After World War II, the United States was a nation that found itself in the throes of self-examination. At times, this took on a greater dimension on the home front and found its way into the best export that the country had — motion pictures. It was during this time that the film noir genre was picking up steam, highlighted by a low-key visual style of lighting and plot themes that conveyed a grittiness that could veer into the cynical while providing new perspectives. One of the films that packed a serious punch is Anatole Litvak’s The Snake Pit starring cinema legend Olivia de Havilland. Released in 1948 by 20^th Century Fox, The Snake Pit sparked discussions about mental health issues in the U.S. and helped changed how treatment was applied.

The Snake Pit opens with Virginia Cunningham (Havilland) at a mental institution called Juniper Hill State Hospital. She has been suffering from schizophrenic episodes, such as hearing voices to the point where she can’t even remember her husband, Robert (Mark Stevens). During sessions with Dr. Mark Kirk (Leo Glenn), flashback sequences show how Virginia and Robert met in Chicago, Illinois and formed a relationship before Virginia abruptly left town. They run into each other again in New York City, where Virginia has an evasive answer for why she split. Robert courts her again, and Virginia agrees to marry him with some reservations. They marry in May, but Virginia fervently believes it is November, and snaps at Robert when he corrects her. This marks the beginning of Virginia’s mental instability until she is admitted to Juniper Hill.

Throughout The Snake Pit, Virginia finds herself wrestling with her suppressed memories brought forth through various treatments by Dr. Kirk (which include electroshock therapy). These recollections include a strained relationship with her mother, and a previous engagement that ended in tragedy. Virginia navigates through the different levels of the hospital, forming bonds with a few of the other patients. She becomes fond of Dr. Kirk, which allows her to feel more calm during Robert’s visits. Still, Virginia must unravel what made her ill, and she also must deal with the abusive and jealous Nurse Davis (Helen Craig).

Making The Snake Pit was a major gamble for a Hollywood studio, and Litvak didn’t take the opportunity lightly, as he demanded that the entire cast and crew go along with him to lectures held by notable psychiatrists. The cast and crew were also required to observe the inner workings of various mental institutions, and Litvak requested that none of the actresses wear girdles or bras and forbade them to use hairdressers during production. This demand for detail makes The Snake Pit even more gripping, and there are a couple big reasons why. The first is Litvak’s keen sense of framing, as Virginia anchors numerous scenes, even in the most frantic of moments. Litvak also utilizes a whip pan, resulting in rapid and disorienting shots. He embraced this technique years prior, and it’s used in The Snake Pit more than eight times. During one striking moment, Virginia experiences a severe breakdown and envisions herself within “the snake pit.” She wakes up screaming, encased in a tent restricting her movements. Litvak also plays with the lighting in certain scenes to elicit strong emotions from the audience, most notably during a dance sequence involving Juniper Hill and an all-male institution.

De Havilland’s performance fuels The Snake Pit. The veteran actress matched Litvak’s zeal for the material, and prepared by observing hydrotherapy and electroshock treatments. She also underwent a diet to lose weight, and had dark circles of makeup applied under her eyes. This was a year after winning an Academy Award for her lead performance in To Each His Own. De Havilland’s drive prompted Litvak to film all the hospital scenes first, then halt production for a month so that his lead actress could recover enough to film the flashback scenes. It was also a stroke of irony that de Havilland took the role, as the first choice of the studio, Gene Tierney, had to turn it down due to being pregnant with her second child. Tierney herself would struggle with mental health issues, undergoing severe bouts with manic depression that halted her career.

Moviegoers and critics weren’t the only ones struck by the gritty and powerful impact of The Snake Pit, as the film prompted 13 states to totally revamp their laws concerning the treatment of mental health issues. In addition, acclaimed author Stephen King has cited the 1948 drama as an inspiration for some of his literary works. The Snake Pit became the first Hollywood film to address mental health in such a raw way, and set a standard for future films that similarly explore the topic.