Few writers make a living from their work: we necessarily have Day Jobs, and even if we don’t we have Other Lives to draw on. For more than 22 years my day job’s been in the NHS, as a psychiatrist, currently working with A&E and the transplant service. Until recently I kept this entirely separate from my writing (kids’ adventure fiction, drama for stage and radio, and now for the screen). I’m not sure why: maybe it just felt wrong to be stealing patient’s stories, however I dressed them up. But the more screenwriting manuals I read, the more psychiatric textbooks I wrote, the more value I saw in directly comparing the two practices. I ended up with the tentative conclusion that screenwriting is psychiatry in reverse. Knowing this might not guide writers in treating themselves or their friends – but it may well help them push through the next rewrite.

Psychiatrists and the patients they treat feature widely in cinema, in roles ranging from the benign (Good Will Hunting) to the demonic (Silence of the Lambs). So screenwriters are familiar with the process of practicing psychiatry, even if its depictions are often distorted: and a never-ending stream of manuals tell us about the process of screenwriting itself. These manuals urge us to be Creator Gods in the worlds of our stories: omniscient, omnipotent, controlling everything that happens there. We must know our main characters intimately: we grant them wants, needs and flaws; we endow their tastes and prejudices – and we must know their backstory as we do our own. This knowledge underpins whatever we make them do and say in the story as it unfolds. In other words we move from the general (plot, theme, structure, character, character arc, genre etc) to the specific of action and dialogue, the key components of the screen play itself.

There are very few screenwriters – or at least few successful ones – who simply launch in to a new screenplay, and immediately type out blocks of action and dialogue, even for a first draft. That stage is more often the end product of a long process of thinking about the story, the characters who play it out, and the kind of film we’re trying to write.

We start with generalities: I want to write a thriller set in modern day London. The central character’s a young art thief struggling to escape his past. The theme is redemption.

We end up with specifics:

INT. EXPENSIVE LONDON HOUSE/LOUNGE – NIGHT

JAMIE prowls silently around a darkened room. Clocks tick richly, but there is no other sound save his breathing, and the faint thump of his heartbeat. His torchlight picks out a series of expensive sculptures and works of art. His gloved hands caress them, one by one….

Psychiatry works in exactly the opposite direction: the psychiatrist starts from the specifics of what an unfamiliar patient says and does, and slowly builds a picture of who this person is, and what has happened in his life to bring him to the clinic – or to A&E – today. Psychiatric training instills an almost ritualized assessment process, which includes a requirement to describe in detail the patient’s appearance and behaviour, apparent mood, and patterns of speech and thought. Example: “Mr. X was restless and agitated, pacing around the A&E assessment room at speed. He was dressed in fashionable and relatively new clothes, but he was unshaven and disheveled as if he had not changed for some days. He appeared anxious and afraid, and seemed to be responding to something outside the room not apparent to others. His speech was loud, rapid, and hard to interrupt. His thought process appeared speeded up, with a rapid progression from one subject to another. His ability to concentrate on questions or requests was much impaired.”

These features lead the psychiatrist to generate hypotheses: has he been overusing stimulant drugs? Is this a relapse of bipolar disorder? Is he actually being pursued by someone? These hypotheses can then be tested, by further questions to the patients or others. The picture is sketched at first, then gradually filled in, with more specifics, a little like painting by numbers, until the general image (ie the diagnosis) is clear enough to act on.

That’s at the acute end of psychiatry: but the same applies in other areas. Let’s jump forward a month or two. Mr X’s relapse of his known bipolar disorder resolved quickly when treatment was re-instituted. He’s now in the out patient clinic, discussing the reasons why he stopped his treatment and thereby risked relapse. The same process applies, of moving from specific answers to specific questions, and towards a general understanding, which can then be shared with the patient in an effort to help him make any necessary changes. Doctor to Mr X: “I get the sense that you stopped your medication not so much because you’re troubled by side effects, but because you resent being told to take it by your doctors and your family. Maybe if you felt you had more control you’d resent it less.”

So what, you’re probably asking? Nice theory, perhaps: but how is it relevant to screenwriting? Well it may just help the writer stuck between drafts, and unsure how to vivify his characters or make his plot cohere. Instead of endlessly reworking structure or tweaking dialogue, why not set your characters on the couch, a diploma on the wall, and the clock running?

Ask your characters, one by one, the questions a psychiatrist might ask them. What’s troubling you? How long have you felt that way? How bad is it? What makes it better/worse? Have you felt that way before?. Start with specific questions: give specific answers, always expressed in the language your character would use. Work towards general statements, such as : After my father beat me throughout childhood, I resent and fear all authority figures: those I fear most, I obey; others, I attack.

Better still, why not team up with a fellow writer, and put her characters on your couch, while she returns the favour? Use a tape recorder, and just talk, so you’re not inhibited by the need to make notes.

If this works at a basic level, it might be worth trying the advanced version of the game, with an extra rule: you, the script doctor, can ask whatever you like: but the characters can tell you nothing beyond what they say, do, observe or learn, in the course of your screenplay. So if you’ve decided to avoid the use of flashbacks, you have to get across the information about your character’s’ paternal beatings in some other way. If you don’t want to risk clunky expositional dialogue “Look at these Father’s Day cards! Let me tell you about my old man…..” you are forced to find some more imaginative way to convey it: or to decide it doesn’t matter. But if you drop it, you must ask whether your character’s actions still make sense to an audience which doesn’t know his backstory.

As screenwriters, most of our journey is from general to specific. Every once in a while, it’s worth turning around the other way, to work as psychiatrists do. You stand to gain a better understanding of the core of your characters, and an audience’s eye for whether that core shows through in what your characters say and do. if, in the process you can get your characters to pay you an hourly rate, so much the better!
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ABOUT STEPHEN: A doctor by training, Stephen’s been working part time in order to write for more than ten years, during which time he’s published seven children’s books, and written drama for the stage and Radio 4 . His first produced screenplay, an adaptation of Philip Pullman’s The Butterfly Tattoo, is just about to get a UK cinema and DVD release. He lives in the Borders and works in Edinburgh.

Stephen on Wikipedia

Stephen on IMDB

My post on Stephen’s adaptation of The Butterfly Tattoo (From Adrian Mead’s The Art & Business of Adaptation course, for all the notes (5 posts), click here)
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Thanks Stephen! Awesome stuff there and very important to those of us rewriting, which I am at the moment…