Disease vs. Disorder: Lars and the Real Girl

Katy Kay
5 min readJan 31, 2018

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There are several main characters in “Lars and the Real Girl”. I would consider them to be Lars, Karen, Gus, and Margo. I believe that all of these characters, except for Lars, only display “normal” behavior because their behaviors do not result in them feeling “clinically significant distress or disability” (Paris, 2015). Lars on the other hand, demonstrates both normal and abnormal behaviors. Lars demonstrates normal behaviors when he is leaving his church by helping an older lady carry flowers. When he is at work, a coworker wants him to look at the porn on his computer. Lars stays calm, despite the fact that his coworker is pressuring him, and says no. When Lars goes to a party he dresses up nicely for the party and shakes a man’s hand. Later in the movie, he goes bowling with Margo and and appears to be having fun because he is smiling and clapping. He seems to also be checking out Margo, but when Margo flirts with him he says he can’t cheat on Bianca. These are all examples of Lars demonstrating normal behavior.

Lars demonstrates many abnormal behaviors in the movie. Some of these abnormal behaviors appear to be obvious symptoms of mental illness, while others could be normal responses to situations. I find it difficult to determine if some of these abnormal behaviors are normal responses to situations without knowing the character’s thought process when doing the behavior. As a result, I am not describing all of the abnormal behaviors in the film, but just the ones that can more clearly be categorized into these two options. Listed below are some of Lars’ abnormal behaviors, under each bullet point is a sub-bullet point explaining why they could be considered symptoms of mental illness or normal reactions to a situation.

-Lars tells his brother, Gus, and his sister-in-law, Karen, about the visitor that he has at his house. He describes her and explains that he doesn’t feel right having her stay in the garage with him since they’re both religious. When he introduces her to them, they discover she is a life-size doll.

—This is an example of a delusion and, therefore, could be a symptom of a mental disorder

-Throughout the rest of the movie, Lars talks to the doll, Bianca, and he thinks she responds

— Hearing something that is not there is an example of a hallucination. That could be a symptom of a mental disorder.

-Lars describes to his doctor what hugs feel like to him. He says that they hurt and feel like a burn. The doctor offers to help him and he agrees. She later tries touching him, increasing the strength of her touch each time. This causes him discomfort and eventually he panics.

— This appears to cause Lars to feel intense distress despite the fact that she didn’t actually push hard. This could be a symptom of a mental disorder.

-Lars shares that he is worried that Karen will die while she is giving birth. He then gasps for breath, seems panicked and says “It’s so dangerous!”

— Since Lars lost his mother after she gave birth to him, this is a normal response to this situation.

-Lars does not respond to Margo when she says hi to him or when she asks if he wants to carpool with her.

— While this may be considered abnormal, if he is attracted to her then he may just be nervous to speak to her. (normal behavior)

-Lars gets upset with the doll, Bianca, that she agreed to volunteer with a woman instead of playing scramble with him like they had planned. He then yells at the doll for messing up his schedule.

— This is a tricky one. He is imagining that the doll is doing any of this in the first place. However, I chose to consider this a normal response because, if Bianca were a real woman that was his girlfriend, it would make sense that he is upset.

-Lars tells Karen that Bianca left him. Karen says that she didn’t abandon him and that she will be back. Lars responds by saying, “You don’t know that, people don’t care.”

— Lars indicates that he feels this way because in the past people have shown that they don’t care about him. In particular, his brother left him at one point and it probably made Lars feel like his brother didn’t care about him. Therefore, this is a normal response to the situation.

Lars is the most “disturbed” character in the film and his brother, Gus, is most “disturbed” by Lars’ behavior. Gus “acts out” in multiple ways after discovering that his brother believes the doll is real. The day that he finds out about the doll, he says to his wife, “He’s crazy, right? He’s crazy! What do we do?” He then begins to think about the costs of a mental hospital and says “He’s totally insane!” Gus worries what people will think of his brother and their family. The doctor explains that it will help Lars if they go along with the delusion that the doll is real. Gus looks very embarrassed as he considers going along with this idea.

The reason that Gus is “disturbed” by Lars’ behavior is because Lars is his brother and he cares about him. He also appears to feel guilty for leaving him alone with their father. In the film Gus says, “Lars is going to love that thing his whole life and it’s all my fault.” He later says to Lars, “I shouldn’t have left you alone with him when he was sad. It was selfish and I’m sorry.”

People are fascinated by bizarre behavior- whether or not it is the result of mental illness. To answer your question, I think it is alright to make movies like this. Movies are an art form and it gives people the opportunity to share their interpretation of mental illness. That said, it is easy to misunderstand mental illness and interpret it in a way that may offend some people and so it is important to do research about a mental disorder prior to creating the film.

Some additional, random thoughts that I would like to share:

-I wonder if the town is sad because they’ve connected with the idea that Bianca is real or is the town sad just because Lars is sad

-This movie is unrealistic in that a community wouldn’t go along with something like this.

-It is my understanding that mental illnesses, like delusions, are not so black and white… where one only has delusions towards one specific thing. Also, is it really possible for a delusion to have such an ending as this and then the person goes back to a normal life?

-Am I stereotyping mental illness? Possibly. One thought I had from reading the first six chapters in the book, The Intelligent Clinician’s Guide to the DSM-5 is that this book makes me realize that I’ve gone into a “grayer” field of study than I ever realized!

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Katy Kay

School Counselor. Nature Lover. Aunt. Hiker. Montanan. Volunteer. Mashed Potato Extraordinaire. Dreamer. Bobcat. Blogger?