Hollywood Biopics and Mental Health Through the Lenses of ‘The Aviator’ (2004), ‘A Beautiful Mind’ (2001) and ‘Love & Mercy’ (2014)

20 years ago, a master was at work, yet again. With The Aviator (2004), Martin Scorsese focused on the life of Howard Hughes, and one might assume that this was a passion project of his, one that has gestated for years. Scorsese has had plenty of those, to be sure, but this one seems to be more of a studio passion project. With all the versions that were almost filmed, featuring heavy hitters like Warren Beatty, Steven Spielberg, Brian De Palma, William Friedkin, and Christopher Nolan (and that’s just in the director’s chair), this film, which is now firmly entrenched in the pantheon of great biopics, feels a bit like a miracle. And yet, it exists, and is one of his most successful works in terms of award nominations. 

The Aviator earned 11 Academy Award nominations, winning five: Best Cinematography, Best Film Editing, Best Costume Design, Best Art Direction, and Best Supporting Actress (Cate Blanchett). Quite a haul for a filmmaker who is usually shunned, in terms of wins, at the Oscar ceremonies. But more impressive than any awards is that he managed to create a biopic of Hollywood royalty without either getting bogged down in tedious detail or pulling punches regarding Hughes’ behavior and mental health struggles. Smartly, Scorsese picks a very particular time period in the life of Howard Hughes, along with a few important flashbacks to show the connective tissue necessary for character closure. Of course, both biopics and mental health are consistent fodder for the world of cinema. Given my own career as a mental health professional, this is of particular interest to me. To compare and contrast styles, two other films of this ilk have been chosen, one that was given awards attention, and one that was, sadly, completely shut out. As we examine Howard Hughes, we will also take a closer look at mathematician John Nash in A Beautiful Mind (2001) and Brian Wilson of The Beach Boys in Love & Mercy (2014).

The Order of Disorder

Howard Hughes: No, wait! Honey, you can’t move! You can’t move, you’re safe here! You’re in the germ-free zone now, y’understand?

Ava Gardner: I’ll take my chances.

Howard Hughes: No, no! Honey, wait… wait, uh…

Ava Gardner: Love what you’ve done with the place…

The Aviator (2004)

We all have things in film we are picky about. As a mental health professional, you might imagine where my particular annoyances lie. And here, I get to talk about them. Any time a film prominently features therapy or apparent mental health issues, you can count on me to try to pick them apart. Many times, therapy will consist of practitioners merely giving advice, no cognitive work, or their actions are tantamount to waving a magic wand to fix these mental issues. The same can be said of medications working immediately, as opposed to taking time to work into a person’s system. Now yes, movies are not reality, but these all become harmful messaging when given to the general public about an actual science that is, at the best of times, difficult to navigate.

But fear not, because apparently Martin Scorsese and Leonardo DiCaprio (expertly playing Hughes) did their research. It is relatively well-known that Hughes suffered from Obsessive Compulsive Disorder (OCD). Put in its simplest terms, OCD is a disorder whose hallmarks include intrusive thoughts, which leads to a desire to perform certain actions. The thoughts are the obsessions and the actions are the compulsions. A common obsession is the fear of contamination, which is shown clearly in the opening scene of the film (and at numerous other points throughout the runtime).

It is important to note that Hughes grew up in a time of medical outbreaks (cholera and polio were of particular concern), so contamination was a founded fear. The film opens, with the scene being slowly lit to reveal young Howard, standing in a tub of hot water, while his mother carefully brushes him clean. To add fuel, she teaches him to spell a single word, quarantine. From both a screenwriting and directorial standpoint, this is a stroke of genius. It allows perfect setup for Howard’s troubles later in life. This fear and desire for cleanliness comes from a place of love and protection. We understand the obsession and it allows Howard to be less alienating to the audience, a necessary ploy as he is in every frame of the film. 

Anyone with knowledge of either film or pop culture history knows where this ends. Howard Hughes, urinating into milk bottles, never leaving his screening room, hair and nails unkempt. This is a bit of a minefield as it has become more of a pop-culture joke than a serious discussion about OCD. Scorsese does get us there, but he, rightfully, is much more interested in the journey, both of his mental health and his successes. It is a marked difference from many stories about mental health struggles in that he shows the arc of the disease. In several moments, Howard seemingly gets stuck on a phrase, as the obsessions pile up. It is unlikely that he spoke these aloud without people confronting him in daily life, but it is effective cinematically. It provides a sense of both concern and alienation. This (paired with his need for order, perfection, and cleanliness) illustrates an intriguing picture of a very ill, albeit successful man. DiCaprio gives one of his best performances here, focusing on the humanity of the man, a truly difficult task given his Hollywood standing, success in the aeronautics industry, and drastic change by the close of the film. DiCaprio never loses this humanity, and we find ourselves both entertained by him and sorrowful for his many losses.

Another Oscar darling (8 nominations, 4 wins), A Beautiful Mind, struggles with representing disorder on screen. It has several other problems, as well. Russell Crowe, fresh off Gladiator the previous year, is put into a precarious position. This is the opposite of an action role, given the focus on the mind and, specifically, mathematics. Add to that being forced to wear dentures and giving a valiant but deeply unsuccessful attempt at a West Virginian accent, and you have a recipe for disaster. But the real problems are the dishonesty and the dramatization of Nash’s very real disorder. Nash was diagnosed with schizophrenia, of a paranoid subtype. It should be noted that diagnoses of subtypes are no longer recognized by the psychological community. Schizophrenia is a deeply misunderstood diagnosis. Most often, these individuals are painted as dangerous to others, when in reality they are more likely to hurt themselves. The basics of schizophrenia are that it is a disorder that affects the emotions, rational thinking, and interactions with others. In active periods, the individual may experience hallucinations (visual, auditory, tactile, olfactory, or gustatory), delusions, difficulty concentrating, and a flattening of emotional expression.

Much of this is certainly shown in A Beautiful Mind, but much of it, according to Nash himself, is a misrepresentation. Nash never experienced visual hallucinations, only auditory. So, the character of his roommate, Charles Herman (Paul Bettany) and the Defense agent, WIlliam Parcher (Ed Harris) are invented out of whole cloth for the film. One can certainly see why the temptation was there, as these performances are a joy to watch, especially in comparison to Crowe’s relatively uninspired vocal and physical choices. This does not even touch on the fact that the film disregards Nash’s sexuality, as he was arrested in a sting targeting gay men during this time period. But, there is one thing that A Beautiful Mind shows us that is important in the area of mental health. The film clearly shows the effect that these disturbances can have on a marriage or a family. Despite the fact that he and his student, Alicia (Jennifer Connelly), have a romantic relationship seemingly devoid of any spark or chemistry, her screen presence is blameless. As the story unravels and his diagnosis becomes clear to her, Connelly hits another level. Her exhaustion, worry, care for her child, and, at one memorable moment, rage, are all perfectly in step with the character she has built. Of course, the film also ignores their divorce and remarriage, but you can see why, in their romantic story, they might want to skip over that upsetting detail.

The least known film of these three, Love and Mercy, may handle the mental health aspect with the most care. Brian Wilson (Paul Dano and John Cusack), member of one of the most popular bands of the time, has been diagnosed with paranoid schizophrenia by his doctor, Eugene Landy (Paul Giamatti), but we later find that this is a misdiagnosis, in order to keep him under the doctor’s control. His actual diagnosis is schizoaffective disorder. This disorder, notoriously difficult in differential diagnosis, combines symptoms of schizophrenia and a mood disorder (usually depression or bipolar disorder). But, as the film posits, that difference is quite important in treatment and medication. In a pivotal moment, the older Brian takes his medication just before eating and is clearly drowsy, appearing almost drunk. The effect of these medications could be read as Lundy drugging him purposefully.

Love and Mercy, through the use of music and ambient sound, manages to put us in the headspace of Brian, in both positive and negative moments. The sound design, combined with Dano’s performance (one of the best of anyone in the past few decades) help us understand his suffering. Cusack never reaches the heights of the young Brian, but he does keep us rooted in his struggle and the burgeoning romantic relationship. His reaction to Lundy is also interesting in that it shows the power of connection to a therapist. Despite the fact that Giamatti is just short of a cackling villain, it helps shine a light on the dangers of psychologists who do not have the best interest of their patients at heart. The film also provides a deeply important lesson on correct diagnosis, medication compliance, and having a support system, best represented by Wilson’s future partner, Melinda Ledbetter (Elizabeth Banks).

An Ounce of Prevention

Dr. Rosen: Imagine if you suddenly learned that the people, the places, the moments most important to you were not gone, not dead, but worse, had never been. What kind of hell would that be?

A Beautiful Mind (2001)

One thing that is often presented in dramatic and violent ways is the treatment aspect of psychology. This is especially true in biopics, as many take place long before the advent of more effective (and less horrific) methods of assisting those that struggle with mental health. I mean, let’s be real, there were times when certain diagnoses were seen as communing with the devil, as opposed to mental struggles that can be altered with actual help, instead of deep, disturbing violence. And sadly, many of these treatments come from a past that is not as distant as we would like to think!

In The Aviator, despite Howard Hughes’ massive successes, playboy lifestyle, and general braggadocio, internally, he was suffering. As we mentioned, much of this is rooted in personal and area history. And like many people with mental health issues, not only of the time but generally, he suffered in relative silence. The official diagnosis of OCD certainly did exist during Hughes’ life, but treatments, much like for Schizophrenia, would seem barbaric. Treatments would consist of bloodletting and being relegated to an asylum, likely against their will. And speaking of disturbing, the history of asylums is a rabbit hole that you probably would not enjoy going down. It can be understood that Hughes’ desire for success and wanting things his way is tied to his own desire for control over his mind. But, it is clear that he understands that this is not normal behavior. In one heartbreaking scene, a man on crutches asks Howard to hand him a towel to clean off his hands in the restroom. For further context, Howard carries his own private soaps to avoid contamination. DiCaprio’s performance of both fear and sorrow in this moment is tremendously impactful. His soulful eyes looking into the mirror as he apologizes truly connects with how difficult it is to live with a serious mental illness.

A perfect example of the aforementioned horrific psychological treatment history is explored in A Beautiful Mind and, disturbingly, is shown in great detail. It is important to show these impacts, but also important to remember how far we have come. Given the consistency of Nash’s delusions, Dr. Rosen (Christopher Plummer) clearly understands that treatment is necessary. Unfortunately, the treatment at this point in history was Insulin Coma Therapy, followed by Electroconvulsive Therapy (ECT). The insulin therapy involves injecting large doses of the drug to induce a coma. Afterwards, ECT is used to essentially reset the brain and simply hope that this reduces or removes his hallucinations. Through modern eyes, this looks like pure torture and has been described as such by John Nash, himself. Luckily, current treatment involves prescription medication and cognitive therapy. These sequences are expertly filmed by brilliant cinematographer Roger Deakins and allow us to feel both its necessity and the terror experienced by both John and Alicia. However, as a mental health professional, it is difficult to watch a story in which the eventual solution amounts to John simply ignoring his delusions and carrying on.

Brian Wilson, being treated for the wrong diagnosis, obviously struggles. This is the best part of John Cusack’s performance; his sadness paired with near catatonia, once medicated. Wilson was given antipsychotic medications (Navane and Serentil), as well as an anti anxiety medication (Xanax). As detailed earlier, this is particularly dangerous because they were unneeded. On top of that, antipsychotic drugs cause a condition called Tardive Dyskinesia (TD). TD causes involuntary muscle movement, and for Wilson this was shown in facial tics that Wilson will have for the rest of his life. If an individual needs these medications, TD may be worth it, but in this case it is gross negligence, at best. Although the film neither shows his treatment nor his stays in hospitals prior to the events of the John Cusack portion of the film, it is likely that Wilson’s previous drug use and the physical abuse he suffered from his father had a serious impact on his mental health. What Love & Mercy does show is the importance of social support. Wilson has discussed many times that the support he has from his family has made his life much easier, paired with his return to music. 

A Fine Line Between Genius and Insanity

Brian: I hear voices. I was going to tell you but I didn’t want to scare you away.

Love and Mercy (2014)

Another always concerning trope of people with mental health in films is the idea that there is hidden genius due to their struggles. We should remain aware that normal, everyday people struggle with mental health issues and these stories are just as important. This focus on genius is as true in biographical films as it is in narrative fiction on screen. It is a bit more excusable with the biopic structure, because all three of these men are geniuses in one way or another; Music, Movies, Mathematics. But, the exploration of genius is certainly quite different in all three.

In Love & Mercy, for those with music knowledge, the idea of genius is completely obvious. The album “Pet Sounds,” produced in 1966 is seen by most as one of the most influential and important rock albums in history. For director Bill Pohlad, these scenes must have been nerve-wracking. If they are not done well, all of the reality of the film likely falls apart. “Pet Sounds” was produced by Brian Wilson while the rest of the band was on a world tour. This album combined many different styles of music, along with found sounds, and odd instrumentation. The idea of composing anything like this is nearly unfathomable to normal human beings. The film manages the nearly impossible. Pohlad balances both Brian’s experience (through a combination of beautiful scoring and that wonderful Dano performance) and an understanding that this is the definition of an album that is “not for everybody.” Although we are easily swept along, and have the knowledge that this will stand the test of time, the film also shows us who The Beach Boys were previously. This is obviously not in the same style and we can at least understand their concern and worry. Screenwriting wise, there is an included scene that hammers down this genius. Sure, we have watched all kinds of instruments, animals, and other gathered accoutrements, but do we know if it’s any good? Luckily, afterwards, there is a moment between Brian and another accomplished musician solidifying that, yes, this actually does work from a musical perspective. This allows the film to not have incessant needle drops to prove its point. Instead, we are rewarded with Dano singing “God Only Knows,” which not only shows his artistry, but also provides detail for his relationship with his father (Bill Camp).

A Beautiful Mind takes a bit of a different tactic. Director Ron Howard understands that, unlike music, most of us have no basis for or proclivity towards higher mathematics. Math is a background player in this film, showing complicated formulas on chalkboards and, more memorably, on the windows of the library, but never bothering to explain them. Instead, in between fantastical moments of fancy with John’s imaginary life, we are left with a different kind of genius, full of pomp and circumstance. It is an odd balance, to have the protagonist of your film set in college never go to class and act like a spoiled child when he loses a board game, but still remain at least mildly likable. This may offer a clue into why the film chose to create imaginary friends that never existed, even in Nash’s own plagued mind. Crowe does his best and, thankfully, despite the previously mentioned accent and prosthetics, he has an inherent charm that draws us into his orbit. This, combined with Connelly’s knowing smiles and mild adoration of Nash, helps us care in the slightest bit. Unfortunately, the movie is so wrapped up in the shock of mental health issues and his treatments that, at some points, we forget why we are even telling this story. The film seems to depend more on postscript details and our own post-movie research to solidify his actual genius and his contributions to the field of mathematics.

The Aviator has a distinct challenge. After all, Howard Hughes could be termed a genius in more than one field. The wonderful thing about a Howard Hughes film is that although many know his name, and his end, the middle is an enigma. He was wildly accomplished both in the sphere of Hollywood and in that of aeronautics. It is not a coincidence that Scorsese introduces the adult Howard on the set of Hell’s Angels. The film was, at the time, the most expensive on record and featured many scenes in the cockpits of planes during dogfights. This is not only true to his life, but an efficient way to show both of his passions. As a side note, despite his prowess at, well, everything, the dogfighting and flight sequences are so excellent that it makes me wish Scorsese would make a pure action picture. 

The film also uses his diagnosis of OCD as one reason for his successes. Many sequences of DiCaprio running his hands along the side of his plane to make sure the rivets are completely flat are one prime example. This likely allows him to soothe his symptoms as well as make his planes more aerodynamic. Another is the reshooting of Hell’s Angels for sound after realizing that this was the future of cinema. One can imagine that Scorsese, at some levels, admires this in Hughes. Unsurprisingly, this becomes an issue in Howard’s private life, leading to his inability to hold his tongue both privately and publicly. Although we mostly root for him, thanks to a charming and debonair DiCaprio, there are moments, specifically when he lashes out at Kate, in which we feel her injury and understand how difficult Hughes was interpersonally. But this does not change his genius, which is mostly represented by an unwillingness to give in to strong pressures. On many occasions, he is told what he cannot do, and it is always understood that he will push forward. This (relative) little guy facing down the industries of film and aeronautics does always feel like one we can get behind with ease.

It is no surprise that, when rewatching Scorsese’s work, we can remain impressed. He is seen as a master of the form for many reasons. The Aviator is one of the greatest biopics ever filmed. It is an examination of a difficult and brilliant man in more than one industry. An incisive look at mental health. Most movies (especially biopics) that try to be great in this many areas fall flat on their faces. Other than the horrific plane crash on screen, there is none of that to be seen here. Despite its long run time, numerous cameo appearances, and the recreation of a Hollywood long since gone, there are almost no false notes in The Aviator. This is the biopic the industry should always aim for; not simply a recognizable name, but a startling, beautiful story for us all to hold onto.

The Aviator is available to stream through MGM+, A Beautiful Mind is available to rent or buy via Prime Video and Google Play, Love & Mercy is available to stream via Tubi, SlingTV, Roku Channel, Prime Video and more.