Noa Ashman – Lars and the Real Girl

Lars and the Real Girl is a heartfelt and poignant film that captures the essence of early attachment loss and the brilliant capacity for resilience in the human spirit. Early in the film we are introduced to Lars as the tender but quirky and stereotypically schizoid soul. We immediately connect with his benign curiosity about human relationships (staring from afar though a frosty and foggy window into his brother and sister-in-law’s home) while he awkwardly retreats from any invitation to join in a real human interaction.

As the story unfolds, we learn that Lars has slowly “decompensated” over many years and it is only when he brings his girlfriend, Bianca — an “anatomically correct,” internet-purchased, life-size doll — to dinner at his brother’s house that his family notices how desperately he has been struggling to keep a foothold in the world of relating. With Bianca in tow, the rigidly tense and wooden Lars becomes relaxed, supple and smooth in his body and facial expression. We see similar transformations in everyday life when a distressed toddler self soothes with a lovey or when a high-functioning neurotic waiting in line immediately reaches for his iPhone. Transitional objects are everywhere, but none so striking as Bianca in a “town so far north, that a physician need also be a psychologist,” Lars’ sister-in-law comments.

When the family seeks consultation with Dr. Dagmar to assess Lars’s mental state, Dagmar offers a more psychoanalytically oriented and compassionate way to deconstruct his delusion: “What we call mental illness isn’t always just an illness. It can be a communication. It can be a way to work something out.” She further contextualizes the presenting issue by asking the family to consider — why now? When she asks about any life changing events, brother, Gus immediately denies, while his pregnant wife refers to her now obvious growing belly. With great economy of words, Dagmar connects Lars’ symptoms in the present with the past – the trauma and loss of his mother at his own birth. As he gets closer to becoming an uncle, the preverbal pain of his past loss and the terror of losing the closest living maternal figure he has in his life becomes excruciating and calls for a complex set of defenses to stave off his psychic disintegration. Meanwhile the impatient and often mentally concrete Gus, is desperate for a quick fix perhaps to assuage his own mounting anxieties about the impending birth. After all, he lost his mother, too.

Dagmar simply and brilliantly suggests an intervention that will help Lars, and by extension, the family and their community. If we were to imagine Dagmar’s rationale for treatment as drawing upon the work of Donald Winnicott, we might observe her tapping into the need for play to work through developmental stages of merger transitioning to separateness and independence. She further encourages the play by insisting that “[Bianca] is real, ” and that everyone should go along with the delusion for as long as Lars needs it.

Like a sensitively attuned child analyst, Dagmar joins with Lars’ highly organized fantasy and helps him work out his projections through play. Dagmar closely tracks Lars and affirms his concerns that the sickly Bianca needs “treatments.” While Bianca recovers in the examining room after her weekly appointments, Dagmar engages Lars in therapeutic “small talk” gradually shifting and deepening the work to more directly attend to Lars’ inner world. In one scene, Lars describes the pain of human skin-to-skin contact as an experience akin to icily numbed feet from a prolonged stay in the snow coming inside to the warmth. It simply hurts – terribly. Suddenly the pathetic fallacy, to borrow the literary term, comes into full view: This movie is set during the thick of winter, and slowly, painfully and in an anything but linear fashion, we watch as Lars and his community embark on the journey to thaw into a spring awakening of creativity, connection and intimacy.

To borrow from Kleinian theory, we also might imagine, if we can bear it, the starved Lars’ ravenous hunger for human contact. Though deprived for a lifetime of this essential touch, he experiences an equally powerful dread and terror of the very thing for which he longs. These bodily sensations lead to a phantasy for an object such as Bianca who can satisfy this hunger. Working “inside out and outside in” (Berzoff, Flanagan, Hertz, 2002), Lars must use play to work through the confluence of his inner conflicts and social realties.

Throughout the film, we witness a transition not only in Lars but also in his family and larger community as they also learn how to play. In the beginning of the film, we see a community of depressed, irritable and socially isolated people hungry for intimacy but incapable of traversing the emotional terrain to attain it. The impenetrable Gus is closed off from Lars and from his wife’s passionate attempts to unify the brothers. Churchgoers move through rituals but with a rote and deadened presence. Office co-workers bicker between the walls of their cubicles and steal each other’s inanimate but treasured belongings (action figures and teddy bears). We catch a glimpse of the many competing transitional objects that stand in place of real relationships to quell the loneliness.

The story progresses and we watch Lars move from a symbiotic merger with Bianca to a messy, disappointing and at times inchoate separation and individuation from her. Meanwhile, Lars begins to wonder with Gus, “When did you know you were a man?” The brothers wrestle with this question and only then can they articulate and begin to mourn what was lost between them. In this way, a real relationship in the present begins to emerge. Similarly with the townsfolk, as they come together to embrace the fantasy of Bianca, it is as though walls come down, people connect and the community begins to thaw. On one evening when Bianca attends a benefit for the hospital, Lars goes bowling with some of his co-workers. The cinematography and music coalesce to show the beginnings of Lars’ capacity to connect with a real person. At the end of the evening, it begins to snow but he reaches out and shakes hands, skin-to-skin with Margo.

In due time, Lars gets ready to let go of Bianca. In fantasy, he allows her to die and the community comes together to mourn her loss. Lars can feel sadness but can also hold onto the happiness he found in his relationship with her. He could allow himself to be nourished and comforted by the real ladies of the church who knit by his side in his time of grief. He can tolerate a conversation and even gentle touch with Margo, a potential new love interest.

In the final scene they stand side-by-side at Bianca’s graveside. Margo comments, “There will never be anyone like her,” which makes Lars smile. She is attuned to his experience as he is comforted by her intimate engagement with him. He is beginning to take her in. We see Dagmar watching from afar and at this point, she walks away: he is back on his trajectory and no longer in need of her scaffolding. Margo suggests they should “catch up” with the rest of the community, but Lars instead invites her to take a walk. This ending suggests that Lars will find his own way, meandering off the beaten path, doing things his way. The key difference is that he will no longer have to go at this journey alone.


Noa Ashman, MSW is in private practice in Bethesda, MD where she specializes in the treatment of couples and adults in individual psychotherapy. She teaches at Smith College School for Social Work, and she supervises therapists and doctoral-level psychology students in the George Washington University’s Professional Psychology Program. She is a graduate of several training programs at the Washington School of Psychiatry, and she is actively involved in Section VIII (Couple and Family) of the Division of Psychoanalysis (39) of the American Psychological Association.

She received her Masters degree from the National Catholic School of Social Service (NCSSS) at the Catholic University of America (CUA) in Washington, DC and she completed her undergraduate studies as a double major in French and Psychology at Washington University in St. Louis. After college, she received a Fulbright scholarship to study and teach in France. For more information, please visit

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