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How Persona reimagined mental illness in the movies

Fifty years on, Ingmar Bergman’s cinematic fever dream of blurred identity remains a radical account of psycholosis

Celebrating the mammoth retrospective at the British Film Institute this spring, we explore the world of cult auteur Ingmar Bergman – from his groundbreaking depictions of mental health to his collaborations with his number-one muse, Liv Ullmann. 

According to legend, Sigmund Freud once turned down a huge sum of money to write a Hollywood screenplay. Apparently, the founding father of modern psychiatry thought cinema was incapable of rendering the psychoanalytical process – but never in his wildest dreams could Freud conceive of a film like Persona, Ingmar Bergman’s 1966 masterpiece of psychological tension.

Actually, Persona takes its name from another psychoanalyst, Carl Jung, who used the term to describe the ‘social masks’ we create to protect ourselves from the demands of adult life. Bergman’s film, famously dubbed “the Mount Everest of cinematic analysis”, is difficult in many respects: a multi-faceted musing on the mysteries of the self, motherhood, art, cinema and god, in no particular order. But with its searing account of what psychosis feels like from the inside, it also exploded conventions on the portrayal of mental illness on screen, a topic that still divides audiences to this day with films like Silver Linings Playbook (2012) and Split (2016).

Bergman got the idea for Persona in 1965, while laid up in hospital with a bout of pneumonia. Struck by an uncanny resemblance between Bibi Andersson and Liv Ullmann in a photograph of the two actresses sunbathing together, he sketched out the film’s wispiest of plots, in which a psychiatric nurse, Alma (Andersson), is tasked with caring for a famous stage actress, Elisabet (Ullmann), who has suddenly fallen mute. Taking her to a countryside retreat on doctor’s orders, Alma finds herself drawn into Elisabet’s orbit, until the pair’s identities begin to merge.

There are plenty of ways to interpret the events of the film, but the beauty of Persona lies in its refusal to neatly delineate the boundaries between the real and imagined. In the 1960s, films about mental illness tended towards the hysterically overwrought (Suddenly Last Summer) when they weren’t hamming it up for genre thrills (Psycho, Whatever Happened to Baby Jane?). Only a handful of directors – Cocteau, Buñuel, Polanski – had been able to suggest a porous world where the life of the mind and external ‘reality’ mingled freely on screen. But none went as far as Bergman, who wanted us to leave his film questioning everything, including the nature of cinema itself. In Persona, the feminist scholar Susan Sontag wrote, “hallucinations or visions will appear on the screen with the same rhythms, the same look of objective reality, as something ‘real’”.

To this end, Bergman devises a string of techniques to frustrate viewers’ attempts at imposing a coherent narrative on the film, from the repeated fourth wall-breaking of his characters to the use of uncanny sonic cues like dripping taps and foghorn whistles. Our experience as a viewer echoes that of Alma, who, unnerved by Elisabet’s refusal to speak, talks incessantly in an attempt to paper over the silence with reassuring stories. But the more she talks, the more she feels a rising sense of panic that all her stories are just that: empty fictions.

What psychological ailments might these characters be experiencing? Alma suffers from auditory hallucinations when she hears someone speak her name over the radio, paranoia, and so-called ‘passivity phenomena’ – the feeling that your thoughts are not really your own – that are known to be symptoms of schizophrenia. Alternatively, if we decide that Alma and Elisabet are in fact the same person, then Alma might be suffering from what Jung called ‘enantiodromia’, whereby an individual who comes to identify too closely with their persona experiences a return of their ‘repressed’ opposite. In other words, Elisabet is an expression of Alma’s subconscious, an ‘ideal’ self long since abandoned to the compromises of adult life. “What happens with everything you believe in? Isn’t it needed?” complains Alma at one point. “Can you be one and the same person at a time? I mean, two people?”

Zooming out again, Alma/Elisabet can be read as an avatar for unresolved traumas in Bergman’s own life. Speaking to Dazed about her role in the film, Liv Ullmann recalls feeling that the director “was very sad about life, he wanted to stop talking. He wanted to isolate (himself) in a very strange way”. His mother, Karin, was a nurse who admitted to feeling miserable after the birth of her son in a diary excerpt published in Bergman’s autobiography The Magic Lantern. “He looks like a tiny skeleton with a big fiery red nose. He stubbornly refuses to open his eyes... I lie here helpless and miserable.” In the film’s indelible opening sequence, a young boy reaches out to a blurred image of a woman – Alma? Elisabet? – projected on to a screen, suggesting the director’s own feelings of abandonment towards his mother.

Alma’s divided self is revealed over the course of the film as her fascination with Elisabet curdles into a kind of obsessive hatred. At the peak of their intimacy, Alma recalls a beachside orgy that led to an abortion in startling, erotic detail (Ullmann famously rewrote the scene to excise any details giving away Bergman’s ‘male gaze’). But things turn sour when Alma reads a letter Elisabet intended for the doctor, which reads oddly like a psychiatric report. Feeling that she is being taunted, Alma starts to rage against Elisabet’s silence, even forcing her to speak in one disturbing scene where she threatens her with a pan of boiling-hot water.

As for Elisabet, her ‘condition’ might be the result of a psychological breakdown, or a conscious decision to spurn the roles that society affords her as a woman and an actress. But is the decision to disengage from life a role like any other? What if there is no true self, Elisabet’s silence seems to ask, just a series of stories we tell ourselves? “At least that way you don’t lie,” says the doctor, sceptically observing her patient. “This way you will not have to act roles and put on false gestures, you think... But life seeps in through everywhere.”

The shifting of Alma and Elisabet’s identities is all the more unsettling because it’s never really ‘consummated’: the famous scene in the mirror, where their heads entwine, is followed by a beachside scene in which Elisabet denies knowledge of anything happening, rather than the expected personality swap. Instead, Bergman uses uncanny techniques to suggest odd discrepancies, like the sudden appearance of Alma’s husband in one scene where he keeps calling her Elisabet. 

In other moments, the film seems to play out like a psychiatric session in real time. Think of the orgy soliloquy: it’s a moment of catharsis that sees the ‘therapist’ looking on silently as the patient undergoes a process of self-revelation. Only somehow, the roles have been reversed. Other techniques, such as role reversals and ‘doubling’, where a participant (prompted by a therapist) stands behind a psychiatric subject and gives voice to the other person’s feelings, are encoded in cinematographer’s Sven Nykvist’s iconic framing of the pair’s faces, and in a scene where Alma cruelly confronts Elisabet with the secrets of her past. Bergman filmed the scene with a camera trained on each actress in close-up. Instead of cutting between the two, he let the scene play out twice, culminating in a subtly monstrous composite of the two actresses’ faces.

It’s this loosening of the bonds between cause and effect, between reason and unreason, that gives Persona so much of its lingering power to frighten. The film’s radical expanding of the language of the uncanny makes it an unshakable portrayal of psychosis, one that’s inspired imitators from Robert Altman to David Lynch and, in Black Swan, Darren Aronofsky. But where Aronofsky needed to crack bones and ruffle feathers to make audiences crawl out of their skin, all Bergman needed was a pan of boiling hot water. “You’re really scared now, huh?” cries Alma in triumph, as Elisabet’s mask momentarily slips. “What kind of person are you, really?”

Ingmar Bergman season is on January through March at the BFI.