Wednesday, March 10, 2010

"A Beautiful Mind"

The film “A Beautiful Mind” characterizes the story of the brilliant mathematician John Forbes Nash who suffers from paranoid schizophrenia. This film was directed by Ron Howard and it's based on a true life story of the genius mathematician Nash which is portrayed by the actor Russel Crowe. At the beginning of the film Nash starts his career at Princton University as a mathematics graduate student where he was well known for his intelligence. Nash is an arrogant, awkward socially-inept mathematics student, who spent most of his time making an effort to discover a revolutionary equation in mathematics. At half way through the film, we discover that half of the places and situations that occur in the film are only illusions within Nash's “beautiful” mind. This is when we determine that Nash is suffering from a severe illness which is schizophrenia. One of the first imaginary characters that Nash develops in his mind is his roommate Charles Herman, (Paul Bettany) a student of English Literature.

Schizophrenia has been defined as “ “split mind”. It refers not to a multiple personality split but rather to a split from reality that shows itself in disorganized thinking, disturbed perceptions, and inappropriate emotions and actions” (Myers, 2007, p678). Nash experienced severe delusions and hallucinations which were then diagnosed as symptoms of paranoid schizophrenia. There are subtypes to Schizophrenia, and paranoid schizophrenia is when being preoccupied with delusions or hallucinations, generally with cases of persecution or grandiosity (Myers, 2007).


According to the DSM -IV the following is the diagnostic criteria (1994).

A. Symptoms of schizophrenia:
1.Delusions
2.Hallucinations
3.Disorganized speech (e.g., frequent derailment or incoherence
4.Grossly disorganized or catatonic behaviour
5.Negative symptoms, I.e. affective flattening, alogia, or avolition (DSM-IV,1994).
295.30 Paranoid Type –Schizophrenia
A subtype of schizophrenia which the following criteria are met:
A. Preoccupied with one or more delusions or usual auditory hallucinations.
B. The following are not noticeable: disorganized speech, disorganized or catatonic behaviour, or flat inappropriate affect (DSM-IV, 1994).


Patients with schizophrenia have either positive or negative symptoms. The positive symptoms are hallucinations, speech disorganized, delusions, inappropriate laughter, and tears. Patients with negative symptoms are usually quite, toneless voices, expressionless faces, and rigid bodies. Inappropriate behaviours are usually governed by the positive symptoms, and the absences of appropriate behaviours are the negative symptoms (Myers, 2007).


Scientists are still not clear about the specific causes of schizophrenia; however research has demonstrated that people with schizophrenia have different brains than those who don't have the illness. Schizophrenia is like many other illnesses such as cancer, and diabetes, it is caused by a mixture of problems such as genetic vulnerability and environmental factors that happen while a person goes through development. A recent study shows that specific genes increase the risk for schizophrenia. The genes do not cause the illness but they increase the percentage up for developing it (NAMI, 2007).




Treatment approaches used with schizophrenia are usually a mixture of therapies. The different approaches are chosen to reduce the symptoms and lessen the chances of the symptoms to return to the individual with the illness. There are about nine therapy approaches: Medication treatment, Antipsychotic Medication list, Psychosocial Treatments, Rehabilitation, Individual Psychotherapy, Cognitive Behavioural Psychotherapy, Family Education, Self-help Groups, and Community and Social Support (Franklin, 2004).


Antipsychotic medications have been used since the 1950's. These medications reduce symptoms in schizophrenic people, and allow them to function efficiently. The antipsychotic drugs do not cure schizophrenia but they do reduce the symptoms of the illness. The dosage of medication varies from one patient to another, and it's all up to a qualified psychiatrist in the medical treatment of mental disorders to make decide on the dosage. New Antipsychotic drugs, such as risperidone (Risperdal) and olanzapine (Zyprexa) or clozapine are better than the old drugs that were used to treat patients. Antipsychotic drugs are efficient at reducing specific symptoms such as hallucinations, and delusions, which are very common in schizophrenics. These antipsychotics have side effects that are unwanted which are: drowsiness, restlessness, muscle spasm, tremor, dry mouth, or blurring of vision (Franklin, 2004).


Antipsychotic Medications are used as well.

Brand & Generic Names of some medications.
  • Abilify -aripiprazole
  • Clozaril -Clozapine

  • Geodon -Ziprasidone

  • Haldol- Haloperidol

  • Lidone- Molindone

  • Loxitane -Loxapine

  • Mellaril-thioridazine

  • Moban-molindone

  • Navane-thiothixene

  • Orap - Pimozide

  • Permitil-Fluphenazine

  • Prolixin -Fluphenazine

  • Risperdal-Resperidone

  • Serentil-Mesoridazine

  • Seroquel-Quetiapine

  • Stelazine-Trifuoperazine

  • Taractan-Chlorprothixene

  • Thorazine-Chlorpromazine

  • Trilafon-perphenazine

  • Vesprin trifuopromazine- Trifuopromazine

  • Zyprexa-Olanzapine (D.Franklin, 2004)
Psychosocial treatment is to help those patients with less severe symptoms of schizophrenia. This approach of therapy helps patients social functioning, whether it's at the hospital, community, home, or on a job. The reason why this therapy is important for patients with control over their psychotic symptoms, is because the age they're at is the critical career years of life which is around 18-35 years of age. Patients will have difficulties in communication, self-care, motivation, and maintaining relationships. Thus, this type of therapy is great for those that want to rejoin society again (Franklin, 2004).


Rehabilitation are non-medical interventions for patients that suffer from schizophrenia. They are programs that help patient’s social skills and vocational training. There are a variety of programs for the rehabilitation that are, vocational counselling, job training, finance management, public transportation, and social skills. All the programs help patients get back to their original self, and be able to function well in society (Franklin, 2004).


Cognitive Behavioural Psychotherapy has been known to be the most efficient type of psychotherapy when treating a psychological problem. Cognitive therapy is “therapy that teaches people new, more adaptive ways of thinking and acting; based on the assumption that thoughts intervene between events and our emotional reaction” (Myers, 2007, p52). Also, behavioural therapy is combined with the cognitive therapy and therefore, it should help the patient perform effectively in life by reducing the symptoms and focusing on the important aspects of life.


The treatment that was demonstrated in the movie had different approaches. Nash was put into a psychiatric hospital, and he received anti psychotic medications. Also, towards the middle of the film he was administered insulin shock therapy.


Nash enters a world of mystery and imagination when he meets Parcher who asks to help the pentagon with their code decyphering. Now Parcher is the second person that he creates within his mind. In addition, this job that he has been given arouses his interest and he becomes part of the government where he's relied on. At one point in the movie he has to locate and stop the Russian nuclear bomb. This is the second situation that he creates within his mind, where he's unaware of its nonexistence.


Nash's roommate Charles introduces his young niece Marcee to Nash. Subsequently, Nash proposes to Alicia one of his students that he met and admired. Nash continued teaching but one of the symptoms that Nash exhibits was being paranoid in class, where he sees’s men outside stalking him. This demonstrates paranoid schizophrenia, and till now he is still unaware of his illness. His wife Alicia (Jennifer Connelly) becomes pregnant, and Parcher starts stalking Nash asking him for help to break the code or the Russians will come after him.


One day where Nash was lecturing men come in and therefore, he escapes. At that instant the psychiatrist Rosen introduces himself and Nash escapes. Thus, Rosen takes him to the psychiatric hospital to help him out with his illness. It became very difficult for Nash to cope with his and relationships.Nash was admitted to the hospital to see a psychiatrist where he was asked to talk about who he see's and what are his complications. Nash cut's his wrist to look for the implant that Parcher implanted and he discovers that it's gone. The psychiatrist Rosen diagnoses Nash with Schizophrenia where he receives 10 weeks of Insulin shock therapy.


Alicia suffered from all the difficulties that Nash is going through. She stood by him and tried to prove that he has delusions, and hallucinations, but Nash gets upset at her for not believing him. The problem with schizophrenia is that patients see things as a normal brain see's things. It seems so real that it's so hard to believe that they're unreal. He continues to stay far from Alicia not like before, and Alicia stands by him to help him overcome the illness. Nash was prescribed antipsychotic medications by Rosen, but he stops taking the medication, and therefore, his hallucinations come back again. The result of not taking the medication has been putting Nash's family in danger. Alicia asks him to watch their baby at one point and he goes on with his hallucinations saying that Charles was watching the baby. Alicia becomes very frustrated and asks him to get back to the hospital, and calls Rosen but Nash runs after her and hurts her. As she was running away from the house Parcher asks Nash to “finish her” meaning kill her. Nash see's Marcee again, and runs to Alicia telling her that Marcee isn't real because she never gets old. This is where Nash wakes up from his hallucinations and starts thinking critically about his illness. Then he gets back to the hospital again and signs commitment papers to stay and receive therapy.


After he comes out of the hospital he goes to his old friend from Princeton University Martin, and asks him if he can work in the library. But, unfortunately his hallucinations come again when Parcher shows up. This incident demonstrates Martins kindness and loyalty by standing up for Nash. Then he goes back to work on some theories in the library, and although Charles, Marcee, and Parcher show up he learns to ignore them. Despite the serious illness he had he worked hard and came up with the game theory and received a Nobel Memorial Prize in Economic Sciences. At the end of the film Martin asks Nash if he still sees’s Charles, Marcee, and Parcher. Nash replies in an inspirational positive way which really appealed to the viewers, and his reply was “No, but I've gotten used to ignoring them, and as a result, they've kind of given up on me. I think that's sorta what it's like with dreams and nightmares. We've gotta keep feeding them for them to stay alive.” This shows a great philosophy in overcoming difficulties and shows great strength in Nash himself.


As for the portrayal of the paranoid schizophrenia in the film it is very much the same as what the Psychology Eighth Edition in Modules presents. Both the positive symptoms and the negative symptoms had been described in the book. And the character Nash shows all the positive symptoms of schizophrenia. Except for the therapy, the textbook doesn't mention that Insulin shocks therapy is a cure to schizophrenia whether it's paranoid schizophrenia or any other subtype. But the film demonstrates this type of therapy when Nash is admired to the hospital. As for the medications, the textbook, and the movie state that medications are crucial to reduce the symptoms of schizophrenia, and that the medications have side effects. Overall, this is an excellent film for demonstrating schizophrenia, and it was well covered in terms of the aspects of the illness, and the therapy.







References:



National Alliance on Mental Illness. (2007) Mental illnesses. Schizophrenia. Retrieved from


Franklin. D (2004) Psychology Information Online. Treatment of Schizophrenia. Retrieved from

Myers, D. (2007) Psychology Eighth Edition in Modules. New York: Worth Publishers

American Psychiatric Association (1994). Diagnostic and statistical manual of mental health disorders (4th ED). Washington DC





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