every step of the analysis. In order to be an effective therapist for a person who may be diagnosed with BPD, like any mental health diagnosis, uncovering potential bias in the diagnosing clinician and in the proposed treatment plan is mandatory. Likely the most important bias that we must overcome for folks with BPD is our own capacity for empathy, which may come about for varied reasons, not least of which may include sexism and gender stereotypes. Even Glen Close, who has apologized for her portrayal of mental illness as directly linked to violent crimes, might do well to extend that apology to include the misguided, potentially disastrous notion that mental illness may be somehow fundamentally un-empathetic.

[1] https://www.youtube.com/watch?v=GY_NQK7rJrY
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References
 
American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders, fourth edition, text revision. Washington D.C.: American Psychiatric Association.
 
Clyman, J. (2012). Young Adult: The new borderline personality disorder in cinema. Retrieved from http://www.psychologytoday.com/blog/reel-therapy/201203/young-adult-the-new-borderline-personality-disorder-in-cinema
 
Employee Assistance Professionals Association. (n.d.). Counselor creates unique multimedia method for acquiring clinical skills. Retrieved on December 7, 2014, from http://www.eapa.info/ChaptBranch/webdocs/Beneficial1108.pdf
 
Goldberg, F. R. (2011). Borderline personality disorder: A case study of the movie Fatal Attraction. Retrieved from http://img-srv.dtcbuilder.com/engine/Builder/images/2/9/0/8/6/0/file/7.pdf
 
The Guardian. (2013). Glen Close says sorry for her portrayal of mental illness in Fatal Attraction. Retrieved from http://www.theguardian.com/film/shortcuts/2013/jun/05/glenn-close-apologises-mental-illness-fatal-attraction
 
Kaplan, H. I., & Sadock, B. J. (1991). Synopsis of psychiatry, behavioral sciences, clinical psychiatry, sixth edition. Baltimore: Williams & Wilkins.
 
Wirth-Cauchon, J. (2001). Women and borderline personality disorder: Symptoms and stories. Rutgers University Press: Piscataway, NJ.

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