Dressed To Help Or Kill? – Mental Health Professionals Seen Through Costume

Costumes embody the psychological, social and emotional condition of the character at a particular moment in the script. It is impossible to design for the actor unless the designer knows who the character is.

Yvonne Blake

A costume designer has to fulfill many duties during the designing process of any production, but the most important is to understand and analyze characters. What happens when a costume designer has to create a character, whose profession itself is to do the same? Depending on the attitude of the portrayed mental health professional, their relationship with the patient can be understood through costume.

If the psychotherapist is not in the lead role, their purpose usually is to guide, give space to the main character. Therapy sessions are used as a narrative device in films to reveal the patient’s inner thoughts. Psychotherapists often encourage patients to express their thoughts, feelings, or, on the contrary, they might have a purpose of silencing, even tormenting the patient for their own benefit. In Bryan Fuller’s Hannibal, we find one psychotherapist in a leading role and three others in important roles, which is rather unusual. As Angela Ndalianis writes in her article, Hannibal: A Disturbing Feast for the Senses:

The television series Hannibal (NBC, 2013-) is, without doubt, one of the most powerfully affect-driven shows to ever grace the television screen. Hannibal not only inflicts a cacophony of sensory assaults on the characters that inhabit its dark narrative universe, but also extends these assaults to the audience that participates in the world it has to offer.

Creating the atmosphere and costumes of this series plays a crucial role, and it is worth asking if we can consider a pattern among the representation of psychotherapists regarding the costumes.

The psychotherapist as a character and the representation of the profession in films and TV series have been widely discussed among mental health professionals and in film and media studies. I structured my essay on the already discussed stereotypes to analyze the aspect of costume and my interpretation of their meaning, as well as citing from interviews with costume designers. I discuss the responsibility of the costume designer creating representation for a certain profession. Apart from the specific articles and books discussing the psychotherapist character, I am going to refer to Kaiser’s The Social Psychology of Clothing in relation to the psychotherapist-patient relationship and its visual representation through costume. As a case study, I am going to analyze the series Hannibal, observing the element of costume on a frame by frame analysis while also quoting from other interviews made with Christopher Hargadon, the costume designer behind the series.

Why are there so many articles about the representation of mental health professionals in film and television?

The obvious answer is the widespread popularity and approachability of television series and films and their effect on public opinion.

People are relatively uninformed about the problems of people with mental disorders, and the media tend to be especially effective in shaping opinion in those situations in which strong opinions are not already held.

– writes Wedding, Danny, and Ryan M. Niemiec in Movies and Mental Illness: Using Films to Understand Psychopathology.

Mental health professionals must establish mutual trust and understanding with their patients. As most people’s sources of information are representations through films, psychotherapists on-screen influence the public’s attitude toward both mental health professionals and institutions. In the United States, mental health professionals were so concerned about the lasting effects of popular films that an established committee called Media Watch was set up by the Media Psychology Division of the American Psychological Association (Young, Stephen Dine, 2008). As Irving Schneider suggests in his article of the American Journal of Psychiatry:

Throughout the century psychiatry has sought scientific understanding and effective treatment for the conditions so vividly depicted in the movies. At the same time, movie psychiatry has projected a view of the profession through the distorting lenses of fear, defensive ridicule, and the yearning for an ideal parent. To the extent that the parallel professions pay attention to each other’s work, both may profit

A professional understanding, collaboration, and research for the creative team in any case of a motion picture production, especially for films dealing with delicate questions like mental health and illness, is necessary. Although stereotypes help the audience understand and get immersed in the story. But what are the main stereotypes of a psychotherapist?

Articles written by both mental health professionals and researchers in film studies usually bring up three main stereotypes. Namely:

  • Dr. Dippy,
  • Dr. Wonderful,
  • Dr. Evil.

In a study conducted in 2008 (Young, Stephen Dine, 2008), researchers analyzed popular films between 1990 and 1999 based on character motivation of the portrayed mental health professionals. In their study, they determined five main categories of character motivation which are strongly connected to the three main stereotypes. These drives, according to the study, can be money or prestige, power, love or lust, self-healing, or concern for others.

The first stereotype, which is the least common among popular films, is the comical character of Dr. Dippy” (Schneider, 1987). He seldom does any harm to the main character, but his work methods are usually strange or not sufficient. He usually has to deal with his own problems. His motivation could be a concern for others and the need for self-healing.  As this stereotype is generally used in comedy, characters of this kind, in the view of the costume, are also more generic and superficial.

In the example of Analyze This (1), the psychotherapist character wears plain clothing that almost merges with the scenography. No dominant colors or striking patterns are visible, as he lacks dominance in his relationship to his patient and wife. Other examples of this character are in (according to Schneider’s listing) Mr. Deeds Goes to Town (1936), Bringing Up Baby (1938), Carefree (1938), What’s New, Pussycat? (1965), High Anxiety (1977), Love at First Bite (1979), and Serial (1980).

(1) Analyze This (1999).

The second widely discussed character is “Dr. Wonderful”. These characters are often motivated by caring for others, in a way that can be viewed as too idealistic. As Schneider writes:

To begin with, he is invariably warm, humane, modest, and caring. Time is of no concern to him. He does not seem to work by the clock, and, in fact, patients can see him or talk to him at any time and for any length of time.

This stereotype although paints a positive picture of mental health professionals, raised concerns among therapists, as this character raises sky-high expectations for the general audience, and presents a false image of therapy itself.

If we look at examples from Good Will Hunting (1997) (2) or from the To the Bone’s (2017) (3) highly skilled professionals, we find approachable middle-age male characters, father-like figures. Soft materials in relatively light colors suggest their openness towards patients. On these stills from the films, time is of no concern, as these scenes take place outside the office and the office hours.

In Hannibal, this character is embodied in Dr. Alana Bloom, the young and attractive psychotherapist. Although portraying a working professional, the study about character motivation shows that:

Female clinicians were often portrayed in an eroticized manner (…) degree of love motivation as the dependent measure. (…) Young (20s–30s), female characters were more motivated by love (M = 3.11) than were characters in any other category.

In Hannibal (Season 1), Alana Bloom (4) is portrayed wearing high heels, skirts, accentuating the waist and hips. Rich patterns, detailed and feminine floral designs mark her clothing. Their materials are soft, maintaining the approachable feeling. Her color palette is much warmer than the series’ general color scheme. She is always properly dressed, her hair and makeup completing the ideal image.

(4) Alana Bloom. Stills from Hannibal (2013 – 2015) season 1

In The Social Psychology of Clothing, the part about female health practitioners’ clothing reads:

Neat yet casual appearance (…) renders credibility to her role (…) if she were dressed too formally, her rapport with low-income patients might be diminished. On the other hand, if she were dressed sloppily, her appearance could be taken as a sign of disregard or incompetence

Another female character in the series is Bedelia Du Marier (5), who portrays the unusual role of Hannibal’s psychiatrist, a psychiatrist’s psychiatrist. In season one, she keeps a distant approach in her treatment. She must establish her role as a therapist on a higher level, treating a colleague. She appears in more formal wear, mostly in a skirt suit, which later on, as their relationship evolves, changes. I would note that skirt suits are generally the clothing that most female psychotherapists in films are portrayed in. On a social psychological level, skirt suits can be understood in many ways.

(5) Bedelia Du Maurier. Still from Hannibal (2013 – 2015) season 1

Several studies indicate that a woman makes a stronger businesslike impression in a skirted suit (…) a woman may be viewed as very serious and capable, yet unfriendly or unimaginative. (…) A blazer may be a good intellectual clue, increasing respect a perceiver has for a woman; however (….) also tends to decrease likeability

Dressing characters for television series is a demanding task, as we get a greater look at each character’s wardrobe. Costume designer June Hudson made a great point about dressing characters for the television series Doctor Who (1963 – present), which is applicable to many other series.  

Women may change their style of dress often, but men cling to their clothes, to what they know and like. As far as dress is concerned women are revolutionary, whereas men are evolutionary

Before discussing Hannibal’s costumes, I should introduce the third and most well-known stereotype amongst the portrayed mental health professionals, “Dr. Evil”. His character is known for dramas and horrors. His motivations are fueled by the need for power, dominance, or money.

One of the earliest examples of Dr. Evil is in The Cabinet of Doctor Caligari. Apart from portraying the “mad scientist,” the expressionist German film is also, as LoBrutto states:

An analogy to the moral and physical breakdown of Germany at the time, with a madman on the loose reeking havoc on a distorted and off-balanced society, a metaphor for a country in chaos

Dr. Caligari’s character (6) is painted diabolically with a contrasted look and strong silhouettes (LoBrutto, 2005). The distorted shadowy figure reflects on the dark and evil system behind him.

6) The Cabinet of Doctor Caligari (1920).

However, we must consider that Dr. Evil is not always evil because of his bad intentions but because he becomes a product of an ill system, or a portrayal of it, which the costume can also suggest. A controversial example is in Good Will Hunting when according to mental health professionals, the portrayed therapist’s “actions are unethical and unlikely to promote therapeutic trust and effective therapy.” The character of Dr. Sean Maguire is choking and threatening his patient, but the majority of the audience found that particular scene acceptable, motivated by good intentions. Thus Dr. Sean Maguire remains Dr. Wonderful. Films portraying mental hospitals before psychoanalysis became the standard method of therapy, may seem evil, considering the brutal nature of the applied therapy.

More often than not, movie psychiatrists (…) wore white coats, struggled to find a serum for treating psychosis, and were prepared to treat physical illness and even do surgery when necessary.”

If a psychotherapist is not portrayed in private practice but in institutions, hierarchy plays a crucial role in presenting the character. Power as a motivator paints a negative picture on mental health professionals, although, as mental hospitals are totalitarian institutions, power relationships cannot be avoided. Uniforms signify this, as they are representations of the status quo (Kaiser, 1990).

The presence of power as a motivator is negatively correlated with concern for others is another indication of how expressions of power in mental health are viewed apprehensively (…) the existence of power relationships is unavoidable in mental health activities

Among the portrayals of mental health professionals on screen, depending on the location of practice (mental hospital versus private practice), we have to separate the presence and absence of uniform. Although the white coat is a universal signifier of a health professional, we cannot say there is no uniform in private practice at all. On-screen, mental health professionals are most likely to be shown and represented in smart, casual, or even quite formal dressing. The reason for this might be from Hollywood movies. As the 2008 character motivation study reads:

A profession—a difficult one that requires a great deal of training and commitment, leading most practitioners to want to be well compensated (…) As clothing is one of the first impressions we get of a character in film, costume has to signify social class as well as the “a character’s psyche, their motivations, and how they want to be perceived

Wyckoff, 2009

Psychotherapists are ought to be aware of their own representations in the sense of the social-psychological effect they can have on patients. They must communicate they are well established, educated people. For that, establishing shots for psychotherapists usually show their office shelves in the background, packed with books to suggest their intellect. Psychotherapists in films often do not only consider their profession as just a job. It becomes a part of their identity. Using Kaiser’s term, we can observe role embracement among psychotherapists.

One brings multiple identities to context; these identities intersect one another, and some are likely to become more salient than others (…) Role embracement refers to a close link between a particular role or performance and an identity meaning that the role is likely to be integrated into one’s self-concept

There is a lot we can tell about Hannibal (7) when we first see him in practice. A perfectly fitted three-piece suit, elegantly embracing Mads Mikkelsen’s well built, strong figure. Hannibal’s style is extraordinarily stimulating. He represents a highly intellectual man with exquisite taste. Hannibal is well aware of his looks, and what that means for his patients, colleagues, or victims. His clothing is always stylish and formal, but he knows how to appear approachable and human as well.

(7) Hannibal Lecter. Stills from Hannibal (2013 – 2015) season 1.

His background, a kind of indeterminate European heritage, with an awareness of history and culture; personally, very erudite and cultivated.  I wanted him to have a cutting-edge look, very modern, but I wanted to integrate almost a historical feel into his clothing as well

Christopher Hargadon

The awareness of history and culture is reflected in the well-tailored three-piece suits (8) Hannibal wears. The perfectly fitted garments accentuate the actor, Mads Mikkelsen’s masculine, well-built figure.  Although the suit is the usual outfit for Hannibal – as it demands authority and gives him an eloquent look –, when he tries to befriend one of his patients, the series’ other main character, Will Graham, he wears something softer. Both in color and material. Hannibal and Will generally have matching color schemes as well.

(8) Hannibal Lecter. Stills from Hannibal (2013 – 2015) season 1.

The first episode’s light grey color suit slowly shifts towards darker tones towards the end of the season. One element stays constant, though. All suits are checkered or show some sort of pattern. The geometric patterns on Hannibal’s suit give a feeling of the precision and counting nature of the character. As the colors used for the suits range between grey and brown, the pattern gives more space for expression. Hannibal’s showrunner, Bryan Fuller requested costume designer Christopher Hargadon to avoid using black in Hannibal’s garments to go against the stereotypical color for the evil character. Hannibal is much more layered, has more depth to him than being the average two-dimensional villain. Television series usually build on stereotypes to appeal to the public’s eye. Although Hannibal is a television series, it avoids stereotypes and constantly plays with the viewer’s expectations.

In conclusion, the psychotherapist as a character is someone who can analyze their own personality and their surroundings. They are aware of their own social psychological reflections. Their uniform – apart from the white coat they seldom wear – lies within their relationship towards their patients and the atmosphere they want to create during the therapy session on the screen. In practice, the filmed version of therapy is heavily different than the procedure in reality. Filmmakers’ main concern is to tell a story from an aspect they intend to present. More discussion with mental health professionals could bring a fruitful collaboration to films concerning representations of mental health and illness.

Nevertheless, the costume designer must occupy the therapist’s chair to understand and help tell the story of the psychotherapists themselves.


Bibliography

  • Anderson, Martin. “‘One Flew Over the Psychiatric Unit’: Mental Illness and the Media.” Journal of Psychiatric and Mental Health Nursing 10.3 (2003): 297-306.
  • Batty, Craig, ed. Screenwriters and Screenwriting: Putting Practice into Context. Springer, 2014. (Chapter 5.) Costume as Character Arc: How Emotional Transformation is Written into the Dressed Body Craig Batty)
  • Britton, Piers DG. “Dress and the Fabric of the Television Series: The Costume Designer as Author in Dr. Who.” Journal of Design History 12.4 (1999): 345-356.
  • Haddad, P. (1991). The ‘Evil’ Psychiatrist and Modern Cinema. Psychiatric Bulletin, 15(10), 652-653. doi:10.1192/pb.15.10.652
  • Kaiser SB. The Social Psychology of Clothing: Symbolic Appearances in Context.  1990.
  • LoBrutto, Vincent. Becoming Film Literate: The Art and Craft of Motion Pictures. ABC-CLIO, 2005.
  • Landis, D. N. (2012). Filmcraft: Costume Design. Ilex Press.
  • Niemiec RM. Movies and Mental Illness: Using Films to Understand Psychopathology. Hogrefe Publishing; 2014.
  • Schneider, Irving. “The Theory and Practice of Movie Psychiatry.” American journal of psychiatry 144.8 (1 987): 996-1002
  • Shortland, Michael. “Screen Memories: Towards a History of Psychiatry and Psychoanalysis in the Movies.” The British Journal for the History of Science, vol. 20, no. 4, 1987, pp. 421–452. JSTOR, www.jstor.org/stable/4026417.
  • Young, Stephen Dine, et al. “Character Motivations in the Representation of Mental Health Professionals in Popular Film.” Mass Communication & Society 11.1 (2008): 82-99.

Interview

Filmography

  • Analyze This. Dir. Harold Ramis. 1999. Village Roadshow Pictures, NPV Entertainment Baltimore Pictures, Spring Creek Productions, Face Productions. Tribeca Productions.
  • Good Will Hunting Dir. Gus Van Sant 1997. Be Gentlemen Limited Partnership, Lawrence Bender Productions, Miramax.
  • To the Bone. Dir. Marti Noxon 2017. Netflix.
  • The Cabinet of Dr. Caligari. Dir Robert Wiene.1920. Decla-Bioscop AG (as Decla Film-Gesellschaft – Berlin).
  • Hannibal. Creator: Brian Fuller.2013 – 2015 Dino De Laurentiis Company, Living Dead Guy Productions AXN: Original X Production, Gaumont International Television.

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