“Nise: The Heart of Madness” tells the story of real-life psychiatrist Dr. Nise da Silveira in 1940s Brazil. Da Silveira is a pioneer of humane methods of curing mental illness, in contrast to the then-revolutionary ice-pick lobotomy and electroshock therapy methods. Introducing practices such as art-making and animal care, she transformed psychiatric care at a local hospital on the outskirts of Rio de Janeiro. Despite denigrating criticism and opposition from fellow doctors — all male — da Silveira relentlessly pushed for compassion and creativity as the best possible cures.

This struggle is where director Roberto Berliner begins his film. Da Silveira stands in front of a closed metal door and, upon receiving no reply to her polite knock, begins to bang on it with the force of a bodybuilder. This opening shot cleverly foreshadows the many hurdles da Silveira will have to bypass to ensure her practice and patients are left alone and respected. Berliner works especially hard to foreground the issue of sexism in the male-dominated world of science and academia. He endows da Silveira with all the cinematic qualities of a powerful woman: stubbornness, confidence and frankness.

Relegated to the neglected Sector for Occupational Therapy after refusing to perform lobotomies, da Silveira immediately sets her own rules and reinvents the department. Re-educating the indifferent and often violent male staff, she tells them, “Listen, observe and shut up.” This line sounds particularly forceful uttered by a petite woman in a pencil skirt. It reverberates throughout the movie, reminding audiences that while a loud voice is needed to challenge authority, sometimes patient silence also works wonders.

Through Berliner’s quietly scrutinizing camera, we witness the power of observation. As da Silveira helps the mentally ill by encouraging self-expression and understanding through art, Berliner draws our attention to this slow but necessary process. There are a number of meditative interludes in which the camera focuses on the paintings themselves, following brush strokes and zooming in on the texture of canvases. These scenes emphasize the artworks as products of healing — a notion that will lead to the finale’s glorified art exhibition.

As deserving as da Silveira’s character is of praise and respect, the same agency is unfortunately not given to the patients she — and thereby the audience — observes. Her mentally unstable patients — clients, as she calls them — are humanized and treated with compassion. But Berliner fails to bestow them with the power to direct our gaze. The violence against them is graphic, but its consequences are not fully discussed.

There are a few loose ends in this film, revealing the fate of the institutionalized. After a tragic event occurs at the art studio, and the ill artists’ work is consequently removed to go on museum display, the artists themselves effectively disappear from the narrative. Such foregrounding of da Silveira at the cost of her clients seems to oppose the film’s general message of recognition and respectability for the marginalized and misunderstood. While “Nise: The Heart of Madness” advocates beautifully for patience and emotional detail, its own narrative focus remains too narrow.

“Nise: The Heart of Madness” opens in theaters Friday, April 28.

Email Zuzia Czemier-Wolonciej at [email protected].