Lars knows what he needs. His mother died when he was born, and his father may have been so consumed by grief that he neglected his younger son. Lars developed an allergy (aversion?) to human touch and emotional connection. Lars knows that he needs a woman who will not threaten him with affection.
Lars introduces his life-size doll Bianca to his older brother Gus and his sister-in-law Karen as though she is a real woman. (0:18)
Gus tells Karen, "My little brother is totally totally insane." (0:19)
After examining Bianca Dr. Berman asks Lars to "bring her in every week for special treatment." (0:28)
Dr. Berman assures Gus and Karen, "I don't believe he's psychotic or schizophrenic... I don't think this is caused by genes or faulty wiring in the brain... He appears to have a delusion." She continues, "Chances are he's been decompensating for some time." Gus: "Lars is nuts." Dr. Berman explains, "This isn't necessarily a bad thing. What we call mental illness isn't always just an illness... it can be a way to work something out." She recommends to them, "Go along with it." (0:29)
Dr. Berman begins her "treatment" of Bianca by obtaining a more complete history from Lars. (0:43)
Gus's coworker asks Gus, "So what's the difference between a delusion and a hallucination?" Gus explains, "It's false perception versus false belief." (0:45)
Bianca and Lars attend another session with Dr. Berman. Lars begins to open up about his own discomfort with physical affection from others. (0:46)
Lars takes Bianca to the cemetery where they visit the graves of his parents. (0:57)
In another session with Dr. Berman Lars explains that Bianca's mother died in childbirth as did his. (0:57)
Lars suffers a panic attack. (0:59)
Another session with Dr. Berman. (1:11)
In a session with Dr. Berman Lars appears to take a small step toward acknowledgment of reality. (1:25)
Lars announces that Bianca is "dying." (1:29) Now he knows he doesn't need her any more.
Bianca's funeral. (1:38)
What every psychotherapist wants to make happen for the patient: Dr. Berman plays only a small role, assisted by an accepting and loving social network and Lars own inner strength and instinctual knowledge of what he needs and when he no longer needs it. Was Lars mentally ill at all? If so, what might you diagnose? Does this happen to real people?