Unsane: How the Mental Health Industry Silences Women’s Trauma

by Callie S. Blackstone

Steven Soderbergh’s movie Unsane contains elements that are not commonly found in horror films. We have all seen horror movies that take place in psychiatric units. The setting is so common that it is almost mandatory in every major horror movie franchise. (Halloween 4, anyone?) Yet Soderbergh’s film offers a view of the mental health industry that goes beyond utilizing a straight jacket to signify either how terrifying a horror villain is or how traumatized one of his victims might be. Soderbergh’s movie examines how the mental health industry — one that is meant to ensure people’s safety during times of crisis — is driven by a societal need to silence women’s trauma.

The movie opens with a scene that is depicted through the eyes and words of a stalker. The rest of the film follows the experiences of Sawyer Valentini, the woman he is terrorizing. Soderbergh’s choice to open with the stalker’s point of view sends a clear message: the perceptions and ideas of a male stalker are more valued than those of his female victim. Throughout the film we watch Sawyer attempt to navigate a world in which she has been terrorized: she relocates, obtains a new job, and struggles to find sexual connection in the midst of terrifying flashbacks.

Sawyer decides to pursue mental health treatment to help her cope with this trauma. When she verbalizes her experiences during the initial screening, she endorses a history of passive suicidality. The woman that screens Sawyer enacts a second trauma upon her — she hospitalizes Sawyer against her will based on these statements. Sawyer continues to lose autonomy as she pays the price for her stalker’s actions, even long after he is gone.

But is he gone? As Sawyer attempts to navigate life on the psychiatric unit, she quickly realizes that one of the orderlies resembles her stalker. She attempts to verbalize this, yet the hospital staff cannot—or will not—hear her. Sawyer’s attempts to advocate for herself parallel the experience that is unfortunately common to so many women—when she reaches out for help to cope with trauma inflicted by a man, she continues to be traumatized.

As Sawyer goes on her journey of self advocacy she begins to recognize that no one will help her—like so many women that speak up after being the victim of violence. The audience watches as she stops obeying the rules of a society that will no longer help her—she yells at a psychiatrist and she begins to engage in violent fights with other residents. Her pains and fears go unanswered.

Soderbergh’s decision to use an iPhone to film the movie adds a sense of paranoia and confusion. While the audience experiences this tone, they consistently wonder—is Sawyer telling the truth? The audience is complicit with the society that would listen to the stalker’s testimony first and consider Sawyer’s feelings to be untruthful. Is she a young woman that is advocating for herself against a system that is attempting to silence her? Or is she merely a crazy young girl?

Viewers watch as Sawyer does whatever it takes to escape the psychiatric unit as well as her stalker. She is eventually able to escape and kills her attacker. Finally, her character is free.

Or is she? The movie closes with one last scene of Sawyer’s life. While at a restaurant she believes she sees her stalker and approaches him with a knife. Before she takes action, she realizes it is another man. What does the closing scene leave the audience with? Should we continue to doubt Sawyer’s perceptions of her stalker because she is unreliable? Or are we to recognize that the trauma women face at the hands of our society often leave us a little Unsane?