Reel psychiatry.

REEL PSYCHIATRY

In the 1982 movie "Airplane II: The Sequel,' a psychiatrist testifying in court is asked to give his impression of the defendant. His deadpan reply: "I'm sorry, I don't do impressions. My expertise is in psychiatry.'

Over the last 80 years, however, moviemakers have not been reticent to offer their impressions of psychiatrists and others in the psychotherapy profession. In the process, according to psychiatrist Irving Schneider of Chevy Chase, Md., they have invented a new profession that only occasionally resembles real-life psychiatric practice. "Movie psychiatry has projected a view of the profession through the distorting lenses of fear, defensive ridicule and the yearning for an ideal parent,' he says.

Three distinct types of celluloid psychiatrists have emerged from those lenses, maintains Schneider in the August AMERICAN JOURNAL OF PSYCHIATRY. He calls them Dr. Dippy, Dr. Evil and Dr. Wonderful. In a review of the movie treatment of psychiatrists in more than 200 films, Schneider says he found that all three incarnations debuted at the dawn of the century.

The first of them appeared, appropriately enough, in "Dr. Dippy's Sanitarium.' This 1906 film features four patients who chase an attendant out of the sanitarium while performing slapstick routines, closely followed by the corpulent Dr. Dippy and other attendants. The chase ends back at the hospital, where Dr. Dippy, no devotee of drug therapy, soothes the patients by giving each a pie.

The other two characters appeared in D.W. Griffith's 1908 production, "The Criminal Hypnotist.' The tale revolves around an evil hypnotist who puts a woman into a trance and steals her father's money. The villain is foiled and the trance lifted by a heroic "mind specialist.'

The three kinds of movie practitioners differ in method and in the patients they treat, says Schneider.

"Dr. Dippy is the familiar comical movie psychiatrist--the one who is crazier or more foolish than his patients,' says Schneider. The examples range from Wyrley Birch, the Viennese-accented Dr. Von Haller of "Mr. Deeds Goes to Town' (1936) who condemns Mr. Deeds but is exposed as a fool, to the sex-crazed Dr. Fritz Fassbender played by Peter Sellers in the 1965 "What's New, Pussycat?'

Dr. Evil is driven by madness, neurosis or insecurity to use power for personal profit and unleash evil on the world. A familiar figure in horror movies, Dr. Evil made one of his earliest appearances in "The Cabinet of Dr. Caligari' (1919). Other versions include a homicidal psychiatrist played by Leo G. Carroll in Alfred Hitchcock's "Spellbound' (1945), the institutional practitioners of shock therapy and lobotomy in "One Flew Over the Cuckoo's Nest' (1975) and Michael Caine's portrayal of a psychiatrist who dresses up like a woman and kills female patients in "Dressed to Kill' (1980).

No such shenanigans are engaged in by Dr. Wonderful, whose chief method is the talking cure. A warm, caring sort, he often uncovers a traumatic event in a patient's life and provokes an instantaneous cure. Dr. Wonderful began to appear in the 1940s, says Schneider, who cites the character of Dr. Berger played by Judd Hirsch in "Ordinary People' (1980) as "the most wonderful of Dr. Wonderfuls.'

The frequency of each type of psychiatrist in the movies reviewed by Schneider breaks down as follows: 35 percent Dr. Dippys, 15 percent Dr. Evils, 22 percent Dr. Wonderfuls and the rest difficult to type. It is not a flattering distribution, notes Schneider. Dr. Evil would be more prevalent, he adds, if exploitation and horror films were included in the review.

Yet cinematic stereotypes of psychiatrists are often double-edged, producing pairs of "good' and "bad' practitioners, according to literature professor Krin Gabbard of the State University of New York at Stony Brook and psychoanalyst Glen O. Gabbard of the C.F. Menninger Memorial Hospital in Topeka, Kan. For instance, in recent decades several movies have employed what the Gabbards call "the faceless psychiatrist,' who has few, if any, identifying traits. In the 1957 film about baseball player Jim Piersall, "Fear Strikes Out,' a good "faceless' doctor seems to cure the athlete simply by being near. A bad version of this character type may not even be shown, such as the off-camera psychiatrist in 1970's "Diary of a Mad Housewife' whose advice to a frustrated woman is portrayed as pathetically misguided.

When women are cast as psychiatrists, as they have been in a number of films beginning in the 1940s, they are usually corrupt or "inadequate as women' and ripe for romantic conquest by a male patient, say the Gabbards. Their review of more than 250 American films in which a psychiatrist or psychotherapist appears is contained in their book Psychiatry and the Cinema (University of Chicago Press, 1987).

Psychiatric films can be divided into three historical periods, explain the Gabbards. The first stretches from Dr. Dippy and other turn-of-the-century one-reelers about escaped lunatics to around 1957. During this time, psychiatry was plugged into several movie genres, such as the detective film and the screwball comedy, but the realities of the profession were ignored in favor of escapist fantasy. Dr. Wonderfuls of this period "were little more than glorified guidance counselors' who helped achieve a "consoling resolution' to the story, say the Gabbards.

The second period, from 1957 to 1963, was the "Golden Age of psychiatry in the cinema,' in which benevolent psychiatrists routinely returned troubled people to well-being. "Fear Strikes Out' and another 1957 film, "The Three Faces of Eve,' helped to initiate the Golden Age. The culmination of this period came in 1962 with a number of movies, including "David and Lisa,' which many psychiatrists still refer to as one of the most realistic depictions of psychiatric treatment.

Third, say the Gabbards, is a period of consistently negative depictions beginning in 1963. Psychiatrists and psychotherapists were often associated with society's false values and shown to be inept or malevolent. The 1950s fantasy of social harmony and better living through psychiatry--"created by psychiatry itself as well as by the movies,' according to the Gabbards--inevitably failed and fed the fire of anti-authority, antipsychiatry movies.

The appearance of "Ordinary People' in 1980, they say, may have signaled a turning in the negative tide of movie psychiatrists.

But both Schneider and the Gabbards hold a special place for the films of Woody Allen and Paul Mazursky. These directors, they say, gently poke fun at psychiatry while using it to explore human relationships. Mazursky cast a real-life psychologist, Penelope Russianoff, as Jill Clayburgh's therapist in "An Unmarried Woman' (1978) and used a practicing psychiatrist, Donald Muhich, in the role of a therapist in four other films.

Psychotherapists who view, rather than act in, movies about their profession have long complained about the images presented to the public. But Schneider holds that they can learn much from their movie counterparts. "When recommending hospitalization or assertive treatments,' he says, "the psychiatrist might well remember with what fear and distrust they are typically depicted in the movies.' In addition, Schneider says the recurring image of Dr. Wonderful as someone motivated by caring and not money, who works in a modest office and is willing to show concern and quickly respond to emergencies, is "the expression of a public desire psychiatry should heed.'

Psychiatry's image problem in movies of the last 20 years mirrored a general trend, say the Gabbards, marked by declining numbers of medical students choosing to pursue a career in psychiatry and a steady decrease in federal funding for psychiatric research and education. At the same time, they note that "the public at large has always maintained a split view of psychotherapists and psychoanalysts.' Awe at their perceived ability to unscramble the mysterious workings of the mind is mixed with contempt for their limitations and disappointment with their failure to solve complex problems. Psychotherapists perceived as "somehow perfect or superior to everyone else' are envied and feared, and must be "continually ridiculed and put in their place.'

Therapists must accept that they serve as a target for negative feelings in their patients, say the Gabbards, and that this role can spread onto the movie screen. Mental health professionals can take some consolation, however, in the intense interest in psychiatry and psychotherapy expressed by filmmakers and ticket buyers. "To paraphrase Oscar Wilde,' they conclude, "the only thing worse than being portrayed in movies negatively is not being portrayed in movies at all.'

Photo: The situation does not look good for Katharine Hepburn in "Bringing Up Baby' (1938), but she eventually outsmarts the psychiatric quack played by Fritz Feld.

Photo: Timothy Hutton, portraying an emotionally disturbed adolescent, talks to Dr. Berger, played by Judd Hirsch, in "Ordinary People' (1980). The therapist, as well as his office, are depicted as informal, slightly disheveled and down-to-earth.

Photo: Peter O'Toole describes his sex life to the libidinous Dr. Fritz Fassbender (Peter Sellers) in "What's New, Pussycat?' (1965).