Snigdhaa Rajvanshi
Released in 2010, Shutter Island, starring Leonardo
DiCaprio, Mark Ruffalo and Ben Kingsley is one of the most well-known
portrayals of Schizophrenia in popular media. Along with starring celebrated
actors, the movie also provides a suspenseful thriller that is enough to keep
the viewers guessing till the conclusion of the movie. However, while the movie
is a great source of Hollywood-like entertainment, many have wondered if it is
a reasonably accurate representation of people suffering with Schizophrenia or
just a gross dramatization of the disorder. Since the movie is extremely
popular, it plays an important part in forming the audiences’ perception of the
disorder and subsequent reactions. This blog aims to analyze the protagonist of
the story – Teddy Daniels and determine if his presentation of schizophrenia
was portrayed accurately on-screen, or if, his symptoms resembled schizophrenia
at all. While doing so, this blog also expects to highlight the possible impact
the movie may have had on its audience, both positive and negative.
In the movie, Teddy
Daniels, a US Marshall, is assigned to investigate the seemingly impossible
disappearance of Rachel Solando- a patient at Ashecliffe Asylum along with
his partner Chuck Aule. As the story progresses, it is revealed that Teddy was
himself a patient of the asylum who was admitted two years ago on the charges
of killing his wife after she drowned their three children in a lake. According
to the Diathesis-Stress model, stress can trigger psychosis if the person has a
genetic predisposition to schizophrenia (Hooley et al., 2021). Throughout the
length of the story, Ted is shown to have flashbacks and nightmares about the
time he served in the army against Germany in Dachau during world war 2. It can
be safely argued that the traumatic stress from Ted’s time in Germany and the
bloody death of his family can be the two possible instances that triggered
Ted’s psychosis. While Ted is not shown to abuse cannabis, which is proven to be highly correlated with Schizophrenia, he is shown to be an alcoholic and a
chain smoker. While alcoholism and smoking are not contributors to schizophrenia, the movie does a spectacular job of highlighting the comorbidity of disorders where Ted showcases symptoms of schizophrenia and substance abuse and possible PTSD.
The movie highlights the two
most popular symptoms of schizophrenia- delusions, and hallucinations. Ted,
imagining himself to be a respected US Marshall, imagines himself to be the
center of the conspiracy that was going on in Ashecliffe. He is convinced that
it is his responsibility to expose the doctors at the asylum and then is later
convinced that he is alone and that the people at Ashecliffe are after him,
drugging him and isolating him from the rest of the world so that they can
perform an experimental transorbital lobotomy on him. It can be very clearly seen
that Ted suffers from delusions of grandeur and persecution along with
paranoia. Ted is also shown to experience both visual and auditory
hallucinations. His hallucinations manifest themselves in relation to his past
traumas. His primary hallucinations include his wife, Dolores Chanal, a little
girl (who is later revealed to be his dead daughter), and the runaway patient,
Rachel Solando (named after his daughter). He also creates fictional characters
that add to this fictional world including the janitor was set fire to the
apartment that killed Ted’s wife in his fictional world- Andrew Laddeis. Laddeis
is then revealed to be the actual identity of Teddy himself as it is
rationalized as the creation of a separate identity named Teddy Daniels in order
to escape from accepting the reality where he killed his wife. His
hallucinations feed into his delusions. His wife, in many instances, informs him
of the presence of Andrew Laddeis, her killer, in the asylum as the 67th
patient. Rachel Solando, with whom he interacted in a cave, confirms all
his delusions about the conspiracy at Achecliffe and informs him that he “has
no friends” when asked about the disappearance of his partner, Chuck. The DSM V
(Hooley et al., 2021) lists five important symptoms in Criterion A for a
diagnosis of schizophrenia- Delusions, Hallucinations, Disorganised behavior
and/or speech, and negative symptoms (like diminished emotional expression or
avolition) experienced over at least six months. Interestingly, Ted fails to showcase any disorganized behavior including catatonia,
disturbed everyday functioning, or any negative symptoms. While instances of
aggression and disregard for self-safety are shown at various points of the
movie (he climbs down a hill in order to save his partner), Ted’s character
fails to showcase any failed regard to maintain personal hygiene, diminished emotional
response (his interactions with his wife) or lack of motivation (he was
extremely motivated to find Rachel Solando).
While schizophrenic
delusions are often isolated beliefs, they can also sometimes “become
elaborated into a complex delusional system." (Hooley et al., 2021) as was
the case with Teddy. Hallucinations also “often have relevance for the patient
at some affective, conceptual, or behavioral level. Patients can become
emotionally involved in their hallucinations, often incorporating them into
their delusions.” (Hooley et al., 2021) which explains the basis of Teddy’s
hallucinations in his traumatic past and his attempts to escape from the same.
Moreover, in some cases,” patients may even act on their hallucinations and do
what the voices tell them to do" (Hooley et al., 2021) rationalizing
Teddy’s compliance with his wife and Rachel Solando. However, the absence of
any other characteristic symptoms of schizophrenia, although does not rule out
the diagnosis, also opens the door to other possible diagnoses.
Delusional Disorder is
characterized by the presence of delusions (and possible non-prominent
hallucinations) without the “gross disorganization and performance deficiencies
characteristic of schizophrenia” (Hooley et al., 2021). Dr. Alistair Munro,
author of Delusional Disorder: Paranoia
and other related illnesses (2006) states, that otherwise showing normal
emotion, patients with delusional disorder tense up and can be made angry very
easily. This explains Ted’s reaction to the conversation around violence and
defense mechanisms with the head psychiatrist of the asylum. It can be argued
that the conversation reminded him of the violence that he witnessed (and
partook in) in Dachau and the violent end to his family. However, it is
important to take into consideration that the hallucination frequency and intensity
in delusional disorder are considerably less (or even non-existent) than in
schizophrenia (Muñoz-Negro et al., 2017). Therefore, Teddy’s case becomes
interesting as it cannot be conclusively be termed as either schizophrenia
(absence of disorganized behavior) or delusional disorder (high intensity of
hallucinations).
Although it would be
unrealistic to expect an extremely accurate representation of mental disorders
from a commercial movie, Shutter Island,
while dramatizing the disorder, does a relatively good job at portraying a
possible schizophrenic. However, their focus on the delusions and
hallucinations of the protagonist while completely disregarding all the other
symptoms of the disorder opens the way for an argument in favor of delusional
disorder. This can prove to be dangerous as the movie overshadows a possible
delusional disorder, which is anyway a lesser-known form of psychotic
disorder, by schizophrenia leading to a distorted image of both delusional
disorder and schizophrenia in the audiences’ perception. Despite that, the
movie has other positives. Teddy’s wife is described to be a suicidal bipolar,
a diagnosis that ultimately led her to burn their apartment in the city and
drown her three children. The movie highlights the struggles of the family
members living with a person diagnosed with mental illness and the consequences
of the associated ignorance. Teddy accepts that it was his fault that he did
not get his wife the help she needed after she confided in him with her
struggles. His avoidance led to the death of his children and wife and Teddy’s
subsequent psychosis. While the movie portrayal of schizophrenia cannot be
termed entirely accurate, Teddy Daniels or Andrew Laddeis still is a good, thriller-induced, Hollywood-esque introduction into the world of schizophrenia. Although this famous movie has possible negative effects, an argument in the favour of its
positive public impact can able to viably made.
References
Hooley, J. M., Nock, M., & James Neal Butcher.
(2021). Abnormal psychology. Pearson.
Muñoz-Negro, J. E., Ibáñez-Casas, I., de Portugal,
E., Lozano-Gutiérrez, V., Martínez-Leal, R., & Cervilla, J. A. (2017). A
Psychopathological Comparison between Delusional Disorder and Schizophrenia. The
Canadian Journal of Psychiatry, 63(1), 12–19.
https://doi.org/10.1177/0706743717706347
Munro, A. (2006). Delusional disorder: paranoia
and related illnesses. Cambridge University Press.
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