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Letter to the Editor

Psychiatrists Can Answer to Societal Debates Triggered by the Arts: A Response to Dr Martinho

Jasmina Mallet, MD, PhD, and Sélim Benjamin Guessoum, MD

Published: September 3, 2020

See letter by Martinho and letter by Mallet

Psychiatrists Can Answer to Societal Debates Triggered by the Arts: A Response to Dr Martinho

To the Editor: We have read with interest the letter written by psychiatrist Dr Martinho; we appreciate this interesting comment and would like to clarify some points. It is a relief to see that art can provide such various opinions, which is the meaning and purpose of art in our opinion.

The term madness, which we do not like either, was used in reference to the book in a purpose of clarity for readers and fans of the show. We agree that artists have no obligation or "intrinsic" duty to adapt to psychiatry or any other discipline. However, artists are involved in a society and are part of it. In this way, art might also reflect actual concerns and is a powerful vehicle through which to disseminate ideas and concepts. Art may not have to adapt to ethical morals or standards, but as spectators, we can voice our concerns or feelings. Above all, art may be criticized—it is one of its objectives: to make the public wonder and think, to destabilize, to induce debates and opinions, including on societal issues. Obviously, the author of Game of Thrones does not have to promote mental illness care. But, as spectators or as psychiatrists, we have the right to give opinions, to contribute to the debates triggered by the arts, and to explain what is disturbing with regard to the way madness is still represented to millions of people. To our knowledge, the author is now writing a new end to Game of Thrones.1 Let’s hope that the madness of Daenerys will not be so logical and fatal.

Also, television does have an influence on society.2 Movies and TV shows are not just aesthetic productions; they also have an impact on people, including their psychology. TV series often directly address health and societal concerns, some directly (eg, 13 Reasons Why3 or Sex Education4), others more metaphorically (eg, Game of Thrones). We should allow ourselves the opportunity to express our concerns with no underlying intention to limit the freedom of artistic expression. Artists expose some ideas, and we have the right to give our opinion on them. As such, psychiatrists should enter the debate. The representation of psychiatric symptoms should be questioned, just as the representation of gender and racial issues can be.

Finally, as psychiatrists we can share our knowledge of mental illness with other individuals to better tackle mental health stigma. There was no aesthetic judgement in the comment on Game of Thrones, only disappointment in how stigma is still powerful in Western culture. In the United States, other series attempt to deal with this issue, and it might be a useful medium through which to destigmatize mental illness, for both patients and their families.


1.Martin GR. A Song of Ice and Fire : The Complete Box Set of All 7 Books. London, UK: HarperCollins; 2012.

2.Zuckerman D, Wilcox BL, Huston AC, et al. Big World, Small Screen: The Role of Television in American Society. Lincoln, Nebraska: University of Nebraska Press; 1992.

3.Asher J. Thirteen Reasons Why. New York, New York: Penguin Random House; 2007.

4.Sex Education. Netflix Official Site. Accessed August 13, 2020.

Jasmina Mallet, MD, PhDa,b

Sélim Benjamin Guessoum, MDc,d,e

aAP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France

bUMR1266, Institute of Psychiatry and Neuroscience of Paris, University Paris Descartes, Paris, France

cAP-HP Greater Paris University Hospitals, University Hospital Cochin, Paris, France

dUniversity of Paris, PCPP, Paris, France

eUniversity Paris-Saclay, UVSQ, INSERM, CESP, Villejuif, France

Published online: September 3, 2020.

Potential conflicts of interest: None.

Funding/support: None.

Prim Care Companion CNS Disord 2020;22(5):20l02718a

To cite: Mallet J, Guessoum SB. Psychiatrists can answer to societal debates triggered by the arts: a response to Dr Martinho. Prim Care Companion CNS Disord. 2020;22(5):20l02718a.

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