Howard Hughes and the OCD Case in The Aviator Directed by Martin Scorsese

At the height of his power, Howard Hughes became one of the most influential figures in the United States. He owned numerous business enterprises across the country — from RKO Pictures film production company to Hughes Aircraft and Trans World Airlines (TWA). In some sense, Hughes can be described as a mixture of Elon Musk and Donald Trump. He combined the passion for technologies of the former with an eccentricity of the latter. However, that comparison would be invalid for approximately the last twenty years of Hughes’ life, as he completely secluded himself from society and died alone.

Leonardo DiCaprio portrayed Howard Hughes in his days of glory when he was a daring aviator and a handsome man loved by Hollywood’s most beautiful women. At the beginning of the film, Hughes is a pioneer, an adventurer: fearless, ambitious, and reckless. By the end of The Aviator, the signs of Hughes’ severe mental disorder become increasingly more evident. Stress, related mental disorder, and developed phobia eventually led to a tragic end for one of the most powerful moguls in American history.

Stress in Relation to Disorder

Being a leading businessman implies not only an extremely wealthy and luxurious life but also a significant amount of stress. According to the American Psychological Association, stress is a “physiological or psychological response to internal or external stressors” (American Psychological Association [APA], 2021). Stress affects body systems, influences people’s feelings and behavior, and contributes directly to physiological or psychological disorders (APA, 2021). Throughout the timeline shown in The Aviator, Howard Hughes experiences constant exposure to stress from various sources.

On the one hand, Hughes had to deal with the business-related stress on multiple occasions. After the failure of the XF-11 reconnaissance aircraft test flight, the US Army canceled its order for another Hughes’ project, the H-4 Hercules flying boat. Nevertheless, Hughes took a significant risk and mortgaged TWA assets to continue the development of experimental aircraft. At the same time, Hughes’ main rival Juan Trippe received assistance from Senator Owen Brewster and tried to seize TWA. Therefore, Hughes had a solid reason to believe that there is an ongoing conspiracy against him.

Moreover, Howard Hughes had complicated romantic relationships with the most desired women of his time. His growing eccentricity and obsession with work slowly made him insufferable. Even Katharine Hepburn, who initially tried to help Howard overcome his worsening mental condition, had left him. Hughes looked for solace in Ava Gardner, a leading Hollywood celebrity of the 40s, but to no avail. By that time, Hughes developed paranoid tendencies and started to track Gardner with microphones and listening devices, which resulted in an altercation and the end of relationships.

Overall, the stress related to the initial technical failure of the promising prototype project, the immense pressure from the influential business rival, and unsuccessful romantic relationships induced phobias and anxiety disorders. By the end of the film, Hughes mustered all his courage and defeated Trippe and Brewster in court. Howard also fulfilled his “the plane will fly” vow, as the XF-11 flawlessly passed the second test flight. However, those were the last triumphs in Hughes’ life, and the ending shows him in a severe panic attack, foreshadowing the grim future.

Irrational and Abnormal Beliefs and Their Manifestations

During The Aviator’s screen time, Howard Hughes displayed abnormal behavior on multiple occasions. The number of cases increases, and their manifestations become more evident by the film’s ending. What people initially believed to be the eccentricities of a businessman turned out to be the early signs of a severe mental disorder. Whether Howard Hughes was too powerful and independent, or the people around him were too indecisive or disgusted by his behavior — nobody did anything about his worsening condition.


When filming Hell’s Angels, Hughes becomes obsessed with the idea of a perfectly realistic representation of the aircraft. He spends a big budget on filming and even borrows extra cameras from the other studio, even though he already has a plethora of them. Hughes is not concerned about the cost or difficulty of the filming process — he cares only about the realism of flight sequences. Hell’s Angels become a successful release, but Hughes remains unsatisfied and orders the film to be recut.


In The Aviator, Howard Hughes displayed two main obsessions. First of all, he is obsessed with aviation, as suggests the film’s title. That obsession could explain why Hughes risked his life by testing potentially dangerous prototypes and mortgaged one of his biggest assets. The second obsession that overwhelmed Hughes — cleanliness, combined with an extreme phobia of germs. The seemingly almighty mogul became afraid of touching the doorknob to leave the restroom. He spent three months in a “germ-free” zone before the hearing and saw an anxiety-caused hallucination involving the men in germ-resistant suits afterward. Therefore, the germs became his greatest fear and eventually forced Hughes to spend the rest of his life in seclusion.

Possible Diagnosis

Howard Hughes displayed abnormal perfectionism and an unhealthy obsession with cleanliness combined with anxiety and fear of germs. While perfectionism and a desire to control everything around can be attributed to Obsessive-Compulsive Personality Disorder (OCPO), the particular obsession with cleanliness points at Obsessive-Compulsive Disorder (OCD) (Trosclair, 2020). Stress affects body systems, influences people’s feelings and behavior, and contributes directly to physiological or psychological disorders (APA, 2021).

Hughes’ obsession did not provoke anger; instead, it made him anxious and forced him to seek seclusion in a “germ-free” zone, which is also more fitting the OCD case. Therefore, the most likely diagnosis for Howard Hughes from The Aviator is F42 Obsessive-compulsive disorder (ICD-10 Version: 2016, 2021). Starting from that point makes it possible to attribute an OCD psychological model and develop a potential treatment plan.

Psychological Model and Possible Treatment Plan

The Aviator begins with Hughes’ childhood sequence when his mother warns little Howard about the recent cholera outbreak in Houston. Berman et al. (2017) provide an example of behavioral-caused OCD when a parent reinforces compulsive rituals and avoidance by repeating prayers or avoiding possibly dangerous objects like knives. In Hughes’ case, his mother’s fear of contagious disease developed into his fear of germs and obsession with cleanliness. According to Bhikram et al. (2017), 55-65% of patients with OCD report worries about contamination. Therefore, Howard Hughes could have become an ordinary patient if he received the necessary help in time.

Since Hughes’ case fits into the behavioral OCD model, it would be logical to implement the “exposure with response prevention” (ERP) treatment. ERP consist of two main components: confronting anxiety-provoking factors with exposures and refraining from response with safety behaviors (Berman et al., 2017). This treatment strategy leads to the gradual diminishing of fears, as the therapist brings the patient to the realization that nothing harmful would happen if the patient refrains from safety rituals. With ERP treatment, a brave man such as Howard Hughes could have overcome the fear of germs and return to normal life.


Howard Hughes from The Aviator displayed typical symptoms of behavioral-induced OCD. However, the clinical psychiatry of the 40s and 50s was not able to help him in time. Moreover, Hughes was such a powerful figure that the people around him decided not to interfere, despite his worsening mental condition. Unfortunately, he was left alone to decay slowly, while the modern psychiatry and OCD treatment techniques would have probably returned him to normal life.


American Psychological Association. (n.d.). Stress. In APA Dictionary of Psychology. Web.

Armstrong, T., Bunmi O., & Olatunji, B.O. (2017). Pavlovian disgust conditioning as a model for contamination-based OCD: Evidence from an analogue study. Behaviour Research and Therapy, 93(2017), 78-87. Web.

Berman, N. C., Schwartz, R., & Park, J. (2017). Psychological models and treatments of OCD for adults. In J. S. Abramowitz, D. McKay & E. A. Storch (Eds.), The Wiley handbook of obsessive compulsive disorders (pp. 223-243). John Wiley & Sons, New Jersey. Web.

Bhikram, T., Abi-Jaoude E., & Sandor, P. (2017). OCD: obsessive–compulsive … disgust? The role of disgust in obsessive–compulsive disorder. Journal of Psychiatry & Neuroscience, 42(5), 300-306. Web.

ICD-10 Version: 2016. (n.d.). Web.

Trosclair, G. (2020). Do you really have OCD? Or is it OCPD? GoodTherapy. Web.

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