Cinematherapy - Using the Power of Movies for the Therapeutic Process

By Birgit Wolz, Ph.D., MFT

My connection with cinematherapy began during a seminar I attended about using metaphors from movies to understand emotional issues. During the workshop, another participant mentioned a study that got my attention. It purported that more people experience relief from symptoms of trauma by watching films than through psychotherapy.

I had to admit that many times in watching films, I'd had powerful experiences that made it easy to believe the study might be true. I was also reminded of the experiences related to me by many of my clients. I wanted to learn more about the impact of movies on the psyche and using films to support the therapeutic process. Now I use cinematherapy as a therapeutic modality in my work with individual clients as well as in a cinematherapy group. In talking to colleagues I learned that the practice of using clients' responses to movies has spread, and now, more and more therapists recognize the value of cinematherapy as a therapeutic modality.

Why cinematherapy works

Watching a movie with conscious awareness can be similar to experiencing a guided visualization. The therapeutic effect and the theoretical basis for both modalities are therefore closely related. In fact, the use of films in therapy allows us to draw from multiple theoretical psychotherapeutic orientations. Films are metaphors that can be utilized in therapy similar to stories, myths, jokes, fables, or even dreams. In cognitive-behavior therapy movies are used in combination with the established modalities of this field. Films can fulfill the role of a supportive device for understanding maladaptive core beliefs and for cognitive restructuring. Cognitive insights tell clients what to do but affective insights give them the motivation to follow through. Behavior modification treatment can be supported by watching movies where a character demonstrates courage in face of a challenge. The client becomes motivated to copy the behavior seen on screen and is more open to successfully undergo treatments such as "exposure with behavior avoidance prevention". Systems oriented therapists can find support for their approach by choosing movies that communicate unfamiliar concepts of family systems and their dynamics as well as communication patterns.

Identifying with a character can help clients develop ego strength as they recall forgotten inner resources and become aware of the right opportunity for those resources to be applied. As clients identify with a film character they see their own issues unfold. This brings to life issues they previously wanted to avoid. Viewing characters in combination with the subsequent reflection in individual or group therapy allows clients to process their feelings with a sense of increased safety. Understanding reactions to characters, who are "different" and unlikable can guide the client to discover in the "shadow" of their own psyche and story their true self and their potential. Watching movies at home in this context serves as a bridge between therapy and life.

The cognitive effect can be explained through recent theories of learning and creativity, which suggest that we have seven "intelligences". The more of these intelligences we access, the faster we learn because they employ different methods of information processing. Watching movies can engage all seven of them: the logical (plot), the linguistic (dialogs), the visual-spatial (pictures, colors, symbols), the musical (sounds and music), the interpersonal (storytelling), the kinesthetic (moving), and the intrapsychic (inner guidance). In addition films galvanize feelings, which increase the probability that clients will carry out new and desired behaviors.

Identifying with a character can help clients to develop ego strength as they recall forgotten inner resources and become aware of the right opportunity for those resources to be applied. Understanding reactions to characters who are "different" and unlikable can guide the client to discover in the "shadow" of their own psyche and story their true self and their potential. Watching movies at home in this context serves as a bridge between therapy and life.

Clinical examples

To illustrate, here are two  examples from my own practice. The names have been changed in order to protect the client's confidentiality. I'll begin with "Sally." She arrived at our session confused and worried. The night before she had become angry with her boyfriend and yelled at him. Now, she said, she felt bad about it because she saw that the small mistake he had made didn't justify her acting out this way. The real reason for her reaction was her hurt about his plans to leave then next morning on a fishing trip with his buddies for a couple of weeks. Sally felt excluded and abandoned.

As we explored this, Sally came to understand that her anger was a way for her to push him away by defending against her vulnerability and fear of abandonment. She sensed it would help her to tell him about these feelings when he returned, but she was too "afraid to look stupid," she told me. "It would make me feel too weak. He might take advantage of my vulnerability, criticize me, see me as needy, and push me away. Then I would feel even worse."

In the process of working with this, Sally began to understand that these beliefs might be based on projections. But a significant shift in that understanding didn't happen until she viewed a movie I suggested: "Sliding Doors" (starring Gweneth Paltrow). I asked her to focus specifically on the combination of strength and vulnerability that the main character, Helen, displays when she meets James again on the street and expresses her interest in him even though she is not sure whether he is still interested in her. James responds with emotional openness too and they develop a close relationship from this point on.

When Sally came back for her next session she remarked that, "Helen looked like she put herself out on a limb. She looked not weak at all. In fact, she seemed kind of courageous and strong allowing herself to be so open and emotionally vulnerable." Sally was able to internalize Helen's courage: "I can see myself as Helen. What Helen can do, I could do too." First Sally was able to understand more clearly how she had been projecting. She recognized the good-hearted nature of her boyfriend. Then Sally saw the opportunity to experience more emotional closeness if she allowed herself to be vulnerable with him. We discussed that at times of emotional stress she usually is not in touch with her strength and courage and the means by which she can access them. Through watching and discussing this movie scene, it sank in consciously for Sally that she already carried these qualities inside her. It's my belief that without the aid of the movie, it would have been much harder for Sally to recognize this capacity in herself.

A second example from my practice involves "Alice." She had worked with her grief over the pending end of her marriage for quiet a while. When she came to her session one day, she told me she had had another big fight with her husband because she felt very oppressed by him again. For a long time he had been her "main purpose in life." Now it became clear to her that her marriage was over. She had tried for a long time to make it work. During the session she cried a lot and felt some relief. After a while she said, "I believe that something good will come out of this but I can't be sure". I told her that many movies have been made that begin in despair and end in triumph. If she could identify with characters, trapped in their circumstances, and share their disappointments as well as their unsteady steps toward liberation, she could start finding reason for optimism in her own situation. This could help her gain the courage to do what is necessary to change her situation.

I encouraged her to let a film inspire her to learn how to survive her loss without succumbing to it, possibly coming out of it transformed. I suggested several movies and asked Alice to choose a film that had touched her when she seen it before. It was not crucial that the plot matched her situation exactly as long as a character was going through this kind of transformation. Alice chose the Alan Alda film, "The Four Seasons." Throughout the next sessions we addressed the following themes going back and forth between her process and a scene or a character in the movie that had inspired her: acceptance and compassion with herself and her grief, small acts of courage despite fear (such as reaching out to friends and joining a divorce support group), determination and endurance, and transformation. Alice started to enjoy her newly gained freedom after her separation. She discovered new strength and compassion. She got in touch with a sense of autonomy and new purpose.

Guidelines for watching movies with conscious awareness

The following is a set of guidelines I give to my clients and group members who want to use movies for healing and growth. I begin by encouraging them to adapt the techniques to suit their own personal style as they progress. I tell them:

In preparation for each viewing session, sit comfortably. Let your attention move effortlessly, without strain, first to your body then to your breath. Simply inhale and exhale naturally. Follow your breath in this innocent, watchful way for a while. Notice any tension or holding. As you grow aware of them, let your breath travel into these spots. To release tension you may experiment with "breathing into" any part of your body that feels strained. Never force your breath.

Your gentle attention is sufficient to help you become more present and balanced, as it spontaneously deepens and corrects your breathing if it is constricted. Experience your condition without inner criticizing or comment. If you notice yourself judging or narrating, simply listen to the tone of your inner dialog as you come back to your breath. Lay judgments and worries consciously aside.

As soon as you are calm and centered, start watching the movie. Most deeper insights arrive when you pay attention to the story and to yourself. While viewing, bring your inner attention to a holistic bodily awareness (felt sense). This means you are aware of "all of you" - head, heart, belly, etc. Once in a while you might notice your breathing from an inner vantage point - from your subtle, always-present intuitive core. Observe how the movie images, ideas, conversations and characters affect your breath. Don't analyze anything while you are watching. Be fully present with your experience.

Afterwards reflect on the following:

Do you remember whether your breathing changed throughout the movie? Could this be an indication that something threw you off balance? In all likelihood, what affects you in the film is similar to whatever unbalances you in your daily life.

Ask yourself: If a part of the film that moved you (positively or negatively) had been one of your dreams, how would you have understood the symbolism in it?

Notice what you liked and what you didn't like or even hated about the movie. Which characters or actions seemed especially attractive or unattractive to you?

Did you identify with one or several characters?

Were there one or several characters in the movie that modeled behavior that you would like to emulate? Did they develop certain strengths or other capacities that you would like to develop as well?

Notice whether any aspect of the film was especially hard to watch. Could this be related to something that you might have repressed ("shadow")? Uncovering repressed aspects of our psyche can free up positive qualities and uncover our more positive qualities of our whole and authentic self..

Did you experience something that connected you to your inner wisdom or higher self as you watched the film?

It helps to write down your answers.

The reasons why watching movies with conscious awareness can work therapeutically are the following: The unconscious communicates its content to our conscious mind mostly in symbolic images. We can become aware of this "communication" through dreams and active imagination, which are "windows" to the unconscious: both convert the invisible forms of the unconscious into images that are perceptible to the conscious mind. Feeling moved by a movie scene shows that they symbolically reflect relevant unconscious material. We are interested in learning about the unconscious because it often is in conflict with our conscious ideas, intentions and goals. Exploring the effect of a movie on us can therefore break down the barriers between the two levels of the psyche and set up a genuine flow of communication between them. Unconscious material can start to become more conscious. This helps us to resolve some of our neurotic conflicts with the unconscious, and thus to learn more about who we really are as authentic human beings. We learn to respond to life's challenges and changes more successfully from a more present and authentic inner place instead of reacting from old dysfunctional emotional and behavior patterns.

If some of the mentioned guidelines turn out to be useful, you might consider using them not only in "reel life" but also adapt them to "real life" because they are intended to make you become a better observer. As observing helps you to "step back", the bigger picture becomes more obvious. This way, watching screen movies helps you learn to understand yourself and others more deeply in the "big movie" of your life. You develop a skill to see yourself and the world more objectively, and less through a rigid, judgmental, or emotional filter (projection).

More detailed guidelines and a bibliography can be found on other pages.

Birgit Wolz wrote the following continuing education online courses;

Cinema Therapy - Using the Power of Movies In the Therapeutic Process, which guides the reader through the basic principles of Cinema Therapy.

Cinema Therapy with Children and Adolescents - This course teaches Cinema Therapy with young clients. It includes numerous movie suggestions, which are categorized according to age and issues. It serves therapists, teachers, and parents.

Positive Psychology and the Movies: Transformational Effects of Movies through Positive Cinema Therapy - This course teaches how to develop clinical interventions by using films effectively in combination with positive psychotherapy. It serves for mental health practitioners and anybody who is interested in personal growth and emotional healing.

Therapeutic Ethics in the Movies - What Films Can Teach Psychotherapists About Ethics and Boundaries in Therapy, which covers: confidentiality, self-disclosure, touch, dual relationships and out-of-office experiences (i.e., home visits, in-vivo exposures, attending a wedding, incidental encounters, etc.)

Boundaries and the Movies - Learning about Therapeutic Boundaries through the Movies, which covers informed consent, gifts, home office, clothing, language, humor and silence, proximity and distance between therapist and client, and, finally, sexual relations between therapist and client.

DSM: Diagnoses Seen in Movies - Using Movies to Understand Common DSM Diagnoses.

Psychodynamic Diagnostic Manual (PDM) - A New Approach to Diagnosis in Psychotherapy