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  • BIOETHICS FORUM ESSAY

Dirty, Filthy Love

It takes Mark a long time to sit down. If he sits too quickly, he is “damaging my coccyx and spine with the impact. This, in turn, causes a ripple effect up through my body, neck jerking, sending head forward, causing teeth to gnash together and chip. At the same time, I am also damaging the structure of the chair. The frame is splintering, buckling under my weight. The carpet below is damaged and underneath that the foundations, the concrete is cracking.” When he climbs stairs he has to repeat each fourth step, and if he steps in dog poo he will be hours scrubbing it from his shoes, and sometimes his entire body.

Mark’s struggles are the subject of Dirty, Filthy Love, a 2004 British film directed by Adrian Shergold and released by Sundance, which I recently found at my local video store. The artwork on the DVD case features a large image of a pill encapsulating the subtitle “an obsessive compulsive comedy”, suggesting the film would have something to say about drugs and mental illness. Not so. But it does offer some larger and very worthwhile reflections about the nature of mental illness and how others respond to it. It is also very funny.

Earlier in Mark’s life, his idiosyncrasies were simple ticks or “habits,” as he calls them. By the time we meet Mark, played by Michael Sheen, his wife has kicked him out, he’s on “stress-leave” from the groovy London architecture firm where he recently made junior partner, and he is crashing on a single mattress in his friends’ spare room. None of which is helping him curb his compulsive repetitions, obsessive cleanliness, or uncontrollable barking (a result of Tourette’s syndrome). There is nothing dirty or filthy about Mark’s life (although his language can get salty), and he isn’t getting much love, either.

In a doctor’s waiting room, fellow-patient Charlotte (Shirley Henderson) recognizes what his physician apparently does not care enough to see, and she invites him to join her self-help group. If he joins, she pleads, the group will number seven, which would be good therapy for her because she has an aversion to odd numbers. Climbing the stairs (four up, one down) to his first group meeting, Mark is overtaken by a man required to keep his back touching the wall all the way up the stairwell. Another group member cannot help flicking off the lights when confessional discussions get tense, as they do when Charlotte and another woman (who forces her boyfriend to undress before he enters their flat each night) argue about whether obsessive compulsive disorder is a core part of who they are or an illness. Charlotte believes it’s the latter, and she leads the group on a trip to a farm, where she orders them to surrender their packets of sanitary wipes before plunging their bare hands into the mud for five minutes – a grueling task that brings tears to their eyes.

Sparks fly between Charlotte and Mark, but their romance must compete with his obsession for his imminently ex-wife, Stevie, who can’t, or won’t, understand his condition. When he follows Stevie (Anastasia Griffith) and barks at the man she is having coffee with, she tells him to cut it out. By contrast, when he blurts out “nice tits” to Charlotte, she quips back “nice arse.” And when he later becomes a hermit confined to a one room flat, it is Charlotte who finds and bathes him, and takes him on a drive to the seaside.

Drugs and physicians are conspicuously absent from the film. Although we meet Mark’s comically incompetent doctor and know that Mark is on medication, these aspects of his story pale next to his (and others’) agonized attempts to get a grip on his sometimes terrifying, sometimes hilarious, “habits.” This absence is not a point the film wishes to stress – this is not a movie about the evils of the pharmaceutical industry or the “beauty” of mental illness. But it does sometimes stretch credibility. When Mark’s friends return home to find him naked in their kitchen sink bleaching his feet, I could not help pleading with the screen: “Take him to the hospital.”

But this film is not interested in laying out the most sensible option in a moment of psychiatric crisis. Although Charlotte does speak favorably of cognitive-behavioral therapy, evading a discussion of the various medical responses to OCD and Tourette’s allows it to emphasize the importance of understanding, patience, and acceptance in Mark’s repair (there is no cure here). As Mark watches and re-watches a home video of his own wedding, we’re struck that even when he was “well” he would jerk his chin up repeatedly in self-conscious moments – what has been throughout the film a mark of his madness was once an adorable tick. And Mark’s early success as an architect, we are left to conclude, may well have had something to do with his eye for detail.

Habits can act as harmless, or even useful, ordering mechanisms in our lives and obsessions can be the route to deep attachments – recent neuroscience research has remarked on the similarities in brain activity of individuals with OCD and those in love. We’re all on the spectrum, Dirty, Filthy Love suggests. But as it also so sympathetically shows, an OCD-ruled life can become a relentless maze of rituals and aversions in which friends and family are as lost as the sufferers themselves.

The hope in the film comes from love and understanding. (But don’t worry, this is not a painfully cheesy movie – it’s British, after all.) Since most people with mental illnesses receive care from a family member, and since studies confirm that involvement of relatives in treatment can significantly increase its success, preserving intimate relationships may be as important as establishing medical ones. In the film’s climax, Charlotte confronts Mark’s ex-wife and delivers her best advice. “Why couldn’t you just listen to him?” she screams.

– Josephine Johnston

Published on: August 30, 2006
Published in: Arts & Ideas, Health and Health Care

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