Cinema-laden psychiatry and American fight films: Cluster A personality disorders in The Matrix
At Rutgers-Robert Wood Johnson Medical School, we have developed a multimedia curriculum called C- L (Cinema-Laden) Psychiatry to supplement psychiatric education for residents and medical students on their psychiatry clerkship. In our module on personality disorders (PDs), we require students to view movies from three franchises: The Matrix (1999), Kill Bill Vol 1 and Vol 2 (2003, 2004) and Fight Club (1999). In this paper, we describe how The Matrix can be used for instruction in Cluster A Personality Disorders. Specifically, we examine the characters of Thomas Anderson, Morpheus and Trinity with regard to schizoid, schizotypal and paranoid personality traits, respectively. Our work is grounded in social learning theory, theories of multiple intelligences and critical thinking schema.
Keywords: Media, Education, Personality Disorder, Cluster A, The Matrix
At Rutgers-RWJMS, we have developed a multimedia curriculum designed to educate medical students and psychiatry residents on a variety of psychiatric conditions. Cinema-Laden Psychiatry requires young clinicians to view a number of movies and prepare discussion points relevant to psychiatry. During discussions on rounds and during noon lectures, students and physicians filter the characters, themes and subtexts of the films through the lens of psychiatric disorders.
In one of our modules, we explore the personality disorders through the genre of American Martial Arts movies. In addition to using movies that demonstrate characters with identifiable personality disorders, we want the movies to be fun, widely viewed and accessible. We ask students to view four recent American martial arts movies: The Matrix (1999), Kill Bill Vol 1 and Vol 2 (2003, 2004), and Fight Club (1999). In these movies, we find grounds to discuss all the personality disorders. Specifically, The Matrix showcases Cluster A, Kill Bill demonstrates Cluster B and characters in Fight Club evidence Cluster C personalities.
In this paper, we describe how The Matrix can be used as a teaching tool to explore the Cluster A Personality Disorders. When learning psychiatry, one learns the abstractions of the DSM-V, but also searches for concrete examples for illumination and complexity. Popular movies such as The Matrix can serve such a purpose. Because students and residents often consume news, books, blogs and movies from a wide variety of specialized niche markets, blockbuster movies can serve as a common source of reference in discussions. In recent years, movies have played an increasingly important role in supplementation of themes in traditional curricula.
Directed by the Wachowski brothers, the 1999 film The Matrix was one of the great blockbusters of the 1990’s, grossing over $463 million at the box office alone1. It spawned two sequels, together grossing more than one billion dollars.
The Matrix – The Other Modern Prometheus – is a post-apocalyptic, dystopian movie set 200 years in the future where machines with Artificial Intelligence (AI) have taken control of the world and subjugated the human race by growing humans in pods and harvesting energy from their body metabolism. Meanwhile people live out their lives engaged in a computer programmed virtual reality. This virtual reality is guarded by sentinel programs within the matrix called “agents.” A resistance against AI has formed, occasionally releasing people from virtual reality to join their cause.
Because The Matrix has such strong philosophical, religious, sociological and psychological themes, it has been used in many academic settings from college-level religion classes to analytic philosophy classes to critical literature seminars and high school composition instruction. 2 3 4 5 6 7 8 9
II. Mr. Anderson and Schizoid PD
The protagonist in The Matrix, Thomas Anderson (Keanu Reeves), is a computer programmer by day and a computer hacker with the moniker “Neo” on his off hours. The first scene in The Matrix reminds the viewer that schizoid individuals are socially detached and may gravitate towards solitary jobs; Thomas Anderson is in his apartment where he is surrounded by computer equipment and books, his computer is scanning hacker-type websites, and in his apartment, the audience sees no evidence of friends or family.
The audience is given no indication that he enjoys or seeks the company of others, giving the viewers evidence that Anderson does not associate with friends or family and that he does not desire such encounters.
Like Neo, individuals with schizoid personality disorder are quiet, reserved, and distant. Their sexual lives may exist solely in fantasy. In fact, in order for a resistance member, Trinity (Carrie-Anne Moss), to meet with Anderson, she has to hack into his computer and goad him into accepting an invitation to go out. (“Follow the white rabbit,” she tells him’meaning to accept the party invite from the woman with a white rabbit tattoo.) That night, Trinity tells Anderson, “I know why you live alone, and why night after night you sit at your computer.” This further connects Anderson to the schizoid lifestyle.
At Anderson’s work desk later in the movie, we again see a striking lack of personal artifacts. While the order of his desk stands in contrast to the chaos of his apartment, the one unifying aspect is his lack of evidence of a social life’no pictures of parents, no photos of friends or significant others.
Anderson has become suspicious of the nature of existence, but his paranoia is not to be confused with the social anxiety of the avoidant personality. Anderson seems sure of himself in situations of conflict, and he gives the audience no indication that he is concerned about the opinions of others. Further, in the scene where Anderson is confronted by Smith, he demonstrates this very aspect of the schizoid personality – he is indifferent to the criticism by others.
Anderson’s mental life is significant for his magical/surrealist thinking. Anderson makes the comment to the people who pay him for his computer work: “You ever have that feeling that you’re not really sure if you’re awake or still dreaming?” Later, Morpheus (Laurence Fishburne) picks up this theme while talking to Neo during their first meeting:
Let me tell you why you’re here. You’re here because you know something. What you know you can’t explain. But you feel it, you’ve felt it your entire life. That there’s something wrong with the world. You don’t know what it is, but it’s there. Like a splinter driving you mad. It is this feeling that has brought you to me.
Neo agrees with Morpheus and agrees to follow him out of the shared delusion of the virtual world.
Schizoid individuals may come off as cold and aloof, but can generate creative ideas and invest enormous energy in nonhuman interests and philosophical movements. As such, Neo follows Morpheus without hesitation–he instantly agrees to leave the world without thought to severing ties with family, friends or loved ones. For all the audience can tell, Neo has lived a schizoid life without meaningful relationships.
When using Neo as a model for teaching about the schizoid personality, it is important to contain the conversation to the first half of The Matrix. In the second half of the movie (i.e., after he has been freed) and in the subsequent sequals, Neo demonstrates strong personal attachments and romantic interest in others. Before following Morpheus out of the matrix, however, Anderson lives a schizoid life.
Neo’s personality seems to dramatically change after he takes the blue pill. It is not entirely unreasonable to believe that a drug is the catalyst for Neo’s new personality’one that allows him to form deep bonds with crew members, respond appropriately to a mentor, and even form a profound romantic attachment with Trinity. Here, we remind students that personality disorders cannot be diagnosed until a drug induction is ruled-out.
For teaching purposes, we ask students to consider whether or not the blue pill is an LSD-type hallucinogen, pointing out that LSD is strongly fluorescent and will glow blue under UV light. If this is true, then Neo’s personality cannot be assessed after he takes the blue pill’perhaps all his experiences and his personality change are the result of the blue pill-induced hallucination.
Since we have no evidence that Anderson used drugs prior to taking the blue pill, we must focus our diagnosis of his maladaptive traits during that antecedent period of his life. And because we cannot rule out that the blue pill is actually the cause of his personality change, we must exclude the predicate changes.
III. Morpheus and Szhizotypal PD
The character of Mopheus (Laurence Fishburne) exemplifies many of the characteristics of the schizotypical personality disorder. As the captain of the Nebuchanazzer, Morpheus’s duty is to spearhead the resistance by the people of Zion (the only remaining human city) in part by hacking into the matrix and liberating those people who seem ready to be freed.
Morpheus’s motivation is central to our discussion. He was freed from The Matrix by the founder of Zion, and he subsequently received a prophecy from the Oracle (Gloria Foster) that he would find the reincarnation of the founder. This belief, that a savior with the reborn spirit of his mentor, is crucial to the formulation of his having schizotypal personality disorder. This is further evidenced by his chosen name’Morpheus was the Greek god of dreams’and then tasking himself with the job of awakening the reincarnated soul of Zion’s founder.
In the virtual reality world of the matrix, it is reasonable to believe that a person can fly, that one can travel through telephone lines, or that agents can possess any body they wish. Within the movie, these beliefs are a part of reality. These are culturally sanctioned beliefs with a firm grounding in the laws of the virtual reality programming and not necessarily magical. These beliefs are challenged in subsequent movies but not in the 1999 film.
What separates Morpheus from the other characters in the movie is that he has odd and magical beliefs about destiny, prophecy, and reincarnation that are shared by none of the other characters. In fact, even the Oracle tells Neo, “Morpheus believes in you Neo. And no one, not me, not you can convince him otherwise.” That is, Morpheus believes that Neo is the reincarnated founder of Zion returned to the world to end the machine dominance over humanity.
Beyond this, Morpheus is given to an odd pattern of speech, often relying on elaborate metaphors. In his first meeting with Neo, Morpheus uses an extensive metaphor about Alice in Wonderland to describe the choice that Neo has to exit the matrix. Additionally, the name of his ship is a reference to the ancient Babylonian king Nebuchanazzer, and his approach to Thomas Anderson is steeped in messianic references and gnostic allusions.
In teaching young clinicians about personality disorders, we encourage them to think critically about patients and to apply the standards of diagnosis exemplified in the DSM-V. To that end, exercises where we evaluate a character are of value, whether or not a character rises to the level of full diagnosis.
While Morpheus demonstrates many of the characteristics of the schizotypal PD, he is not socially impaired or uncomfortable with close relationships in The Matrix. Here, we break from speaking about The Matrix exclusively to mention that in subsequent movies (The Matrix Reloaded  and The Matrix Revolutions ), Morpheus does demonstrate difficulties with his spouse, child and superiors because of his outlier belief in Neo. This may raise him closer to the level of a true personality disorder.
IV. Trinity and Paranoid PD
If we constrain our discussion with student clinicians to The Matrix and not the subsequent two films, then none of the principle characters in The Matrix is actually paranoid. Agent Smith (Hugo Weaving) is actually the agent of the AI overlords who have captured nearly all the human race and plugged them into a massive shared hallucination so as to use their bodies for electricity and thermal energy. Everyone in the resistance was selected because they were perceptive, not paranoid.
Below, we identify some of the moments in which Trinity’s behavior would be considered paranoid if Agent Smith was not actually monitoring her. The examples fall into two categories: (1) a belief that one’s conversations and doings are being monitored and (2) a belief that an all-powerful organization is controlling even the minute details of society.
In the opening scene, we understand that Trinity’s call is being traced by the agents of the machine army. Trinity recognizes it and immediately disconnects the phone. In fact, her call was being traced, and she was being betrayed by an ally. She quickly hangs up the phone, only to be accosted by police and agents a few minutes later. Key to the discussion is that Trinity’s paranoia is not bizarre, and it is not, therefore, psychotic. A member of a counter-revolutionary militia, Trinity’s phone is in fact tapped by government officials because she has been betrayed by a double agent.
Later at the party scene that Trinity has instructed Anderson to attend, Trinity tells him, “They’re watching you, Neo.” The ambiguity of “they” does not phase him, and Trinity feels no need to elaborate– clearly both characters have an understanding that a Big Brother type government agency is monitoring them.
Trinity’s paranoia is reinforced by other characters. Her leader and mentor, Morpheus, tells Anderson: “They’re coming for you, Neo, and I’m not sure what they’re going to do.” The ominous “they” again intimates a shared notion of a kabul of powerful oligarchs watching one’s every move. At this point in the movie, Morpheus knows who “they” are–the sentient agents of the AI programmers–but Anderson does not. Morpheus’s intentionally vague pronoun, therefore, clues the audience into the subculture that all the freed minds derive from–the paranoid. Moropheus, Trinity and Anderson all speak the same language of paranoid mistrust.
The critical teaching points regarding Trinity center on students’ critical thinking: it does not matter that Trinity is insightful and not in fact paranoid. She exhibits more than enough paranoid-type thinking to warrant an in depth discussion, and the very exercise of applying DSM standards, analyzing her as a character and ultimately not diagnosing her with a PD gives student clinicians an opportunity to learn how to evaluate a person for Paranoid PD.
C-L Psychiatry at Rutgers-Robert Wood Johnson Medical School has been successful in achieving the educational goals and objectives of the Psychiatry clerkship because it gives instructors and young clinicians a common set of images and characters to analyze and evaluate. The Matrix, of course, is not for everyone: no movie has universal resonance. In our focused setting, however, The Matrix serves as a great example of the Cluster A Personality Disorders. Combined with the other martial arts movies in the PD module, we are able to teach the salient points of PD by encouraging students to prepare informal reflections on the nature of the characters and the descriptions of personality disorders found in the DSM.
Our curriculum is strongly grounded by Albert Bandura’s social cognitive theory, Howard Gardner’s theory of multiple intelligences, and the critical thinking schema developed by Bloom and others.
Albert Bandura’s social cognitive theory (1977, 1986) is considered to be the most prominent among social learning theories. 10 11 Rooted in behaviorism and social learning theory, social cognitive theory contends that people learn behaviors, internal standards, values, and cognitive strategies by observing the behaviors of others. In addition to observational learning through modeling, Bandura stressed that much of the information we acquire comes from our interactions with other people. Feature films allow for viewers to experience such interactions vicariously.
Bandura posits that such observational and vicarious learning takes places among the cognitive processes of attention, retention, production, and motivation. Not surprisingly, the use of feature films in the classroom has been found to promote attention to and retention of information. 12 13
At nearly the same time that Bandura constructed his social and cognitive theory, Howard Gardner published his seminal work on the theory of multiple intelligences 14. By recognizing that student clinicians possess a range of intelligences, we have sought to innovate a traditional lecture model of psychiatric education with a curriculum that involves analyzing characters from various popular films. Especially for students with strong interpersonal intelligences, the role of cinema can help solidify central teaching points in diagnosis and treatment.
Furthermore, built on Benjamin Bloom’s seminal work from the 1950’s (with revision in recent years), we recognize that instructors should seek to push students beyond simple memorization of DSM criteria and test preparation factoids 15. As it stands today, Bloom’s Taxonomy of the Cognitive Domain identifies six levels of thinking: Recall, Understanding, Application, Analysis, Synthesis and Evaluation. We expect that young clinicians will apply their knowledge to the movies, analyze motives of the characters and judge the characters based on the criteria from objective sources.
Because students will encounter patients in a complex setting that often defies simple descriptions, we propose that using movies as texts for analysis is an appropriate way for students to analyze simulated patients. By using characters from these films as simulated patients, we allow students to debate the characteristics of their personalities in a low-stress, engaging environment.
Finally, we hope that “C-L Psychiatry” is enjoyable to students. Much of medical education requires students to memorize large chunks of material, analyze carefully and perform rapidly. By utilizing a range of movies in the instruction of psychiatry, we find that students have opportunity to apply their knowledge in an enjoyable setting.
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