With Shame in cinemas this week, everybody is talking about sex addiction. Though the film avoids explicit mention of it, director Steve McQueen has discussed it in interviews and it is widely assumed to be the reason for its central character's obsession, which dominates his life. But there's a problem with the notion of sex addiction, and that's that the vast majority of psychiatrists think it isn't real. And this isn't the first time films have been connected with dubious science that may sell tickets but tells us nothing about how people's minds really work.
Selling tickets is, of course, a perfectly reasonable objective for any filmmaker, but it can be problematic if it encourages popular misunderstandings of how the world works. This is especially the case if it leads to people with real problems being stigmatised or not getting the help they need. And in genres where we look for stories we can believe in, shouldn't we ask for realism in psychology too?
The term 'sex addiction' first came to popular consciousness in the mid-Nineties. It has been associated with figures like Bill Clinton, Tiger Woods and Dominique Strauss-Kahn as well as several people in the film industry, with David Duchovny checking himself into a specialist rehab clinic in 2008. Many people have ridiculed it as an excuse for people – usually rich men – to sleep around and then expect forgiveness and pity when they claim they couldn't help themselves. But Shame presents us with a figure – played by Michael Fassbender – who is clearly losing control of his life because of his sexual impulses.
Proponents of sex addiction as a real condition argue that it can work like drug dependency because sex triggers a chemical pleasure response in the brain. The problem is, so does anything that we find fun. The American Psychiatric Association has refused to list sex addiction as a disorder because it considers the name misleading in this regard. It does acknowledge that people may have abnormally high sex drives, but this is contentious because it's difficult to assess what's within a normal range on the scientific data alone, and different people's conclusions are likely to have more to do with their moral values than measurable facts.
Does this mean that the story told in Shame is essentially nonsensical, carried only by the strength of Fassbender's performance? Not quite. Whilst sex addiction may be dubious, obsessions and compulsions are well recognised psychological problems that may take many forms. The behaviour of a character like this may also be rooted in depression or a number of other problems. The key to treatment would be to find that underlying cause rather than being distracted by the sex. The fact films on the subject are repeatedly distracted by the sex (there's another high profile one currently in the works - Thanks For Sharing, with Gwyneth Paltrow) might prompt us audience members to ask questions about our own approach to the issue.
Cinema is often, by its nature, sensational, but sometimes taking a sensational approach to psychology can have serious consequences. This happened in the Seventies when films like Schizo (tagged 'When the left hand doesn't know who the right hand is killing!') conflated schizophrenia with dissociative identity disorder and helped to create a moral panic about the risk supposedly represented to society by sufferers. The muddle of ideas around the condition proved misleading for everybody, including future generations of filmmakers who often simply borrowed those ideas without doing their own research. So now it is commonly believed that schizophrenic people have multiple personalities, making them the 'realistic' equivalents of the demon-possessed cinematic villains of yore, despite the fact many psychologists contend that that level of personality separation doesn't exist in anyone.
Then there's psychology as it is used within films. What is it reasonable to assume a character with psychological training can work out about others?
The 'science' of criminal profiling has existed in a vague sense since the Middle Ages but was brought into the modern world in the 1940s. It was popularised by films like The Silence Of The Lambs and has since become a mainstay of popular crime dramas on both the big and small screen. There's just one problem – most of it doesn't work. Whilst some aspects of offender behaviour can be profiled statistically, the old stories about detectives with brilliant insight who can look into the mind of a killer and tell you what he had for breakfast have no foundation in reality. Even what films have taught us about serial killers is largely fabrication – there are no 'organised' and 'disorganised' types, most choose their victims pretty randomly and trophy collecting is rare. The real thing is much more like the eponymous subject of Henry: Portrait Of A Serial Killer than standard screen villains awarded the title, and distinctly unglamorous.
All this demonstrates how film absorbs and reiterates popular culture in ways that often serve to distort poorly understood science still further. Cinema can tell us how to interpret the actions of others and what to believe about ourselves, its authority often going unquestioned. Thanks to Shame and its ilk, sex addiction clinics will once again do good business and there will be a widespread reinforcement of the popular notion that sex is inherently shameful in some way, a subject we should pretend to be disinterested in (no matter what we go to see in the cinema). The real shame is that the facts are forgotten.