Psychopathology Film Analysis: Tarnation

Tarnation               

                          

Plot Summary:

This is a self-portrait documentary about Jon’s life struggles with his own depersonalization disorder and with his mother’s, Renee, bipolar and schizophrenia. This film analysis is, however, focused on Renee, whose life started out as a beautiful child model. After she fell off from the roof, she is never the same again. She is subjected to hundreds of shock therapy in which Jon believe to be unnecessary and damaging treatment that cause his mother mental illness. Tarnation well illustrates those effects of the brain damage, traumatic abuse, and her current schizoaffective disorder.

Disorder:

Schizoaffective disorder involves the symptoms of schizophrenia and a mood disorder. It is a subtype of schizophrenia—a psychotic disorder in which disturbed thought processes, distorted perceptions, unusual emotions, and motor abnormalities deteriorates functioning (Comer, 2010). Common symptoms include delusion, hallucination, and other disturbances in thought, perception and behavior, inappropriate affect, blunt and flat emotion, and impaired social skills (Student Notes).

From the movie, Renee is delusional, for examples, she believed that her parents were not her real parents and that Elizabeth Taylor was her mother. She also believed that she was physically abused as a child. She believed that her parents, Rosemary and Adolph, are psychotic, neurotic, schizophrenic, and that they lock her up in the closet for days and whip her. Also, she had disorganized thinking speech clearly shown in the illogical and peculiar conversation with the husband. Moreover, lithium is a mood stabilizing drug that serves as a treatment for bipolar disorder. The fact that she had lithium overdose suggests that she is also bipolar. People with bipolar disorder experience both the high of mania and the crash of depression. Manic period could be depicted, for example, when she has decreased need for sleep, increased energy, the mood of exaggerated joy, more talks, laughter, and self-understood jokes than usual (with the pumpkin and other objects), and racing thoughts and experiences. It is possible that she knew her cycle and that she went back to the hospital before she was depressed. This confirms me that she has a schizoaffective disorder that involves schizophrenia and bipolar disorder.

Causes:

Biological – (1) Renee could inherit that biological predisposition to schizophrenic and develop the disorder later after facing the extreme stressors of shock therapy, rape, marital abuse, extended stays in mental hospital. (2) Moreover, schizophrenia is related to biochemical factor. She could have abnormal activity or interactions of neurotransmitters like dopamine and serotonin.

Psychodynamic – According to Freud, schizophrenic develops from the regression to a pre-ego stage and effort to reestablish ego control (Comer, 2010).

Behavioral – It could be the result of faulty learning. Renee could receive very little reinforcement as a child and pay more attention to irrelevant matters. From there, her behavior appears abnormal. In mental institution, she could have been labeled in this way and may act accordingly to that label. Abnormal behaviors may be rewards by sympathy and attention, resulting in reinforcement and eventually are labeled as schizophrenic.

Cognitive – People develop delusional thinking when they try to understand their unusual experiences, strange biological sensation. Renee could start with experiencing some kind of hallucination as a result from biological sensation, and later try to understand and make sense of those strange sensations, and eventually develop into misinterpretations and delusion that she is being persecuted.

Treatment:

Biological – Antipsychotic with antidepressant for depressed schizoaffective patients or with mood-stabilizing drug (Lithium) for the manic.

Psychotherapy – Cognitive behavioral therapy (CBT) for schizophrenia is to guide patients to more accurate interpretation of their experiences.

Family & Social Therapy can also be very effective. People with schizoaffective disorder can actually discuss with others their real-life problem.

Psychopathology Film Analysis: The Silence of the Lambs

The Silence of the Lambs        

      

Plot Summary:

This film is about a F.B.I trainee from the behavioral unit, Starling, who is assigned to seek advice and psychological insight from the imprisoned psychopath, Dr. Lecture, who used to be a psychiatrist, in order to catch a psycho serial killer so called “Buffalo Bill” who kidnaps, murders, and skins off female victim. As Buffalo Bill was pursuing his plan on the latest victim who happened to be the senator’s daughter, Catherine, The Silence of the Lambs clearly illustrates his symptoms of the following disorders: Antisocial and histrionic personality disorder, Transvestic fetishism, Autogynephilic transsexualism.

Disorder:

            Antisocial personality disorder is marked by pattern of disregard and violation of other’s right through aggression and antisocial behaviors, without feeling guilt or remorse (Student Notes). Buffalo Bill violated social norm by kidnapping and killing women. He used false name and stayed in the house that was not his. He disregards the victim’s safety for he lives for his own personal gain of skin. He is very aggressive and impulsive. When Starling was suspecting him, for example, he rushed to the basement and prepared to attack her.

Histrionic personality disorder is characterized by pattern of excessive attention seeking, emotion instability, and self-dramatization (Student Notes). Seeking to become a woman and targeting on a senator’s daughter shows his desire for complete attention. He is also very dramatic, in the scene “It rubs the lotion on its skin. It does this whenever it’s told. It puts the lotion on its skin, or else it gets the hose again. Now it places the lotion in the basket”. He has excessive emotionality, for examples, when Catherina started screaming or crying, so did Buffalo Bill. He is, as well, lively and seductive in his own way.

            Transvestic fetishism is known as cross-dressing. Buffalo Bills enjoyed makeup and dressing up in women’s cloth. He had entire secret basement filled with women clothing including the one that he was making out of victims’ skin. He also had, to some degree, Fetishism — sexual interest that centers on a nonliving object or non sexual body part (Student Notes). Example is in one of the scene where Buffalo Bill sighed with ecstasy when he touched and felt Catherine skin at the back after he knocked her out in the van. His obsess with women skin suggests that he gets some sort of recurrent sexual urges from it.

            Transsexualism is remarked by strong and persistent cross-gender identification and persistent discomfort with one’s biological sex or inappropriateness in the gender role of that sex (Comer, 2010). Buffalo Bill could not stand being a man, he desired to be a woman to the point that he started killing for their skin to make himself a female dress. He spent most of his time cross-dressing and worked on his feminine appearance. He is an Autogynephilic type—attracted to oneself as a female. He always fantasized himself as a female, one example could be when he was dancing with his penis tucked between his legs and posed for the camera.

Causes:

Biological – Buffalo Bill’s antisocial and histrionic personality disorder could arise from low serotonin activity and deficient functioning of frontal lobes which is responsible for sympathy.

Psychodynamic – It is from his “severe childhood disturbances associated with violence”, “years of systematic abused” that makes him “hate his own identity” as quoted by Dr. Lecture.

Behavioral – His behavior is learned by modeling. He might have parents with such antisocial behaviors and/or his parent might unintentionally reward him for such behaviors. Cross-dressing could acquire from this operant conditioning as well (Comer, 2010).

Treatment:

Cognitive – Cognitive deals with schemas by challenging his faulty logic, changing his beliefs, trying to guide him to think about moral issue, and assigning behavioral tasks.

Psychotherapy – Psychotherapy, hormone therapy, and sex change could help stop violence behaviors since those behaviors could develop from the rejections of many hospital for sexual reassignment surgery.

Behavioral – Aversion therapy may help teach him appropriate response for certain stimuli.

Psychopathology Film Analysis: Little Miss Sunshine

Little Miss Sunshine                                           

Plot Summary:

            This film is about Hoover’s family, which includes the dad Richard who always refuse to lose, the son Dwayne who refuses to talk, the grandpa Edwin who is addicted to heroin, the uncle Frank who fails suicidal attempt, the mom Sheryl who tries to keep the family unites together, and their road trip to California in hope of having their daughter Olive wins the Little Miss Sunshine beauty pageant. Here, major depressive disorder is portrayed in Frank, however, he become better as the movie progressed.

Disorder:

Major depressive disorder is a severe mood disorder with people who have major depressive episode that occurs every day for 2 weeks with at least five of the following symptoms: fatigue, insomnia/hypersomnia, decrease/increase in appetite, significant weight loss/gain, psychomotor retardation, self-denunciation, recurrent thoughts of death or suicide (Student Notes).

In the film, Frank suffers from MDD. By trying to escape from failures in relationship and career, he attempted suicide by severely cutting off his wrist. Doctors and Sheryl, from then, needed to ensure that Frank is always around people and that he stays away from any sharp objects because he would likely attempt suicide again. On the day being discharged from the hospital, sitting on the wheelchair, Frank was in severe depressed mood. He seemed miserable, sad, and helpless. Decreased appetite and lack of sleeping could be the reasons why he seemed so dull, no energy, not at all active. Through his slow movement and silence, he showed clear physical, mental weakness and diminished interested in talking. Evidence is shown when Sheryl asked him to talk but he refused with a single response, “No”. On the scene where they make a pit stop, Frank ran into the student he fell in love with when he was a professor, from his expression, heartache, disappointment, and humiliation hit him hard once again. However, I believed he represses a great deal of his emotions for the family’s sake even though he is plagued with MDD. As the movie progressed, there is no more clear indication of him acting abnormally. Having a very warm, caring, and supportive sister who always wants to help him recover from his mental breakdown, being able to talk with family about his life struggles, deepest suffering, being able to connect with Dwayne who suffered similar depression, being preoccupied with Olive’s quest all seemed to really help improve his mental state, showing that depression can be treated with family support and time.

Causes:

Psychosocial – His stressful life events—intense romantic failure, getting fired, career disappointment, and homosexual stigma were the most probable causes.

Biological – Frank could inherit genetic disposition which made him more susceptible to depression. Brain circuit and low activity level of norepinephrine and serotonin could also be linked to major depression.

Psychodynamic – According to Freud, Frank has focused and unable to accept his loss. He regressed to the oral stage of development and cannot distinguish himself from others. Then, his introjections and incorporation comes (Student Notes).

Behavioral – Frank’s MDD results from the significant reduction in positive reinforcement.

Cognitive – According to Beck’s theory, Frank had certain early experiences that lead to formation of dysfunction beliefs, making him vulnerable to depression when the critical stressors mentioned above serve to activate those assumptions that trigger thoughts and in turn produce depressive symptoms (Student Notes).

Treatment:

Biological – Biological treatment is not really necessary in this case since he is getting better without one. But if not then he should start with antidepressant drugs, for example, the SSRIs. If it does not response then continue taking meds with electroconvulsive therapy, or ETC.

Psychodynamic – Encourage Frank to associate freely during therapy, share his associations, dreams, and displays of resistance and transference could definitely help (Comer, 2010).

Behavioral – Therapist could use various strategies to increase Frank’s positive behavior, for example, engaging him with activities that he consider pleasurable could lead him to better mood, then, reward him correctly to his behaviors. Ignore and do not entertain his depressive behaviors, instead, reward his constructive behaviors and social skills (Comer, 2010)

Cognitive - Behavioral Therapy – It is the use of systematic way to teach him to evaluate his beliefs/thoughts (Student Notes) First, use behavioral technique by increasing his activities to improve his mood. Second, teach him to recognize and share his automatic negative thoughts, challenge those thoughts, and conclude the ground less reality behind them. Third, teach him to change his style of interpretation, recognizing the negative bias in all his interpretations of events. Last, help change his maladaptive attitudes (Comer, 2010).

Family-Social Treatments – Interpersonal Therapy

Psychopathology Film Analysis: Fight Club

Fight Club

Plot Summary:

            This is a personal-narrated story about an insomniac, unnamed reliability consultant of a car company, the narrator himself, and his radical consciousness after he met a soap salesman, Tyler. Together, they formed the Fight Club at the basement of a bar which later on Tyler took over and form the Project Mayhem, a group of terrorists. Only toward the end the movie revealed that both Tyler and the narrator were not two separate individuals, but rather the same person, a person who was clearly suffering from Dissociative Identity Disorder.

Disorder:

People with Dissociative Identity Disorder, also known as Multiple Personality Disorder, develop two or more distinct personalities, each with unique set of thoughts, behaviors, emotions, and memories. Those split personalities usually are totally opposite, cannot be integrate by patients, and they are at some point in control. Such symptoms are not associated with medical conditions or the use of substances (Student Notes) (Comer, 2010).

From the movie, the narrator/Tyler suffers from DID. At the beginning of the movie, the narrator had this intense stress all the time when a woman named Marla came into scene, he was too timid and shy so he developed coping mechanism, that is his alter personality, Tyler, who was very confident, charm, and outgoing. During Tyler and Marla were having sexual relationship, the narrator was not aware that it was himself and Marla having that relationship, not realizing that he and Tyler were the same person, and that Tyler was his own inner urge for that woman. Furthermore, Tyler took over narrator’s action as he was sleeping, and the narrator had no memory of being Tyler at all. Good indication was when he woke up in different places all the time. He had complete amnesia of Tyler’s actions, for example, Tyler/narrator burned down his own apartment, traveled across countries to form his own fight club, and planted bombs in different buildings without knowing that he did. Only toward the end of the movie, the narrator came to realized that Tyler was actually himself because people kept calling the narrator Tyler, and telling him that he was the one giving them hand scars. Moreover, as he was tied to a chair, seeing his imaginary identity Tyler pointed a gun to his head, he found out that the gun was instead in his own hand. Most of all, he showed self-mutilation which is very common in DID patients in order stop the alter personality by eventually shot himself in the mouth to get rid of Tyler.

Causes:

Psychodynamic – Excessive repression, the ego defense mechanism, from traumatic childhood events such as childhood abused has caused the disorder. The narrator could try to fight off from bad impulses (from his job, loneliness, etc.) by unconsciously prevent them to reach awareness and assign other personality, Tyler (Comer, 2010).

Behavioral – Dissociation is an escape behavior of Tyler/narrator result from reinforcement rather than unconscious (Comer, 2010).

Treatment:

Little treatment is known as the disorder is extremely complicated. I personality do not think the below treatment would work with Tyler/the narrator case.

1. Stabilize & recognize the disorder – stabilize by bonding with different identities and educate them to recognize the nature of their disorder

2. Recover the memories – working through trauma, connecting real life events, identities

3. Post integration therapy – merge all the different alter personalities into one integrated identity (Comer, 2010) (Student Notes).

Psychopathology Film Analysis: American Beauty

American Beauty       

                    

Plot Summary:

            The film is about how every character in the two families, Burnham and Fitts, struggle to find freedom and control their own destiny, as a result of their psychological problems, developed many poor choices and associated consequences. The father from one of the families, Lester Burnham, was trying to escape his stressful life through reckless behaviors of pedophilic dream and drug use whereas the father from the other family, Frank Fitts was trying to militarily control his family while hiding his homosexuality. This analysis is however is about Ricky Fitts, the son of Frank, who portrayed schizotypal personality disorder throughout the movie.

Disorder:

Schizotypal Personality Disorder is a personality disorder characterized by excessively introverted with social and interpersonal deficits, cognitive and perceptual distortion, and eccentricities in communication and behavior (Student Notes).

From the movie, Ricky showed schizotypal personality disorder in several ways. He was a social outcast with odd character, peculiar appearance, blunt emotion, and high degree of confidence. He wore strange clothes, loved strange art, and had strange affection toward Jane. He had emotionally detached parents and a history of severe childhood abuse that is clearly shown by how he highly respect his father like an authority out of his fear of being hit, ending each sentence with “sir”. Furthermore, he was obsessed with videotaping everything that he found beautiful and interesting, however, he has this distorted concept and perception of beauty. For example, a plastic bag dancing in the wind, a dead bird, and a dying woman, to him, is beautiful to be filmed. Moreover, like most people with schizotypal personality disorder, he had the symptom of bodily illusions, for example, he sensed an external force with God, and that God is looking at him every time he watched any dying subjects. In the ending scene when Jane’s father was shot, he basically stared at him for many seconds and eventually smiled. Last but not least, his conversation was vague and sounded as if he was a very disturbed teenager. At the scene when Ricky was filming Jane complaining about her father, Ricky seriously asked Jane if she want him to kill her father for her. He also thought she was seriously saying yes to him but in fact she was never serious about it.

Causes:

Biological – Schizotypal personality disorder similar to schizophrenia in that they are linked with the high activity of the neurotransmitter dopamine, smaller temporal lopes, enlarged brain ventricles, and loss of gray matter (Comer, 2010).

Psychosocial – Ricky’s childhood abused and the emotionally detached parents are two obvious causes.

Cognitive – Defect in short-term memory and attention may be the contributing factors.

Treatment:

Biological – Low dose of antipsychotic drugs can reduce Ricky’s thought problems.

Psychotherapy – Cognitive behavioral therapy (CBT) is the combination of cognitive and behavioral techniques can be used to help Ricky to function more effective. Cognitive one could be teaching him to evaluate his unusual thoughts or perceptions objectively and ignore the inappropriate one or point out the inaccuracy of those odd ones. Behavioral deals with Ricky’s social skills training, appropriate speech, dress, and manner, and how to be comfortable around others (Comer, 2010).

Family & Social Therapy can also be very effective. Ricky can actually discuss with others their real-life problem. He obviously needs social and family support of his schizotypal personality disorder.

Psychopathology Film Analysis: Girl, Interrupted

Girl, Interrupted

                         

Plot Summary:

            This film is about a teenage woman, Susanna, who was put in a mental institution because of her suicidal attempt, aspirin overdose with vodka. She spent almost a year there, making friends with all kinds of different patients and experiencing many hard times including watching the result of her best, social path friend’s, Lisa, shock therapy or worst, witnessing her suicidal friend hanging dead. To get out of there, she soon learned to corporate, follow rules, and started to open up; she eventually was discharged. Throughout the movie, Susanna’s Borderline Personality Disorder was clearly presented.

Disorder:

Borderline Personality Disorder is a personality disorder characterized by repeated impulsive behavior, instability in interpersonal relationships, self-image, and moods. People with BPD have history of intense volatile relationship, low tolerance for frustration and being alone, and drastic reaction over small provocation. Self-mutilation and suicide attempt are common. They may have transient episode of psychotic like symptoms or have overlap symptoms for mood disorder (Comer, 2010) (Student Notes).

From the movie, Susanna was very impulsive. She had sex with the husband of her mother’s friend, kissed with the security guard, and had casual sex with two people in the same day while she was in the mental institution. She also stole her medical record, broke out of the hospital, tongued her medication, and drugged a nurse there. These spontaneous behaviors are some of the signs. Moreover, she does not really know who she is and had hard time being herself. She showed repeated unstable self-image that can be observed as she alternate from moment of self-acceptance to moment of extreme depression and confusion, for example, when she refused to get out of bed when Lisa left. The reason Susanna was in the mental institution in the first place was aspirin overdose with alcohol. This suggests her suicidal attempt. In the early scene, she had severe bruises on her hands showing self-mutilation. Furthermore, her beliefs that she had no bones in her hand and that her bone were constantly disappearing and reappearing clearly showed her transient episode of delusion. Last but not least, she has unstable interpersonal relation. For example, she goes from thinking that Lisa is the perfect friend to hating everything about her, then back to wanting that friendship again.

Causes:

Biological – Lower brain serotonin activity is linked with Susanna’s impulsive and suicidal behavior. Also, close relatives of people with borderline personality disorder are five times more likely than general population to have the disorder (Comer, 2010).

Psychodynamic – Early lack of parental acceptance caused the disorder. Susanna could have been neglected and rejected by her parent as child, and this could lead to inability to cope with separation out of a fear of abandonment tortures (Comer, 2010).

Sociocultural – Her culture undergo rapid change and loses it stability so it inevitably leave her with identity problem, feeling of emptiness, high level of anxiety, and fear of abandonment (Comer, 2010).

Treatment:

Biological – Antidepressant and antipsychotic (lithium and Prozac are common) can help calm the emotion and aggression of people with BPD (Student Notes).

Adapted Psychotherapy – This may help improve people with BPD by reducing their dependency.

Cognitive behavioral therapy – BPD specific one that encourage patients to accept the negative affect without engaging in maladaptive or self-destructive behaviors.

Psychopathology Film Analysis: Take Shelter

Take Shelter

Plot Summary:

            This is a story about a construction worker, Curtis, who lived with his wife and his deaf daughter, Hannah in a small town of Ohio. His He had a fulfilling life until one day he experienced reoccurring, terrifying, getting worse-and-worse nightmares and day visions of the coming tornado, bringing harm to all his love ones. He kept everything to himself while redirecting his anxiety into the obsessive building of expensive tornado shelter in his backyard, resulting in the strains to his family, marriage, and most of all how society perceive him. Take Shelter gradually portrayed Curtis’s condition of Brief Psychotic Disorder.

Disorder:

Brief Psychotic Disorder is the presence of delusions and hallucinations, disorganized speech or behavior. Distinguishing features is that it last for more than one day but less than one month, like a time-limited and non-reoccurring schizophrenia (Student Notes).

From the movie, Curtis was out of touch with reality and was not able to separate his dream sequences from reality anymore because they become more and more vivid and real, leaving him physical effects such as bedwetting, seizure, pain, bleeding, and injury. Those nightmares include a huge tornado approaching, his own dog attacking him, his colleague and his wife violently attacking him, invaders kidnapping his daughter. Eventually his dreams came to dictate his waking actions as paranoia. He also experienced auditory and visual hallucination. He heard claps of thunders, saw groups of dark scary-looking clouds from time to time throughout the movie and saw thousands of migrating birds and bats when no one else does. Strange and maladaptive behaviors include his obsess with renovating the tornado shelter, spending all his savings for the daughter’s education, taking away health insurance money that was supposed to be for the daughter’s surgery, taking out unable-to-pay-back loan from the bank. He also borrowed large tools from construction job that made him ended up getting fired. Last, the whole movie demonstrated that the disorder does not last more than a month, as an evidence for his brief psychotic disorder. According to my interpretation, the huge storm finally happened because of the wife reactions toward the end when she really saw the approaching tornado, proving that it was not the Curtis’s delusion. His condition could be cured afterward, if not, then that could be progress to be schizophrenia.

Causes:

Biological – Curtis clearly have inherit that biological predisposition to psychotic disorder from his mother who paranoid schizophrenic. The disorder developed later in his adulthood after facing stressors including the daughter deafness, finance difficulties, etc. (2) Also, He could have abnormal activity or interactions of neurotransmitters like dopamine and serotonin.

Cognitive – People develop delusional thinking when they try to understand their unusual experiences, strange biological sensation. Curtis start with experiencing nightmares and vision and related hallucinations as a result from biological sensation, and later try to understand and make sense of those strange sensations, and eventually develop into misinterpretations and delusion that the terrible thunderstorm is really coming.

Psychodynamic – According to Freud, it develops from the regression to a pre-ego stage and effort to reestablish ego control (Comer, 2010).

Treatment:

Biological – Antipsychotic drugs can reduce delusion and hallucination those symptoms.

Psychotherapy – Cognitive behavioral therapy (CBT) is to guide patients to more accurate interpretation of their experiences.

Family & Social Therapy can also be very effective. People with the disorder can actually discuss with others their real-life problem.