NEW YORK, NEW YORK, 1962
When Marilyn Monroe arrived at Madison Square Garden to perform at a gala Democratic Party fund-raiser and birthday salute to President John F. Kennedy, her reputation as a temperamental, sexy, vulnerable, and troubled star preceded her. Her erratic behavior on the set of her latest film, Something’s Got to Give, had compromised the production, and her producers had failed to keep her in Hollywood. The rumor that she was having an affair with JFK had become widely circulated, and she was ill with a high fever. However, nothing was going to prevent Marilyn from making her appearance at this historic event. When Peter Lawford introduced her, the crowed roared as she shrugged out of her white ermine stole, revealing a flesh-colored, sequined gown, so form-fitting she had literally been sewn into it. She minced across the stage and into the spotlight. Despite her unsteady appearance and disjointed performance, her oppressively sexy, nightclub-style version of “Happy Birthday, Mr. President” was mesmerizing. JFK’s nearly speechless reaction only added to Marilyn’s legend, as the entire nation was riveted by this early, and very public, collision of sex, politics, and Hollywood.
COLLEGE PARK, MARYLAND, 1974
By the mid-1970s, Elvis Presley was deep in the throes of a dependence on prescription drugs. It should have been apparent to any observer, as evidenced by his dramatic weight gain and puffy face, his inability to remember lyrics, his slurred speech, and his rambling diatribes during his shows. According to Jerry Hopkins, author of Elvis: The Final Years, “It was a bad time for Elvis. Everything seemed to be coming apart.”
The King was in rough shape when he arrived to play a concert at the University of Maryland. When Elvis arrived at the venue, he fell out of the limousine to his knees. As his band looked on in horror, he staggered up the stairs to the stage. Grabbing the microphone for balance and slurring his words, he swayed on his feet as he rambled his way through a two-hour show. Elvis ended his performance with a tirade against the rumors that he was “strung out” on drugs, imploring his fans to take his word, rather than that of movie magazines, gossip columnists, or reporters. Five months later he was hospitalized to treat an enlarged colon, the press was told. Years later, his private physician, Dr. George Nichopoulos, confirmed that the main reason for the hospitalization was to allow Elvis to undergo drug detoxification.
LOS ANGELES, CALIFORNIA, 1999
By the time Robert Downey, Jr., dressed in an orange prison jumpsuit, appeared in a Malibu courtroom to answer to his third parole violation in as many years, the gifted actor, musician, and physical comedian had become as famous for his addictions as for his talent. His fans and detractors knew all the details of his downward spiral. The multiple arrests, imprisonments, and stints in rehab had all made tabloid headlines; the entertainment press dissected each comeback and fall with mingled horror and relish. There was the arrest for speeding and drunk driving, along with possession of heroin, crack cocaine, and an unloaded gun. There was the bizarre incident when he was found passed out in a bed at his neighbor’s house and arrested for being under the influence of drugs. His continued drug use caused him to violate his parole continually. Downey didn’t deny he had a problem. “It’s like I have a loaded gun in my mouth and my finger’s on the trigger,” he told the judge. “And I like the taste of the gunmetal.” Downey was sentenced to the California Substance Abuse Treatment Facility and state prison in Corcoran. A year later, he was released on bail and went to work on the popular series
Ally McBeal. However, neither a year in prison, nor a critically acclaimed role on a hit series, were motivation enough to curb his self-destructive tendencies. On a break from working on the show he was arrested again, at a posh resort in Palm Springs, California, when police found cocaine and Valium in his room after receiving an anonymous 911 call.
Three very different stars; three snapshots of the kind of celebrity conduct that has spread to epidemic proportions in today’s celebrity landscape. When I look at the behavior of Marilyn, Elvis, and Robert Downey, Jr., and the actions of the people around them during their careers, I see a pattern that has only been amplified in today’s world.
After her death, Marilyn Monroe’s addiction to opiates and other pharmaceutical drugs was well documented, as was her over-sexualized behavior, her penchant for nudity, and her constant preoccupation with her image. But while she was alive, she sought stability in her relationships, marrying men like Joe DiMaggio, whom she considered a “decent” man, and Arthur Miller, the bookish American playwright. Despite her carefully maintained persona as a ditzy blonde, Marilyn cared deeply that she be perceived as a talented actress. She was ambitious in her career, and longed for a family to enhance her lonely personal life.
Her childhood was traumatic. She never knew who her father was, and her mother was institutionalized for mental illness. Marilyn spent much of her young life in foster homes and with family friends. She was sexually abused at a young age, married for the first time at sixteen, and divorced four years later. Arriving in Hollywood at the age of twenty, she used her sexuality to seduce agents, producers, directors, and the American public. Increasingly addicted to barbiturates, pain-killers, and alcohol, Marilyn nevertheless built a successful career, making thirty films in her sixteen-year career, and along the way establishing herself as a Hollywood icon.
Elvis Presley depended on the people around him to hide his sense of shame; in return, he was exploited by them. Introduced to prescription drugs during his time in the U.S. Army, he grew increasingly dependent on them throughout the 1960s, though his habit remained hidden from the public until the early 1970s. By then, sadly, he was habitually sick or high, and eventually his fans got used to seeing him that way. In the end, he was no longer able to perceive how ill he had become, which is why he continued to get up in front of people and behave so erratically. Society’s collective denial of his illness and addiction was so profound that it took twenty years for Elvis’s personal physician to be penalized for being too liberal in his prescribing of drugs, despite the fact that, at the time of his death, Elvis had as many as ten different prescription drugs in his system.
Elvis spent his career surrounded by enablers, but they didn’t take the same care to hide his problems as the Hollywood handlers who shaped Marilyn Monroe’s image. Whether their acceptance of his increasing substance abuse was symptomatic of the changing standards of behavior in the rock ’n’ roll lifestyle of the 1970s, or a testament to his inner circle’s reluctance to challenge their leader, Elvis’s dysfunctional behavior was more amplified than Marilyn
Monroe’s indiscretions a decade earlier. And yet, even as his career peaked, then began its precipitous fall, Elvis’s performances were broadcast to a vast public, through radio and records, movies and television, in a media synergy that Marilyn never experienced.
The son of an avant-garde filmmaker and an actress, Robert Downey, Jr., was born in Greenwich Village in New York City. He moved frequently during his childhood, living in Paris, California, Connecticut, and London. At seventeen, he dropped out of high school in California and moved back to New York to pursue an acting career. From the mid-1980s through the 1990s he worked with respected directors like Oliver Stone, Robert Altman, and Richard Attenborough, and stars like Kevin Kline, Michael Douglas, Halle Berry, and Penelope Cruz. In 1992, his portrayal of Charlie Chaplin in Attenborough’s Chaplin even garnered him an Academy Award nomination for best actor. However, by the late ’90s his escalating drug and alcohol problem had become an inextricable part of his persona, and his friends and handlers seemed helpless to control him. The public was divided, some decrying him as a common addict, others excusing his outrageous behavior as the price of creative genius.
These days Downey’s story sounds a note of redemption, with a second marriage, a revived movie career, and years of sobriety. However, his earlier downward spiral illustrates the blunt reality that recovery from addiction almost always includes a series of relapses and progressive consequences. In the end, the fact that he was unwilling, or unable, to hide his increasingly dangerous and destructive behavior may be what saved him.
In 1991, I started working in the field of addiction medicine at Las Encinas Hospital in Southern California. Las Encinas has been
known as one of the nation’s most prominent psychiatric hospitals since the 1930s and 1940s. It’s also one of the places where Hollywood went, and still goes, to get dried out and cleaned up. Since I’ve worked there, I’ve treated people from all walks of life, from everyday people to many of the biggest stars of the past five decades. To the doctors and staff at the hospital, even the biggest of these celebrities are simply patients. Still, I’d be lying if I didn’t admit that, over time, the famous people who have become patients have become increasingly challenging to treat.
I remember the first time I truly recognized that treating celebrities could pose a special set of challenges. In the early 1990s, a major film star who was a severe alcoholic entered treatment at the hospital. She made it quite clear that she expected to be treated as a celebrity first and a patient second. And we complied. She demanded a special room, which we had to repaint before she would move in. The CEO of the hospital got personally involved in her case, even making sure there were always fresh flowers in her room. We made special allowances for her, letting her opt out of certain groups. She did poorly in treatment. I quickly perceived that treating celebrities as special in any way could have catastrophic consequences for their recovery.
Such behavior is common among celebrities in trouble. When Britney Spears was considering going into treatment, a story made the rounds of rehab centers that she had asked that an entire wing of a hospital be closed to the public while she was in residence. More and more frequently, I’m finding that even nonfamous rehab patients arrive at our clinic expecting such special treatment. One of the hardest things I must convey to my patients, famous or not, is that their rehab cannot be successful until they realize that they’re not special.
Las Encinas isn’t the only place I’ve seen stars behaving badly.
Having hosted innumerable celebrity guests on my radio shows, I’ve witnessed outrageous celebrity behavior both on and off the air. Yet I still get upset whenever I hear one of these individuals characterized as obnoxious or crazy in the press. Having grown friendly with many of these guests, I can see the pain or illness that underlies their behavior, and it is heart-wrenching for me to watch what they are doing to themselves, and how the public reacts.
My time at Las Encinas has convinced me that Hollywood itself has undergone something of a transition, at least when it comes to the personalities of those who come to us for treatment. When I treated movie stars from the 1940s, ’50s, and ’60s, they often presented as vain or self-preoccupied, but still deeply sensitive and caring. As a young doctor, I was often conscious of the fact that my patients wanted to make me feel good about the job I was doing. Typically, these patients were being treated for alcohol or drug addiction. While their substance abuse was obviously an issue, their struggles with it had been carefully guarded and weren’t really reflected in their public image. These were people who had maintained long careers and lasting relationships, and I observed very little obvious chaos in their personal lives. In fact, I was frequently surprised by how chronic and severe their problems were, given how well-kept and together they seemed on the surface.
As these old-time Hollywood stars gradually died out, I started treating a younger generation. These patients were the stars of the 1990s, and they gloried in the sex and drugs and rock ’n’ roll lifestyle. They were sick, but they weren’t jaded: As their friends overdosed and died—John Belushi, River Phoenix, Kurt Cobain, Chris Farley—they realized that it might not be enough just to ease up on the partying. Maybe they needed to admit that they had a problem, not just their alcohol or drug habits, but something deeper that was driving the magnitude of their substance abuse.
After spending nearly two decades working to understand addictions and the underlying psychological conditions that can complicate and undermine treatment, I’ve become attuned to alarming trends among my celebrity patients. Beyond any doubt, the trajectory of dysfunctional celebrity behavior has escalated. The addictions are more extreme, the behaviors are more intense and attention seeking, and the senses of entitlement have reached toxic levels. I have also noted an alarming increase in how many such patients reveal that they suffered childhood traumas, and the fallout in their lives is clear: These patients are disturbingly lacking in empathy, unable to maintain healthy relationships, and frequently unwilling to do the hard work necessary to maintain recovery.
I’m also sensitive to how the extreme behavior of celebrities is often misrepresented in the press. The celebrities who lose control of their lives and end up in rehab are often portrayed as not really sick, or not actually pursuing genuine treatment; the media presents their unhealthy behavior as gossip fodder, as entertainment. Yet, in truth, most of the people I see are very sick indeed. Moreover, the public response to celebrities in distress is increasingly lacking in empathy. Online commenters and talk-show callers often assume a finger-wagging attitude toward celebrities, scorning their behavior as “spoiled,” dismissing each new breakdown as “just another publicity stunt,” and demanding that they be held accountable for their behavior.
Because of Loveline
, I’ve met many of the celebrities whose behavior regularly lands them in the tabloids, or on the more sensational entertainment shows. They often confide in me, sharing their personal stories and asking my advice. It’s clear to me that many of them are suffering from significant mental health issues. Almost without exception, such a conversation changes my perspective on these celebrities immediately. Instead of seeing their
behavior as a way to attract media attention and stay in the spotlight, I recognize that it usually has roots in a troubled past, and likely signals that the patient is headed for hard times. As reporting on celebrity behavior becomes ever more ruthless and mean-spirited, I am struck by this disconnect between how a celebrity’s behavior is portrayed in the media and the very real problems that underlie their actions.
It’s easiest to understand the scope of what I have been observing if you imagine the trajectory of celebrity behavior as a bell curve. In the past, such behavior was clustered in the center of the curve: A few outliers displayed extreme pathological behavior, but most troubled celebrities managed to maintain a certain level of control over their lives. Today, the shape of the distribution has shifted, with more and more individuals falling into the region of extremely problematic behavior.
Now, for every Marilyn Monroe there is a Paris Hilton, an Anna Nicole Smith, a Lindsay Lohan. For every Elvis Presley, there is a Tommy Lee, Scott Weiland, or Kiefer Sutherland. And, remember, the behavior in question isn’t limited to drinking, drug use, or other forms of hard partying. Though a certain amount of vanity has always gone hand-in-hand with celebrity—no one ever claimed that Marilyn and Elvis weren’t preoccupied with their appearance—today’s celebrities take it to a new level, and at a much younger age. Influenced by the demands of their career, by overbearing parents, or simply by their own insecurities, even teenage stars have increasingly resorted to body reshaping or image-changing plastic surgery, turned to prescription medications to lose weight, or fallen into debilitating eating disorders, such as anorexia and bulimia.
It’s impossible to talk about the new generation of badly behaved celebrities without examining the four young women considered by some the “Four Horsewomen of the Apocalypse”: Paris Hilton (a socialite and heiress who achieved celebrity without the burden of performing); Nicole Richie (Paris’s friend since kindergarten, and the adopted daughter of singer Lionel Richie); Lindsay Lohan (a child star, teen sensation, talented actress, and poster child for the perils of growing up in the spotlight); and Britney Spears (a multiplatinum recording artist who became at least as famous in 2006 and 2007 for her bizarre behavior as she was for her singing career). More than anyone else in Hollywood today, these young women have set a new bar for outrageous behavior on the celebrity circuit. Moving in and out of one another’s orbits, they have invited intense media scrutiny for most of this decade, turning their lives into minor epics of dysfunction.
In 2002, the radio station I worked for asked me to introduce a band at a concert they were sponsoring. This gig sticks in my mind, not because of any of the performances, but because it was the first time I came face to face with a celebrity who was, in the well-known phrase, famous for being famous.
As I was waiting backstage for the show to begin, I started hearing whispers about one of the other presenters, a young woman who’d just begun showing up on the Hollywood scene. From what I could gather, she’d had bit roles in a few unremarkable films, but the producers and other event organizers at the concert—all women—didn’t seem interested in her as an actress. What they all wanted was to meet “Paris the heiress.” They were excited about being in the same orbit as this beautiful, rich socialite, though their excitement was definitely tinged with envy. Paris Hilton was already on her way to becoming a celebrity, despite her lack of any special quality or talent beyond simple beauty. By virtue of hered
ity, and an unrelenting determination to be noticed, she had been elevated over thousands of other young, attractive, fame-seeking women in Los Angeles. Paris was exploiting a new formula for fame, and I remember thinking that she was unlike any of the celebrities I had met before.
I had my next glimpse into what made this new breed of celebrity tick in late November 2003, when Paris’s friend Nicole Richie came to Loveline to promote The Simple Life, one of the first celebrity reality shows. Paris was also supposed to be a guest, but she failed to show. When Mark naively asked why, Nicole explained, “Well,...