Applied Psychology OPUS

A One Way Ticket to Shutter Island

Justina Passarelli

Psychology as a field is often misrepresented in modern cinema and Martin Scorsese’s latest film, Shutter Island, is one that may leave a negative impression of psychology on the viewer. In the story, U.S. Marshall Teddy Daniels (Leonardo Dicaprio) sets out to find an escaped patient from Ashcliffe Insane Asylum on Shutter Island. However, in a radical twist, we find that Teddy is himself a patient at the asylum. He suffers from Delusional Disorder, creating a false world to escape the dark reality of his past. Shutter Island is one of the many films that present the ethical considerations of psychological treatment to a mainstream audience. While it succeeds in accurately presenting a severe case of mental illness and the changing treatment options of the time, it may ultimately fail to shed a much needed, positive light on the modern field of psychology.

Was Teddy Delusional or Are We?

Teddy displays features of both Grandiose and Persecutory Delusional Disorder. According to the American Psychiatric Association's (2000) Diagnostic and Statistical Manual of Mental Disorders (text revision; DSM-IV-TR), this mixed type is characterized by feelings of immense importance and feelings of being watched or victimized. Teddy experiences both; believing he is on the verge of a grand discovery and simultaneously is being conspired against by the doctors at the asylum. For those with Delusional Disorder, full periods of remission may be followed by subsequent relapses, as is Teddy’s case.

Perhaps in response to his experiences in war and the death of his wife and children, Teddy creates an entirely different identity, complete with a new name, profession, past and present. To prevent the truth of his situation from shattering his newly constructed sense of self, Teddy believes any information provided by his doctors is merely part of the conspiracy to keep him in the institution. This altered sense of reality serves as a defense mechanism, a means by which he protects himself from the pain of his past experiences. Despite several hints and associations purposely expressed throughout the intervention, Teddy’s delusions persist until the final scene, leaving us with an eerie sense of just how powerful and complex the mind can be in its defense.

While the disorder is portrayed in a very realistic light, it might be hard for a viewer with no background in psychology to believe the extremity of Teddy’s Delusional Disorder. This type of disorder is even difficult for clinical psychologists to fully understand, so the average viewer may question Teddy’s delusions, or may even leave feeling delusional themselves.

The War Between Archaic Methods and Progressive Treatment

A psychological thriller portraying psychological treatment in the 1950’s is likely to leave viewers wary of the state of modern psychology. As we experience Teddy’s flashbacks of the war, we are confronted with another conflict - a psychology in the midst of profound change. On one hand Shutter Island depicts the traditional inhumane treatment of patients in an asylum, evidenced in the harsh militancy of the warden and his accordance with the archaic treatment of lobotomy. On the other hand, Shutter Island depicts advancements in psychoanalysis, as evidenced by the more progressive standpoint of Dr. Cawley, a proponent of a more compassionate client-centered alternative.

While Shutter Islandis a fictional depiction of patient abuse, it is important to note that it is, unfortunately, an accurate one. In the 1950s, lobotomies were widely practiced as a way to "tame" or "calm" severely violent or problematic patients. However, lobotomies are rarely practiced today because a large number of deaths resulted from the procedure. Even so, when necessary, the procedure is much more advanced than it was 50 years ago, when, as the movie showed, doctors used an ice pick to probe the brain through an individual’s eye. Now, lobotomies are only an option in the most extreme of circumstances and as a last resort, after psychotherapy, medication and all other resources have failed.


Shutter Island is in fact an accurate depiction of the changing methodology in clinical psychology and worthy of praise in that area. But to those unfamiliar with the history and progression of psychological treatment, the way this film portrays psychology in the 1950s might leave viewers uneasy about its modern practice.

One Flew East, One Flew West

Shutter Island isn’t the only film that skews audience perceptions of psychological treatment. Its famous predecessor, One Flew Over the Cuckoo’s Nest, shares similar misrepresentations of the field. By presenting lobotomies and electroshock therapy as dangerous treatment options, both films portray psychologists’ disregard for the well-being of their patients. Furthermore, the ending of each film leaves us to question just how "crazy" the main character was, reminding us that abnormality is societally determined and often misunderstood. It is important to remember that both of these films occur during the 1950’s, not presently, and while they do raise necessary concerns about how we understand the abnormality of mental illness, they no longer reflect the treatment realities of the modern field of psychology, which strives to rehabilitate individuals without violating their rights as human beings.

Cinematic diagnosis: 

Shutter Island evokes an array of philosophical questions: What is insanity? How can psychologists diagnose such an abstract concept? Can it ever be cured? This film speaks volumes to society’s conclusions on what is sane and what is not. And to some effect, calls all psychological diagnoses into question. Shutter Island does a great job at depicting Teddy’s particular case of Delusional Disorder accurately, but unfortunately, without proper understanding of the 1950s context, may end up doing more harm than good to the representation of psychology in modern film.

Keeping context in mind, Shutter Island can be a wildly fascinating film, full of action, mystery and suspense. If you are even remotely interested in psychology, and especially if you are in pursuit of a career in this field and you have yet to see Shutter Island, well, you must be insane.


American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: APA.