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Smile (2022): Mental Health in Horror | Review

By Xandra Button


Courtesy of IMDb

I’m not sure what to think of 2022’s latest horror movie, Smile. On the surface, Smile is the perfect scary movie. It has amazing jumpscares, haunting storylines, and made me afraid to go to sleep after seeing it. In fact, it was one of the most unsettling horror movies I’ve ever watched. Looking only at the soundtrack, atmosphere, and acting, Smile would be worthy of being a new

Halloween classic. So what is it that makes me so hesitant to recommend this movie?

Simply put, I cannot recommend Smile because the plot mishandles its portrayals of mental illness, making the movie inaccessible and possibly offensive. Smile follows Dr Rose Cotter, who works at a therapy clinic. When one of Rose’s patients begins describing disturbing visions, visions of people grotesquely smiling at her, Rose begins seeing the same thing. As Rose delves deeper into the mystery surrounding these smiles, her visions get more horrific.


If you watch Smile only expecting a horror movie, you may be surprised by what you get. When analyzing this movie, it becomes less about a demonic, smiling creature and more about Rose’s inability to cope with the horrible traumas she has experienced in her life. In fact, the demonic entity tells Rose that it has attached itself to her because she has been traumatized. Later, Rose discovers that she can rid herself of the smiling curse if she passes her trauma onto another person. It is not hard from here to see how Smile works as a metaphor: the smiling creature is not just a horror movie gimmick but a representation of how trauma can be passed from one person to another, and how, if you don’t seek help dealing with these traumatic memories, your life can begin to unravel.


Thinking of the movie this way, Rose becomes not just a victim of a disturbing curse but a symbol of what can happen if you do not seek help during a psychotic episode. As Rose sees more smiling visions, she becomes more visually dishevelled and less mentally coherent. Many times throughout the movie, Rose is offered help in the form of therapy, which she refuses. Rose becomes so engrossed in her visions that she is willing to destroy her relationships with anyone who doesn’t believe her. Eventually, Rose isolates herself from everyone in her life, convinced that it is other people who are making the smiles worse.


Smile clearly wants the audience to see the connection between Rose’s curse and mental illness. Throughout the movie, characters use therapy buzzwords and often suggest that Rose’s mental state is a result of her genetics and past trauma. While Smile may have had good intentions in trying to depict a taboo topic, the execution of this idea is poor. The movie equates mental illness with an inescapable monster. This is problematic because, while someone who suffers from psychosis or paranoia may always be mentally ill, that does not mean they must always live in fear or isolation, as Rose does. It is harmful of Smile to suggest that mental illness is something that only gets worse over time, from which there is no escape.


Smile also misses the mark metaphorically because the audience is aware that the smiling creature following Rose is real. This means that Rose is not having a genuine psychotic episode but that her would-be delusions are actually factual beliefs, which creates many problems in the film. For example, in one scene, Rose refuses to go to therapy because she knows her therapist won’t believe that a monster is following her. Rose is obviously right for refusing therapy because the smiling creature could take the form of the therapist and cause Rose harm. However, if the movie wanted to be a metaphor, Rose should be able to save herself by talking to a therapist, taking medication, and recognizing her delusions. Smile creates similar paradoxes throughout the film.


I would not recommend this movie to everyone, especially those who have experienced mental health crises. Many of the scenes could be triggering or invalidating. However, I appreciate that the film wanted to give a real depiction of mental health in horror, something unusual to see in the genre. If Smile had shown Rose overcoming her curse with the help of others, I believe that the film could have succeeded as a metaphor. However, while it is easy to get wrapped up in analysis, you should by all means see Smile if you are not stressed by depictions of mental health crises and if you like distortion of reality. I do think it fell short metaphorically, but the atmosphere it creates is truly disturbing, and it will have you on the edge of your seat. It may not be the next classic, but it is enjoyable for a specific audience, and I appreciate the message it attempted to send.

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