How animated film Inside Out and its hit sequel changed therapy

NEW YORK – In 2012, when Ms Olivia Carter was just starting out as a school counsellor, she employed all sorts of strategies to help her primary school-age pupils understand and communicate their feelings – drawing, charades, colour association and role-playing.

After 2015, though, starting those conversations became a lot easier, she said. It took just one question: “Who has seen the movie Inside Out?”

That 2015 Pixar hit, about core emotions such as joy and sadness, and this summer’s blockbuster sequel Inside Out 2, which focuses on anxiety, have been embraced by educators, counsellors, therapists and caregivers as an unparalleled tool to help people understand themselves.

The story of the moods steering the “control panel” in the head of a girl named Riley has been transformational, many experts said, in day-to-day treatment, in schools and even at home, where the films have given parents a new perspective on how to manage the turmoil of growing up.

“As therapeutic practice, it has become a go-to,” said Dr David Langer, president of the American Board of Clinical Child and Adolescent Psychology.

And it is so in his household too. “I have nine-year-old twins. We speak about it regularly,” said Dr Langer, who is also a professor of psychology at Suffolk University in Boston.

Inside Out finger puppets were in frequent rotation when his children were younger, a playful way to examine the family dynamic. “The art of Inside Out is explicitly helping us understand our internal worlds,” he said.

And it is not just schoolchildren that it applies to.

“I’ve been stealing lines from the movie and quoting them to adults, not telling them that I’m quoting,” said Regine Galanti, an author and psychologist in private practice on Long Island, New York, speaking of the 2024 sequel.

Audiences have lapped it up. Inside Out 2 has grossed more than US$1.5 billion (S$2 billion) globally, shattering box-office records for animation along the way.

Its influence is visible in themed bulletin boards dotting school hallways, character-based lesson plans and educators’ do-it-yourself craft projects.

There is also the popular touring exhibition Emotions At Play, developed by the Children’s Museum of Pittsburgh, in conjunction with Pixar. Since 2021, it has been inviting visitors to create glowing “memory spheres” or keep the “train of thought” on track. (“Core memory” is a phrase that the first movie helped introduce to the TikTok generation.)

For Ms Carter, a national school counsellor of the year for her work at a junior high in Cape Girardeau, Missouri, Inside Out provided a shared language and a visual iconography that makes abstract concepts concrete.

“I have the figurines of each feeling, so pupils can show me who’s at the control panel,” she said.

Like children’s television shows Mister Rogers’ Neighborhood (1968 to 2001), Sesame Street (1969 to present) and Daniel Tiger’s Neighborhood (2012 to present), it offers a common reference point for families.

And Inside Out 2’s focus on anxiety, which has reached crisis proportions among adolescents, normalises experiences that for young people could seem isolating or overwhelming, and makes them relatable.

“Almost every day, there’s a pupil who’s struggling or having a panic attack,” Ms Carter said. “I could see this being something that I lean on pretty heavily for a long time.”

None of this was the intention when the film-makers set out some 15 years ago to make a movie with “emotions as characters, like our version of the Seven Dwarfs”, as American film-maker Pete Docter, chief creative officer of Pixar and a director of Inside Out, put it in a recent video interview.

At the time, he said, he “was really just thinking about animation that was exciting to me”.

But soon after the idea was born, Docter was stymied, he said, about which feelings to include. It turns out psychologists do not have a consensus on how many there are.

“Certain researchers will say there are five emotions, others say 14,” Docter said.

Dr Dacher Keltner, a professor at the University of California, Berkeley, who served as a consultant on the movies, contends that there are 27 categories, with fuzzy boundaries.

Docter decided to approach the problem as an artist first. “I finally said, ‘All right, look, I’m just going to spend the weekend drawing each emotion and thinking about, as an animator, how I could make that one fun and clear,” he recalled.

He settled on joy (ultimately, a glowing yellow sprite), anger (blocky red), sadness (blue skin and sweater), fear (attenuated purple) and disgust (judgmental green).

Colourful graphics developed by researchers, like American psychologist Robert Plutchik’s “wheel of emotions”, also helped.

Members of the Pixar brain trust got to work, plumbing, as always, their own experiences. Speaking with experts along the way, their understanding of what emotions mean shifted. “I always thought anger is just something that I regret later, that gets me in trouble – road rage or whatever,” Docter said. “And then, you realise, oh, no, it’s about fairness.”

American screenwriter Meg LeFauve, who co-wrote both films, said: “I remember I was taught as a kid not to be jealous. But the truth is, jealousy and envy, they’re telling you what you want. And that’s incredibly important to note, especially for women.”

All of that helped them conceptualise one thing mental health professionals love about the films – that they do not villainise any feelings.

In the first movie, the leader, Joy (voiced by Amy Poehler), finds space for Sadness (Phyllis Smith), as 11-year-old Riley adjusts to her family’s move from Minnesota to San Francisco.

In Inside Out 2, Riley is a teenager, and new emotions like Embarrassment, Envy and Ennui flood her system. Anxiety (Maya Hawke), orange and wild-haired, rejiggers Riley’s sense of self.

The movies “treated those uncomfortable emotions as factory settings that are necessary to overall health”, said Dr Lisa Damour, a leading adolescent psychologist, author and speaker who served as a consultant on the second film.

Shaping that into a story that was entertaining and not a therapy session was the challenge for the film-makers, especially after the first movie resonated in ways they did not expect.

LeFauve, who along with her co-writers was nominated for an Oscar, recalled a Los Angeles psychiatrist approaching her at an awards ceremony after the first film. Her work involved helping children process traumatic events the night they experienced them, and she told LeFauve: “You made my job so much easier.”

“It got me very choked up,” LeFauve said. “Who needs an Academy Award? Honestly, to create something in the world that can be used for children in a moment of trauma is amazing.”

But the film-makers all said that while they were conscious of the real-world stakes for the sequel, they tried not to focus on them. (The movies’ mental health consultants did not read the scripts. They gave feedback on clips once the animation was in process.) You “don’t want to trip over the science and not deliver the story”, said Dave Holstein, one of the screenwriters.

When, towards the end of the film, Anxiety is exiled to a chair and ordered to worry about a Spanish test instead of an unknown future, that is a LeFauve speciality.

“I’ve been doing that my whole life,” she said. “I’m anxious to go into a meeting. I will say, ‘Thank you, anxiety. I know you’re trying to save me. I hear you, but please take a seat. I’m not going to die, it’s okay.’ And then give her a job.”

Inside Out arrived at a moment when educators and caregivers were paying more attention to what is known as social-emotional learning – prioritising connection and communication skills, and recognising, not tamping down, children’s sensibilities as part of their self-regulation.

It is a huge generational shift in schooling. “I’m 35. I don’t think we ever spent time feeling our feelings,” said Ms Carter – and it was reflected in Inside Out and fuelled by it: a cultural feedback loop.

For the first screenplay, LeFauve lifted a moment straight out of her children’s pre-school, when a teacher mirrored back a pupil’s melancholy (“you feel sad”), putting her hand over his with compassion. In the movie, Sadness does the same for Riley’s imaginary friend.

Acknowledging feelings “is like a magical thing”, Dr Damour said. “If a person says, ‘I feel sad’, they suddenly feel less sad.”

That Inside Out helps families have those conversations together amplifies one of its messages – to embrace people’s personalities in all their shades and shadows.

Ms Anne Fullenkamp, senior director of creative experiences at the Children’s Museum of Pittsburgh, witnessed it, because its exhibition – like the movies – appeals to children and grown-ups. They would stand together at the control panel, weighing how to balance their sentiments.

“You see parents and caregivers getting very emotional,” she said. “They’re getting in touch with things they hadn’t thought of in a long time – and their kids help them navigate it and get there.” NYTIMES