How ‘Nightmare Alley’ Elucidates the History of Addiction in America

Guillermo del Toro’s 2021 film ‘Nightmare Alley’ resurrects dark truths about the nation’s treatment of people with addiction. 

IMDB/Photo by Kerry Hayes

Guillermo del Toro’s 2021 film Nightmare Alley provides a lens into the past. A haunting and inquisitive work, it elucidates the dark history of being substance-dependent in America.  

Set in 1939, Nightmare Alley follows protagonist Stanton Carlisle, a determined everyman who starts as a low-level carnival hand. Artfully embodied by Bradley Cooper, Stan masters the deceptive techniques of a mentalist, feigning psychic skills to clear a path to high-earning, upscale performances. Stan’s rise and fall is a memorable character arc that unearths long-held perceptions about identity and addiction. Central to the plot is the geek figure — a powerful representation that can stimulate dialogue on mental healthcare and unearth the roots of society’s tendency to perceive addicted individuals as “other.”

Nightmare Alley first entered the zeitgeist through William Lyndsey Gresham’s 1946 novel of the same name. Originally adapted to film by Edmund Goulding in 1947, it showcases the sleazy inner workings of a carnival hierarchy. In del Toro’s 2021 version, from a screenplay by del Toro and Kim Morgan, the geek is introduced as an anonymous, unwashed man trembling in a pit. The crowd looks down from above as he gnarls the head of a live chicken. Blood spurts wildly; the audience is simultaneously disgusted and entertained. 

Carnival culture developed over a tumultuous period. The dehumanizing role of the geek — later revealed to be afflicted with alcoholism or drug dependence — was a result of various social and economic factors. Like the carnival culture that contained him in subhuman conditions, the life of the geek, addiction treatment, and responses to mental illness are products of their time.

Derived from the 16th-century European geck, meaning “fool or simpleton,” the dictionary definition of the word geek had evolved to “sideshow freak” by 1916. With the publication of Gresham’s novel, the meaning morphed to “wild man.” In the 21st century, geek shows are outlawed; modern-day performances may include the bug-munching insectivore or the human ostrich, who ingest glass and other inedible objects. But the reintroduction of Nightmare Alley comes at a divisive time, with overdose rates increasing as the nation grapples with COVID-19. 

The Great Depression defined the 1930s. It was toward the end of the economic downturn that Gresham wrote his novel. In Depression-era America and the years that followed, people with substance dependence had few prospects. The medical community had started to circulate the ‘addiction as disease’ concept, but a change in perception at the beginning of the 20th century led to increasing stigma. 

In favor of de-medicalization and criminalization, authority over the mentally ill changed hands. Inebriate homes, the first generation of addiction treatment, were shuttered. The disease concept died, and people were sent to drunk tanks, hospital foul wards, and insane asylums. 

Legislators attempted to curb substance abuse throughout the first half of the century. Laws began to regulate once-accessible opiates for medical purposes only, and prohibit the manufacture and sale of liquor. When Prohibition ended in 1933, afflicted individuals were blamed for lack of control; the wealthy elite were treated discreetly in private hospitals. Viewed as feeble-minded “dope fiends” and degenerate “drunkards,” addicted individuals, the mentally ill, and the developmentally disabled were subject to state laws that allowed for their sterilization. Shock therapies emerged, along with a resurgence of surgical intervention — most notably the lobotomy in 1937, which severed connections between the frontal lobes and the rest of the brain.

Nightmare Alley illuminates the power dynamics of addiction. Like a ball and chain, it reduces the affected individual to the role of the dependent. Unlike genetically unique “freaks,” geeks were replaceable. Viewed as unskilled and often paid in alcohol or drugs, the geek represented in del Toro’s film is in a desperate cycle. He experienced changes in brain chemistry and physically uncontrollable cravings that were largely misunderstood. The choice isn’t freedom or the cage; instead, it’s the horrors of carnival imprisonment, the horrors of poverty-level mental healthcare, or the horrors of severe, potentially fatal symptoms of withdrawal.

In an advanced stage of physical addiction, the geek performance is an act of prevention. The act is shocking, and it makes sense that performers were under the influence. The geek himself is seeking dissociation. Driven mad by delirium tremens, with madness reinforced in each act, he falls deeper into the abyss. The perceived willingness to trade substance for sub-humanity speaks volumes to the depth of illness; the geek is the exploitation of that illness personified. 

Reform movements in the 1950s gradually reduced illicit aspects of carnival games. Sunday School shows were considered clean operations — all “hankypank,” which meant no strip acts or geek shows. In 1956, the American Medical Association (AMA) declared alcoholism an illness that required medical care. Addiction, however, wasn’t formally recognized as a disease until 1987. In the time Gresham wrote his novel, addiction as a disease concept was in its infancy, overshadowed by political, social, and economic factors. In Goulding’s 1947 film, Stan (played by Tyrone Power) doesn’t understand how anyone can “get so low.” 

Noir in both film and literature has been known to examine the ideals of individualism, economic mobility, and the American Dream. In relation to the formation of identity in America, critics of Nightmare Alley have referred to the tale as a musing on whether class seals your fate. Responsibly bringing the figure of the geek back into requires a realization that the identity of the geek has historical precedents in stigma, as medical anthropologist Emma Backe argues, “the debasement of the performer” is a key part of the performance.The geek show functioned as more than a savage spectacle, because it soothed an unconscious fear that anyone could become a geek. Separated and dehumanized in his addiction, he effectively becomes the “other.”

In the book Media, Performative Identity, and the New American Freak Show, Jessica L. Williams examines “freak” as a performative identity in that it requires an audience to exist. The role of the viewer is important because the viewer completes the identity.  She notes a quote from scholar Robert Bodgan, “our reaction to freaks is… the result of our socialization, and of the way our social institutions managed these people’s identities.” Is there an obligation to learn from history, even through the lens of entertainment, to avoid making the same mistakes?

In the final scene of del Toro’s Nightmare Alley, Stan loses everything but the bottle. He finds his way back to carnival life. Teary-eyed, he accepts the only open job: the role of the geek. The denouement is in the last line of dialogue, delivered by Cooper: “Mister, I was born for it.” In a real-life parallel, Gresham became dependent on the drink. Before his death by suicide, he wrote, “I had controlled anxieties by deadening them with alcohol… I found that I could not stop drinking; I had become physically an alcoholic.”

How far has society come? Discussions about addiction, now referred to as “substance use disorder,” are softer, but stigma persists. Today, it’s impossible to calculate the number of substance-dependent Americans. Some are functioning in silence, others are in treatment, and many are unhoused in major cities. In the novel, Stan reflects on how a mentalist accesses his marks. It’s the presence of fear, he says, inside each of us: “They have it too — a nightmare alley.” When it comes to substance use, class is one thing. Illness is another. Addiction does not discriminate. 


‘Nightmare Alley’ streams on HBO Max and Hulu Feb. 1.

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