The Rabbit Hole - Complicated Grief

December 15, 2010
Michael Blumenfield, MD

Dr. Blumenfield reviews a movie that he believes will make an excellent teaching film for those studying manifestations of grief.

The following was originally posted at Psychiatry Talk.

One of the things that I enjoy doing when I am not writing this blog or doing other professional work, is to watch movies. In fact, my wife and I frequently attend preview screenings, and we write brief reviews in our blog FilmRap.net.

Recently we saw a new movie, which is going to be released this week in Los Angeles and New York as well as across the country shortly thereafter. Aside from it being an excellent film which will probably get some Academy Award consideration, I believe that it will make an excellent teaching film for mental health professionals who are studying manifestations of grief. I will reproduce our review of it and then add a few additional comments:

David Lindsey—Abaire as screenwriter for this film, based on his own play, really gets into the head and the emotions of two grieving parents 8 months after the death of their five year old son who died running after his beloved dog. We never meet Danny and barely see a picture of him but we come to clearly understand the relentless pain in all it’s forms, which his parents Becca (Nicole Kidman) and Howie (Aaron Eckhart) are feeling. Each of them are grieving in his and her own way which despite sharing this most personal tragedy and a good previous relationship, there seems to be no room for empathy between them. Becca’s quest to find some way to deal with her deep dark feelings leads her to establish a relationship with Jason (Miles Teller), the 18 year old high school senior who swerved his car, which he confesses to her may have been going a mile or two over the speed limit, which led to the tragedy and now has created a bond between them. Becca’s somewhat religious mother (Diane Wiest) whose son died at age 31, eleven years previously, provides a counterpoint from where she is coming. Nicole Kidman who saw the original play and started the ball rolling to make it into a movie chose John Cameron Mitchell to direct it. Mitchell and Lindsey Abaire who were guests at our screening acknowledged that they complemented each other as they explored the fine points of this film. The director, who had only a 4 million dollar budget, shared with us that he let the actors steep themselves into their emotional roles which he appeared to nimbly direct as well as spending a great deal of time in editing the fine points. He gave a touch of humor to a primarily a dark movie and kept us the audience observing at a slight distance from the unimaginable tragedy. We did not shed a tear for the young boy who we did not meet or really know. As mental health professionals who have worked with many grieving patients, we had the feeling that we were empathizing with people we cared about, as we might with a patient who is involved in their own dynamics that are unfolding before us at somewhat rapid pace. The fact that the writer, director, and actors really nailed the complicated feelings and interactions without ripping apart the guts of the audience (which they could have easily done) may be judged a shortcoming of the movie by some, or the height of sophistication by others.

This movie also merits comparison with four other movies, which we have seen in the past year and each of which shows attempts at dealing with grief in a different manner.

A Single Man shows Colin Firth in an Oscar-nominated performance as George a college professor whose lover has died in an auto accident and in his grief he is on the verge of suicide when he meets a young student who cares about him. Robin Williams does an excellent job as an unsuccessful writer in World’s Greatest Dad grieving a teenage son who committed suicide. The father pretends his late son has written the story of being bullied and the result is a game changer for the community and for the dad, which gives some meaning to this tragic loss. The Lovely Bones deals with the murder of a young teenager (Saoirse Ronan) who had just begun to feel the glimmers of romance, which leads the audience to feel her parent’s unresolved grief despite the youngster’s ethereal existence. There is a small amount of compensation as the killer is caught through the efforts of the girl’s sister. The film, which most closely resembles the Rabbit Hole, is The Greatest which brought together a comparable great performance by Pierce Brosman and Susan Sarandon who are the grieving parents of a teenager killed in car accident while he is with his girl friend played by Carey Mulligan. The potential for the parents to live with their grief is the unborn child being carried by the young girl friend whereas in the film which we reviewed today, the hope for a better future is only hinted by a subtle but important gesture at it’s conclusion. We thought these two were both excellent films The Greatest didn’t achieve the critic’s Oscar acclaim and it appears that the Rabbit Hole may get some such bids. However, overall, we rated the Rabbit Hole a notch lower. We certainly do believe that this movie is the finest example and should be used as a teaching tool and stimulus for discussion for those who are studying the grieving process, as well as a movie worth seeing for anyone interested in these all-too-real human emotions.

Additional Comments

To experience the death of your young child is one of the most painful, difficult, and traumatic events that a human being can go through. Mental health professionals who have studied this event have recognized that the subsequent grieving has certain characteristics that go beyond and are somewhat different than the usual emotional responses that are seen after the death of a close friend or relative. It has been labeled as complicated grief, and this term includes other circumstances in addition to the loss of child, such as the death of an adult or child by murder, suicide, unusual unexpected trauma such as terrorists attacks (eg, 9/11), etc. While the loss of a close person is rarely forgotten, there often is a gradual resolution of the intense feelings over the course of a year with amelioration of most of the symptoms such waves of sadness, episodic crying, insomnia, intrusive thoughts, occasional hallucinations, intense anger, etc. Most people who grieve usually do not find it necessary to have counseling or any form of therapy. With complicated grief, such feelings, rather than resolve, often intensify in the months following the loss. There may be evidence of major depression with weight loss, continued insomnia, and even suicidal ideation. There can be a resort to heavy drinking or drug use. There can be intense anger, not only at self but at others, often with a demand of some type of restitution or revenge. Relationships are greatly strained, and marriages often are not able to withstand this trauma. Psychotherapy is often helpful with or without medication. Sometimes, a group process is used that includes other people who have gone through similar losses. It may be useful for some type of a memorialization process to be developed where the memory of the lost person is perpetuated in some worthy fashion. The above movie certainly did not touch upon most of these issues but it did clearly show the impact on the parents of the traumatic loss of their child. The subsequent behavior and the emotional responses of each of the parents were very real and plausible in view of the loss that they had suffered. As I noted, this film would be an excellent starting off point for professional students to discuss and analyze the grieving responses in this very difficult situation. Obviously the movie gives the viewer a certain cathartic experience and you can also appreciate it as a very good creative artistic accomplishment, which may be viewed by many as one of the best films of the year.