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© Birgit Wolz
Occidental, CA, USA



Therapeutic Movie Review Column

By Birgit Wolz, Ph.D., MFT


Lars and the Real Girl

Director: Craig Gillespie
Producers: Sarah Aubrey, John Cameron, Sidney Kimmel
Screenwriter: Nancy Oliver
Cast: Ryan Gosling, Emily Mortimer, Paul Schneider, Kelli Garner, Patricia Clarkson
MPAA Rating: PG-13
Year of Release: 2007


In this fable-style movie, Lars Lindstrom, a painfully shy 27-year-old man, lives in a frosty rural Wisconsin town. He works at a boring office job and attends weekly church services. His mother had died at his birth and Lars was chronically traumatized growing up with his depressive, emotionally abusive father. Since his dad died recently, the family home has been occupied by his brother Gus and his pregnant sister-in-law Karin. She tries hard to invite Lars over for an occasional dinner to share their lives. But he recoils from human contact and sits in his cabin behind the big house, alone in the dark.

Margo, an awkward but sincere and sweet-natured co-worker, is more interested than other colleagues to get to know Lars, who avoids her. But he shows interest when a male co-worker makes him aware of anatomically correct vinyl love dolls on the Internet. They can be ordered customized to specifications. Not much later, an enormous crate is delivered to Lars' cabin.

That evening, Lars knocks at Gus and Karin's door. "I have a visitor ... this is Bianca," he says, proudly, introducing a life-size plastic woman in a wheelchair, "She's not from here." He looks very happy when he explains that Bianca is a shy, paraplegic missionary of Brazilian and Danish blood he met online. Because she is as religious as Lars is, she will have to sleep in the big house.

Because Gus and Karin are very concerned, they arrange for Lars and Bianca to start seeing Dagmar, the town's family doctor, who has been trained in psychotherapy. She advises them to allow Lars to go along with his fantasy by saying, "There's nothing to gain, and much to lose, from telling a delusional patient that his mind's creation is not real. Bianca is in town for a reason, and everyone who cares about Lars is going to have to deal with that".

When she first arrived, Bianca looked like a typical sex toy, but a thorough makeover makes her look perfectly "local". Lars has an explanation for everything, including why she does not talk or eat. She turns out to be the only kind of companion he can tolerate, not least because she can not physically touch him. He shares his deepest thoughts and feelings with Bianca. Their conversations range from loving exchanges to intense arguments. She is as real as anyone in his life can possibly be, at this point of his psychological and social development.

Gus, who is very much a guy's guy, is mortified because he is worried about what people will think about his family. But guilt makes him try to tolerate Bianca. Years ago, he had left the unpleasant family home and now suspects that Lars would be less damaged if he had stuck around. For Karin it is easier to accept Bianca because she believes that, for Lars, any change is progress.

The people of their community start treating Bianca with the same courtesy that Lars does. They have sadly watched Lars closing into himself and are moved by his attempt to break free. Only when he takes the doll to the local church, folks worry that Lars has crossed a line. But they decide not to judge himsince some of them have their own idiosyncrasies. Some church members own inanimate objects of their own that they treasure. They reconsider their own lives and begin to value what really matters. They give Bianca jobs and involve her in social activities that conveniently give Lars time away from her.

Once a week Dagmar pretends to   "treat" Bianca who has to undergo "special tests." Simultaneously, the doctor treats Lars' trauma in the next room. Among other things, he gradually learns to tolerate physical touch, which initially literally hurts him.

After several weeks of treatment, Lars begins to notice Margo. Consequently, Bianca "gets sick and dies". He is ready to shed his buxom psychological crutch. The doll has served her purpose by eliciting the healing support from his family, the community, and a therapist that he needed, as well as by providing him with "romantic training wheels". Now Lars appears to overcome his delusion and eventually opens up to Margo.

Cinema Alchemy

I had worked with my 53 year-old client Alex on his dysthymic disorder and on his chronic anxiety for several weeks. He was gay and regretted that he had only been in short term romantic relationships all his life. My client was a charming and kind man who had many friends and warm relationships with his colleagues at work.

Alex told me in one of his sessions that he loved Lars and Real Girl , which he had seen in a movie theater. When I asked him what he loved about this film, he responded that he enjoyed the humor of the movie as well as the main character's transformation. Upon further inquiry, my client revealed to me that he felt especially affected by the scenes, which showed how Lars was not able to connect romantically with a real person and those, which showed his reaction to physical touch.

I asked Alex whether these scenes remind him of his own life. He wondered whether he might have a part in his psychological make-up that resembles the main character, his "Inner Lars". This part is afraid of vulnerability, which he would feel if he opened up to dating somebody. Alex said, "I would have to go the extra mile to visit clubs or respond to dating ads on Internet Web sites. Most people on these sites are looking for younger partners. I am too old and overweight."

We continued our dialog by using the metaphors that this movie had presented. Alex recognized that, as Lars hurt when he was physically touched, my client's "Inner Lars" was afraid to get hurt by emotional touch. "Allowing myself to be touched could end up in feeling rejected or me having to reject someone," he said. Both possibilities seemed equally scary.

Further exploration revealed that Alex had been deeply traumatized by an alcoholic and abusive father and a highly conflictual divorce of his parents when he was a child. He loved his mom and hated his father after he had learned, at a young age, that his dad had an affair with a married woman in their hometown and conceived a child with her. Consequently, Alex developed doubts and fears about romantic relationships early in his life.

Based on this new understanding of his history, I developed a treatment plan for my client's trauma. Several EMDR sessions were successful. He was able to overcome much of his fear and started to thing about dating again. The transformation that Alex had watched Lars go through in the movie provided him with hope, motivation, and strength that he needed throughout the emotionally demanding EMDR procedure.

Theoretical Contemplation

Films can be seen as the "collective dreams" of our times. Therefore, the Evocative Way of Cinema Alchemy utilizes movies in a therapeutic manner by borrowing from dream work. As it is possible to gain insights from dreams, emotional responses to movie scenes or characters can help clients to understand themselves better. When certain movies resonate with clients, they touch into an preconscious or unconscious part of their psyche. A film may move them deeply. A character or a scene might also upset them intensely. Understanding their emotional responses to movies, just as understanding their nighttime dreams, can serve as a window to their unconscious. Both dream work and The Evocative Way are ways to bring their unconscious inner world to a conscious level.

There is no need to recommend specific movies to clients in The Evocative Way . For this approach, it usually doesn't matter whether or not the therapist has seen the movies, which clients might bring up in their sessions. Sometimes being unfamiliar with a film can even be an advantage because the therapist is forced to see the movie through their clients' eyes, like their dreams. When clients see themselves as experts in knowing certain movies, greater rapport is possible, and there is an increased likelihood for more independence in the relationship.  

Guidelines for Questions and Interventions

•  What scene and/or character affected you most?

•  Does this remind you of an experience in your current life or your past?

•  Are you aware of a part inside yourself that could be called your "Inner (name of character)"?

•  What function does this part have in your life? How does it serve or hurt you?

•  Initiate dialog between "Inner (name of character)" and "True or Higher Self" and/or other parts.


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