The Therapeutic Powers of Movies: An Interview with Dr. Birgit Wolz on Cinema Therapy

Our parents, friends, or other people often tell us what to do but for some reasons, we don’t follow them. But when we watch a movie that says the same thing, we follow them!  Let us learn from Dr. Birgit Wolz as she shares how movies shape life, how they can be therapeutic, and how she addresses the doubts against Cinema Therapy.

What motivated you to specialize in Cinema Therapy?

Since I was a child, movies had a strong impact on me: I identified with movie heroes and gained strength and courage that way, or I learned to understand my inner world through understanding my emotional reactions to movie scenes or characters. I experienced catharsis through movies too. For example when I had a life-threatening stroke, I became physically and emotionally paralyzed and could not even cry. I noticed with surprise that I started crying uncontrollably whenever I saw films that showed characters in tragic experiences. All the blocked up tears began flowing in response to watching the characters’ pain.

In 2002 I visited a workshop called “Movies and Mythic Imagination – Using Films in Depth Psychology”. I became fascinated with the idea of using movies with my clients to understand their emotional issues and to support their process. I used Cinema Therapy in my writing, in my practice with individual clients, couples, in a weekly Cinema Alchemy group, and in workshops. I have amazing success with this method. Therefore, I am very passionate about teaching it to other therapists – currently mainly through my online courses.

Do you mind telling us how the use of films in therapy was discovered or invented?

As with most “new” ideas, many aspects of cinema therapy are not really new. The use of movies for personal growth and healing carries forward a long-standing connection between storytelling and self-reflection that in all probability dates back to the beginnings of spoken language. Many cultures throughout human history have recognized the transformative and healing effect of the act of telling and listening to stories. Cinema therapy can be traced back to bibliotherapy, which is the use of engaged reading in order to gain insight into one’s psyche (Mellon, 2003). The practice of bibliotherapy may go back as far as the ancient Greeks where the door to the library at Thebes bore the inscription: “The Healing Place of the Soul” (Riordan and Wilson, 1989).

Beginning with the spread of psychoanalysis during the first half of the twentieth century, analysts began prescribing specific reading material, often novels, for some of their patients. In 1916 the term bibliotherapy made its first appearance in psychological literature (Shrank & Engels, 1981). During the explosion of the self-help movement in the 1960s through the 1980s, the main focus shifted away from the use of fictional books to nonfiction self-help manuals. Even so, in 1983, James Hillman emphasized the practice of using fiction in therapy in his book, Healing Fiction (Hillman, 1983).

The Greeks used drama in their visual and performance arts as a catharsis to deal with their emotions. Up to this day the Greeks don’t sit passively in their seats as we do, and clap politely at the end. In both ancient and modern Greek theaters, people yell, scream, cry, and become quite expressive. The ancient Greeks had developed poetic ways to heal the emotional wounds caused by war. Tragedy had been performed for catharsis to cleanse disordered emotions and heal trauma. Aristotle theorized “tragic plays have the capacity to purify the spirit and aid us in coping with aspects of life that cannot be reconciled by rational thought” (Murnaghan, 1951).

Cinema Therapy was mentioned in psychological articles as early as 1990, and in 1993 Marsha Sinetar published the first book that specifically discussed the use of movies as a tool for personal growth: Reel Power — Spiritual Growth Through Film (Sinetar, 1993). Others followed as you can see on my bibliography: http://www.cinematherapy.com/bibliography.html.

In your website, you mentioned that the use of films “can be integrated into a range of psychotherapeutic orientations, from depth psychotherapy, cognitive-behavior therapy, to systems oriented therapy,” how do we know which one is more appropriate to us?

The four ways I use movies in my work are the following:

The Evocative Way:

Films can be seen as the “collective dreams” of our times. Therefore, the Evocative Way utilizes movies in a therapeutic and growth-provoking manner by borrowing from dream work. As it is possible to gain insights from any dream, emotional responses to almost any kind of movie scene or character can help clients to understand themselves better. When certain movies resonate with clients, they touch into an unconscious or preconscious 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.

The following therapeutic methods are especially conducive to a combination with the movie watching experience when Cinema Alchemy is practiced in The Evocative Way:
Parts work
Couples, family, and group therapy
Interactive hypnotherapy or imagery work
Suggestive hypnotherapy
EMDR – resource installation, and positive psychology EMDR.

There is no need to recommend specific movies to clients in The Evocative Way. For this approach, it usually doesn’t matter whether the therapist has not 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 the 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.

The Prescriptive Way:

In The Prescriptive Way, specific films are prescribed to model specific problem-solving behavior. It is based on the same concept as Milton Erickson’s Teaching Tales with their embedded suggestions. Listening to stories and watching movies in a focused way creates a form of trance state, similar to the state often achieved via guided visualizations.

Movies can also help clients to learn “by proxy” how not to do something or not to behave in pursuit of their goals, because they see the negative consequences of a character’s action. It is often helpful to use movies in this way, when clients who struggle with addictions, or when a couple works on their communication. Here films are used as cautionary tales.

The following methods are especially conducive to a combination with the movie watching experience when Cinema Alchemy is practiced in The Prescriptive Way:
Cognitive therapy
Behavior modification therapy
Couples and family therapy
Coaching
Positive Cinema Therapy

The Cathartic Way:

Emotions are stored in the body as well as the mind. Cathartic therapeutic techniques allow therapists to help clients access these stored emotions and release them.

Because many films transmit ideas through emotion rather than intellect, they can neutralize the instinct to suppress feelings and trigger emotional release. By eliciting emotions, watching movies can open doors that otherwise might stay closed. For many of our clients it is safer and therefore easier to let go of their defenses while watching a movie than it is in real life with real people. By identifying with certain characters and their predicaments, they can experience emotions that lie hidden from their awareness.

Emotional release usually lifts a client’s spirits for a little while as the overwhelming emotion diminishes. Energy that was drained by depression or grief can reemerge, at least temporarily. Often this “break” allows a depressed person to start exploring and healing the underlying issues that caused the depression originally. Grief can be processed more easily.

Cathartic psychotherapy tells us that laughter too releases emotion. Laughter can relieve anxiety as well as reduce aggression and fear. Often clients are able to approach a solution to a problem they were worried about with less emotional involvement and a fresh and creative perspective after watching a humorous movie. Even light depression can lift for a while.

Cinema Therapy with Groups:

The impact of films as catalysts for psychological processes dovetails well with the therapeutic effects of group dynamics. Group members’ reflections about their emotional response to a movie are an added component that enriches group therapy. By understanding and sharing what moved them about certain movie scenes or characters, participants acquire an effective tool to get to know themselves and others. After leaving the group they are able to continue using what they have learned about self-discovery when watching films.

What are the cases where it is not recommended to administer Cinema Therapy?

• Effectiveness suffers with clients who are incapable of drawing insights from metaphor.
• Prescribing films is often not effective with small children except in family therapy.

Young children’s developmental limitations reduce the effectiveness of prescribing films usually because of the time lapse between their viewing of the film at home and the discussion in session. This is different when a discussion follows immediately after a clip is shown in session, or when families watch movies together at home in the context of family therapy.

• No film assignment to clients with serious psychiatric disorder seen in private practice.

When these clients watch films in their own homes, it might be difficult for them to deal with issues that come up during or immediately after viewing. This is especially true for clients that have some kind of psychotic disorder because they might have trouble distinguishing reality from fantasy. (Ulus, 2003)

• No film assignment, when violence in client’s home.

Films sometimes introduce subjects that clients may have avoided in therapy, which can be very productive under many circumstances. When there is violence in the home, the risk of unmonitored film assignment and an unpredictable reaction is too great.

• No film assignment, when client recently had trauma similar to a character in the movie.

When a client recently went through a traumatic experience similar to that of the character in a movie, the film experience can potentially be re-traumatizing. I work with clients who have experienced a murder in their family. I am very careful with assignments of movies that have a murder as part of the plot, even if this is not a dominant part of the film. The client’s attention most likely would go to and stay with that part. As clinicians we need to make decisions about a client’s readiness for a film by using similar criteria as we use with any high-impact homework or other kind of intervention.

• No film assignment, if client might infer wrong motives.

It is possible that a client might infer the wrong motives into your film assignment when the movie shows a certain unattractive character, which fits the client in ways that could be offensive. This could negatively affect your rapport with the client. You might not assign this kind of movie, or you might use the client’s response for transference work.

• No film assignment, if client dislikes movies.

When someone undergoes Cinema Therapy, how does he/she know that it is effective?

When clients experience a relief of their symptoms, we know that the therapeutic work was effective.

Movies affect us powerfully because the synergistic impact of music, dialogue, lighting, camera angles, and sound effects enables a film to bypass ordinary defensive censors in us. “Hollywood took the original invention of the cinematic camera and invented a new art form in which the viewer becomes enveloped in the work of art. The camera carries the spectator into each scene, and the viewer perceives events from the inside as if surrounded by the characters in the film” (Wedding, Boyd & Niemiec, 2005, p. 1). Movies draw us into the viewing experience, but at the same time – often more easily than in real life – afford a unique opportunity to retain a perspective outside the experience, the observer’s view.

I recommend that in therapy, movies be used in combination with a traditional therapeutic modality, like depth psychotherapy, parts work, cognitive therapy, EMDR, hypnotherapy, Narrative Therapy, couples, family, and group therapy, etc. Cinema Therapy is meant to be a supportive, adjunct tool for these therapeutic approaches. Therefore its therapeutic value depends on the therapeutic efficiency of these other modalities. CT enhances the effect of these methods.

Just like in any practice, there are usually critiques. What are the challenges you’ve received regarding your practice of Cinema Therapy? How have those challenges empowered you?

My challenge was to gain clarity and to find responses to the doubts that were expressed in regards to CT. This process empowered my work and me. I am telling you about my responses and learning experiences in the following:

It is obvious that many films play to the lowest common denominators — the base human instincts and desires. Even so, it is practically impossible to number the movies that seek the opposite pole, that strive to inspire the highest human values. The vast majority of movies simply hope to entertain by spinning a good yarn, and even those sometimes end up unintentionally serving as a catalyst for personal insight into the darker side of the soul. When those dark aspects are brought into the light of conscious awareness, true inner freedom is possible. Like no other medium before it, the popular movie presents the potential of a new power for illuminating the depth of human experience.

I most frequently hear to following arguments against the use of movies in therapy:

• Cinema Therapy is too simplistic an unscientific tool with little research to account for therapeutic value; one cannot treat serious psychological problems just by letting clients watch movies

Again, cinema therapy is only an adjunct tool. If the main modality within which it is used helps treat serious problems, the use of films can only increase this effect.

• Most movies are bad in quality and bad for the psyche, especially the violent or depressing ones

First of all, I believe that many movies have been made that are inspirational and useful for cinema therapy. Whether a movie is seen as good or bad is mostly a matter of taste, like most artistic expressions. Whether a film touches the viewer is much more important for its therapeutic value than its artistic excellence. For us it is also important to choose an appropriate movie for a specific treatment goal. What about the fact that the media talks a lot about the negative effect that TV and movies have on viewers? How can watching commercial movies be good for anyone?

Yes, movies can have a powerful effect on our psyche. Like the proverbial hammer, which can be used to harm or to serve us, movies can be damaging or they can be used to our advantage. Therefore it is important to choose the appropriate films and follow the guidelines that I suggest.

Through movies that show undesired behavior we can learn how to not behave. We see the negative consequences of a character’s action and learn “by proxy” Solomon, 2001, p. 10). These films can serve us as cautionary tales. For example, if somebody struggles with an addiction, a movie like 28 Days (2000) can be a wakeup call. Gary Solomon says: “You can see denial far more clearly when it is acted out in a movie than when you read about it in a book or if a therapist tries to explain it to you. Once you see what denial really looks like by observing an actor or actress playing a role, you can get in touch with your own denial” (Solomon, 1995, p. 16).

But most frequently, the question about the negative effects of films comes up around violent movies. Some claim that violent movies have a cleansing effect of the release of intense, stored emotion. They are cathartic and discharge pent-up aggressive feelings in a harmless way. Other research found that violent movies make already aggressive viewers even more aggressive. I have observed that both can be true depending on the personality of the viewer. Violent films can be re-traumatizing if they reactivate previous psychological trauma. Therefore therapists have to be careful when violence is part of a chosen film. Many movies might need to be excluded from use in therapy for most clients. I have a client though who has violent trauma in her background and finds a sense of resolution and healing when the bad guys in violent movies get beaten up at the end.

In general I would like to consider the following: Contemplating certain movies that trigger fear, anger or sadness in therapy might help clients become more conscious of these emotions, if they have been repressed. In work with psychological trauma, some treatment methods help clients to process trauma within a so-called “therapeutic window”. Interventions are done within this “window”, when they create enough therapeutic challenge but don’t lead to an overwhelming internal experience. Emotional overwhelm needs to be avoided because it can create an avoidance response, like dissociation, etc.

Therefore, certain films, even those with some violent elements – used carefully and creatively – can help clients get in touch with unresolved trauma and therefore serve as an intervention that provides sufficient therapeutic challenge to enter the “therapeutic window”.

For example, I have used Affliction (1997), a movie about alcoholism, childhood abuse, and the serious consequences on the life of the survivors of this kind of trauma. After watching this film, a client of mine was able to acknowledge the impact of his father’s alcoholism and physical abuse on his emotional development for the first time. The movie, in combination with client-centered therapeutic work, helped him to break through his denial safely, and he started working on his recovery. With another client I began using EMDR after the movie brought up memories of abuse.

A client told me that being confronted with intimidating situations through the movie helped her contemplate solutions for similar situations in her own life and prepare her to deal with these, as they came up later.

Films that some people might consider depressive should be used carefully too. For example the new movie The Hours (2003) is very intense in terms of dealing with issues of depression and suicide. In this film some characters choose “life over death”, and in that sense there is an element of hope. Others end up committing suicide. The depth of despair and depression that the main characters face is extremely potent and it is possible that this film could, perhaps, reinforce the negative beliefs of a seriously depressed or even suicidal person.

On the other hand, I have noticed that depressive films, which usually portrait depressed characters, can – almost like support groups – help clients feel less alone and isolated with their experience. Depressive films can help normalize depression, especially if it results from grief, or serve as a psycho-educational tool in cognitive work with depression.

A thorough assessment is required before assigning this kind of film. In order to assess correctly, clients should be asked how they responded to certain depressive movies before.

• Most people want to be entertained by films instead of analyzing them for therapeutic purposes; they don’t want to spoil their fun of watching movies.

I don’t ask a client to analyze a movie but to watch them with conscious awareness, as I will demonstrate soon. Besides, people who seek therapy are usually receptive to therapeutic interventions.  Watching a movie is considered one of the more pleasurable ones.

We usually remember our experiences better when we have them under two distinct circumstances: Pain and pleasure. We also learn well when we are relaxed. Since entertainment can create pleasure and relaxation, a movie with high entertainment value can have a high therapeutic value, if it conveys therapeutically relevant messages.

When clients and group members are afraid that their fun with movies will be spoiled forever once we start using them for therapeutic purposes, I usually tell them the following: It’s not only OK but very good to be entertained by a film. Enjoying a movie might give you a little vacation from your troubles and help you approach a solution with less emotional involvement and a fresh and creative perspective. Conscious awareness does not need to interfere with this. The goal of cinema therapy is to help you be both entertained and conscious. Like in real life, your conscious awareness will increase and decrease at times. Learning to have control over this will benefit you greatly in life. In real life it is often even harder not to get “caught up” in things and “run on automatic”. Sometimes we become conscious only later when we look back. Most psychotherapeutic and spiritual orientations (Buddhism talks about “mindfulness”) teach us to become more aware about ourselves.  Learning more conscious awareness while watching movies can create a bridge to more awareness and therefore more control over your real life.

Where are studies at the moment and what breakthroughs are you anticipating?

I am not aware of any recent studies. Therefore I can’t anticipate any breakthroughs in the near future. Please check the following link for research that has been conducted in previous years: http://www.cinematherapy.com/links.html.

I saw that there are guidelines in choosing and watching a movie. What movie elements or themes would you like movie-makers to keep or start doing to improve the practice of Cinema Therapy?

According to my experience, most movie-makers (except for Stephen Simon who founded the Spiritual cinema Circle: https://www.spiritualcinemacircle.com)have absolutely no interest in CT. It is a clinical method that uses movies, not the other way around.

Birgit Wolz, Ph.D., MFT

Working since 1991, Dr. Wolz is based in Loch Lomond, California and has worked as a psychotherapist, hypnotherapist, and grief counselor. She has two master’s degrees – an MA in Counselling Psychology from John F. Kennedy University in California and an MA in Business from Freie Universitaet Berlin in Germany. She also holds a PhD in Economics from the latter university. She facilitates cinema therapy and workshops and offers trainings and online courses for therapists and nurses. You can reach her on http://www.cinematherapy.com or http://bwolz.com/html/profile.html.