Watching Solveig Melkeraaen’s film with a psychiatrist gave me answers the audience are denied in this underexplored self-portrait of depression and ECT
Given that in the UK alone around a quarter of the population will experience some sort of mental health problem each year, any documentary exploring the issues is a welcome addition to the debate. Watching Good Girl alongside Dr Peter MacRae, a consultant psychiatrist at East London NHS Foundation Trust, offered some interesting insights into both the reality of mental health and the pros and cons of documenting the experiences of an individual.
Good Girl is a self-portrait of Norwegian filmmaker Solveig Melkeraaen as she undergoes treatment for depression. A successful director at an early age, Melkeraaen found that she was feeling empty and unhappy despite her career and relationship. She decided to film her journey through her illness and recovery, sharing with us a very personal view of the process.
Although her family and friends rally around her, they feel unable to help and Melkeraaen admits herself to hospital. After three months and a failed suicide attempt, she opts for a series of six electroconvulsive therapy (ECT) treatments. It appears to be a success: she is “happy” again and tries to go back to her old life. We see her family toasting her recovery with a sincere wish from her mother that she stay well; unfortunately this turns out not to be the case and Melkeraaen returns to her depressed state and another round of ECT.
ECT has a varied history in terms of its use in treating mental illness. Developed in the 1930s, it was widely used in the 1950s and 1960s as treatment for a variety of diagnoses. In its early days it was given without anaesthesia or muscle relaxants, which could lead to a full body mass convulsion and in some cases even broken bones. Surrounded by controversy, especially around issues of informed consent, it has been depicted in literature and on screen before, notably in One Flew Over the Cuckoo’s Nest, where it is shown as a barbaric procedure used as a form of control over a non-compliant patient. Melkeraaen’s decision to allow her second round of treatment to be filmed is in part for the audience but also for herself: she wanted to see what was really happening to her during the session.
It is in the introduction of ECT that the film begins to enter murky waters. The depiction of the procedure was frank, and according to MacRae, felt truthful. MacRae unpacked for me (in a way the film did not) why it might be used. “The idea is to induce a generalised seizure that in some way has a pervasive brain-wide disruption of cell function … I 100% believe it works: there’s good evidence, and I have seen it work anecdotally … I’m an advocate of ECT as a last resort in extreme cases.”
Although there is obvious merit in creating work which discusses ECT and mental health, MacRae felt that there were gaps in what we were seeing which could seem to misrepresent the treatment. “For someone [who has] never had ECT before, you would really be waiting for the point at which they were at imminent risk of severe harm or death, for example if they stopped eating and drinking to the point of physical collapse, but of course I’m not sure what the treatment is like in Norway.”
A self-confessed perfectionist and over-achiever, Melkeraaen is aware that trying to be a “good girl” is a contributing factor to her illness. However, it feels significant that the film doesn’t explore the root cause of this. Instead, the only attempt at explanation comes in the guise of genetic predisposition, when she discovers her grandmother also suffered from depression. Otherwise, Melkeraaen’s upbringing and family are not discussed. MacRae agreed that we were not getting the full picture of Melkeraaen’s diagnosis: “I was concerned that it showed so little of the psychological context and healthcare support context of her illness and route to ECT. She seemed just very sad one minute and then back having ECT the next”.
In terms of the film’s style, there are some beautifully shot and arresting hyper-real scenes in which Melkeraaen tries to convey to the audience a true sense of what is going through her mind. At one point she is caught up in a bizarre chatshow, the next trapped in a huge empty swimming pool, literally and metaphorically drowning. The most significant vignette features her as a director shouting criticsim at herself as a dancer: the inner voice of the perfectionist made real. The pressure Melkeraaen puts on herself to be seen to be coping, to be “good”, is apparent in a poignant scene with her mother, in which they discuss her illness : Melkeraaen hides her tears and distress throughout. Painfully, the viewer can see what her mother cannot.
Any film which explores mental illness from the point of view of the person experiencing it will bring interesting and useful insights and do its part to reduce the stigma around seeking help for mental illness. As MacRae concludes: “the point should be to identify people with this illness as being humans, as being us, and make their experience understandable so they aren’t stigmatised, so they get more help”. This film may miss some of its targets as a piece of documentary filmmaking, but in the final analysis gives us a human, if flawed, window into the experience of an individual.
This article first appeared on The Guardian website, here