How Curb Your Enthusiasm Was Used To Treat Schizophrenia

In our wildest dreams, we never would have thought that Larry David could help treat mental illness. Cause it? Sure. But if you asked us how the cantankerous creator of Curb Your Enthusiasm could possibly help alleviate the stresses and symptoms of a disease as insidious as schizophrenia, the only answer we’d be able to come up with is “leave the room.”

That’s not how researchers at the University of North Carolina at Chapel Hill saw it. In 2004, Dr. David L. Roberts, then just a post-grad student, showed episodes of Curb Your Enthusiasm to his schizophrenic patients in order to teach them how to handle the difficulties and complexities of social norms – by using Larry David as an example of exactly what not to do.

In a New Yorker article published in 2007, Roberts told the story of how he reached the conclusion that clips of TV’s pettiest malcontent could be the perfect learning tool for an individual suffering from debilitating psychotic disorders that would typically alienate them from any kind of social situation. 

Back in 2004, Roberts and his colleagues were using basic behavioral therapy methods with an unresponsive group of schizophrenic patients to little success. The student researchers struggled to get their patients to focus on the role-playing exercises designed to get these individuals adjusted to the idiosyncrasies of typical social interactions.

During their downtime, however, David noticed that the patients who huddled around the common room television had the surprising capacity to understand social situations on screen despite their inability to read social cues in their own lives. Said Roberts, “They were laughing at the ironic commercials. They were laughing at ‘Friends.’ They were laughing at all the places I was laughing.” 

Dr. Roberts noted one particularly nonverbal patient’s ability to appreciate the tension in a scene from Monk where the famously obsessive-compulsive title character refuses to shake someone’s hand because of his debilitating fear of germs - “I asked a man who’d been an inpatient for ten years, and who was generally blank, what had happened, and he shook his head and gave me a wry grin. Unspoken communication is huge for someone like that.”

The researchers shifted their treatment strategy towards this newfound appreciation for the art of comedy as a learning tool. It didn’t take long for them to narrow down their teaching materials to one show – and one man – in particular. Larry David played the perfect schizophrenic stand-in since he fell victim to so many of the same social traps that ensnare people who suffer from serious mental diseases.

“On his way into his dentist’s office, he holds the door open for a woman, and, as a result, she’s seen first. He stews, he fumes, he explodes. He’s breaking the social rules that folks with schizophrenia often break” Said Dr. Roberts. “Or the one where Ted Danson and Mary Steenburgen invite Larry and his wife to a concert: the night arrives, they don’t call, Larry assumes they don’t like him, then it turns out he got the date wrong. It’s a classic example of a major social cognitive error—jumping to conclusions—that schizophrenic patients are prone to.”

After Roberts and his colleagues played clips from Curb Your Enthusiasm to their schizophrenic patients, the researchers led a group discussion in which the patients analyzed where Larry went wrong and how he could have behaved more appropriately. Eventually, Roberts and his adviser David Penn began to develop this method into a formalized set of practices called Social Cognition and Interaction Training, or SCIT for short. 

However, the researchers hit a snag in their quest to basically make it possible for a doctor to prescribe episodes of Curb to treat mental illness – they couldn’t get the rights to the show. Despite numerous appeals, they never received approval from HBO to use the award-winning semi-improvised sitcom in a clinical setting. This forced Roberts and Penn to take matters into their own hands – by producing and filming original scenes written to imitate the blowups and social miscues that Larry David would make.

This means that a major educational institution funded the creation of a knock-off Curb Your Enthusiasm in order to treat schizophrenia and skirt copyright laws. Sometimes life is the real sitcom.

SCIT was a success, and in the years since the writing of the original New Yorker piece, its methodology has been published into textbooks, translated into seven different languages, and implemented in ten different countries across the world. David L. Roberts went on to get his Doctorate from UNC Chapel Hill, and he currently teaches at the University of Texas Health Science Center. 

There’s something beautiful and poetic in the reality that Larry David’s numerous neuroses allowed him to create a TV show so amazing that it would not only exonerate an innocent man on death row, but also that it would be used to treat some of the most difficult and tragic conditions known to humanity. 

Said Larry when he learned of his show’s role in the success of SCIT, “A lot of the time, it’s just me expressing myself freely. I knew that my own mental health was problematic, but should I be worried? I mean, I blow up, too! Is this something undiagnosed? Do I need to see a clinical psychologist?” 

Honestly, Larry? Probably.

Top Image: HBO Entertainment

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