According to Greta

Greta threatens to "walk over to the pier and jump. End it all." She says of her grandmother Katherine, "Gram has some serious anxiety issues. Maybe I should give her some of my pills." (0:02)

Greta: "I'm going to kill myself before I turn 18." She reads from a list of ways to end her life. (0:05)

Greta hints at the loss of her father: "If Dad were alive..." (0:20)

Greta takes unidentified pills. (0:21)

Greta attempts to pit her male friend Julie against her grandmother. (0:42)

When Julie asks Greta whether she would kill somebody, she answers, "Just myself." (0:45)

When Greta's grandfather Joseph announces that he "found a pill in the toilet bowl," Greta identifies it as "Lexapro... SSRI... supposed to make me normal and boring... mood altering drug. The only reason he even wrote the scrip is my mom saw an ad somewhere." (0:50)

Joseph: "Greta's father killed himself... She was there." (1:06)

Standing on the bow of Joseph's cabin cruiser Greta pushes the anchor overboard and allows the rope to wrap around her leg, dragging her into the water. Julie dives into the water to rescue her. Greta's grandmother Katherine suffers a heart attack. (1:07)

Julie confronts Greta and tells her about "my friend. I found him hanging by an electric cord... You just wanted that drama... I wish I could help you. I'm doing my own thing." (1:10)

When Greta reads a letter Katherine wrote to Joseph after he had gone to sea with the Navy expressing regret that she did not tell him how she felt, she begins to view her grandmother as more than an authority figure who wants to control her behavior.

Julie detaches from Greta emotionally, knowing he cannot rescue her and that she will drag him down with her if he permits her to. By doing so does he create an atmosphere more conducive to Greta addressing her own dysfunction?

This story paints the three generations of women as dysfunctional and both men, Joseph and Julie, as more functional, and even as instrumental in the women getting their acts together. Sexist?

Did the dysfunction in this family start with Katherine? With Greta as the identified patient what would be your plan for working with this family? Would you want Julie to attend a session?

Bereavement | detachment | escitalopram | multigenerational perspective | multigenerational  transmission | SSRI | suicide

A Scanner Darkly

Spoiler alert!

Charles tries desperately to remove bugs from himself, then his dog. He refers to them as aphids. (0:01)

A lecturer describes to an audience of men the community's problems with substance D addiction. He says the drug is derived from blue clerodendron flowers. Fred, introduced as a narcotics agent, (and "the ultimate everyman") elaborates on the subject, but he becomes confused and aborts his lecture. (0:04)

Donna and Fred (later to be known as Bob) seem to arrange a drug deal on the phone. (0:11)

James tells his friend Charles there is no "cold turkey" was substance D. (0:14)

He refers to James' "visions of bugs" as "garden variety psychosis." He talks about "phases" of addiction. He suggests that Donna has lost sexual interest because of her use of substance D. Charles and James return home from a grocery store, apparently after having purchased ingredients with which to synthesize or extract cocaine. James inflates a plastic bag from an aerosol can. He says, "[they] mixed the cocaine with oils so it cannot be extracted..." He places the bag in the freezer. (0:15)

A man and woman in white coats (neuropsychologists?) tell Fred that several agents have been admitted to "neural aphasic" clinics. They administer a "psychground (?) test." (0:24) They ask Fred, "Are you getting any "cross chatter" between hemispheres? (0:25) The female doctor assures Fred, "This is no Rorschach test where an abstract blot can be interpreted many ways." She tells him it is superior to the Rorschach. (0:26)

James, apparently acting as an informant, says Bob Arcter is addicted to substance D. (0:30)

Fred appears disoriented. (0:33)

Bob (Fred), James, and Ernie swallow red capsules of substance D after Bob protests that they will "wind up like" [Charles], and Ernie says, "Don't blame it on the drugs.". (0:38)

Ernie touching an ashtray says, "This roach is still hot." (0:43)

Bob asks Donna, "Did you smoke a joint... ?" (0:46)

As he rolls a joint Bob sees Ernie and James appear to morph into insects. (0:53)

Fred takes red substance D capsules. (0:55)

A voice appears to emanate from the radio: "Freck [Charles] becoming more depressed decided to off himself... bought a large quantity of downers and took them with some cheap wine..." (0:58) After drinking wine and swallowing pills Charles hallucinates. (1:00)

Donna and Bob appear intoxicated. Donna says, "I do a lot of coke." (1:04) Later she says, "I don't shoot up." (1:06)

Bob gives capsules of substance D to Connie. She rejects his advances. When he awakens he sees Connie and Donna appear to transform from one to the other beside him. (1:07)

Back at the scanner Fred re-creates the visual image of Connie alternating with Donna. (1:11)

Fred undergoing more more neuropsychological testing. (1:12)

The psychologists observed that Fred seems "more depressed today." (1:13)

The psychologists tell Fred he suffers from "competition phenomenon... competition between the left and right hemispheres of your brain..." caused by use of substance D which resulted in damage to his left brain which might be treated with "hemispherectomy" and may result in permanent "organ damage." (1:16)

Fred says, "I'll never take substance D again for the rest of my life..." He minimizes that the amount he is taking now is "not much" but that he has been taking "... more recently because of job stress..." (1:17)

Another agent tells Fred an "officer who becomes an addict and doesn't report it promptly" can be charged with a crime. (1:21)

Fred experiences hallucinated visual distortions. (1:23)

In a car with Donna driving Bob shivers while hugging himself, perhaps withdrawing from a drug. (1:26)

Donna walks Bob into New Path Recovery Center where he falls to the floor and vomits, still shivering and holding his stomach. (1:27)

Bruce (a.k.a. Bob, Fred), now at a farm run by the treatment center, discovers the blue flowers from which substance D is extracted growing hidden under rows of corn. (1:34)

The film ends with a dedication by author Philip Dick listing his friends who were died or were hurt by "mistakes in playing."

addiction | clinical neuropsychologist | cold turkey | delusional parasitosis | drug | formication | hallucination | Intoxication | psychological testing | psychosis | Substance-Induced Psychotic Disorder | Substance-Induced Sexual Dysfunction | suicide | Substance Withdrawal

My Mother's Castle

Sequel to My Father's Glory

Close-up of Mr. and Mrs. Cassignol preparing absinthe by pouring water over a sugar cube resting on an absinthe spoon into the green liquid, producing the characteristic louche. (0:30)

absinthe

Miss Potter

Beatrix learns from his sister Millie that Norman has died while Beatrix was with her parents in the lake country. (1:06)

Beatrix cries in bed. (1:06) She acknowledges in a conversation with Millie that grieving is "getting easier." (1:17)

Bereavement

La Strada

Spoiler Alert!

Gelsomina seems naive, innocent, child like, but not always unintelligent. Would you make a diagnosis? Does she represent a real character or a part of all of us? The first loss, her sister Rosa, leads to her hitting the road with traveling performer Zampanò. When Zampanò unintentionally kills high wire artist Il Matto (The Fool, 1:26), Gelsomina seems unable to accept that he is dead. Before he dies, she says, "The fool is hurt." then, "He's Dieing."  After he dies she repeats, "The fool is hurt." But ironically, Zampanò, who barely ever demonstrated caring for her, seems most aggrieved of all when he learns of Gelsomina's death (1:41) years after leaving her on the road.

Bereavement

Some Folks Call It a Sling Blade

A psychiatric ward provides the setting for the entire film which became the prequel to Sling Blade. (0:00)

Most patients in the day room sit quietly, some making repetitive movements. (0:01)

A patient sits in front of a checker board but does not respond when another moves his pieces. Catatonia? Another patient perseverates with a ball. (0:02)

A reporter comments on the insanity defense. (0:05)

 A female patient moves her head. Does she suffer from tardive dyskinesia? (0:09)

Karl tells the story of his isolation in his shed as a child and the murders that led to his commitment with what we might describe as flat affect. (0:13)

Do Karl's head movements suggest tardive dyskinesia? (0:20)

The price tag still hanging from Karl's shirt cuff suggests personal neglect. (0:21) How would you diagnose him? Mental Retardation? Autism? Schizophrenia? Compare Karl to Boo in To Kill a Mockingbird. What about Mr. Woolridge? Asperger's?

Would the insanity defense be used today to defend a 13 year old charged with such murders?

catatonia | flat affect | psychiatric hospital

Bread and Tulips

When he brings Alba into his apartment waiter Fernando hastily removes a hangman's noose from the ceiling. (0:23)

When Alba returns to the apartment unexpectedly we see Fernando standing on a stool, ready to hang himself. (0:29)

Fernando removes the rope with noose from the ceiling. (0:30)

References to joints and drugs include a conversation between Alba and her son Nic. (1:41)

suicide

Army of Shadows

Based on the book by Joseph Kessel: Army of Shadows.

Illustrates the concept of suicide to avoid torture or to avoid revealing information dangerous to comrades in the French resistance during World War II.

Philippe tells Claude, "Always carry cyanide capsules on you. If you're caught, use them." (0:40)

Claude tells Mathilde, "[Felix] has no cyanide tablets on him. The Gestapo won't let you commit suicide." (1:26)

Jean offers tortured Felix a cyanide pill he has smuggled in prison even though he is already near death. He does not respond. (1:41)

Luc tells Bison that Mathilde will be "unable to commit suicide." Bison responds, "I'd want to be killed." (2:16)

"Claude Ullmann, alias Le Masque, had just enough time to swallow his cyanide capsule on November 8, 1943"

suicide

The Double Life of Veronique

Suggestive of reduplicative paramnesia. Physically identical, and both possessed of musical talent, Polish singer Weronika and French music teacher Veronique see each other only once, when Veronique travels to Krakow (0:15). But Veronique does not realize she has seen Weronika until a lover draws her attention to a photograph he believes to be of Veronique, but is in fact of Weronika, taken during the trip (1:24).

Veronique, mysteriously connected but otherwise unaware of the existence of her double, tells her lover after Weronika's death, "It's as if I were grieving." (0:31)

Bereavement | reduplicative paramnesia

Fetching Cody

Spoiler Alert!

Art realizes that by selling drugs to Cody when she arrived on the street he contributed to her apparently inevitable and premature death which will cut short their relationship, so when he discovers how to travel back in time, and after multiple failed attempts, he finally succeeds in saving her.

Art pops a pill while sitting on a toilet (0:04)

Art pops "zips" taken from dealer friend "Sudden" (?) (0:10)

When Art climbs into Cody's room through a window he finds her unconscious on the bed. On a table nearby are a syringe, spoon and lighter. Did she overdose? (0:12)

Cody's brother Holden shoots himself in the head: twice on camera (0:40), once off camera. (0:44)

Art's dealer friend "Sudden" (?) asks, "You score some fluoxetines?" (1:01) [This is: a) a joke, b) an error, or c) Prozac really is a street drug?]

Art asks Cody not to shoot up as she starts to prepare a syringe. (1:14)

Is Sabrina transsexual? (0:06)

fluoxetine | heroin | suicide

Bobby

Campaign volunteer Jimmy asks his colleague Cooper, "What if I was stoned?" (0:18)

Cooper tells hippy drug dealer Fisher "We just want to get another joint from you" (0:28)
Fisher: "Why are you here? What are you looking for? Why do you want to get stoned?"
Jimmy: "We want to get stoned because it feels good, man."
Fisher: "Bingo! Because it feels good! You want to get stoned because it feels good, right?"
Cooper: "Right!"
Fisher: "Wrong!"
Cooper: "Why is that wrong?"
Fisher: "Because it's a cop out"
Jimmy: "Ok, then can you explain to us why, for what other reason than the fact it feels good, do we want to get stoned, man?"
Fisher: "Because it's our way of getting closer to god. That is what you're looking for; except for you didn't know it until this minute."

Fisher uses an eye dropper to drip LSD onto sugar cubes. (0:37)
Fisher: "LSD was first discovered in 1938... She can be beautiful. She can be terrifying. The difference between a good trip and a bad trip is completely contingent on your willingness to let go."

Fisher, Jimmy, and Cooper experience sensory distortions after taking LSD. Fisher converses with an orange. (0:44)
Jimmy and Cooper play tennis while intoxicated. (0:57)
Jimmy and Cooper still intoxicated by the pool. (1:03)
Waitress Susan suspects that Jimmy and Cooper are intoxicated because their pupils are "like saucers." (1:12)

Jack and Samantha, by the swimming pool, discuss Jack's psychotherapy. (1:02)
Jack: "You're being passive aggressive."
Samantha: "all that headshrinker gibberish stuff."
Samantha: "I never thought you needed to be fixed in the first place."
Jack: "It was your idea for me to go."
Samantha: "because you're sad."
Jack: "it's called depression..."
Samantha: (I don't understand what you have to be depressed about. What do you talk about in there anyway?"

hallucination | hallucinogen | Hallucinogen Intoxication | LSD | psychedelic | psychotomimetic

The Rules of the Game

After André drives their car into a ditch Octave asks, "Want to kill yourself over Christine? Go ahead, but without me." Later André admits, "So I'm nuts." (0:12)

Robert implores André, "Please help me calm her down." while carrying Jackie (1:22)
Robert asks André, "What's the dose?" Robert replies, "Give me four." Jackie, seeing what the two men says, "Sleeping pills? I hate sleeping pills." (1:23)

Even in France before World War II some distrusted "big pharma." Octave explains to Christine, "Today everyone lies. Pharmaceutical fliers, governments,..." (1:30)

hypnotic | suicide

Notes on a Scandal

Teacher Sheba does wrong in her sexual relationship with 15 year old student Steven, but teacher Barbara comes across as more malevolent in exploiting the situation to meet her own relationship needs and shows a pattern of such behavior over time.

Sheba, admittedly flawed, seems to have made a very big mistake, perhaps arising out of a variety of circumstances, including her own family background, but I find little to suggest a psychiatric diagnosis.

Barbara, however, might meet criteria for a Personality Disorder. Which one? She doesn't quite fit Borderline, but that seems closest.

Personality Disorder | Sexual Abuse of Child

Raising Jeffrey Dahmer

#raisingjeffreydahmer

(See also: Dahmer)

Jeffrey, on the witness stand, describes how he encountered one of his victims: "I asked him if he wanted to get high. He said yes." (0:01)

When a telephone caller tells his father Lionel that Jeffrey's mother Joyce has been taken to the hospital Lionel asks, "Overdose?" introducing the suggestion that she might have a drug problem. (0:03)

Lionel confronts young Jeffrey about killing goldfish. (0:18)

Lionel's mother Catherine talks about Joyce "checking herself in... needs help" apparently for a drug or psychiatric problem, and asks whether she will "get off of all those drugs." She says Lionel was a shy boy like Jeffrey. (0:19)

Jeffrey tries to hypnotize girl Elizabeth. (0:21) He orders her to take off her shirt; she starts to comply. (0:22)

In a TV interview Dr. Francine Price, presumably a psychologist or psychiatrist, refers to Jeffrey as a monster and a serial killer. She says as children they torture animals, that they might be loaners and might come from abusive home environments. (0:24)

 Lionel tells his second wife Shari about his belief that Jeffrey killed the gold fish and possibly a dog. (0:24)

Lionel talks about how Jeffrey collected road kill. (0:25)

Jeffrey plays with animal bones as Lionel removes dead animals from under the house. A "friend" on TV says Jeffrey told him he was sexually abused by Lionel. (0:26)

Jeffrey's friend tells Lionel Jeffrey drinks a lot. (0:36)

Lionel tells Shari about burning a garage when he himself was a child and about his fear of punshmnt by his own father. (0:37)

Lionel finds blood, tools, and animal remains in Catherine's house where Jeffrey lives. (0:40)

Jeffrey tells Lionel about experiments with chemicals and dead animals. (0:42)

Jeffrey tells Lionel how he stole a manaken. (0:44)

Lionel tells Jeffrey his sentence to jail for molesting a 13 year old boy is "only a year" (0:46)

Lionel tells Mr. Parker, Jeffrey's attorney: "He's a pedophile and an alcoholic." and expresses fear that if he is released he will not get needed help. (0:47) He adds, "He needs to talk to a professional, a psychiatrist or psychologist. (0:48)

Lionel reads Jeffrey's discharge from military service because of "alcoholism." (1:03)

Lionel asks Shari, "Do you think it was the drugs?" referring to Joyce's use of drugs during her pregnancy with Jeffrey. (1:08)

Looking out the window, Lionel  sees detective John Amos put revolver to head and pull the trigger. (1:09)

Catherine awakens complaining of a "horrible smell." Gustatory hallucination? (1:09)

Lionel blames himself for not knowing what his son would become. (1:12)

alcoholic | Antisocial Personality Disorder | hallucination | hypnotism | Jeffrey Dahmer | Pedophilia | suicide

Tuya's Marriage

Baolier tells how he gave up after repeated failures in drilling for oil and climbed to the top of a derrick, planning to jump to his death. He says, "You can kill somebody, but you can't commit suicide." (0:31)

Bater, despondent after Tuya leaves him in a nursing home, finishes off a bottle of wine or liquor, smashes it, and cuts his wrist with the broken glass. (0:49)

Tuya, angry at Bater, at his bedside in a hospital, refers to her own thoughts of suicide when she tells him, "If I could I would have done it already," (0:54) and, "then you can watch me die." (0:55)

suicide

Color of Night

Spoiler alert!

Michelle, distraught, removes a pistol from a drawer and places the barrel in her mouth as though preparing to shoot herself. (0:02)

Michelle in psychologist Bill's office in what appears to be a psychotherapy session. She jumps through the window and falls to her death. (0:03)

Bill and Larry, apparently in Larry's office, talking about Michelle's suicide. Is Larry a colleague, supervisor, or Bill's psychotherapist? (0:06)

Group psychotherapy session conducted by psychologist Bob:

• A copy of Peck's The Road Less Traveled sits on the bookshelf. (0:08)
• Bill joins the group, introduces himself as a "behaviorist." He says he is not a psychiatrist but is a psychologist and psychoanalyst. (0:10)
• Sondra admits, "I steal things." (0:12)
• Clark tells the group that Richie has gender identity problems and Social Phobia. (0:12)
• Richie stutters, "I can't talk." (0:13)
• Buck says he "lost my wife and daughter, and I can't seem to get past it." (0:14)
• Clark says he suffers from obsessive-compulsive disorder. (0:15)

In Bob's home we see books about Sigmund Freud on the bookshelf. Bill tells Bob, "I think I'm going crazy." (0:22)

Bill tells detective Hector there is an "issue of confidentiality" "similar to Miranda." (0:30)

In another group psychotherapy session Bill tells the group that Bob has been murdered. (0:38)

• Casey asks whether someone might need Xanax. Sondra asks whether someone might need Librium. (0:40)
• Bill admits to the group that, "Six weeks ago I spoke harshly to a patient, and she committed suicide right in front me." He explains that, "I don't see red now." (0:41)

Someone off-camera whips Casey, who is tied up for masochistic sex, apparently in his home. (0:86)

Bill visits Sondra at her home where they discuss other members of the group. (1:08)

Bill visits the shop of Richie's brother Dale and asks whether Richie sought treatment from another psychiatrist after leaving Dr. Niedelmeyer. (1:12)

Bill visits Dr. Niedelmeyer's wife. (1:15)

Group psychotherapy session led by Bill (1:16)

• Bill tells Sondra her husband was "projecting on you." (1:17)

Bill visits Clark at his home where they talk about Sondra. (1:23)

Bill visits Buck at his home. (1:31)

• Buck manifests exaggerated startle response to the sound of thunder, describes to Bill the murder of his wife and daughter which occurred on a stormy night. (1:33)

Bill visits Casey (1:40)

Group psychotherapy session led by Bill (1:52)

• Bill reads Bob's note about sociopathy. Hector joins the group. (1:55)

Larry talks to Bill about "multiple personality disorder," apparently in reference to Rose. (1:59)

Dr. Niedelmeyer's wife tells Bill, "Richie Dexter killed himself because he couldn't stand what Dr. Niedelmeyer was doing to him. He hanged himself with a belt." She tells Bill that Richie had a sister named Rose. (2:03)

Finding Richie in Dale's shop, Bill tells him he needs to see Rose. Richie becomes Rose, switches back to Richie, then back to Rose. (2:06)

After Rose shoots Dale with a nail gun in order to save Bill she tries to shoot herself in the neck with the gun, but it fails to fire. Bill then follows her to the top of a smokestack from which she appears to intend to jump. (2:13)

What should Bill do about his relationship with Rose now? He has already given up his practice back in New York and probably was practicing without a license in Los Angeles, so if boundary violations or other professional misconduct result in revocation of his license or expulsion from his professional association it might have little impact. However, might he be vulnerable to a malpractice suit or charges of practicing without a license? What effect would continuing their romantic relationship have on Rose? What impact would it have on her if he breaks off their relationship? What kind of treatment would you recommend for the surviving members of the psychotherapy group, Buck, Sondra, and Clark? Should they continue together in a group. Should Rose participate? Aside from the ethical questions, is it possible that Bill could effectively treat these people?

Rose's personality as Sondra's girlfriend Bonnie seems distinct from that of Bill's lover, but we have little sense of how she behaves with Clark, Casey, or Buck. Overall, is this kind of behavior consistent with Dissociative Identity Disorder?

Bereavement | boundaries | confidentiality | cross-dressing | Dissociative Identity Disorder | Gender Identity Disorder | group psychotherapy | Obsessive-Compulsive Disorder | psychoanalyst | psychologist | psychotherapist | psychotherapy | Sexual Masochism | sociopathy | startle response | Stuttering | switching | suicide

On the Beach

Spoiler alert!

It's 1964. USSR and USA have annihilated each other, and as the resulting cloud of nuclear fallout heads south Australia maintains life as close to usual as possible. But while awaiting certain death from radiation sickness the government has prepared suicide pills for all.

For much of the film American submariner Dwight talks about his wife Sharon and children as though they are still alive, acknowledging later in the film that he knows they must be dead when he tells Moira, "I can't cope with it." (1:00)

Peter asks a government official to help him obtain pills designated for assisted suicide for himself and his family. (0:46)

Peter tells his wife Mary about the suicide pills. Mary answers, "we don't have to discuss it do we?" She appears to be referring to the risk that he will not return alive from his mission

Moira tells Julian, "you're going to kill yourself." (1:03)

Peter asks Julian, "How do you tell a woman you love she has to kill herself and her baby?" (1:11)

Julian talks about "... weapons we couldn't use without committing suicide" (1:27)

Officials distribute suicide pills from the steps of a hospital. (1:57)

Julian stuffs cloth under the door of his garage then gets into his Ferrari and starts it. (2:05)

Peter brings suicide pills to Mary. (2:07)

Do you find it plausible that so many would choose suicide under these circumstances and that a government would provide the means, all with no apparent dissent?

Bereavement | denial | suicide

High Art

Spoiler alert!

This film surely holds the record for the number of scenes depicting snorting of a powder drug from mirrors with rolled currency, but we might assume it to be cocaine until 0:37 when Syd says, "I did a line of heroin." The film is about relationships, not drugs, but the most interesting character, Lucy, remains largely a mystery throughout.

Snorting a drug, presumably heroin: in a bathroom (0:07); Lucy & Greta (0:10); Arnie (0:14; Greta then Lucy (0:20); Greta and Syd (0:31); Arnie (0:33); Syd (0:46); Greta prepares (1:31); Lucy (1:32)

Greta: "We had fabulous opium there." (0:34)

Arnie injects heroin. (0:45)

Greta nearly dies of an overdose, but Syd revives her with CPR (0:51). [Is this at all plausible?]

Arnie tells Syd Lucy has died (1:34). Evidence points to suicide by overdose of heroin.

Bereavement | heroin | overdose | suicide

A Good Year

Uncle Henry's unexpected death after years without contact leads Max to renewed understanding of how important his uncle was to him and what he really wants (and who he wants to be) for the rest of his life.

Bereavement | corrective emotional experience