Major spoilers for Phantom Thread below. You have been warned.
Ever since I saw Paul Thomas Anderson’s Phantom Thread, I have been obsessed with understanding the psychological roots of the film’s twisted love story. As we learn in the film’s denouement, not only has Alma (Vicky Krieps) been poisoning her uptight couturier boyfriend Reynolds (Daniel Day-Lewis) to gain control over him, but Reynolds has become complicit in this victimization. In his inimitable words: “Kiss me my girl, before I’m sick.” (Put it on a Hallmark card, please.) In Paul Thomas Anderson’s skilled hands, this bizarre tale of dominance, submission, and poisoned omelettes turns out to be rather a beautiful love story. But if a relationship like this happened in real life, what would it look like? And which authorities and mental-health professionals would we have to alert?
According to Marc Feldman, MD, an international expert in Munchausen syndrome and author of the upcoming book Dying to be Ill: True Stories of Medical Deception, Phantom Thread absolutely appears to be a case of “Munchausen syndrome by adult proxy,” a form of abuse in which a caregiver artificially induces illness in someone he/she is caring for. While poisoning an adult instead of a child is rare (there are probably fewer than 15 cases in the professional literature), Feldman says the film definitely rings true to him. “The definition of Munchausen by proxy abuse is that the perpetrator makes the victim ill to gain emotional gratification, and that certainly takes place in this movie,” he tells me. “In some ways, Alma is a typical perpetrator in that she probably has a personality disorder and is female. But in the vast majority of cases, the perpetrator is the mother of the victim, is often depressed, and has some medical or nursing training. These facts in no way detract from the movie’s credibility, because Anderson has a very different story to tell.”
Feldman says he hasn’t seen any MBAP cases with such overt BDSM overtones (although, as he points out, drawing on his previous psychoanalytic training: “When a mother injects a child with a syringe, the mother is entering the child’s body in a way that could be symbolic for emasculating him. The intrusion into the body always has psychosexual overtones”). Yet he was reminded specifically of one famous case in the medical literature: the story of a gasoline injector, an Israeli man who injected his wife with gasoline so that he could take care of her when she was sick. After she died of this poisoning, he hired a nanny, and did the same to her (the nanny ended up a paraplegic). When he was eventually sent to jail, he became a model prisoner, which allowed him to gain access to a set of syringes and toxic chemicals, with which he then injected his cell mate.
“I realized if you read the whole case, there is a sexual dynamic, it is almost fetishistic in his rendering his victims submissive,” Feldman tells me. “And he could be all-powerful. And that’s a thread, not to use a pun there, that seems to be found everywhere in the case, that it had psychosexual overtones. That’s probably the only case I can think of that’s like that, at least explicitly.”
However, Feldman says he has never seen a case where (à la Phantom Thread) the victim colludes with the perpetrator to achieve some sort of gratification. That’s because in most cases the victims tend to be unable to comprehend the abuse they are undergoing or unable to resist, often because they are physically or intellectually disabled. “I have never come across a real-life case in which the victim in MBAP consciously colluded with the perpetrator because of deep, unmet needs of his own,” says Feldman. Still, that isn’t to say it couldn’t happen. “I wouldn’t be at all surprised to see a case in which that was the primary driver, because I’ve stopped being surprised by anything in this field,” he adds. “I anticipate when I give lectures I’ll talk about this film to just illustrate the perversity and range of human behavior.”
While Alma’s backstory remains mysterious throughout the film, given his knowledge, Feldman says it’s reasonable to assume she may have experienced MBP abuse in her own life. “People have experienced MBP abuse are at quite an increased risk of participating in it later in life. During the movie, I did wonder, could she have experienced this form of mistreatment herself?”
He ended our interview on a disturbing note: “I also wondered about the baby at the end, because those who engage in the behavior are likely to do it [again] when similar situations arise. So as the baby gains skills of emancipation, would Alma be equally threatened by that? I saw the baby and thought: Oh no, it may be at risk.”
It’s a credit to Paul Thomas Anderson’s filmmaking that, amid all this, I still kind of want Reynolds and Alma to live happily ever after. (But Cyril, you old so-and-so, please keep an eye on the baby.)