An interview with film director Paul Dalio: Touched With Fire

In early December, I was fortunate to be invited to a film screening of “Touched With Fire,” starring Katie Holmes and Luke Kirby. The movie is about two young poets with bipolar disorder who meet and fall in love while on a psychiatric unit. It opens in theaters on Feb.12.

The screening was introduced by Johns Hopkins Hospital’s psychiatrist in chief Ray DePaulo and following the movie, director Paul Dalio and psychologist Kay Redfield Jamison, Ph.D., both gave short talks and answered questions. The movie was inspired by Dalio’s personal experience with bipolar disorder. Jamison, author of Touched With Fire: Manic-Depressive Illness and the Artistic Temperament (New York: Free Press, 1996) had offered hope to Dalio during a difficult moment with his illness. Numbed by the medications that made his moods tolerable, she had assured him that his creativity would reemerge, as indeed it did. Jamison’s book lent its name to the movie title, and she had a cameo role in the film. In the movie, Jamison, playing herself, tells the couple that it took a while for her moods to calibrate, but that medicines were a godsend and they helped her to become both happier and more productive.

“You’re concerned about losing your art and losing your passion,” Jamison says to Marco, the character played by Kirby. “Medication’s not going to take your personality away; it’s not going to take away your own gift. It’s a fire when it’s out of control, and what medication can do is tamp that down a bit without losing that gift.”

While this insight was helpful to the real-life Dalio, the character Marco struggles deeply as tries to hang on enough to love, work, and strive toward a future he longs for, all while mourning what he sees as the loss of himself. “I want the mania!” he tells Carla, played by Holmes, in one of the more poignant scenes.

Enough plot spoilers. The love story is emotional, and the portrayal of bipolar disorder is the best I have ever seen in the popular media. The characters are three-dimensional and about so much more than their illnesses, and many of the scenes ring so true. This is bipolar disorder with all its raw passion and pain laid out for an audience. No one has odd mannerisms and no one walks around dressed in plastic bags; instead, these are beautiful people ravaged by psychosis and the extremes of their moods, and when it’s not horrible, it’s absolutely wonderful.

In the question-and-answer session after the movie, a member of the audience asked Paul Dalio how to get treatment for someone who is manic. Dalio’s answer was swift: “You have to force them. There is no other way.” As someone who has been interested in patient responses to involuntary psychiatric care, I was a bit surprised to hear that answer from someone who has suffered with the condition and whom I presumed had been treated against his will. When I was asked a few weeks later if I’d like to interview Mr. Dalio, my answer was also swift: Yes, I would.

Dalio talked openly with me about his own psychiatric history, and he was quick to say that he shared Marco’s struggles. The love story that unfolded with Carla was fictional, but when I asked about several of the scenes, Dalio said, “Yes, that happened to me!”

Dalio has been admitted to the hospital four times, twice as an involuntary patient. “I know that in a manic state, no one is going to convince you to go into a hospital,” he said. “My experience was not good at all – it was horrific and frustrating – but it was the lesser of two evils. As difficult as it was, it doesn’t hold a candle to the pain. There is no way I can communicate the pain of bipolar depression.”

Like his character, Marco, Paul Dalio spent years ravaged by his illness. He worked in a warehouse, and he says that during those years he was not very likable. He credits his family with keeping him alive; his father would spend hours on the phone talking him out of committing suicide. The family researched treatment options, and eventually, Dalio began to travel from New York City to see a bipolar disorder expert in Baltimore. His treatment at Hopkins enabled his meeting with Kay Jamison.

“You can’t lie about this disorder,” Dalio said, “and you can’t sugarcoat it.”

Dalio’s life has done a turnaround from his days of being psychotic, suicidal, and unable to function. He holds a degree in screenwriting from New York University and has attended the NYU graduate program in filmmaking. He is married and has two small children.

I asked what helped.

“I resolved to stay on meds,” he said, “even if I felt numb. I don’t drink, not even a toast to the movie. I go to bed at 10 every night, drink green juices all day, use a light box, and take walks. Transcendental meditation helps. And patience – it took 3-5 years before I was really able to feel emotion again. I’ve been stable since 2007, but thriving since 2010, with rich emotions. I have a severe form of the condition.”

Dalio experiences symptoms if he misses even a couple of doses of medication, and with two toddlers, it can be difficult for his wife that he can’t help with the children in the middle of the night. It’s not all hard, though. “My wife is Eastern European, and she has a connection to the darkness. She was always attracted to crazy people and artists, and she finds a lot of pleasure in our lives.” Like Dalio, she is screenwriter, and they collaborate on their work.

Dalio is clear about his agenda for this movie. He sees his bipolar disorder as a gift that fuels creative pursuits, and he wants others to understand how people with this disorder struggle. He used the word “beautiful” to describe the intensity of emotions that Carla and Marco experience in the film, but tragedy and torment are also screaming on the big screen. His second agenda is a plug for mainstream psychiatry and a billboard for hope: take the medications, tolerate the downside, be patient; things will work out.

Well worth seeing.

Dr. Miller is a psychiatrist who practices in Baltimore.