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In Two Minds: Exploring Schizophrenia in Altman’s Images

When researching about schizophrenia for this article, I was stunned to discover that women are more likely to experience the onset of schizophrenia later than men. And tend to develop symptoms in their late 20s, whereas the onset in men is typically in their early 20s.  Although we are never informed of the age of Altman’s character, Cathryn, in Images, it is worth noting that the actress Susannah York was in her early 30s. Which would tie up with the information I discovered.

There are more differences to note as well. Women with schizophrenia may be more physically active and more hostile than men with the illness. They may also experience more auditory hallucinations, as well as paranoid and persecutory delusions. So, women suffering from this mental condition will endure paranoid delusions that consist of thoughts like, “my spouse is cheating on me,” when they aren’t. They will also experience persecutory delusions that can consist of thoughts like, “I’m being mistreated,” when there is no actual mistreatment.

We see the main character plagued by hallucinations, paranoid delusions, and hostile thoughts. In fact, these thoughts are what ultimately lead to her downfall, and she becomes consumed by them, essentially allowing her ‘other self’ to take over. The ending sees her being comfronted by a hallucination that looks, sounds, and acts just like her. Cathryn’s ”other self” informs the ”real” Cathryn (who is naked and in the shower, a reference to Psycho) that she will always love her. It is at that point that Cathryn realises that she is truly powerless, that the illness is far too strong.

The character of Cathryn (Susannah York) in Robert Altman’s 1972 psychological thriller/horror ticks all the right boxes of the symptoms of schizophrenia. Throughout the film we share her experiencing all of these thoughts. The aim of this article is to investigate just how accurate the illness is depicted and examine how Altman manages to create a psychological thriller which tackles the subject of mental illness in a sensitive manner, without sacrificing the sense of horror and isolation that sufferers experience.

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York plays a housewife and children’s book writer. Her relationship with husband Hugh (René Auberjonois) is falling apart after receiving a mysterious phone call from a ‘friend’ who tells her Hugh has been having an affair. Thinking they both need to get away, Hugh takes Cathryn to their house in the country. Here, Hugh indulges in his hobbies, hunting and photography, and Cathryn works on a book of fantasy tales for children.

Before long, Cathryn begins to see apparitions of her late lover Rene (Marcel Bozzuffi) around the house, but it’s a living ex-lover which brings her further stress. Marcel (Hugh Millais), a friend of the couple who is very attracted to Cathryn, arrives for a visit with his daughter, Susannah (Cathryn Harrison), in tow. As Rene’s appearances become more vivid and Cathryn reaches the end of her tether, she begins to drift deeper into a fantasy world, where it’s difficult to tell what is real and what is imagined.

As Ken Anderson from Le Cinema Dreams states, ”Cathryn is a woman haunted. Haunted by past infidelities (lovers, both dead and alive, have a nagging way of reappearing, attempting to resume their dalliances); guilt (she vacillates between being both desirous and fearful of having a child); suspicion (she assigns her own deceitful behavior to her husband); and specifically, the unwelcome, ever-encroaching memories of a lonely childhood.”

The film works because Susannah York seems so fragile and distant, jumping at every little sound. She creates a convincing portrayal of a woman suffering from a mental disorder, and losing her grip on reality. The character of Cathryn is well-developed, and garners our sympathy despite her erratic behaviour and being a person prone to violent outbursts. We buy into her performance because the character is so well written, and York is more than capable, excelling with the material provided.


It is obvious that Altman has done his research into schizophrenia as there are many conditions and elements that he has managed to incorporate into the text. For example, studies have shown that in many cases of schizophrenia in women experience delusions of being pregnant when, in reality, they are not. Or not being pregnant when, in reality, they are. There is confusion about whether Cathryn is pregnant or not, and it is revealed that she has extreme anxiety about being a mother.

We see her confessing this to the ghost of her ex-lover, and confessing that she wished she’d become pregnant with his child rather than Hugh’s. Cathryn may write books for children, but she doesn’t strike me as being very maternal. This might be due to her upbringing as it is implied that she had no mother figure to look up to and spent her days alone. She does have a fairly good relationship with Susannah, but we see that she struggles with the idea of the young girl becoming closer with her. In one scene Susannah confesses that she wants to be like Cathryn and we see the horror on Cathryn’s face. Susannah isn’t Cathryn’s daughter, but its clear that Susannah lives in fear that any child (biological or not) will fall foul of her illness.

Women suffering from schizophrenia have a higher number of delusions of jealousy compared to their male peers. Symptoms of apathy, flat affect, paucity of speech, and social isolation, with their consequent negative impact on relationships, are more often present in men. Mood symptoms, especially depression, are more commonly seen in women. We see this in the opening sequence to Images, where Cathyrn is harrassed by a mysterious caller who informs her that her husband is having an affair. Cathyrn confronts him, and Hugh assures her that he’s not seeing someone else. Cathyrn isn’t reassured, and this is shown when they kiss only for Hugh to ‘change’ into Marcel – which is the first visual calculation that Cathyrn is having.

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Whereas men with schizophrenia frequently lose their sexual drive early in the course of illness and are not likely to be sexually active if their illness is severe, this is generally not true for women. They continue to be interested in relationships and to engage in sexual intercourse. Cathryn has a high sex drive, she craves sexual pleasure, hence her reason for sleeping with Marcel and Rene. However, she is filled with regret and disgust by her behaviour. This is shown in one wonderful sequence where she makes love to Rene, only for her to fall on the bed into a seduction scene with Hugh, playing out in the same way. The man then changes to Marcel. The scene is confusing, disconnecting and disturbing, but this is what Cathryn is feeling. And Altman manages to convey this across to us in an effective manner.

Overall, Altman manages to treat the subject of schizophrenia in a sensitive manner without glamourizing it or mocking the illness. Images remains one of Altman’s strongest pieces, and has become forgotten in his vast filmography. The film will leave you deeply affected by what unfolds on the screen, puzzling about what was real and what was a fiction of Cathryn’s mind. I recommend seeing this film because of it’s complex and masterful act of storytelling, and it’s strong performance by York. There’s so much more I want to say, but I fear I will be here forever, please seek out Images and let me know your thoughts –  I’d love to hear them.


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