Happy Face: The Portrayal of Trauma and Mental Illness in Smile

When we meet Rose, she’s exhausted from relentless nightmares and 80-hour work weeks. She’s been assigned a new patient, Laura (the PhD student), who is in a state of apparent psychosis. Laura has been seeing haunting images of random people smiling, extra wide, yet insists she’s not crazy. She soon becomes possessed, smiling that garish smile she fears most. Killing herself grotesquely, she carves her face into a final rictus while severing a neck artery. 

Rose stumbles backward from the gory scene. A strategically placed pain assessment chart on the wall depicts levels of wellness, ranging from “no pain” (big smile) to “worst pain possible” (frown). The irony requires no explanation, as Rose watches Laura bleed out from the biggest, most horrible grin. 

Rose soon inherits the curse, seeing people wear the same, awful smile. The threat is constant and overwhelming, recalling David Robert Mitchell’s 2014 film, It Follows, where the monster can inhabit any person at any time. Rose is the only one who sees the entity, so she appears to family and friends to be going crazy. 

Because the curse is passed on through bearing witness to suicide, the central idea is that trauma itself is catching. People closest to Rose treat her crisis as something contagious. Her mental illness is to be avoided or sidelined. 

Her sister, Holly (Gillian Zinser), turns her away, confessing she’s spent decades trying to move on from their traumatic childhood (their mother committed suicide). Rose’s erratic behavior reminds her of their mother’s mental illness. She’s worried it will negatively impact her son—as if he could catch insanity. 

Rose’s fiancé, Trevor (Jessie T. Usher) is similarly wary. When Rose tells him she’s seeing things, he questions whether they should get married, saying he wants to know what he’s “hitching his entire life to.” 

Rose doesn’t want people to think she’s crazy, so pretends she’s okay. When she accidentally sounds upset, she apologizes. When she talks about the grisly suicide at work, she minimizes her feelings, saying she’s “just venting.” The day after the suicide, her fiancé texts and says he hopes she’s feeling better. He adds a smiley face emoji, absurdly diminishing her trauma. Surrounded by fake-it-till-you-make-it culture, with smile imagery everywhere, on coffee mugs, clothing, and wall art, Rose takes the hint. She smiles through the pain. 

When Rose eventually tries to explain what’s happening, no one believes her. Much of the film’s anxious energy is here—in feeling her desperation to be understood while her grip on sanity slips. We’re squarely in her traumatized mind when the situation intensifies, the screws ever tightening.

Creepy smiles spreading at every turn, Rose increasingly can’t trust her own reality. The viewer questions it too. She’s very, very tired, and we start to wonder if maybe she is losing her mind, if she hasn’t lost it already.

The filmmaking reflects her disassociation, shots turning at angles, upside down, and finally in a full 360-degree revolution. Scenes have jarring cuts between moments when she’s asleep and awake, losing their grounding in time and space. The effect is claustrophobic—like the haunted house in Natalie Erika James’ 2020 film, Relic, where interior passages become smaller and more impassable as the grandmother’s dementia manifests. 

Feeling hopeless, Rose reaches out to her therapist, Dr. Madeline Northcott (Robin Weigert), and begs for medication to stop the hallucinations. Northcott won’t write the script. She wants Rose to manage her exhaustion and discuss her childhood trauma. Rose refuses to get into all that—it’s simply too much. 

Trauma must be dealt with, though, so the curse finds her again. The monster takes Northcott’s form, smiling wide and attacking. This scene is overwhelming, as the therapist should be someone Rose can trust, and she’s seemingly left with no one. With medication and therapy off the table, the situation feels dire, indeed.

A glimmer of hope resides in Rose’s ex-boyfriend, Joel (Kyle Gallner), who is clearly still in love with her. Joel’s willingness to listen provides some measure of relief though Rose’s reflections on her breakup with Joel are a profoundly sad low point. He was someone who truly saw her, but she couldn’t deal with her traumatic childhood in the context of a functional relationship. Now he could be the monster, too.

Anxiety infuses every moment of Smile, which is as much about the creepy horror of a supernatural curse as a dark look into one woman’s mental collapse. Trauma is a dreadful monster to be fought. It can be managed but never forgotten or destroyed.

The film hurtles toward its conclusion while Rose’s troubled past manifests in the most haunted place. She must face her demons but does so alone—and it may still be too late.