The Transformational Power of Film – Using Movies in Therapy
By Birgit Wolz, Ph.D., MFT

Since I have been working with my clients’ responses to movies as a therapeutic modality, they often tell me that they came away from a theater or TV screen filled with emotions, insights and inspiration. In my work with individuals, couples and groups, I’ve found that having clients watch certain films with conscious awareness has helped them reflect on their inner process — their struggles as well as accomplishments

My own connection with cinema therapy began during a seminar about using metaphors from movies to understand emotional issues. I became inspired to learn more about the impact of films on the psyche and their use to support the therapeutic process.

In cinema therapy, clients are guided to use the psychological effects of film imagery, plot, music, etc. for insight, inspiration, emotional release or relief and natural change. This therapeutic modality is an innovative method based on traditional therapeutic principles, and on bibliotherapy, which has been practiced since the 1930s. Before I explain this further I want to mention a couple of clinical examples.

Case Examples

In one case, a woman I’ll call “Fran” had made much progress in our work. Her depression had lifted and we started discussing terminating her therapy. During that time she arrived at one session very distraught. Unexpectedly she had been laid off from her job, the company was downsizing. Fran didn’t really like her job but was very attached to her co-workers. Leaving her workplace in an upset state of mind, she caused an auto accident in which she was slightly injured. These unfortunate events triggered a lot of self-criticism and grief about disconnecting from her co-workers as well as about her injury.

First we did some cognitive restructuring of Fran’s negative beliefs about herself that were reactivated by these events. When I explained the grief process, Fran could not imagine ever “coming out at the other end”. I suggested she watch the movie Frida and gave her specific guidelines (see www.cinematherapy.com). Frida shows how the Mexican painter Frida Kahlo faced many big challenges with strength and courage throughout her life. The artist was able to let her pain transform her as it led her to create outstanding art, which in return helped her cope. I encouraged Fran to “step inside Frida’s shoes” when she watched the film at home.

The film touched Fran deeply and allowed her to open up to new possibilities for herself. Aided by the emotional impact of the movie and the “modeling” provided by the character of Frida, I guided Fran through the following four stages of understanding and integration:

1. The seed for strength and hope lies in the acceptance of her limitations;
2. Tiny acts of courage can start to put her back in control of her life;
3. Responding with determination to each element in the struggle nourishes hope;
4. Out of all this grows new strength, a new sense of self, new compassion, and a new sense of a strong purpose in her life.

As a result of this work Fran moved through her grief process, gained her confidence back and rediscovered her passion for photography. She had been trained in this field but was never able to apply it. By the time her emotional and physical wounds were healed she found work that allowed her to integrate her skills in photography.

A second case involves a client I’ll call “Terry”. She came to her first session presenting low self-esteem as her main problem. After we talked about her upbringing in a highly critical environment we started working with her “Inner Critic” and cognitive distortions. Terry was so identified with these internalized messages that it was hard for her to fully see the distortions. She could not imagine a different perspective. At this point I suggested she watch the movie My Big Fat Greek Wedding. In this comedy the main character Toula transforms herself from an “ugly duckling” into an attractive, successful woman.

Besides my general guidelines on how to watch a film with conscious awareness, I also provided Terry with the following specific questions to answer after watching the film:

1. Focus on the movie with conscious awareness;
2. Ask yourself whether the perspective of Toula, who thought negatively about herself, was distorted;
3. Can you name any of the cognitive distortions?;
4. How was this character able to let go of self-doubts?;
5. Imagine yourself as Toula when she lets go of her negative beliefs;
6. What thoughts about yourself are dropping away? How does this feel? How do you see yourself and your environment now?

As Terry followed this process and stayed with the questions during our next sessions she was able to understand and consequently disidentify from her negative self-image. Theoretical Context

These case examples show that I draw from multiple theoretical psychotherapeutic orientations as I integrate the use of film in my work. 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 therapeutic effect of films can be explained by different theories.

Since films are metaphors, the depth psychologist can utilize movies in therapy similar to the way in which he might use stories, myths, fables, or dreams. Identifying with a character can help clients develop ego strength as they recall forgotten inner resources. As clients identify with a film character they see their own situation unfold. This brings to life issues they previously wanted to avoid. Understanding reactions to characters that are “different” and unlikable can guide the client to discover in the “shadow” of their own psyche their true self and their potential.

In cognitive 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. The cognitive effect can be explained through recent theories of learning and creativity. They suggest that we have seven “intelligences”, which can be engaged by watching movies: 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).

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 response 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.

Guidelines:

• Start with a film that your client has already seen and that supports your treatment goal. If no appropriate movie comes to mind use the literature, which offers movie recommendations for specific psychological problems
• Clarify your intent when assigning a film in which a client might mistake the role identification.
  Discuss positive and negative reactions to film. Use material according to your theoretical orientation. Some evocative questions are:
• How did the movie touch you, positively or negatively?
• If the film had a unique message for you, what was it?
• What new ideas for new behaviors did the movie introduce?
• Did you experience something that connected you with health and wholeness, your inner wisdom or higher self as you watched the film?
• What other films can you identify that might take the discussion a step further?

More detailed guidelines and a bibliography can be found on the web at www.cinematherapy.com

Birgit Wolz wrote a continuing education on-line course "Cinema Therapy - Using the Power of Movies In the Therapeutic Process", which guides the reader through the basic principles of Cinema Therapy. She also co-authored the on-line course "Boundaries and the Movies: Learning about Therapeutic Boundaries Through the Movies".

Birgit Wolz wrote the following continuing education online courses for mental health practitioners:

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. This course serves therapists, teachers, and parents.

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