Monday, December 8, 2014

Mental Health and Psychopathy in Popular Culture Media: An Analysis of NBC'S ‘Hannibal’

The following is a research paper for a Popular Culture class.
It got rave reviews from the professor, and a grade of 100%...plus a star, which he reserves for high quality work. And he said he thought about giving it a second star, and that it was the first time that he had ever considered that.
The paper can't be that good. But it was a nice compliment, none the less. Which was worth it after the immense amount of work that went into crafting the paper (which only had to be 10-12 pages...and ended up being 30. Ooops!). Part of the reason for the length was the heavy topic, while many of the topics for popular culture are "heavy" in nature...racism, sexism and feminism, ethnic and economic factors...there isn't a lot specifically written on mental illness, let alone psychopathy. Pretty sure he loved the paper because it wasn't the same topic he's been reading about for ages.

If you're interested in reading you can download the .pdf from: https://drive.google.com/file/d/0B0L6-YMPxtu7LTdxQllhLU9SakU/view?usp=sharing

Or read it here.
Hope you enjoy it. And as always, debate, questions, etc., are always welcome.

Enjoy!
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Abstract
This paper explores some of the social implications created in modern society by popular culture mediums. Particularity, the often erroneous portrayal of the mentally ill is discussed through a literary analyses of writings by authors from a variety of fields including law, mental health professionals, and popular culture researches. This paper discusses various legal and social consequences created by narrow narratives of mentally ill characters who are predominantly depicted in negative ways or as violent individuals. In the second half of the literary analysis, the topic narrows and explores psychopathy, both in everyday society and well as the ways in which it has been portrayed in popular culture film/television. This exploration provides a foundation for understanding the nuances of the disorder.
The research portion of the paper applies the concepts presented in the literature review to analyze the television show NBC’s ‘Hannibal’ through dramatic perspective. The overall conclusion is that the writers and directors effectively used narrative and filming techniques to create multi-dimension characters that does not necessarily align with the presuppositions presented by the various writers. It should be noted, however, that it does not invalidate their claims.
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Mental Health and Psychopathy in Popular Culture Media
An ANALYSIS OF NBC'S ‘HANNIBAL’

Popular media is a pervasive influence in modern society. Media, which has the potential to shape our views and skew reality on many issues, can be a major influence in how people perceive the world (Baun, 2009).  Among these issues are those related to the portrayal of mental illnesses in popular culture mediums. The implications of erroneous representation in formats such as film and television can lead to faulty public perceptions, as well as impact the creation of law standards (Covey, 2009) and the treatment of the mentally ill by psychiatry professionals (Molin and Nagim, 2013). The disservice that narrow narratives of media provide can be profound, not only on audience, but also on those it is portraying, often undermining the causes and issues that surround the illness. This demoralization by popular culture can have negative effects on a subject’s openness to seeking treatment, as well as the potential effectiveness of treatment. Additionally, the light in which therapists are cast through the popular culture lens can have further impact on the seeking of treatment by members of the public, which can shape the relationship and level of trust those seeking treatment have with their mental health practitioner.
Many aspects of the way in which popular culture mediums are presented can have an effect on the viewer’s perceptions, including production methods such as lighting choices, music selection, and ambiance (Covey, 2009). In addition, the skill and effectiveness of the actor, and the way in which the lines of the script are selected and constructed to create affect, impact the viewer’s perceptions.

Literature Review
Mental Illness and the Media

In News Media Portrayal of Mental Illness: Implications for Public Policy, Wahl (2003) suggests that the portrayal of mental illness by the media is overwhelmingly negative. Further, he states that themes in media coverage of mental illness tend to be predominantly violent or criminal in nature, and feature a “misplaced emphasis on dangerousness”. According to a media influence study by Kimmerle and Cress (2013), a “considerable portion” of public knowledge on a plethora of issues, is gained from mass media portrayals. Interestingly, in their study, Kimmerle and Cress did not find correlations between attitudes and consumption in regards to the perception of violence in the disorders covered, rather a correlation between knowledge and violence calculation. For example, the results showed that the more people knew about schizophrenia, the more they believed schizophrenics to be violent. The less people knew about Obsessive Compulsive Disorders (OCD) or Major Depressive Disorders (MDD), the more they believed them to be violent. They found that when the content displayed was in the form of a documentary the level of learning was deeper. The researchers attributed this to a shift in mind-set between learning and entertainment when confronted with media, and it reiterated their belief that the success of learning is related to the subject’s mental investment, even where media was concerned. These findings, while it may seem so, do not contradict other studies that indicate that much of what people learn about mental illness is from media, rather it reiterates the learning that takes place.
Not only are the mentally ill predominantly misrepresented, says Wahl (2003), by being portrayed in negative ways, but they also tend to be underrepresented and lack a voice in the media, which he says sends a message that those with mental health issues are “too disordered, too disorganized, too unreliable” to speak for themselves. Further, Wahl asserts that among the portrayal is the lack of messages on recovery, which is a common theme, and a lack of emphasis on the contributions that people with mental illness make to their communities.
Wahl (2003) determines that this portrayal by the media has a negative influence on employers, which “perpetuates stigma and public fear of those with mental illness.” and additionally impacts the decision by employers to hire those with a history of treatment for mental health issues. Additionally, when the mentally ill are actually portrayed as employed members of society in programming, over half the time they are presented as failures at their jobs; this is compared to 15% of non-mentally disordered characters. (Sieff, 2003)
In his work on cultural portrayals of insanity over the decades, Covey (2009) discusses how filming techniques had been used to elaborately distort imperfections in the appearance of the “mad”, essentially to deform them. He says this effectively turned them into monsters and not men. He says that eventually those techniques evolved to “depict mental illness as a real and tangible phenomenon” [suggesting] “madness was a curable rather than punishable condition”. Steiff (2003) also faults filming techniques used in relation to mentally ill characters that “exaggerate the dangerousness of characters with mental illness”. In addition to the “childlike state incapable of independence”, she states that the attribution of neurotic, obsessive, morose, and nervous behavior used in order to add elements of humor to the show is also a problem with the media portrayal of mental illness. Tartakovsky (2009) cites “The Boring Defense” as a leading problem, where the argument by writers and directors may be that portraying the mentally ill more accurately compromises “entertainment value”; a claim that she says is incorrect. She finishes her argument by saying that rather than relying on the stereotypical paradigms, media creators should consider their motives, seek a range of sources, analyze studies and treat sensationalized news portrayals as the exception, not the rule. Treating the exaggerated content as the rule creates a divide between society and the perceived otherness of the mentally ill, says Baun (2009) - a divide so woven into the consciousness of society that the media often does not need to sensationalize the issue for people to naturally make the link.
Adding to the issue, Seiff (2003) says the overall depictions of mentally ill cause confusion in some instances, such as the blending of multiple maladies, such as with schizophrenia and dissociative identity disorder. This type of treatment perpetuates stigma, and “contributes to a lack of understanding” and effectively ignores the significance of mental disorders. The way media presents the difference between “normal” and mentally ill is to present them and their actions as bizarre or wild, which has been increasing over the last fifty years (Seiff, 2003). These polarized portrayals are not the only issue when it comes to mental illness in the media, other problems arise in the way media tends to misrepresent psychiatrists (Tartakovsky, 2009). These issues, says Tartakovsky, often dissuades those afflicted with mental disorders to seek the help that they need. This discouragement disrupts communities by creating and promoting fear, structuring false assumptions, as well as nurturing myths and stereotypes (Braun, 2009), further perpetuating the divide.
Covey (2009) states that in the nineteenth century the tendency of cultural mediums was to insinuate that the “mad” had a total inability to blend in with “normal society”, using “clear markers” of “moral insanity” or “moral imbecility” to convey this message. Further, this tendency propagated popular belief that “feeblemindedness” lends to innate criminality, and was often paired with a “lack of capacity for empathy and a lack of conscience.”  Then in the twentieth century, he says the tendency was to move from grotesque monsters to seductive, psychological portrayals, making the “mad” physically more normal likable characters. In the 70’s and 80’s the overall narrative in film tended towards obscuring the face of the “madman”, making little effort to have them appear “human”, making the evil of the criminally mad “literally and figuratively inscrutable”. This shifted focus on the weapons and tools of their madness, as opposed to their grotesque or disturbing features. Covey states that during this time period the ineptness of the mental health professionals to assist their charges also entered the narrative. At each turn, these had a profound impact on existing real life models of mental illness and “criminal madness”.
Popular culture competes with other paradigms set by religious, education, family and social standards (Covey, 2009). When it comes to mental illness, specifically what is termed “criminal madness”, changes in popular culture have overlapped the development of law. Those in changes in law intersect with popular values such as the “beliefs, interests, ideas, stereotypes, attitudes, preconceptions, and fears” which work together to create what Covey calls “cultural iconography.” Influenced by law, which is influenced by culture, he says this culture becomes “an endless process of production and reproduction”. Covey goes as far as to illustrate how popular media culture impacts juries whose “opinion is essential to the legitimacy and efficacy of courts” and whose influence shapes the decisions made within the court system. Covey attributes a high proportion of the responsibility of creating “social reality” to “those who influence the symbol-creating and symbol-defining engine of popular culture”.
Covey claims that popular media shapes “ontological assumptions”, even in regards to shaping laws, deepening “popular anxiety” in regards to crime related to the “mad”, and is an important reflection on how deep media influence flows. Covey concludes that change in portrayals as well as in law is inevitable and dependent on “broader cultural fashions” constructed by popular culture in the representations of the mentally ill and “criminally mad”.
Criminally Mad as Psychopath
In The Media’s Impact on Public Perceptions of Mental Illness, Baun (2009) states that the graphic depictions of the mentally ill is rooted in a “century old bias” of “subhuman or unworthy” context, manufacturing one-dimensional stereotypical portrayals and propagating intolerance and oppression. In the eyes of the audience, Covey (2009) supports, criminal madness is just a further portrayal of mental illness as it progresses the “guilt by mental illness” verdicts and the fostering of “distortions and myths” regarding insanity defenses that became popular in the 1970’s. Ideological media representation of the characterization of psychopathy, in light of omitted information, when popularized by the media (Paulsen, 2010) skews the reality of the disorder, neglecting the interpersonal, emotional, and lifestyle implications. By focusing on the impulse and aggression alone, this practice effectively renders one-dimensional characters. Further, this disregard shapes the beliefs about people who are clinically labeled “psychopathic” and influences how they are treated (Smith, Edens, Clark, and Rulseh, 2004) as they exist and flourish in society.
The most commonly cited statistic on the prevalence of psychopathy in the general population is 1%[1], while this may appear insignificant, this percentage is considered a low estimate by some researches and represents approximately three million Americans. Gao and Raine (2010) provide a short list of professions that attract psychopathic personalities, or those with psychopathic traits, a list which includes businessmen and physicians, citing characteristics such as egocentrism, charm, and irresponsibility (risk-taking) that contextualize “successful psychopaths”. Successful psychopaths, also referred to as “subclinical psychopaths”, express most of the traits associated with psychopathy (Persson, 2013), but do not demonstrate progressive antisocial behavior and the propensity towards a deviant lifestyle typical of unsuccessful psychopaths (Goa and Raine, 2010). Rather, successful psychopaths enter the workforce and enjoy successful careers (albeit, generally through practices of manipulation and sabotage). According to Decovny (2012), these types of psychopaths make up at least 10% of Wall Street, a conservative estimate by some professionals. To further illustrate the prevalence of psychopathic behaviors in society, a study by Smith, Edens, Clark, and Rulseh (2014) revealed that a quarter of the people surveyed believed that they have had personal experience with psychopaths. These types of “everyday” psychopaths are generally left out of popular culture media representation, or in the least are unrecognizable as psychopaths in media depictions through the lack of clarification supplied by dialogue and the lack of the use of the word “psychopath”, as well as an absence of the violence the audience most commonly associates with the disorder. Without these key “prompts” in popular culture representations, the psychopath is virtually unrecognizable to the viewer. This further illustrates the influence of sensationalized media reports that love a splashy headline and evocative storylines, further perpetuating the focus on violence aggression and mental illness.
The absence of dimension is a reflection of a false attribution to psychopathy through popular culture mediums. According to Lilienfeld and Arkowitz (2007) the misconception is that all psychopaths are violent. This indicates, as demonstrated, that there are everyday nonviolent psychopath that are perhaps neglected in media portrayals of real psychopathy. The successful psychopath, or non-criminal/subclinical psychopath, is pervasive in all facets of society, and are driven by the vulnerabilities they detect in potential victims. The characteristics of the subclinical psychopath, what Babiak and O’Tool (2012) term “Corporate Psychopaths”, are pathological in nature and include attributes such as selfish motivated lying, conning, manipulating, and deception of their victims. Also coined “primary psychopaths”, they present affect impairment, or emotional deficiency, and are a type more associated with success (Maiborn, 2008), additional nonviolent behaviors includes stealing, cheating, and general disregard for the law (Perrson, 2013).  Thus, this type of psychopath derives their pleasure from subtle and not so subtle forms of non-violent abuse and harm, predatorily seeking out others for sex, power, and influence, as well as parasitically for food, shelter, and money. However, these parasitic behaviors are generally attributed to an impetuous and negligent lifestyle, which according to researches are more commonly expressed in unsuccessful (non-subclinical) psychopathy. These behaviors are analogues to “secondary psychopaths”, and are attributes related to lifestyle choices and associated with violence, as well as a surplus of negative emotions such as anger and hostility (Maiborn, 2008).
In addition to the lack of empathy when compared to non-psychopaths, studies of psychopaths in general have revealed an impaired reaction to fear and anxiety (Maiborn, 2008). Subclinical psychopaths, like clinical psychopaths, are said to be unable to experience human emotions and feelings such as guilt and remorse, and according to Babiak and O’Tool, (2012) have an “emotional poverty” which can cause them to seek a “lack of emotional involvement with people, things, or activities that may tie [them] down” (Maiborn, 2008). Despite this inability to express authentic human emotions or behaviors, they are masters of mimicry and look towards those around them for examples to imitate. For them to successfully manipulate victims requires the creation of a “psychopathic fiction”. In creation of this fiction, the psychopath “transforms” into the ultimate icon of friend or lover, or in the business world, the ideal leader, or employee, ultimately tailored to the insecurities or needs of the prey. Additionally, the reputations they create with those that they have successfully formed a bond with, “often provide[s] added protection from closer investigation” (Babiak and O’Tool, 2012).
Paulsen (2010) states that psychopathy can be difficult to distinguish, defined simply by “a cluster of socially deviant behaviors [and] personality traits.” Citing the work of Hare, a prominent researcher in criminal behavior and psychopathy, Paulsen asserts that the difficulty in getting psychopaths to conform to acceptable norms of society stems from characteristics similar to that of adolescences, such as “egocentricity, impulsivity, selfishness, and unwillingness to delay gratification”. Previously thought to be a “natural phenomenon”, Paulsen asserts that psychopathy is now believed to be influenced by “environmental currents”. However, there is a strong case for the implication of biological factors in psychopathy, such as neuropsychological, which are recognized as a catalyst, particularly in subclinical psychopathy (Perrson, 2013). This, Paulsen (2010) says, this still makes psychopaths “biologically different” from others, despite his further analysis, where he indicates that it is often assumed that the nature of the psychopath can be recognized as aligned with that of human nature – primary in terms of instinct of survival and self-preservation. To come up with this assertion, Paulsen draws from philosophical works, such as those of Hobbes – who specifies that the “perpetual and restless desire of power after power” of mankind makes the normal state of man one motivated by ego, personal satisfaction and concern for their own lives only. Citing the work of Fromm, who states that “in the realistic school of life […][children] learn they must seek their own advantage even if other people are harmed”, Paulsen therefore gives credence to the idea that psychopathy may just be an “exaggerated extension of widely accepted values” that some say “are practical and legitimate in the marketplace”. This narrative not only brings to mind the concept of the “corporate psychopath”, but also illustrates the depth of character that writers and directors can draw from when portraying psychopathic mental illness in their work.
The crux of the issue is that serial killers and psychopathy are “inevitably linked”, despite variations in personality traits and types of psychopathy. Serial killers who evade capture for sustained periods and have “adaptive features” in terms of executive functioning, scrupulous planning, superior cognitive processing, and stress reactivity display “elevated psychopathic characteristics”. The researchers coin these serial killers “semi-successful” psychopaths (Gao and Raine, 2010) and are infrequently found to be subject to mental health treatment, even in the cases where “curing” psychopathy is seen as a viable option.
Psychopathy as Mental Disorder
The common theory is that treatment of psychopaths is unlikely, or at all possible, which often supported by news media claims (Paulsen, 2010) and other popular culture reflections. Being able to spot a psychopath, as to prevent becoming his prey, takes precedence over the treatment of the psychopath. Particularly important, says Paulsen, is the ability to spot the psychopathic child so that the child can get help “structuring their existence” and “learning to handle social situations” (quoting psychologist Britt af Klinteberg). Adding more context to the claims of successful therapy, Lilienfeld and Arkowitz’s research in psychotherapy outcome entertains the possibilities of “curing” or “ridding” society of psychopathy, suggesting they believe it to be a treatable condition. Paulsen suggests “power over power” method in treatment, which involves “early control, diagnosing, stigmatizing, isolation, medicine and perhaps cognitive-behavioral therapy”, and considers this method to be the best possible hope. This appears problematic in that, based on other professional texts, stigmatization of the mentally ill, even in the case of psychopathy, such as is done through negative media portrays, and subsequent isolation, is often counterintuitive to treatment.
More concerning in “curing” psychopathy is the broken link from the disorder and psychiatry. Through analysis, Covey (2009) illustrates how the depictions of madness as “moral insanity” took a shift to “psychopathy”, how criminal madness went from being conceptualized as an inability to control “’uncivilized’ impulses”, to that of a monster, more degenerative (often with racial undertones), and then evolved into ominous psychological portrayals with “far less clinical imagery”. This transforms what is commonly recognized as psychopathy out of the realm of mental illness, despite its pervasive inclusion in the mental health diagnostic documentation over the years. Lilienfeld and Arkowitz (2007) find that the violence of psychopathy is more closely linked with Antisocial Personality Disorder (ASPD), and research regarding psychopathy and ASPD illustrate a moderate overlap between the two disorders, despite psychopathic behavior being nested below ASPD in the DSM-IV TR (Diagnostic and Statistical Manual of Mental Disorders) , along with sociopathic behavior, as an unspecified cluster. The inclusion of this disorder demonstrates that, among professionals, psychopathy is recognized as a mental illness and therefore can be subject to clinical intervention.
One cannot fully discuss psychopathy without a brief word on sociopathy. The two are often interchangeable terms due to the behavioral traits they share in common, and are often used interchangeably among professionals, as well as in popular culture. According to Scott A. Bonn (2014), the difference between psychopathy and sociopathy is a matter of nature (genetics) verses nurture (environmental). While they fall under the same spectrum of ASPD, he says that sociopaths are different in that they are capable of empathy and will appear to be very disturbed compared to psychopaths. Additionally, any and all crimes that the sociopath commits is inclined to be unsystematic and spontaneous rather than skillfully premeditated. Psychopaths, on the other hand, are able to emotionally dissociate themselves from their terrible actions, are frequently well educated and able to maintain steady employment and form long-term interpersonal relationships and blend in convincingly. What makes them more dangerous, according to Bonn, is that they view others as “inhuman objects” who then become subjects they are inclined to use for their amusement. The complex nature and the blending of traits, overall, makes the two disorders opposite sides of the same coin. Bonn’s assessment of the subtle differences between the two is a further reflection on how complicated and intertwined the two disorders are, and speaks to the confusion that may occur in programming where the two words are used to describe the same attributes.
There also exists an erroneous link between psychosis, irrationality in relation to reality, and psychopathy, which Lilienfeld and Arkowitz (2007) indicate is rarely the case with actual psychopaths, who seldom express psychotic indicators, and in fact are predominantly rational. This assertion is further supported by findings of the study by Smith, Edens, Clark, and Rulseh (2004) which indicated a basic misunderstanding among popular culture audiences, at the conceptual level, when the participants were presented with symptoms of psychosis and psychopathy. Part of this confusion also lies in mainstream media representation of serial killers in society, such as with the infamous Charles Manson and David Berkowitz (Son of Sam), who were psychotic, rather than psychopathic (Lilienfeld and Arkowitz, 2007). This perpetuates public confusion; much like the misunderstandings Seiff (2004) says is perpetuated by the misrepresentation of schizophrenia and dissociative identity disorder and other mental health issues, painting them all with the broad brush of insanity.
However, many believe that psychopaths are not, in fact, insane. As Maibom (2008) argues in The Mad, the Bad, and the Psychopath, the existence of their sanity is illustrated by what she says is their ability to identify the right and wrong in their actions, even if it is in a superficial way. She says this, coupled with their lack of psychosis, is what should makes them unable to claim insanity as a defense (exclusively used in murder cases). Maibom boils psychopathy down to an immorality and antisocial syndrome, and that we should presume, due to their impairment, they would be unable to acquire any real understanding of moral indiscretions, but at the same time claims it is not a lack of ability. In summation, Maiborn claims that the far-reaching inclusive nature of mental disorders is the problem, and that the psychopathic “disregard for social and moral norms […] differs greatly from […] other such disorders”, stating that “unless we think that bad people must also be mad, there is little reason to think [them] as mad”. Therefore, according to Maiborn, the psychopath’s “badness lies in the [perceived] madness” and their propensity for unjustifiable “gratuitous and sadistic violence”, making them “amoral to the core”. Viewing the criminally mad simply as agents of immorality, which Maiborn has done, is precisely what Covey (2009) says the nineteenth century popular media had a tendency to do, and prolongs the mischaracterization.
Nonetheless, despite the general confusion that surrounds psychopathy as an affliction or a symptom, audiences love a psychopathic villain on the screen.
Psychopathy as Entertainment
As Grixti (1995) says, the public is fascinated with popular culture depictions of psychopaths as serial killers or sadistic characters. As with any popular media portrayal, he says “boundaries between fact and fiction [are] often […] blurred.” Ultimately, he claims that the public’s fascination, and the way in which they recognize mass murderers and serial killers as monsters as uncivilized and inhuman, is an effort to place them in the realm of otherness, to “[distance] them from what we popularly perceive as the norm.” This makes the public more comfortable and less threatened with depictions, but he says this also reinforces “some very deeply ingrained but erroneous assumptions about the roots of human nature”. Grixti (1995), citing Lanchester, also claims that the popularity of the pop culture serial killer is due in part to the illustration of the boundless capabilities of human beings by providing examples of incomprehensible human actions and fuels the belief “that the human psyche is not fully explicable”.
Grixti (1995) claims producing the characters of psychopathy in popular culture in this way creates opportunity for people to identify with the “monster”, while simultaneously granting the ability to “loathe anything [reminding] them of [the] dark side of themselves.”  This somehow allows the psychopath to become a “domesticated mythic monster”, such is the classification of werewolves and vampires. This practice turns the psychopath, as it were, into a consumable “cinematic attraction”. When not turning them into monsters, popular culture makes sense of their behavior by portraying them as clearly psychotic. Grixti says that this “comfortable” stereotyping of murders by popular culture texts ultimately works to prolong the public’s misconceptions about the causes of psychopathy, serial killing, and criminality. He claims this helps consumers identify with lawfulness, thereby recognizing their own feeling of control of their inner beast through their internalization of “rules, demands, and prohibitions of the social order”, thereby reinforcing the “poor understanding of […] emotions and instincts relate to the historical patterns of evolution.”
Paulsen (2010), however, astutely recognizes the juxtapositions of sympathy in critical views of the psychopath. She states that, “just as society does not care about the psychopath’s childhood [in reducing psychopathy to a natural phenomenon, or animal unable to accept “conventional values”]” nor concerns themselves with "his/her reactions to whatever he/she has been exposed to, the psychopath does not care about others’ background and feelings”. As society views psychopaths “as things, as natural phenomena, as animals” so does the psychopath view society. In turn, viewing psychopathy as “a natural phenomenon” results in a perceived untreatable psychopathic state. One might surmise from the reading that reducing the options to early detection and stigmatization, essentially “othering” the afflicted, further perpetuates the ideal that “psychopaths lack fundamental qualities that characterize the human being [and that] they only constitute a threat to humanity […] comparable with an earthquake”. This dehumanization works against any hope for reform, in the event such a thing is possible.
As the literature analysis indicates, the accurate portrayal of psychopaths in popular culture as a complex character is largely absent. Often the characteristics of psychopathy are not perceived as such unless there is violence linked to the character’s behavior or scripted prompts alluding to such. Additionally, the portrayals of psychopaths, and the perceptions the public has about them that correlates to how they may be treated. Much of what the public thinks about psychopathy can be dehumanizing by proxy, which may in fact perpetuate negative behavior. It may be argued that psychopaths are probably not overly concerned about how they are negatively portrayed in media, but there is no way to be sure due to the depictions that work to alienate them from society.
The goal in creating such an in-depth literature analysis was to demonstrate the broad complexity in understanding the gradient that exists in the character of the psychopath. As I move forward in analyzing a popular culture text for accuracy and clarity in the treatment of mental illness, specifically when it comes to the psychopathic disorder, this will assist in contextualizing my perceptions.

Methodology
The methodology in further exploration of the topic of psychopathy as it applies to representation by popular culture mediums will be through the application of dramatic perspective. The dramatic perspective is an analysis of the verbal and nonverbal symbols used in popular culture to create knowledge and understanding (Sellnow, 2014).
The execution of methodology will be in the examination and analysis of the first two seasons, twenty-six episodes, each forty minutes in length, of NBC’s Hannibal (2013- ). The goal will be to explore the methods used in portraying mental illness and psychopathy throughout the series. Additionally, a brief analysis of  the depiction of the role of psychotherapists in relation to disorders and treatment will be explored. Due to the complex associations between sociopathy and psychopathy, no distinction will be made between the two in this analysis and they will be treated interchangeably for the sake of ease.
Specifically, this examination will be completed through analysis of dialogue, as well as filming techniques and imagery used to communicate the story of the characters. The overall goal is to determine whether or not the portrayals in the TV series corresponds to the findings in the literature review regarding mental illness and psychopathy renderings.
Additionally, Appendix A includes a Hare PCL-R (Psychopathy Checklist) on the character of Hannibal Lecter to better determine whether or not his character can be said to be a close, or complete, representation of a clinical psychopathy.

Analysis
The basis of NBC’s psychological thriller Hannibal is centered specifically on characters from Red Dragon, a novel in a popular series by Thomas Harris. The television series appears to revolve around the relationship between an FBI profiler named Will Graham, played by Hugh Dancy, and a forensic psychiatrist named Dr. Hannibal Lecter, played by Mads Mikkelsen. Additionally, the relationships that both Will and Hannibal have with several other key characters come heavily into play when analyzing the handling of mental illness in the series, particularly in terms of elements of psychopathic behavior.
Key Characters
In the first episode of season one, the character Will Graham self-identifies as being “on the spectrum”, clarifying that his “horse is hitched to a post that is closer to Asperger’s and autistics than narcissists or sociopaths.” This statement is made within the first five minutes of the very first episode. While this seems to theoretically be setting the stage for the inclusion of Aspergers or Autism into the plot lines, these disorders are rarely, if ever, discussed again. However, as the viewer will see, the very symptoms that are associated with these disorders, which puts Will in the “other” category, as Grixti (1995) claims incites “public’s fascination”, are called into question later on in the series in regards to legal matters. The primary purpose of establishing Will’s disorder, however, seems to be to explain his deep level of empathy that makes his character a stunning criminal profiler, to explain why he is “so different”, as well to account for some of his personality quarks. However, many of his personality quarks, such as discomfort with making eye contact, seem to disappear quickly within the first few episodes.
When Will’s skills as a profiler are portrayed on screen they accompanied by visual effects and a baritone sound. This is supposed to imply that this is what he sees and hears as he begins the process of entering the mind of the serial killer(s) of whom he is “empathizing” in order to profile them. This is further sets him apart from the “normal” members of his group who, while also working to create serial killer profiles, do not do so accompanied by perceived physiological changes or experiences.
The character of Will Graham in general, despite his clear early-on “othered” status, is presented as being more ordinary than those around him – while clearly intelligent, this appears to be equated with his disorder. His emotions tend towards visual displays of distress and frustration that plays across his face. Will’s style of dress is relaxed, if not out of fashion. He lives in a modest house in the country with a plethora of stray dogs.
In regards to interpersonal relationships, his failed pseudo-romantic association with Dr. Alana Bloom (Caroline Dhavernas), and his friendship with Jack Crawford (Laurence Fishburne) as well as how that relationship is played out over the course of the two series, illustrates his difficulty in creating and maintain strong interpersonal relationships. While his mental disorder is not frequently or directly referenced, these difficulties become recognized as being associated with it. Overall, Will is presented as very average, particularly in contrast with the character of Hannibal Lecter.
The relationship between Hannibal Lecter and Will transpires early in in the series as he becomes Will’s unofficial therapist as he deals with returning to active field duty after years as a professor for the FBI. Will’s previous status of inactive duty was related to his inability to pass the psychological test required of the FBI. The two slowly develop a friendly relationship with each other and it is this relationship, which is the root of the psychological drama throughout the two seasons.
Hannibal Lecter’s character, on the other hand, is highly intelligent, illustrated by his credentials as a former surgeon-turned-psychotherapist. He is highly cultured, as demonstrated by his manner of dress, his articulate way of speaking, as well as his living quarters, and his culinary skills and extravagant diet. He always presents himself as calm and unaffected in the presence of unexpected or chaotic activity. Additionally he establishes various interpersonal relationships over the span on two seasons including a romantic relationship with Dr. Alana Bloom.
In reasoning, the primary purpose of establishing Will’s mental disorder early on may have more to do with adding to the character of Hannibal. For instance, it takes a long time for both Will, who is skilled in empathizing with serial killers, and Jack Crawford, the FBI behavioral specialist (not to mention many other key players), to clue into Hannibal’s “real character”. This provides an illustration of Hannibal’s charismatic and conniving abilities as a psychopath; he can even fool the professionals.
It is notable that there is no part of the storyline that “explains” Hannibal, other than his parents died when he was very young, and he had a sister (who he killed). Will, on the other hand, had an emotionally distant mother, and was an only child. These bits of information parsed over more than one episode to provide insight into what is “wrong” with Will - i.e. symptomatic nurture over nature, but only touched on the underpinnings of what may be considered Hannibal’s genetic malfunction.
Plotting the Psychopath
The plot of each episode revolves around frequent graphic serial murder cases, sometimes spanning as many as three or four episodes. Each case is solved with the help of Will Graham, and increasingly with the help of Hannibal Lecter. Despite all of the graphical serial killing the major moments where the actors allude to psychopathy are in response to the copycat killer, that later turns out to be a serial killer known as The Chesapeake Ripper. We learn early on that despite another person holding the title of The Ripper, Hannibal is in fact the real Ripper who, until mid-season, had been thought to be “on hiatus” for two years – this is before realizing he is also the copycat killer.
While the term “psychopath” comes up often enough, at least in fifty percent of the episodes, it is generally used in relation to a serial killer known as “The Chesapeake Ripper” only, a serial killer that often kills in different ways but always harvests an organ from the body. None of the serial murders are referenced this way, despite their fantastical and often gruesome acts.
However, in the first season “The Ripper” is not referred to as a psychopath, though at one point he is referred to as a sociopath (S1E6). When the characters use descriptors for sociopathy they use references to lack of remorse or guilt, but in some cases they also attribute other qualities, such as sociopathy being indicative of having had no trouble with the law and being more stable, or grounded, in habitation. This description specifically brings to mind Bonn’s assessment of the difference between psychopathy and sociopathy. This is the episode where we first begin to see the interchangeable use of the two terms.
Most notable in psychopathic discussion is S1E6 where there is a dialogue about psychopaths between “journalist” Freddie Lounds (Lara Jean Chorostecki ), Will Graham and Jack Crawford where they mention various professions that attract psychopaths. Freddie, who herself presents several psychopathic traits, finishes by saying “Here we are. A bunch of psychopaths helping each other out”. It is uncommon for popular culture texts to acknowledge psychopathy outside of violent behavior, so this was particularly interesting.
Further, in each of the serial killer cases motives for killing were a central part of the storylines, and serial killers were rarely (if ever) referred to as either sociopaths OR psychopaths. This it itself reminds the viewer that there are various motivations behind killing, rather than relying on the stereotype that all serial killers are psychopaths.
A Psychopathic Hannibal
Still, will it is supposed to be clear early on that he is one, nobody directly refers to Hannibal as a psychopath, even as his true nature is discovered in season two. In referencing the crimes we are to believe he has committed, the killer is referred to as an “intelligent psychopath”, yet even when people being to suspect Hannibal of his dastardly deeds, there is nary an utterance of psychopathy linking his name.
The distinction created by qualifying the term psychopath is illuminating, to the viewer, in that is presents the idea that there then exists an “unintelligent” breed of psychopath. This gives a general impression of the dimensions to psychopathy perhaps previously unrealized and unchallenged by other works of popular culture entertainment. Additionally, that the viewer knows who the “intelligent psychopath” is, provides a very full picture of the non-violent characteristics that can inhabit a psychopath, which is rarely done in other texts.
The humane depiction of Hannibal is further maintained in separating the violent nature from the psychopath. It is not until the tenth episode of the first season that they show Hannibal killing someone, and that instance is purely a self-defense kill. It is not until the eleventh episode that the viewer witnesses Hannibal skillfully mutilate a victim. At this point the viewer has gotten to know Hannibal on many levels that are not indicative of psychopathy.
Psychotherapy
The portrayal of psychotherapists is plentiful in this series. In addition to Hannibal, who can be seen as a therapist with ethically questionable standards, there is the inter-play between him and the very ethical Dr. Alana Bloom. It is her character alone that represents what is recognized as positive representation. However, as the series goes on, she falls prey to her own bias, as well as the manipulation of Hannibal.
Perhaps worse than Hannibal as a therapist is the unethical therapist Dr. Frederick Chilton (Raúl Esparza) who manipulates the character Dr. Abel Gideon (Eddie Izard) into thinking he is the Chesapeake Ripper, through “coercive persuasive therapy” called “psychic driving”. In season two this same therapist gives a chilling and erroneously biased testimony in regards to Will Graham, who is on trial as a serial killer. Previous to this episode Chilton admits fascination with Will’s mental anomaly, marking one of the few times his condition is the subject of discussion. Later, when testifying against Will, Chilton says that Will “has carefully constructed a persona to hide his real nature”, and is “driven by vanity and his own whims” and “likes to play God”, while these statements accurately describes psychopathy/sociopathy, Chilton is careful to draw distinction that Will is neither of those, and indescribable. The viewer, of course, understands that these descriptors are about the real killer, Hannibal Lecter.
As previously stated, the precedence for Hannibal as a violent serial killer is set early on, but what is key is the complex multi-dimensional character they build of him. In several episodes he is seen as showing a range of feelings, such as sympathy, sadness, and what may be perceived as empathy. Despite this array, his distance, or coldness, is still detectable, even in the micro-expressions that play across his face. It is not until the introduction of his own therapist in episode 7, Dr. Bedelia Du Maurier (Gillian Anderson), that the genuine nature of these emotions begin to be called into question. Several key moments in sessions allude to Hannibal’s psychopathic nature. In the first session, Dr. Du Maurier tells Hannibal that she has “conversations with a version of [him]” and follows by referencing the “meticulous construction” of his “well-tailored person suit”, his “human veil”. Again in season two, episode two, Dr. Du Maurier comments to Hannibal about “the person suit you wear”. These statements allude to the “psychopathic fiction” referenced by Babiak and O’Tool, (2012) in which psychopaths “transform” or tailors the self to the needs or insecurities of their victim, in this case Will, and in a broader scope, the FBI. Demonstrated later, this also works well for Hannibal in creating a reputation and bond which provides “added protection from closer investigation.” This is particularly true of Hannibal in the first season.
Later Dr. Du Maurier tells Jack Crawford that Hannibal “can get caught up in self-congratulation – in his own exquisite taste and cunning. Whimsy - that will be how he will get caught”. This alludes to the fall of the psychopath, that their own grandiose estimation of self will be their undoing. Perhaps hinting at a way in which “successful psychopaths” eventually become “unsucceful”.
Humanizing Hannibal?
As previously illustrated, Hannibal and all of his surroundings are treated with great care to impress upon the viewer his very cultured and intelligent nature. He is seen at his desk working on detailed pencil drawings in his opulent office. He is shown skillfully and artfully preparing dishes in his equally luxurious kitchen. These are symbols of success, in that he has leisure time to pursue such activities. Of his many scenes of solitude, there is classical music in the background, the color palette in his home is both comforting and stylish, creating an image of an environment that is overall warm and inviting. This distances the viewer from the aura of coldness and disorganization that one generally comes to associate with depictions of psychopaths.
 To further humanizing Hannibal, they provide many scenes where he exhibits human emotion. There are tears in his eyes as he experiences movements at the symphony, he appears saddened by the death of Abagail Hobbes, he seems disappointed in his inability to “help” Will. Portrayed in such a way, so utterly human, he is appealing to the viewer, and in some case this works to endear him to the viewer, despite the obviousness that he is a serial killer, leaving the question of what of his morals, the ethical workings of his mind, his humanity in dealing with people.
We see Hannibal keeping Jack’s wife, who is terminally ill, from killing herself. However, while this may seem an act of mercy, the avid watcher realizes that he is only doing this as he intends to use her as a means to an end. In another episode, he keeps Will from shooting a morally corrupt social worker (S2E7), but the motivation is unclear. However, in that same episode Hannibal reveals about himself, through the guise of profiling a killer, that he believes the “reward for [the victim’s] cruelty” is that their organs are taken away because “they don't deserve them”. Later Hannibal again reveals that he believes he has a right to choose who lives and who dies, as he compares his actions to those of God (S2E11). It is in these portrays we get to see the grandiose nature of Hannibal’s personality, as he communicates that he feels he is qualified to make such judgment calls related to life and death, and right and wrong. The writers are using these subtle cues to flesh out the characterization of psychopathic nature.
In a session with a patient (S1E8) there is a brief glimpse of Hannibal’s own understanding of psychopathy. The patient in the episode tells  Hannibal that he Googled the term “psychopath” because he thinks his friend is crazy and perhaps might be one. Hannibal interjects, calmly, and states that “Psychopaths are not crazy. They are fully aware of what they do and the consequences of those actions.” This interaction illustrates the appropriate perception that psychopaths know who, or rather what, they are, and that they lack the psychosis akin with insanity.
Near the conclusion of season one (E12), Abigail Hobbes, the girl we are introduced to in episode one and a victim of Hannibal’s manipulation, realizes that Hannibal was largely responsible for the death of her mother, her own near death, at the hands of her (serial killer) father. She realizes that Hannibal had called her father to warn that the FBI was on to him. Hannibal’s response to Abigail’s inquiry as to why he did this was simply “I was curious what would happen”. The event that this scene is referencing is from the first episode of the series in which immediately after Will (and Hannibal) discovers the identity of the serial killer. The first chance Hannibal gets, he calls the man, a stranger, and warns him. When reflecting on the two scenes, this can be interpreted as an illustration of risky behavior and perhaps even relate to impulse issues, as well as selfishness that Paulsen (2010) says is indicative of psychopathy, where the psychopath sees people as objects of amusement.
Additional examples of Hannibal’s risky behavior and impaired affect can be witnesses throughout season two as he again befriends Will, who tried to have him killed while in the mental institution, and who knows that he (Hannibal) is The Chesapeake Ripper, and now understands that he is cannibal. We see Hannibal tell his therapist that he desires a friendship with Will, and despite their sordid past, he still comes off as authentic in this desire. However, let us not forget that Hannibal had skillfully manipulated Will and set him up for the fall as a serial killer prior to all of this. The juxtaposition of these actions is confounding, and it is not until the end of season two that you see the legitimate desire and connection Hannibal had wanted to have with Will, and the utter pain he felt in the final betrayal. While by this time the viewer has witnessed Hannibal’s various display of emotions, it can be inferred that this is the first time the viewer sees his emotions true.
The treatment of Will Graham as a character, on the other hand, is more complex if anything in its simplicity. In his re-enactment as an empathic serial-killer profiler we repeatedly see him doing violent things, saying violent things, playing out uncomfortable scenes. Little can be determined overall the effect this has on the viewer later on, as the viewer comes to terms with the manipulation by Hannibal of Will’s encephalitis (a brain disease he is later cured of). Then again when the viewer grapples with Will, locked up in a mental hospital as a serial killer, knowing that he is, in fact, had been skillfully played by Hannibal. One might surmise that the psychological effect of seeing Will in episode after episode acting in violent way works to emotionally separate the viewer from his character, creating a sympathy for him, but not too much of a sympathy, a tactic that may be part of the writer’s way of evoking a mixed response in the final episode.
 Through the two series Will is the victim of a Hannibal’s lying, conning, and manipulating behavior that Babiaok and O’Tool say is so indicative of psychopaths. Even as the tables turn on Hannibal in the final episode, the enduring portrayal of Hannibal successfully garners the sympathy of viewers, as he expresses his emotional pain. The way in which he was still able to invoke any level of sympathy in the end, when the viewer is left with a shockingly violent and bloody death scene, was jaw dropping. The outcome one is left with following the season two finale impresses upon the viewer the manipulative ability of a psychopath, so well scripted and played by Mads Mikkelsen.
Conclusion
Overall, the subject of mental illness is handled very well in NBC’s Hannibal. The characters of both Hannibal Lecter and Will Graham are treated as complex and multi-dimensional. There was a general lack of focus on Will’s own disorder, which could have easily been exploited. The perceived vulnerability to manipulation was erased by the fact that the rest of the FBI team was also manipulated. In doing this the writers managed to prevent portraying Will as victim due to mental illness, which happens in portrayals where the mentally ill is not cast as the predator. Throughout the various episodes nether he, nor Hannibal, are necessarily treated as mentally ill persons, even when there is questions about mental health arise.
The negative scope of NBC’s Hannibal can be seen in the portrayal of therapists. The depictions of the various therapists in the show are painted as potentially dangerous, manipulative, and driven by bias. Again, the potential danger, as others have written, is in the reinforcement of these damaging stereotypes, which have been known to prevent people from seeking care, or trusting their therapy practitioner.
The writers play lip-service to various mental disorders such as PTSD, schizophrenia, and personality disorders - but they never offer more than the passing mention, they don’t focus on them and they don’t become part of the plot or a point of contention. When mental illness, such as sociopath or psychopathy, were part of the conversation, it appeared that the lines written for the characters elaborated on the disorders they were talking about, making sure that the viewer had an understanding of the characteristics. In focusing on the motives and less on the graphic depictions of violence, the writers and directors generally manage to avoid portraying mass murderers and serial killers as monsters or as uncivilized and inhuman, as Grixti might expect.
While Hannibal seemed to mark high in the Hare PCL-R - Psychopathy Checklist (Appendix A), some might suggest he does not necessarily represent the textbook psychopath many are familiar with, nor does he reflect the usual image of a psychopath in popular culture media. He is presented as far more complex than psychopaths usually are. Not presented as irrational, nor as a “monster”, he, along with Will, are crafted as multi-dimensional characters. In one turn Hannibal is clearly a psychopath, but in another turn, one cannot be so sure. What the writers and directors have managed to create is the perfect portray of a psychopath, so skilled and manipulative that even when you know what you are supposed to be seeing and feeling in regards to his character, you cannot be sure. While Hannibal was occasionally portrayed as violent, as many in the literature review claim is indicative of the depiction of psychopathy, there seemed to be a lack of violence in his violence. To illustrate further, his violence was orchestrated, there was a smooth measure to his movements that betrayed the idea of irrational violence so prevalent in other portrayals of psychopaths – at least until the final episode of season two.
Overall, the findings in the analysis of Hannibal did not fully support all of the topics of contention illustrated in the literature review.
As Mark Rozeman aptly stated in a Slate article, there is “little question that the show does build its foundation on the darker elements of the human mind”. In this very sentence lies Grixit’s theory that in the dark monsters of popular culture, in the recognition of the dark side of themselves, there lies the opportunity to identify with, and simultaneously loath the monster that is Hannibal. Even more, this is a further reflection of human nature Paulsen alludes to in her text.
With any assessment of popular culture fare, the limitation can be said to lie in the hand of the bias of the researcher. My hope is that this analysis of NBC’s Hannibal, and corresponding literature, conveys successful impartiality in the treatment of the issue at hand. While the complex story and characters of this psychological thriller could continue to be read and analyzed, it can be confidently inferred that this series supersedes the expectations of many of the writers in the literature analysis, where psychopathy as the complex disorder it is adeptly translated its multifaceted nature to television screen. Of final note, further limitation will be found in resolution, as the series is still active, and so any final conclusions of overall treatment will be inconclusive in regards to rehabilitation and incarceration of Hannibal.
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Appendix A: Hare PCL-R (Psychopathy Checklist) of the Character Hannibal Lecter
Where a score:
0 = no psychopathy
30< = a diagnosis of psychopathy
40 = indicates prototypical psychopathy
glib and superficial charm
3
grandiose (exaggeratedly high) estimation of self
3
need for stimulation
1
pathological lying
3
cunning and manipulativeness
3
lack of remorse or guilt
3
shallow affect (superficial emotional responsiveness)
2
callousness and lack of empathy
2
parasitic lifestyle
0
poor behavioral controls
1
sexual promiscuity
0
early behavior problems
0
lack of realistic long-term goals
1
impulsivity
1
irresponsibility
1
failure to accept responsibility for own actions
1
many short-term marital relationships
0
juvenile delinquency
2
revocation of conditional release
0
criminal versatility
2
TOTAL
29

Obvious limitations to this checklist is the lack of a complete picture of the juvenile history of the subject, as well as more detailed information related to his past sexual history or any back story information that would be useful in assessing each of the 20 evaluation measures.
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Footnotes
[1] A statistical result of studies conducted by Robert Hare, a Canadian forensic psychologist who specializes in psychotherapy research.