The British Journal of Psychiatry
Vertigo – psychiatry in the movies
Peter Byrne

All of a sudden, Vertigo (1958) is the number one film in Sight and Sound’s once-in-a-decade poll of 846 critics. Following an inauspicious release, it was a critical slow burner, stealing into 11th place in this poll by 1972. On its initial release, The New Yorker declared: ‘Alfred Hitchcock, who produced and directed this thing, has never before indulged in such farfetched nonsense’. Time magazine decided: ‘the old master, now a slave to television, has turned out another Hitchcock-and-bull story in which the mystery is not so much who done it as who cares’.

Its plot is initially boy (ex-cop Scottie) meets girl, boy loses girl, boy finds another girl who looks like the first girl, but then goes much darker. Like all great films, it works because interesting things happen to believable characters within the existence of that film. Its themes, sex and death, may have been premature for (at least) its US audiences. It has similarities with the film it displaced at number one, Citizen Kane: flawed protagonist who searches for the unattainable, technical innovation, and a visceral Bernard Hermann score.

There are other reasons that Vertigo almost became a lost classic. Hitchcock switched studios, affecting its promotion and, crucially, storage of the original prints. Its 1984 rerelease underwhelmed audiences and critics. In 1997, a remarkable 2-year restoration by Robert Harris and James Katz changed everything. They sourced the original costumes to restore the correctly graded colours from VistaVision to 70 mm print. Hitchcock had colour coded the film (green for ‘go’, red for ‘stop’) to heighten sexual tension. They cleaned and digitalised the sound, instructed by the director’s original notes, and even discovered the original music track Hermann recorded in Germany during a US musicians’ strike.

And what has all this got to do with psychiatry? Well, we could insist the film be re-titled ‘Acrophobia’, or opine on the nature of pathological grief. Peter Wollen described the film as a ‘visual encyclopaedia of psychopathology’. It has more psychiatry than Hitchcock’s earlier psychoanalytic film Spellbound (1945), or his archetypal psychokiller film Psycho (1960). The pathology is not all Scottie’s (James Stewart): we the audience are watching him, watching her. Audiences feel his loneliness, driving about a glorious San Francisco, and his vertigo – Hitchcock developed the signature dolly plus zoom technique based on a drunken experience at the Chelsea Arts Ball. To cite a colleague’s description of Basil Fawlty: ‘there’s enough there for an entire conference’.