Being Flynn - Another Cinematic Portrayal of Alcoholism

My previous post looked at the accurate portrayal of alcoholism in the film Flight.  I recently saw Being Flynn starring Robert De Niro in the role of an alcoholic father and self proclaimed novelist.  This film is also a study of alcoholism.

Like Denzel Washington, De Niro accurately portrays the ways that alcoholism impacts the lives of some men.  In this case we meet De Niro's character Jonathan Flynn in a downward spiral.  We first meet his son Nick Flynn and learn through a series of flashbacks that the elder Flynn abandoned Nick and his mother for unclear reasons and he has not seen his father in about 18 years.   We first see Jonathan Flynn when he is driving a taxi.  He is drinking vodka on a regular basis.  We see him lose his job and then his housing and end up at a homeless shelter.  Nick is floundering as a poet and author.  He lacks direction and the flashbacks suggest that childhood adversity has played a big role.  He comes to be employed at a homeless shelter where his father eventually seeks shelter.

The trajectory of that story line is impacted by the fact that Jonathan is a very volatile and generally unlikable character.  Although it is certainly dangerous to live on the street, he has an aggressive attitude at times that is not warranted.  It is the reason he was evicted.  At other times he is able to keep quiet when he witnesses some street thugs beating one of his drinking buddies.  He uses a lot of expletives and at times seems incoherent.  In his interaction with Nick he is unapologetic and grandiose - describing himself as one of America's greatest authors.  When he allows Nick to read his manuscript, the first chapter shows some promise but the rest is incoherent.

Nick is on his own parallel journey.  He is lucky to get the job at the homeless shelter and initially blends in seamlessly with the staff.  The shelter staff and the environment at the shelter is expertly portrayed and very realistic.   The tension at the shelter between caring for desperate and sometimes disagreeable men and the required altruism is palpable.  Eventually Jonathan's disagreeable temperament creates a situation where Nick has to vote on whether to expel him.   He does despite a staff person trying to convince him not to send his father out on one of the coldest days of the year.  Jonathan predictably acts like he relishes the thought and that living on the street is nothing.  When we see what actually happens out there it is clear that his attitude is another manifestation of his pathology.  There is a time when we are not sure whether Jonathan will survive or not.

There are a number of fascinating articles available that look at the process of making this film.  The gold standard for any film is the book and many critics suggest reading that as a starting point.  The real Nick Flynn has some fascinating interviews talking about the evolution of homelessness in America.  When did it become acceptable?  The motion picture business is averse to producing any films that portray characters or themes that the general public would find to be distressing and the main reason is how that translates into box office numbers.

As I contemplated the Flynns' predicament I naturally thought about all of the homeless alcoholic men I have seen in the past 25 years.  At some point in time they all create the anger, frustration, and hopelessness portrayed in this film.  Many of them are not only grandiose and paranoid, but permanently delusional or amnestic.  The good news is that they are also a stimulus for the altruism apparent in the shelter staff in this film and eventually Nick Flynn himself.  This film is similar to Flight in that there are no proposed solutions.  The are no public policy statements.  It is an accurate depiction of real people dealing the the problem of addiction in their daily lives.  Despite those significant problems there are hopeful messages everywhere.  After reading an interview with the author, I am skeptical of the origins of those messages, but based on my experience they seem real.

I also had associations to what I consider to be some of the most important work in alcoholism.  The first was a study of inner city alcoholics by George Vaillant in the 1980s and several subsequent studies by the same author.  Most of the original articles online are available only with steep fees for a one time read.  It is probably easier to look at The Natural History of Alcoholism - Revisited in your local library.  It contains most of the important graphics from the research articles and Dr. Vaillant's views circa 1995.  The summary section looks at seven very important questions about the nature of alcoholism and the answers provided by prospective research on the problem.  In looking at this research, Jonathan Flynn probably most closely resembles the follow up study of 100 consecutive admissions to a detoxification unit in Boston.  At the end of 8 years of follow up, about 32% were abstinent, about 30 % were still drinking and 32% were dead or institutionalized.  One of Dr. Vaillant's characterizations of the recovery process in alcoholism:  "... alcoholics recover not because we treat them, but because they heal themselves.  Staying sober is not a process of simply becoming detoxified, but often becomes the work of several years or in a few cases even of a lifetime.  Our task is to provide emergency medical care, shelter, detoxification, and understanding until self healing takes place." (p384).  Self healing was evident in this film.

The other work that I routinely discuss with people I have seen for alcoholism and the associated comorbidity is the work of Markku Linnoila.  Dr. Linnoila was a prolific researcher in both basic and clinical alcoholism research.  He did some of the early studies looking at cerebrospinal fluid metabolites, especially serotonin metabolites and how they correlate with depression, aggression, and impulsivity over time when men consume alcohol.  These studies continue to provide a scientific basis for advising patients on basic dietary changes and in some cases pharmacological interventions that may assist in recovery.  An important aspect of the work of shelters like the one depicted in this movie is getting protein back into the diet of the homeless with alcoholism.

This film is harder to watch than Flight but it is no less accurate a depiction of how alcoholism can impact the person and their family.  It speaks to the spectrum of intervention necessary to provide safety and assist with recovery.

George Dawson, MD, DFAPA

Vaillant GE. Alcoholics Anonymous: cult or cure? Aust N Z J Psychiatry. 2005 Jun;39(6):431-6. PubMed PMID: 15943643.

Zemeckis portrayal of addiction in "Flight"

I went to see Robert Zemeckis film Flight starring Denzel Washington as pilot Whip Whitaker yesterday.  Spoiler alert - if you are a person who likes to see new films knowing nothing about the plot - stop reading this post right here.  I work at a large residential addiction facility and ran into one of my colleagues in the lobby.  He told me he was there to see the film because it was a good film about addiction.  I was completely surprised.  Robert Zemeckis made the film that I have seen more times than any other - Forrest Gump.  I generally see anything that Denzel Washington does.  Like everybody else, I like his work and he does not make any bad movies.  His last transportation themed movie Unstoppable cast him the role of a wise engineer trying to stop a runaway train.  The trailers I had seen for Flight suggested a similar role.  I expected a heroic pilot with a similar outcome.

From the outset, it is obvious that Whip Whitaker has a tremendous problem.  He wakes up hung over, snorts some cocaine, drinks what is left of a beer and heads out the door with his pilots uniform on.  Almost incredibly he proceeds to inspect his commercial airliner, fly it through extreme turbulence, drinks some additional vodka in flight and takes a 26 minute nap before the critical scene in the movie where he performs a complicated series of maneuvers to save most of the crew and passengers from a mechanical failure.  Subsequent analysis proves that he is the only pilot who could have saved the plane.  But even those facts are not enough to preserve his fleeting hero status.

Throughout the film we see Whip drinking in an uncontrolled manner.  There is some ambivalence.  He gets out of the hospital post crash and goes to the family farm where he proceeds to dump out all of the beer and hard liquor.  He dumps out his stash of marijuana.  There is the implicit recognition that somewhere there are toxicology results that he is going to have to deal with.  As that part of the plot unfolds, he resumes drinking, smoking marijuana, and snorting cocaine with a vengeance.  In one scene he walks out of a liquor store with a case of beer and what appears to be a three liter bottle of vodka.  As soon as he gets into the car he is drinking the vodka like water and drives around with an open can of beer.  There are several scenes where the interpersonal toll of alcoholism is evident with his potential love interests, his son and ex-wife, and friends and business associates who are rooting for him.  The business associates have a common interest in seeing that he is exonerated for any crimes related to substance abuse.

This film succeeds in its depiction of alcoholism and how it hijacks the life of an otherwise highly successful pilot.  On the surface he is a "functional alcoholic."  His friend and former fellow Navy pilot describes him as a "heavy drinker" rather than an alcoholic   He appears to be successful in one aspect of his life but it does not take long to figure out even that is a charade.  He can't tolerate even the suggestion that he has a problem on the one hand and on the other makes the promise that he will stop and he can stop at any time.  He walks out of an AA meeting when the speaker asks people to raise their hand if they are an alcoholic.  There is a contrast between Whip and his girlfriend Nicole illustrating that addiction has no socioeconomic boundaries.  There were so many scenes in this film that captured the problems of addiction.

As an audience member you cannot help getting caught up in his fight with alcohol.  He is after-all the hero of this film and that is firmly established in the first 20 minutes.  You are hoping that he will not pick up another drink.  You are left with a situation where the hero will be dealt with according to technicalities.  His heroism does not count.  The only thing that matters is that he has an addiction.

This is a compelling film about addiction for families who deal with this problem on a daily basis and for those who do not.  It accurately portrays the central problems of addiction and recovery as not just avoiding punishment or making a conscious decision to stop.  It is a lot more than that and hopefully that message will be clear from watching this film.

George Dawson, MD, DFAPA


References (Doug Sellman has done a great job of distilling out the scientific points of addiction):

1. Sellman D. Ten things the alcohol industry won't tell you about alcohol. Drug Alcohol Rev. 2010 May;29(3):301-3. PubMed PMID: 20565523.

2. Sellman D. The 10 most important things known about addiction. Addiction. 2010 Jan;105(1):6-13. Epub 2009 Aug 27. PubMed PMID: 19712126.

3.  Alcohol Action New Zealand web site (various resources)

4.  Alcoholics Anonymous.  Grounded.  Alcoholics Anonymous World Services, New York City, 2001.