Script(ing) treatment: representations of recovery from addiction in Hollywood film doc

This study analyzes the depiction of addicts and addiction in three Hollywood films whose narratives are largely situated within a treatment center: Clean and Sober 1988, When a Man Love

American films and television programs increasingly feature

characters recovering from addiction These representations are based on previous depictions and help create a cultural

understanding of addicts This study analyzes the depiction of addicts and addiction in three Hollywood films whose narratives are largely situated within a treatment center: Clean and Sober (1988), When a Man Loves a Woman (1994), and 28 Days (2000).

It concludes that the films depict a stock experience of treatment that is surprisingly univocal, as well as unrealistic when compared with the availability and realities of real-life programs In addition, the films limit their representations of successful recovery to white, upper-class individuals and offer only one conceptual framework for addiction.

KEY WORDS: Addiction, film, recovery, treatment, representation.

AUTHOR'S NOTE: / would like to thank Dr Ted Friedman, Dr Robin

Room, Karen Hersey, and the journal reviewers for their suggestions and comments on this article.

© 2005 by Federal Legal Publications, Inc.

Addiction and recovery have been topics of Hollywood films and movies of the week and are increasingly integrated into mainstream television shows through the inclusion of addicted characters Now the producers of reality shows have entered

the field with the new American television show Intervention,

on the A&E channel Intervention follows addicts (broadly

defined to include substance abuse, as well as shopping and other addictive behaviors) through the progression of their addiction, and then confronts them with a choice between treatment or expulsion from the lives of their loved ones Although there are myriad possible moral and clinical

objections to such a show Intervention seems to be the next

step in a growing wave of media products using addiction and recovery as plot devices Several recent American television

shows, such as The Sopranos, Dawson's Creek, and Law and Order, include central characters seeking recovery from

substance abuse through clinical treatment and support groups.Although new to the small screen, such television story linestap into a narrative about institutional treatment that has beendeveloping in Hollywood for the past several decades

Addiction has appeared on the movie screen since Edison'searliest films (Starks, 1982); however, the now familiarimages of modem institutional treatment did not appear untilthe late 1980s After a decade of American cultural backlashagainst addicts and drug treatment during the years of theReagan administration, public opinion seemed to shiftthroughout the 1990s toward encouraging people withsubstance-abuse problems to get help (White, 1998) Sincethat time, Hollywood has released several works withnarratives focused on institutional treatment of addiction.Through their representations of addicts, substance abuse,treatment centers and the experience of recovery, these filmshelp construct for their audiences a common culturalunderstanding of addiction They can be viewed as adiscourse in a Foucaultian sense—creating meaning andmarking off the boundaries of how filmgoers should view andunderstand treatment

The representation of drug treatment in America can affect society in several ways, including stigmatization Elizabeth Hirschman (1992), in her study of cocaine use in films, argues that "motion pictures which focus upon addiction can serve as instructive, semiotically-rich texts for communicating cultural knowledge about addiction" (p 428) This communication is not simply one-way, though; it exists as a continual feedback loop, with movies "both reflect[ing] and shape[ing] individual and societal values, attitudes, and behavior" (Wedding, 2000,

p 3) Thus representations from cinema can become received knowledge, which is incorporated into societal views These shifts may then be mirrored and reinforced in subsequent movies Obviously, films are no "magic bullet" with the power

to instantly change public perceptions and beliefs; however, as

a part of the culture industry, Hollywood does participate in teaching us about ourselves.

Films can speak to society as a whole, but they can also be instructive for individual groups Previous research found that movies featuring substance abuse provide a strong point of identification for addicts (Hirschman & McGriff, 1995; Lalander, 2002) Films are part of a learning process about addiction, and the movie screen might be one of the few places where addicts can see their filmic counterparts receiving help.

This study compares the depicted reality the films present to audiences with previous addiction cinema and with real-world economic and cultural conditions Since films privilege certain viewpoints through representational strategies and by leaving out alternatives, I also examine the ideologies of the films and issues of textual silence The study offers a critique of these issues in the spirit of other well-known ideological film

studies, such as Ryan and Kellner's (1988) Camera Politica.

In this article, I conduct a critical discourse/ideological analysis of the three major Hollywood films released since the 1980s that feature treatment as a major part of their

narratives After researching literature on addiction and film,

I chose the films for the study and viewed each one manytimes, specifically looking for socioeconomic representations

of characters, treatment of different races, sexes, and sexualpreferences, methods of production as they relate to addictedcharacters and drug usage, and the depiction of treatment/self-help groups I then outlined the narrative of each filmand compared the uses and meanings brought to addicts,addiction, and substances I found that these movies construct

a fairly unified image of treatment In the films, based substance abuse treatment is readily available tomiddle-class, non-minority addicts The economic realities oftreatment are ignored, as are alternative paths to recovery.Minority addicts are similarly disregarded or stereotyped

12-step-Previous treatment film research

During the late 1970s, some film scholars and researchersinvolved in social, scientific and medical research ofalcoholism began studying the ideological implications ofalcohol and alcoholics in film A 1978 conference sponsored

by the British Film Institute generated several papers aboutthe representation of movie alcoholics, including the onlystudy devoted to examining the depiction of treatment In hispaper, Bruce Ritson (1979) writes: "If I were worried that Iwas becoming an alcoholic and decided to seek help on thebasis of the films about alcoholism which I had seen, I wouldknow that I must avoid hospital[s] at all costs" (p 51) Hediscusses how most movies ignore treatment altogether, butthose that do, feature "a blur of needles, burly attendants,locked doors and terrifying screams" (p 51) No furtherresearch on treatment depictions in film has been publishedsince that time

When combined with the more general literature on addiction

in films, Ritson's analysis provides a good starting point toquestion whether certain ideologies continue to appear in

substance-abuse cinema, and how recent treatment films rework older concepts Much of this previous research specifically centered on alcoholism; however, modern treatment facilities and psychiatric models tend to focus less

on particular substances and group them all under the heading

"addiction" (White, 1998) I adopt the same language and use

"addiction" in place of substance-specific terms.

Treatment films

Although many Hollywood films include depictions of addicts and addiction, only three recent movies have devoted considerable screen time to depicting substance-abuse

treatment: Clean and Sober (1989), When a Man Loves a Woman (1994) and 28 Days (2000) The structure and plot of

these films share a common debt to earlier movies about alcoholism Denzin (1991) has labeled the mid-1940s to early 1960s the "classic" period of Hollywood alcoholism films.

Bracketed by The Lost Weekend (1945) and Days of Wine and Roses (1962), this era also corresponds to the height of the

social-realism movement Social-problem films fell out of favor

in Hollywood, but they found a home with the oft-maligned

"made for TV" movie during the 1970s and 1980s Although alcohol continued to appear in major film releases, "excessive drinking was not automatically connected to the problems that appeared in drinkers' lives" (p 129) Addiction was no longer the focus, merely a subplot The only major American motion pictures addressing substance abuse during the 1970s were either comedies, such as Cheech and Chong vehicles, or

biographical stories like Lady Sings the Blues (1972).

The 1980s signaled a return to the representation of addiction

within a social-realist framework with Clean and Sober The

film follows an addict from drug abuse to treatment and back into society, with over half of the film occurring within a

treatment facility Since the release of Clean and Sober, many

other movies have included characters entering treatment.

trying to quit using, or seeking out self-help groups; however,only two other films also include extended depictions of lifeinside a treatment facility and the methods used to get addicts

clean: When a Man Loves a Woman (1994) and 28 Days

(2000) These three movies present surprisingly similarnarratives about drug treatment Taken together, the filmscreate a depicted reality of treatment for viewers who havenever struggled with substance abuse or known addictsseeking help

In Clean and Sober, Daryl (Michael Keaton) is a real-estate

broker who is unable to give up cocaine and alcohol Afterembezzling company money and becoming implicated in awoman's overdose, Daryl checks into a treatment center tohide While in treatment, he tries to get drugs andromantically pursues another patient named Charlie (KathyBaker) After they are released from treatment, Charlie dies in

a car wreck as she is trying to snort cocaine The film endswith Daryl speaking in front of an Alcoholics Anonymous(AA) meeting

When a Man Loves a Woman chronicles the destruction

addiction visits upon a family Alice (Meg Ryan) and Michael(Andy Garcia) seem to be the perfect upper-middle-classcouple, but Alice clearly drinks too much While intoxicated,Alice hits her oldest child, Jess (Tina Majorino) She agrees

to enter treatment and slowly begins to get her life backtogether Michael finds it difficult to accept his wife's newfriends and way of life, and he moves out The film closeswith Alice speaking at an AA meeting; Michael emergesfrom the crowd and they reconcile

In 28 Days, Gwen (Sandra Bullock) is a party girl who is

unable to stop partying She steals a limousine at her sister'swedding and drives it into a house Subsequently she is court-ordered to enter a treatment program, where she rejects the feel-good camaraderie of the facility However, after some initialescapes and drug episodes involving her boyfriend, Jasper

(Dominic West), Gwen begins to participate seriously in the activities at the treatment center Once she is released, Gwen chooses to leave Jasper in order to pursue her new way of life.

Representations of addicts

I have divided my analysis into two main categories First Iexamine how these films represent addicts and addiction, andwhat these representations suggest I then discuss how treatment

is depicted in the films, and analyze and compare theirconstructed reality with the real-world treatment field

The question of how addicts are portrayed is central tounderstanding the ideological positioning of addiction withinthese films It is also instructive to compare theserepresentations with earlier films to see how certain ideasreappear or become reworked by newer filmmakers Thefamiliar devices of the addict "hitting a bottom" and seekingout help remain Likewise, the addicts who seek treatment inthese newer movies continue to be upper-middle-class andwhite, as in the classical films As we shall see, one of themajor shifts between the classical Hollywood approach andcontemporary approaches is a lessening of the stigma ofusing substances and being an addict

Like all cultural products, films traffic in stereotypes.Filmmakers develop and borrow easily recognizable

"shorthand" devices that stand in for complex cultures andsegments of society Problems develop when theserepresentations are seen as absolute, already existingboundaries that define a larger whole (Dyer, 1979) Suchstereotypes also work to mask the power struggles lyingbehind all such naming and representational activities Cape(2003) identifies four stereotypes of addicts appearing in drugcinema All the main characters in these subject films fallwithin his "tragic hero" mold: a flawed yet "likeable, readilyidentifiable character" (p 168) Many of the stereotypical

qualities identified in other substance-abuse cinema researchalso appear in treatment movies; however, representationswithin these three films do show some signs of departure,especially in their depiction of female addicts I return to adiscussion of gender within these films later.

Films in the first half of the 20th century, as well as those inthe 1970s and 1980s, often associate alcoholism with so-called creative professions, such as writing, acting, etc.(Room, 1989; Denzin, 1991) By the late 1980s, substanceabuse on the screen diversified to include other walks of life,including portrayals from inside the world of corporateAmerica and from the inner cities The addicts in the filmsincluded in this study, like those in earlier movies, begin theirstories firmly entrenched in an appealing, upper-middle-class

lifestyle In Clean and Sober, Daryl is a real-estate broker

who works for a large company and makes very lucrative

deals In When a Man Loves a Woman, although Alice is a

teacher (a profession not commonly associated with aglamorous life), she and Michael have a roomy, upscaletownhouse in San Francisco and go on vacation in Mexico

28 Days, by contrast, never mentions whether Gwen has a

job Her apartment is not especially luxurious; however, thefilm begins with her partying in a posh club Although thesefilms may present a less glamorous lifestyle than 1980s

cocaine films such as Less Than Zero (1987), these addicts

are still financially well off and living attractive lives prior to

"hitting their bottom." They all have financial and socialresources that prevent too hard a fall from their normal life ofprivilege There are no scenes of living on the street or thedesperation associated with the continual hunt for substances.These are most assuredly "upper-class addicts."

In her comparison of 1920s and 1960s alcoholism films Herd(1986) found that the movies shifted from portraying externalcauses for alcoholism to the (now familiar) assumption thatinternal factors cause alcoholism Despite acceptance by themedical community and much of the public that addiction

comes from within, recent filmmakers still find it necessary

to provide a necessitating external factor for a character'ssubstance abuse As is discussed later, this may be attributable

to the AA concept of "hitting a bottom." Regardless, all threetreatment films do offer precipitating events based on anxiety,stress, or failure for each character's addiction

Clean and Sober provides no pre-existing catise for Daryl's

addiction Daryl seems to be quite content with his lifestyle,until the police start pursuing him He responds by increasinghis drug use and then checks into a treatment program Unlike

Clean and Sober, both 28 Days and When a Man Loves a Woman link their characters' addiction to their family history.

During detox, Gwen flashes back to scenes of her childhoodwith her sister and addicted mother The sequences show howtheir mother put them into danger and eventually died fromher using Through the flashbacks and sequencing, Gwen'saddiction is directly linked to her mother's substance abuse

The concept of addiction affecting entire families is endorsed

by many self-help groups, particularly Adult Children ofAlcoholics (ACOA), and it became incorporated intoaddiction films during the 1980s (Lynch, 1999; Denzin,

1991) This approach is even more evident in When a Man Loves a Woman The film suggests several factors for Alice's

addiction, including her father's drinking and Michael'scontrolling nature Although these family issues could beseen as external factors, they are presented less as a cause ofsubstance abuse than as links to an addiction-pronepersonality that, in turn, causes substance abuse

Beginning in the 1980s, an increasing number of films began

to focus on addicts who use multiple substances The classicalsocial-realist films were almost exclusively inhabited byalcoholics; in current substance-abuse films alcoholics arealmost a quaint exception While Daryl splits time betweenalcohol and cocaine, Gwen is equally happy with pills or

alcohol When a Man Loves a Woman offers the sole

throwback to the classical alcoholism film in the character of Alice; however, the people Alice befriends in recovery admit

to using a variety of substances It almost seems that Alice's roles as mother and wife preclude all but the most socially acceptable substance abuse, feeding into ideologically conservative notions about women and motherhood.

In her discussion of 1920s alcohol films, Denise Herd (1986) notes: "Romantic goals dominated the entire plot of the melodramatic film, thus creating the primary situational context of alcohol problems" (p 216) This remains true for the treatment films under discussion here Their increased focus on addiction therapy does nothing to diminish the importance of romance within their narratives.

These relationships are easily explained away as a classical feature of Hollywood scriptwriting, but they do hold a deeper meaning within alcoholism films: "The resolution of his/her drinking becomes a symbol for the resolution of the problems

of the relationship" (Denzin, 1991, p 249) Thus the fate of the couple is tied to whether the addict will choose a life of sobriety or continue using Since Gwen's fiance continues to

use in 28 Days, Gwen's decision to stay clean is reinforced

when she tells him, "Everything has to be different, and that includes us." After a brief kiss she bids him goodbye Daryl is unwilling to let go of his girlfriend, even after he finds drugs in her purse Her death allows him to resolve the situation within the classical alcoholism motif without having to actually choose staying clean over remaining in the relationship By

contrast, in When a Man Loves a Woman, Michael tries his best

to be supportive of Alice, but he has to learn his limitations before they can reunite These relationships are a central focus

of all three films, and their resolution implies a direct correlation between the choices the characters have made about their addiction and their recoveries.

There are other characteristics of addicts common to these three films that researchers have not generally identified with

the larger group of addiction cinema Each movie recognizesthat drug use was, at one time, fun for the addicted character.Many of the earlier alcoholism movies focused almostexclusively on the progressive decline of characters, rarelyacknowledging their pleasurable periods of using "Demonalcohol" was the villain of the classical social-problem film,but recent movies suggest that the substance itself is not thecause of the problem Spouses, co-workers and friends drink

and use drugs in these films For example, in When a Man Loves a Woman Michael usually drinks with Alice, but there

is no suggestion he is an addict Instead, the films imply thatthe nature of addiction is found within the individualcharacter rather than in specific substances—an approachfamiliar to treatment professionals

The representations of addicts in treatment films do replicatesome of the conventions of earlier alcoholism movies.Characters are upper-middle-class and employed, and theyencounter adversities that seem to precipitate an increase intheir consumption of substances Recent films, however,reflect subtle changes in stereotypes of addiction in society.Substance abuse is viewed more as a disease than a moralfailing (at least among the economically well off), and most

of the characters consume multiple types of drugs Thesemore obvious representational strategies combine withconnotations within the text to establish a fairly consistentideological stance

Reading between the lines

The depictions of addicts within these treatment films raiseseveral ideological questions about their handling of issuessuch as race, sexual orientation, class, and gender I addressthese categories in this section and show that these treatmentfilms present a consistent view of middle-class Caucasians'addiction while ignoring or negatively stereotyping addictsfrom different races and socioeconomic backgrounds

As mentioned previously, the main characters of all threefilms could be described as middle-class to upper-middle-class The only "poor" addict developed as a character is

Charlie in Clean and Sober She is also one of only two addicts (the other is Gwen's teenage roommate in 28 Days) to

die in these films Unlike other characters, who have moreoptions because of their money, Charlie is locked in a dead-end mill job with an abusive boyfriend In these films stayingclean seems to be fairly easy if you have the financialresources and a supportive environment

Filmmakers might have chosen to focus on middle-classcharacters in order to subvert cultural stereotypes about whoabuses drugs Earlier films about alcoholics certainly pursuedthis goal (Room, 1989) While this approach might beunderstandable, addicts on the lower rungs of the social andeconomic ladder end up being left out of these tales ofredemption Instead, addicts on the fringes of society are

primarily featured in bleak, cautionary tales such as Menace II Society (1993) or Requiem for a Dream (2000) Through

exclusion and negative portrayals, the subject films seem to limitrecovery through treatment as a possibility for the working class

All three leading actors who portray addicts in these films arewhite These characters' middle-class lives before treatmentseem to be populated entirely by Caucasians (excepting Andy

Garcia, who portrays Michael in When a Man Loves a Woman), with minorities existing only in stereotyped servant

roles like "cleaning woman" and babysitter Denzin (1991)found the same problem with representation in his study,saying that films "systematically excluded certain classes andtypes of subjects," resulting in a "dominant middle-classideology about who had this problem" (p 238) Hollywoodperpetuates racist stereotypes by excluding minorities fromthese stories of redemption and then foregrounding them asaddicted criminals and similar negative portrayals in otherfilms The more socially acceptable "alcoholic" is white, andless appealing stereotypes like "crackheads" are usually

minorities Such an approach also seems to open up treatment

as an option only for the first group, while largely excludingminorities from institutional help Although most major

characters are white, these treatment movies do include some

diversity in their depictions of treatment

All three films feature African-American actors playingtreatment professionals and patients, though few other racialminorities are represented The presentation of black addicts

inside the facilities in When a Man Loves a Woman and Cleati and Sober stands in stark contrast to the presentation of white characters When Daryl enters the detox ward in Clean and Sober, he walks into the television room and sees Xavier

(Henry Judd Baker), a large African-American man, talking

to himself Xavier then throws something through thetelevision, storms out of the room in a flurry of fists andcurses, and begins pacing the halls, physically lashing out atthe staff Comparing this image of a deranged, hulking blackaddict with the dazed, peaceful expressions of the whitepatients as they detox, it becomes apparent that these imagesplay on cultural stereotypes about black drug addicts Theangry, dangerous black man is a stereotype often evoked inpopular cinema (see Guerrero, 1993) and might be expected

to emotionally distance the audience from minority addicts in

the film The African-American characters in Clean and Sober receive barely any screen or speaking time, instead

existing primarily for laughs and plot mechanics

In When a Man Loves a Woman, Michael comes to visit Alice

in the treatment facility, where he meets Malcolm (Bari K.Willerford), a large African-American man who tells him,

"Your wife is amazing." Michael is visibly uncomfortable.After Michael leaves the building, he sarcastically comments,

"I like your new friends." When Alice asks if he metMalcolm, he replies, "Big black guy?" She smiles and tellsMichael, "He's a cokehead (pause), the girls are with him."Michael reacts with a start, but Alice quickly adds, "He's not achild molester, he's an armed robber." The scene is played for

laughs, but it also illustrates that Alice has looked beyond theexterior of her fellow patients and has recognized theircommon "affliction." However, the "humor" of the exchangecomes from stereotyped images of the menacing black addictwho must be kept away from white women, especially littlegirls The underlying message is "Malcolm can be trustedbecause he is off the street and in this nice treatment center."

He becomes an "exception" to the stereotype rather thantranscending it The audience can laugh because Malcolm isnot a "normal" black drug addict Neither film favorablyportrays an addict who is a racial minority So while theaudience is encouraged to identify with white substanceabusers, none of this empathy is shared with minorities

Interestingly, each film does include African-American actorsportraying treatment professionals They are more well-

rounded characters (especially Morgan Freeman's in Clean and Sober) than the black addicts depicted; however, they

could be viewed as "exceptional cases" set apart from theother stereotyped characters In some ways, like manyrepresentations of black judges or police officers, theseofficials reinforce dominant ideological positions bybecoming the point of contrast with the dangerous "Other"most minorities represent to mainstream audiences

Although 28 Days does not include as troubling racial

representations as the other two films, its depiction of the solehomosexual identified in any of the three movies is just asproblematic Gerhardt (Alan Tudyk), speaks in a Germanaccent (further setting him apart from the other patients),cries throughout the film, is unable to articulate himselfwithout becoming emotional, and is the subject of most of themovie's jokes There are no tragedies or life-and-deathconsiderations in his addiction and recovery Inside thefacility he is forced to wear a sign saying "no male contact,"and once he is released, his main concern is "I'm never going

to get laid." His substance abuse is secondary to his role of

buffoon in the film The serious process of recovery in all