A Beautiful Mind. (Reel Life).

This year there were four Oscar nominations for portrayals of mental illness: Russell Crowe's schizophrenia, Judi Dench's Alzheimer's, Sean Penn's mental retardation, and Ben Kingsley's psychopath.

Do we overestimate the accomplishments of actors in these roles? Perhaps. I had that thought as I watched "A Beautiful Mind." If the task was to portray the tortured self-concerns that plague real people who suffer from schizophrenic disorder, Crowe's acting fails.

Or it may be Akiva Goldsman's script. His previous credits include "Batman and Robin" and "Batman Forever." His screenplay takes several pages out of Batman and makes John Nash into the hero who triumphs over mental illness.

The real Nash does have an extraordinary story. He recovered from paranoid schizophrenic disorder and earned the 1994 Nobel Prize in Economics--for work on game theory, work he completed in 1950 as a 22-year-old graduate student in the Princeton mathematics department.

Hollywood has perpetuated two of the most guilt-inspiring myths about serious mental illness. The first, devised by American psychoanalysts (Freud certainly knew better), is that bad parents cause the serious mental illnesses of their children; one of my medical school professors invented the term "schizophrenogenic" for such parents.

The second more insidious myth is that love is the cure. The love-cure idea is guilt inspiring because it makes those involved in trying to help a child, a spouse, a parent, or a patient with a serious mental disorder feel personally responsible when their efforts fail, personally responsible because of their inability to offer unconditional love. The overrated docudrama Shine," based on the life of concert pianist David Helfgott, depicted both myths.

All myths contain a kernel of reality. Parents do pass on their genes to their biologic children, and genes do contribute to serious mental disorders. And although "love is not enough," you have a better chance of making it if someone cares about you.

"A Beautiful Mind" spares us the myth of parents causing their child's schizophrenic disorder, and as a result, some mental health professionals have viewed it as a kind of progress. But it is a deeply misleading portrayal of schizophrenia.

The disorder, as Silvano Arieti described it in his classic work, "Interpretation of Schizophrenia," is experienced as a drama of the self that takes place on the stage of one's own mind. The person is trapped in an egocentric and often terrifying reality. At its worst, nothing else matters, meaningful communication ends, the self is unavailable to others, and the person becomes a burden and an outcast. There have been films that denied the torment of this terrible illness by romanticizing it as a form of wisdom or special insight. "A Beautiful Mind," to its credit, demonstrates how schizophrenia is, in fact, the nemesis of genius.

However, in the black and white of Hollywood depictions, the hero must have an innocent soul. The ugliness of the real Nash's political and religious extremism and his sheer interpersonal nastiness had to be censored to make him a Hollywood hero. Moreover, in the film, Nash's paranoia focuses on the Soviet Union, whereas the real Nash was willing to relinquish his American citizenship and ally himself with the Soviet Union. All of these more disturbing facts and worse have become part of the gossip that attended Oscar voting on the film.

The drama of the self in Nash's case apparently began with ideas of reference, auditory hallucinations, and grandiosity at a time when he was struggling to gain tenure in the MIT mathematics department, his wife was pregnant, and he was already 30--old for an ambitious mathematician. In the midst of all these personal stresses, aliens were calling on him to save the world. He refused the offer of a prestigious professorship at the University of Chicago, stating in his letter that he was about to become the "emperor of Antarctica" and that he was the "left foot of God on earth."

Psychiatrists who have done research on the long-term outcome of schizophrenia find that like Nash, a small percentage of those who suffer from the disorder for many years do recover. But some researchers have begun to wonder whether we have for a century wrongly believed that "schizophrenia" is really a single disorder. Nash, who was blessed in many respects--his genius, his looks, his friends who cared about him--perhaps was also fortunate to have a variant of schizophrenic disorder that can be overcome.

All films turn life into melodrama. One can say that about "Citizen Kane" as well as "A Beautiful Mind," and the filmmakers were quite ingenious in imposing the needs of the medium on their depiction of Nash. The first imaginative leap was to transform Nash's voices and obsessions into visual hallucinations. The screenplay misleadingly puts them into Nash's 20-year-old mind on his first day as a graduate student at Princeton. He is already mad when the film begins, but director Ron Howard makes the viewer believe that the hallucinations are real. Nash's Princeton roommate (Paul Bettany) shows up; he is an appealing, attractive man, an expert on D.H. Lawrence, and he becomes the emotional mainstay of Nash's existence.

Later, the roommate brings his young niece (Vivien Cardone) along to visit Nash. Halfway through the movie, and 10 years later, we learn that they are unreal. By then we are as attached to Nash's benign hallucinations as Nash is. We too want them to be real. Now we are inside the drama of the self along with Nash, and we have to struggle to reconstruct our own sense of reality. Providing this ingenious opportunity for an experience of empathy is the main achievement of "A Beautiful Mind."

These imaginary playmates, which are what they most resemble, turn nasty. They join forces with an imaginary CIA agent (Ed Harris) who enlists Nash's aid to decode Soviet messages hidden in such periodicals as Time and Life. Instead of communicating with aliens, the fictional Nash is crazed but patriotically fighting the Cold War. Delusions and hallucinations, like ideas of reference, put the self at the center of the world, as happened with Nash. Instead, Akiva Goldsman's screenplay has eliminated that driven egocentricity--the drama of the self; Crowe's fictional paranoia is an altruism gone berserk.

The film compresses all of Nash's hospitalization into one where he received insulin shock therapy to the point of grand mal convulsions. It is disturbing even to this psychiatrist to watch that treatment being given to a genius. Even today, with modern efficacious treatments for schizophrenia, we face troubling questions about how much they befog the mind and how much they harm the brain.

His wife Alicia, played marvelously by Jennifer Connelly, faces this difficult choice when Nash has a relapse in the film. Will she risk his genius to restore his sanity through more insulin shock therapy? Heroically, she sends the psychiatrist away (in this film he makes a house call) and tries to connect lovingly with her delusional husband.

In real life Nash was re-committed to the state hospital several times; she divorced him and came close to marrying one of his colleagues. Nash would subsequently spend years in Roanoke, Va., living with his elderly mother who was suffering from alcoholism. He eventually would return to Princeton where his former wife put him up, and he became the resident madman of the campus, spending much of his time in the library. Unkempt, unshaven, and now chronically insane, he was only one step up from being one of the homeless mentally ill. The tolerance of the math department at Princeton and the concern of his colleagues and his ex-wife kept him from taking that last step down. He had refused all antipsychotic medication since 1970 and had been delusional for more than a decade.

Most psychiatrists would have said Nash was hopeless, but in 1990 a turning point came: He began to talk with a mathematician who was working on a problem that had always interested him. Instead of obsessing about messages from aliens, he once again turned his mind to mathematics.

Slowly, he recovered--or, stated more cautiously--went into remission. Although the biography suggests he did this entirely without medication, in the film Nash acknowledges accepting a little of the newer medications. I have no idea which story is true, but surely a great deal hangs on that truth. Few people recover the way Nash has; researchers dispute whether it is more or less than 1 in 12, and he may have done it without medication. There are already advocates who have long opposed medication who are making new claims based on the Nash story.

Life and mental illness are both more complicated than movies. The movie myth that his wife's love was the cure is the emotional high point of the movie. In an imagined Nobel speech, he is shown speaking to dignitaries gathered from around the world. Nash delivers a sermon about how his wife taught him love that puts the face of humility on his unyielding egocentricity. It brings tears to one's eyes, even when one knows better. U

DR. ALAN A. STONE is the Touroff-Glueck Professor of Law and Psychiatry in the Faculty of Law and the Faculty of Medicine, Harvard University.