The relationship between films and psychiatry remains an ambivalent one. Mentally ill patients are often portrayed unsympathetically in a comic, villainous or inaccurate manner; and film makers often see their responsibility towards financial aspects rather than educational direction. Increasingly, films are being used for training medical students and trainees in psychiatry. Films can also be used to study therapeutic relationships between therapists and patients, especially observing transference and counter-transference. The portrayal of mental illness in films can be negative for a variety of reasons: stigma, lack of knowledge and understanding with a focus on entertaining rather than on educating. The portrayal of ECT and leucotomy and associated negative connotations have increased stigma against mental illness and even led to a reduction in the prescription of these treatments. Using films to teach is relatively recent in the UK compared with the USA, where couple therapists have used films with their patients in therapy to illustrate relationship difficulties and potential solutions. ‘Cinematherapy’ as a term has been used to work with teenagers to deal with relationship and individuation issues. An advantage of using films in teaching mental illness is that their use does not involve the confidentiality of a real patient. In addition the ‘patient’ can be seen interacting with others, giving a clearer understanding of the impact of the illness on others. Unlike clinical consultations in very narrow settings focussing on symptoms and treatment which are time limited, films can be used to learn about cultures and their embedded values.