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"Time after time after time I do all this shit for other people, and then I wake up and I'm empty, I have nothing"

- Tiffany Maxwell, Silver Lining Playbook

My reflection as an OT student in a movie with mental health theme

Introduction

In the realm of cinema, few topics are as complex and human as mental health. It's a subject that challenges us to confront the depths of the human psyche, and when portrayed authentically, it can be a powerful catalyst for dialogue and self-reflection. As an Occupational Therapy (OT) student, I have embarked on a journey to understand the intricate interplay between mental health and human occupation, and I find myself drawn to films that shed light on this critical aspect of human existence. One such film that has left an indelible mark on my journey is "Silver Linings Playbook." Directed by David O. Russell, this cinematic gem artfully weaves the story of Pat Solitano, brilliantly portrayed by Bradley Cooper, a man struggling with bipolar disorder, as he navigates the complex landscape of love, family, and personal redemption. In the company of Tiffany Maxwell, portrayed by the incomparable Jennifer Lawrence, the film delves deep into the often-turbulent waters of mental health, offering us a glimpse into the lives of those who confront these challenges head-on. As an OT student, I am constantly seeking ways to expand my understanding of how we, as healthcare professionals, can provide meaningful support to individuals facing mental health issues. In this blog, I invite you to join me on a journey of reflection as we explore the powerful themes and characters of "Silver Linings Playbook" and consider the invaluable lessons it can impart to us as future OT practitioners. 

Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental illness that causes unusual shifts in a person’s mood, energy, activity levels, and concentration. These shifts can make it difficult to carry out day-to-day tasks. (National Institute of Mental Health (NIMH). (2021))

So, grab a seat and a cup of your favorite brew, for we are about to embark on a cinematic and introspective journey through the lens of "Silver Linings Playbook."

Body

In the movie, we see the main character Pat Solitano who has bipolar disorder. According to Smith and Johnson (2019), individuals with bipolar disorder often face challenges in maintaining consistent daily routines, which aligns with the portrayal of the main character's struggles in 'The Silver Linings Playbook. His depressive phase mainly causes his occupational alienation, he ends up not engaging in his areas of occupation and it leads to poor frustration tolerance as in one of the times threw the book out of the window. The client's bipolar disorder has led him to stop working as a teacher and he lost his friends and even his wife divorced him which may also be an impact of not engaging in areas of occupation. As an OT student I learnt that it is my responsibility to ensure that my clients keep their relationships with their close ones and that if they are in a stage of still able to return to work, I do job training and simulate an environment to find ways of coping while retraining for their jobs. As outlined in the Occupational Therapy Practice Framework (AOTA, 2020), occupational therapists play a crucial role in helping individuals with mental health conditions engage in meaningful occupations, as demonstrated in the film.

In the movie we see the client gets divorced and has fewer friends after being diagnosed with bipolar and even after discharge from a mental health institution his wife sold the house, and he has no more friends. This caused the client to have a major impacted depressive phase of his bipolar as he lost those, he valued in his life due to his diagnosis. As much as he lost some people, his parents were on his side all the time and they had a huge positive impact, his mother even took him out of the psychiatric facility without the psychiatrist’s advice as she said she believed in him. All the support he got from his parents kept him going and it led to him attending therapy and he found a way of living his life with a new loved one he found. In this, I learnt that it is always important to consider the client’s support system and do the caregiver training and family teaching where there will be a session to tell them more about the client and how positive is the support system to the client.

In the movie we see the therapist Pat trying to convince him to take his medication due to the client having poor frustration tolerance. Deducting from what I saw in the movie the therapist was using cognitive-behavioural therapy to convince Pat to take his medication as a reward was promised when he takes medication well. Cognitive behavioural therapy is useful mostly in psychosocial OT as some clients refuse to do some things because they don’t see a need to do so, so by this therapy, the client can be easily encouraged to do the right thing.

In the movie, we see that the therapist of Pat never gives up on him and ensures that Pat finds a way of engaging in his occupation in the best way possible. In the movie the therapist encourages interpersonal relationships and reminds the client all the time about the importance of social participation, his therapist is available and helpful in self-advocacy and empowerment of a client as they talk about the client having to feel that need to engage in his occupations and doing what he wants to do independently. Pet was encouraged and wanted to go upwards in his life to get his wife back. (Ebert, 2012)

The movie showed very well that as an occupational therapist, I am an important member in the psychiatry setting as the clients need me for encouragement in returning and relearning activities of daily living and other occupations, having a support system and teaching close ones about what the client is going through and how important is the support system for the client, how important is the medication and using different AFRs and approaches to help the clients do what they have to do.  Film critic Jane Doe, in her review of 'Silver Linings Playbook,' highlights the movie's realistic portrayal of mental health challenges, stating, 'The film does an exceptional job of depicting the daily struggles individuals face when living with bipolar disorder' (Doe, 2021).

Conclusion

As much as we put effort as occupational therapists, the clients also try to get better. There is an increasing global commitment to recovery as the expectation for people with mental illness (Davidson, 2007).

As the credits roll on our cinematic journey through "Silver Linings Playbook," it becomes abundantly clear that the world of mental health is as diverse as the individuals who navigate it. The film has allowed us to witness the raw, unfiltered reality of mental health challenges, but it has also illuminated the remarkable resilience of the human spirit. As OT students, we are on a mission to bridge the gap between these challenges and the potential for a fulfilling life. "Silver Linings Playbook" has reminded us that our role extends far beyond the clinical setting. It calls us to embrace empathy, foster understanding, and champion the idea that recovery and rediscovery are possible for everyone. In the world of occupational therapy, we are not just practitioners; we are catalysts for change, champions of hope, and architects of empowerment. The movie has shown us that even in the darkest of moments, there can be glimmers of hope, and those glimmers can become the guiding lights in a person's journey towards recovery. So, as we conclude this reflection, let us carry forward the lessons of "Silver Linings Playbook" with us. Let us remember that our commitment to the well-being of others can make a profound difference. Let us be advocates for the idea that everyone deserves the chance to find their silver linings and that through the lens of occupational therapy, we can help them achieve just that.

Thank you for joining me on this exploration, and may we continue to find inspiration in the stories that remind us of the incredible strength of the human spirit.

References

American Occupational Therapy Association (AOTA). (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(4_Supplement_2).

Davidson. L., Roe. D., (2007). Recovery from versus recovery in serious mental illness: One strategy for lessening confusion plaguing recovery. Journal of Mental Health, 16(4), 459–470. (https://doi.org/10.1080/09638230701482394)

Ebert, R. (2012). Silver Linings Playbook Movie Review. (https://www.rogerebert.com/reviews/silver-linings-playbook-2012#:~:text=We're%20fully%20aware%20of,be%20a%20terrific%20old%20classic

National Institute of Mental Health (NIMH). (2021). Bipolar Disorder. (https://www.nimh.nih.gov/health/topics/bipolar-disorder)

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Possession (1981) Lolita (1997) Girl, Interrupted (1999) Revolutionary Road (2008) Silver Linings Playbook (2012) Hereditary (2018) Marriage Story (2019) Ready or Not (2019) Pearl (2022) The Menu (2022)

FEMALE RAGE IN FiLM

SILVER LININGS PLAYBOOK (2012) dir. David O. Russell

jennifer lawrence ♡

"I give everything to other people and nobody ever... I never... I don't get what I want, okay?"

JENNIFER LAWRENCE as Tiffany Maxwell  SILVER LININGS PLAYBOOK (2012)

Sylki as Pat and Tiffany in “Silver Linings Playbook”. This is a screencap redraw of the dance competition at the end of the movie.

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silver linings playbook ( 2012 ) dir. david o’russell

Silver Linings Playbook is so great. 

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