Silver Linings Therapy Playbook: Mental Health in Novel and Film

I’ve never read Matthew Quick‘s debut novel, The Silver Linings Playbook, now adapted by David O. Russell for the screen. But I have now seen the filmSome further thoughts and reviews regarding the portrayal of both mental illness and therapy in both genres follow.

The Silver Linings Playbook: The Novel

A former teacher who successfully hid his severe depression from his students, author Quick knows a thing or two about mental disorders. He recently told Steven Rea,, “I still deal with anxiety and depression issues, but the writing is a form of therapy for me.”

The form of therapy for main character Pat, whose diagnosis apparently isn’t made clear, occurs after he’s discharged from several years of long-term treatment at the psych hospital, otherwise known as “the bad place.” According to Nancy Pearl‘s review at, outpatient shrink Dr. Patel is “eccentric (but effective).”

As part of the publisher’s own intro to the book, however, said effectiveness is called into question: “…his new therapist seems to be recommending adultery as a form of therapy.”

Courtney Zehnder, in reviewing Silver Linings Playbook on the site of the Institute for Personal Growth, indicates that the use of therapy and medication becomes a helpful agent of change for Pat but that “…his relationship with his therapist may not be the most realistic portrayal…”

Silver Linings Playbook: The Movie

What kind of mental health issues are shown? First, Pat, who in the film spends less than one year as an inpatient, now does have a diagnosis: bipolar disorder. Others around him exhibit different types of overt issues. Grief, OCD, codependency, and sports mania are just a few that inhabit family members and friends.

It turns out that director/screenwriter Russell was interested in adapting the novel because his son has struggled with “bipolarity and other matters,” reports Hillary Weston at She adds that, in her estimation, Silver Linings Playbook:

…does a beautiful job of subtly portraying the point in illness, treatment, and recovery when one has the clarity and consciousness to recognize his or her behavior and faults but still does not have the power to control them and the shame, guilt, and self-hatred that comes along with it.

Did I think the issues were in fact portrayed realistically? Well, they didn’t seem unrealistic. At the very least, I didn’t come away thinking, That was bullshit.

The critics are somewhat divided on this question, though.

Stephen, is one who points out that realism isn’t necessarily even germane: “…(T)his isn’t just a collection of oddballs (nor meant to be a serious study of mental illness).” And he adds:” It’s really a story about getting past your anger.” Which just may be what makes the movie relatable to all kinds of people regardless of one’s personal experience with mental illness—everyone knows something about anger.

Similarly, the AVClub review takes into account the film’s mainstream essence. It’s:

…the perfect material for Russell, who not only deals perceptively with the dizzying swings of manic depression, but makes it the fabric of a big, generous, happy-making ensemble comedy…

There’s real-crazy and there’s movie-crazy, and Russell gets what he needs from the former (which is really hard to resolve) in order to settle on the latter (which is really easy to resolve)—ultimately, mental illness serves as the vehicle that gets these two quirky characters to the crowd-pleasing place the film needs them to go.

Lou Lumenick, New York Post, doesn’t agree:

I must confess a relatively low tolerance for movies that romanticize, much less trivialize, serious mental illnesses such as bipolar disorder — which here is laughed off as a somewhat charming quirk that’s easily managed with medication. But that’s probably to be expected from a director like Russell, who has famous real-life issues with anger management.

Claudia Puig, USA Today, too has her doubts: “Serious mental illness is not portrayed with full authenticity here, yet Russell’s script, based on Matthew Quick’s novel Playbook, captures a range of eccentricity with comic finesse.”

How about the ending? Irene S. Levine, Life Goes Strong, comes down hard on it in what may be a broadly drawn spoiler, so please consider this when deciding whether to read ahead:

In terms of promoting mental health awareness, the last third of the movie was disappointing. Much like A Beautiful Mind, the ending of Silver Linings Playbook implies that love can transcend mental illness. This is where the movie does a disservice to its audience and oversimplifies the complexity of mental illness and the path to recovery. But the contrived happy ending does allow the audience to leave the theater feeling good and, perhaps, in the mood to talk about the real challenges posed by serious mental disorders.

End of spoiler alert. For now it’s safe to read on…

And what about Pat’s therapist? As it turns out, there’s very little of him in the film. Anupam Kher, the actor who plays Patel, notes in that his character actually joins the others in being “dysfunctional,” however. You don’t know that right away—not until the end, he says.

I beg to differ.

Possible spoiler coming: Pat’s (and the audience’s) very first meeting of Patel immediately follows Pat’s violent response to hearing “My Cherie Amour” in the not-private waiting room. Pat confronts Patel about allowing to be played what is in fact his personal known-to-be-rage-triggering song, and the not-sensible, not-wise shrink admits he purposely did it in order to “test” him.

Not cool, in my humble clinical opinion.

You can read this: Whereas on the more positive side, Dr. Patel does continually encourage Pat to make healthier choices…

Final spoiler alert, sparing you many of the details: …Patel’s not the best at his own choices. The eventual “dysfunctional” twist regarding this doc occurs outside the therapy office and is just one more in a never-ending string of movie depictions of unacceptable therapist boundaries that are never explained to the audience as such.

2 thoughts on “Silver Linings Therapy Playbook: Mental Health in Novel and Film

  1. Hi Myriah, It’s been a long time since I saw the movie (Thanksgiving), so my memory may be faulty, but what I think is that we see so little of his therapy that it’s hard to say. My best guess is that the therapist is trying to offer what we sometimes call supportive therapy in that he’s encouraging his client to do whatever it takes for him to get healthier, e.g., take his meds, change his attitude. Could be a behavioral component to this. I don’t recall if he tries to address family dynamics or childhood stuff, which would add some possibility of a psychodynamic and/or family systems approach too. Sorry I don’t have a more confident answer!

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