Spoiler alert!
Nurse at bedside reads Naval Medical Center Discharge Form: "Depression- PTSD. Ethol Abuse." (0:02)
Rock singer Dori, at the end of a song, says inappropriate, irrational things to her concert audience, appearing to alienate them. Does this reflect delusional thinking? (0:06)
A motor vehicle accident leaves Sue unconscious from a head injury and Father Concoff in critical condition. (0:11)
Mark's father Gil beats Mark up. (0:15)
A sign reads: Haveral County, Connecticut Psychiatric Hospital. (0:16)
Gil talks to Mark about the loss of his mother (0:20)
Dori and Sue at Bedford House, a halfway house (0:28)
Mark's friend tells him about Sue, "She started to barf all her food and mutilate herself with razors." (0:38)
Dori tells Mark, "I'm schizophrenic." Mark tells her he wants to have schizophrenia too because he would be discharged and "be with you." (0:40)
Psychotherapy group. Sue: "I ate 3 bags of marshmallows... I wish I were dead." (0:43)
While meeting with her and her parents Dori's internist mentions "Thorazine." (0:49)
Sue tells Mark, referring to Dori, "She's pretty sick Mark. Schizophrenics are not well." (1:02)
Dori becomes distracted while playing foosball with Mark. (1:08)
Dori back in hospital. (1:09)
In the halfway house Dori breaks window glass, cutting herself. Back in hospital again she takes unidentified pills provided by nurse. (1:10)
Dori composes a letter to Mark: "Then I went insane. I thought hell was really calling me, and I'm back in St. Tony's. These pills make my tongue all heavy and fat." (1:10)
Group psychotherapy at the halfway house. When mark returns Dori addresses him from the porch: "Mark, this is my support group. They're here in order to support me saying that I can't see you anymore." (1:18)
Combat injured Mark passes out after exposure to emotional stimulus in the form of a letter from Dori. Can cataplexy result from a brain injury? (1:29)
At the halfway house Mark discusses Dori with her psychotherapist, who wants him to stay away from her. She says, "The onset of schizophrenia in the early 20s is not a good prognosis." (1:21)
How does the portrayal of Dori in this film match or differ from that of most individuals who suffer from schizophrenia? What other diagnoses might you consider? What about Sue? Can we attribute her psychopathology to the head injury?
Bereavement | cataplexy | chlopromazine | delusion | dystonia | group psychotherapy | Physical Abuse of Child | psychiatric hospital | psychotherapist | Schizophrenia
Monday, January 31, 2011
Saturday, January 29, 2011
City Island
A study in family secrets. Everyone has a secret from the rest of the family.
When Vivian's mother Joyce asks her why they took her scholarship away, she answers, "Because I got caught with pot in my room... It's such a stupid word. Pot." (1:32)
cannabis | family secrets
When Vivian's mother Joyce asks her why they took her scholarship away, she answers, "Because I got caught with pot in my room... It's such a stupid word. Pot." (1:32)
cannabis | family secrets
Monday, January 24, 2011
Drug Runners
A series of brief scenes depict cocaine: dividing the drug on a mirror with a razor, snorting it through a straw, weighing the drug and packaging it. (0:01)
Large packages of cocaine, a man taste testing the drug. (0:05)
Packages of cocaine. (0:06)
In a drug deal we see a briefcase full of packaged white powder. A chemical test of the drug appears to demonstrate it is not cocaine. (1:01)
Preparing to interrogate undercover CIA agent Angela, drug lord Victor orders his moll, holding a syringe: "Consuelo, let's start with Thorazine." She injects Angela's wrist (in the wrong direction). (1:09)
Consuelo injects Angela once more, this time in her right antecubital fossa (this time in the right direction). She tells Victor the "Pentothal should be taking effect." (1:10)
DEA agent Temple observes that heroin is cooking and a drug lab. Powder spills out of a box. (1:14)
chlorpromazine | cocaine | thiopental
Large packages of cocaine, a man taste testing the drug. (0:05)
Packages of cocaine. (0:06)
In a drug deal we see a briefcase full of packaged white powder. A chemical test of the drug appears to demonstrate it is not cocaine. (1:01)
Preparing to interrogate undercover CIA agent Angela, drug lord Victor orders his moll, holding a syringe: "Consuelo, let's start with Thorazine." She injects Angela's wrist (in the wrong direction). (1:09)
Consuelo injects Angela once more, this time in her right antecubital fossa (this time in the right direction). She tells Victor the "Pentothal should be taking effect." (1:10)
DEA agent Temple observes that heroin is cooking and a drug lab. Powder spills out of a box. (1:14)
chlorpromazine | cocaine | thiopental
Saturday, January 22, 2011
Monday, January 17, 2011
The Madness of King George
#madnessgeorge
Spoiler alert!
King George III suffers a bout of acute abdominal pain. (0:18)
George begins to exhibit uncharacteristic behavior possibly suggestive of euphoric mood. (0:19)
George awakens at four o'clock in the morning, fully alert but irritable with increased energy and runs off singing. (0:25)
George leads his staff in the Lord's Prayer, dressed only in his underwear, in the middle of a meadow with Queen Charlotte, then initiates what might have turned into a sexual assault of Lady Pembroke. (0:27)
His staff notice that George's urine is blue. (0:29)
George appears frustrated and irritable. (0:32)
At a court concert George attempts to conduct the orchestra, play the harpsichord and sing. He displays inappropriate affect and inappropriate conduct with the audience. (0:34)
George attacks his son, the Prince of Wales. (0:36)
Dr. (?) Baker tells the Prince of Wales the king is "still demented sir." (0:37)
George, laboring under delusion, takes his children to the roof to avoid a catastrophic flood. (0:38)
George says, "I have to talk to keep up with my thoughts." Flight of ideas? (0:39)
After enduring some abusive behavior by George, Queen Charlotte asks him, "Do you think that you're mad?" He responds, "I don't know." (0:40)
Baker describes George to a group of physicians as suffering from "persistent delirium." (0:44)
George cowers under a bed. His physicians treat him with fire cupping to draw out "humors." (0:45)
George appears depleted, complains that he sees only as if through a fog, and cries. (0:46)
Introduction of Dr. Willis who will provide George with what might best be described as psychiatric treatment, as it were. He observes, "Some of my lunatics fancy themselves king." (0:54)
After his introduction to Dr. Willis George asks, "A mad doctor is it...?" (0:57)
Dr. Willis shows George a chair fitted with leather straps for restraining the occupant, a primitive substitute for treatment. (0:58)
George in a camisole. (1:04)
Dr. Willis spoon-feeds soup to George, strapped in his restraint chair. Willis shows great restraint himself in persisting undaunted even after George spits the soup on him. (1:07)
George, apparently delusional once more, says, "They've killed the queen... I make the weather by means of mental powers." His speech becomes rapid. (1:10)
George, submitting now to his treatment by Dr. Willis, volunteers to be placed in his restraint chair. (1:14)
Staff notice that the color of George's urine has returned to yellow. (1:30)
Was George's condition consistent with an episode of intermittent porphyria? Note the tension between Dr. Willis and his psycho-social approach and the establishment physicians with their biological (if you can call it that) approach. We have made so much progress.
adverse effect | camisole | delusion | euphoria | Flight of ideas | inappropriate affect | irritable mood | Psychotic Disorder Due to a General Medical Condition | restraint
Read the book:
Spoiler alert!
King George III suffers a bout of acute abdominal pain. (0:18)
George begins to exhibit uncharacteristic behavior possibly suggestive of euphoric mood. (0:19)
George awakens at four o'clock in the morning, fully alert but irritable with increased energy and runs off singing. (0:25)
George leads his staff in the Lord's Prayer, dressed only in his underwear, in the middle of a meadow with Queen Charlotte, then initiates what might have turned into a sexual assault of Lady Pembroke. (0:27)
His staff notice that George's urine is blue. (0:29)
George appears frustrated and irritable. (0:32)
At a court concert George attempts to conduct the orchestra, play the harpsichord and sing. He displays inappropriate affect and inappropriate conduct with the audience. (0:34)
George attacks his son, the Prince of Wales. (0:36)
Dr. (?) Baker tells the Prince of Wales the king is "still demented sir." (0:37)
George, laboring under delusion, takes his children to the roof to avoid a catastrophic flood. (0:38)
George says, "I have to talk to keep up with my thoughts." Flight of ideas? (0:39)
After enduring some abusive behavior by George, Queen Charlotte asks him, "Do you think that you're mad?" He responds, "I don't know." (0:40)
Baker describes George to a group of physicians as suffering from "persistent delirium." (0:44)
George cowers under a bed. His physicians treat him with fire cupping to draw out "humors." (0:45)
George appears depleted, complains that he sees only as if through a fog, and cries. (0:46)
Introduction of Dr. Willis who will provide George with what might best be described as psychiatric treatment, as it were. He observes, "Some of my lunatics fancy themselves king." (0:54)
After his introduction to Dr. Willis George asks, "A mad doctor is it...?" (0:57)
Dr. Willis shows George a chair fitted with leather straps for restraining the occupant, a primitive substitute for treatment. (0:58)
George in a camisole. (1:04)
Dr. Willis spoon-feeds soup to George, strapped in his restraint chair. Willis shows great restraint himself in persisting undaunted even after George spits the soup on him. (1:07)
George, apparently delusional once more, says, "They've killed the queen... I make the weather by means of mental powers." His speech becomes rapid. (1:10)
George, submitting now to his treatment by Dr. Willis, volunteers to be placed in his restraint chair. (1:14)
Staff notice that the color of George's urine has returned to yellow. (1:30)
Was George's condition consistent with an episode of intermittent porphyria? Note the tension between Dr. Willis and his psycho-social approach and the establishment physicians with their biological (if you can call it that) approach. We have made so much progress.
adverse effect | camisole | delusion | euphoria | Flight of ideas | inappropriate affect | irritable mood | Psychotic Disorder Due to a General Medical Condition | restraint
Read the book:
Sunday, January 16, 2011
The White Ribbon
The midwife's (Mrs. Wagner) son Karl looks different. Is he mentally retarded? Down syndrome? (0:04)
The schoolteacher (narrator) Martin, one of the pastor's sons, walking precariously on the railing of a bridge. The boy explains, "I gave God a chance to kill me." (0:11)
The pastor tells the children he will tie a white ribbon to each of them to remind them to behave. A behavioral approach to parenting? (0:12)
The pastor beats his children off camera. The farmer's son visits his mother's body after she falls to her death in a mill. (0:28)
The pastor talks to Martin about his symptoms, including depression, weariness, decreased appetite, and insomnia, and implies all result from masturbation. (0:59)
The doctor tells the midwife there is "nothing like a nice dose of self-hate." (1:04)
One of his other sons opens the door to find Max's father hanging by the neck. (1:18)
The doctor's son Rudi, unable to find his sister Anni, finds his father in an examining room apparently sexually abusing Anni. (1:35)
Georg (the steward?) beats and kicks his son for taking Sigi's (the baron's son) whistle. (1:55)
Bereavement | Physical Abuse of Child | Sexual Abuse of Child | suicide
The schoolteacher (narrator) Martin, one of the pastor's sons, walking precariously on the railing of a bridge. The boy explains, "I gave God a chance to kill me." (0:11)
The pastor tells the children he will tie a white ribbon to each of them to remind them to behave. A behavioral approach to parenting? (0:12)
The pastor beats his children off camera. The farmer's son visits his mother's body after she falls to her death in a mill. (0:28)
The pastor talks to Martin about his symptoms, including depression, weariness, decreased appetite, and insomnia, and implies all result from masturbation. (0:59)
The doctor tells the midwife there is "nothing like a nice dose of self-hate." (1:04)
One of his other sons opens the door to find Max's father hanging by the neck. (1:18)
The doctor's son Rudi, unable to find his sister Anni, finds his father in an examining room apparently sexually abusing Anni. (1:35)
Georg (the steward?) beats and kicks his son for taking Sigi's (the baron's son) whistle. (1:55)
Bereavement | Physical Abuse of Child | Sexual Abuse of Child | suicide
Saturday, January 15, 2011
The Black Balloon
A family's emotional challenges and triumphs in raising a child with autism.
Thomas tells the new neighbors of his brother Charlie, "He's autistic." (0:01) How can we tell that Charlie is autistic rather than mentally retarded, or both?
Charlie's mother Maggie administers unidentified medication to Charlie orally using a syringe. (0:04)
Thomas administers medication to Charlie orally using a syringe. (0:15, 0:29)
Maggie uses sign language to communicate with Charlie who we learn has been mute for years. (0:19) We have no reason to believe Charlie is deaf. Why does his mother sign to him?
Charlie's dad Simon tells social service workers visiting his home, "That'd be Charlie. He's autistic, you know. ADD on top of that. (0:49) Do we see any signs of Attention-Deficit/Hyperactivity Disorder? If not, could it be that the medication administered by syringe treats it effectively?
Note the similarities between Charlie and Arnie in What's Eating Gilbert Grape.
Autistic Disorder | mutism
Thomas tells the new neighbors of his brother Charlie, "He's autistic." (0:01) How can we tell that Charlie is autistic rather than mentally retarded, or both?
Charlie's mother Maggie administers unidentified medication to Charlie orally using a syringe. (0:04)
Thomas administers medication to Charlie orally using a syringe. (0:15, 0:29)
Maggie uses sign language to communicate with Charlie who we learn has been mute for years. (0:19) We have no reason to believe Charlie is deaf. Why does his mother sign to him?
Charlie's dad Simon tells social service workers visiting his home, "That'd be Charlie. He's autistic, you know. ADD on top of that. (0:49) Do we see any signs of Attention-Deficit/Hyperactivity Disorder? If not, could it be that the medication administered by syringe treats it effectively?
Note the similarities between Charlie and Arnie in What's Eating Gilbert Grape.
Autistic Disorder | mutism
Thursday, January 13, 2011
The Tiger and the Snow
Poet and professor Attilio and his friend Ermanno discuss dreams. "It denotes a primitive subconscious." and "Sigmund Freud thinks so." (0:17)
In a dream Attilio prepares to wed Vittoria, the woman he loves, as a kangaroo. Ermanno sits at a table watching with a cigar smoking Freud and says, "It's her, the symbolism is obvious!" (0:34)
Attilio finds his poet friend Fuad hanging by the neck from a tree in the courtyard of Fuad's home in Baghdad. (1:35)
Vittoria tells Attilio that Fuad killed himself. (1:45)
Bereavement | Sigmund Freud | suicide
In a dream Attilio prepares to wed Vittoria, the woman he loves, as a kangaroo. Ermanno sits at a table watching with a cigar smoking Freud and says, "It's her, the symbolism is obvious!" (0:34)
Attilio finds his poet friend Fuad hanging by the neck from a tree in the courtyard of Fuad's home in Baghdad. (1:35)
Vittoria tells Attilio that Fuad killed himself. (1:45)
Bereavement | Sigmund Freud | suicide
Wednesday, January 12, 2011
True Romance
Suitcase packed with packages of cocaine. (0:20, 0:34, 1:00)
While attempting to conceal a package of cocaine from an approaching traffic cop Elliott accidentally breaks open the package, covering himself with the white powder. (1:25)
Dick's roommate Floyd smokes marijuana in a clear pipe. (1:37)
Movie producer Lee snorts cocaine after dividing lines with a razor on a mirror. (1:43)
cannabis | cocaine
While attempting to conceal a package of cocaine from an approaching traffic cop Elliott accidentally breaks open the package, covering himself with the white powder. (1:25)
Dick's roommate Floyd smokes marijuana in a clear pipe. (1:37)
Movie producer Lee snorts cocaine after dividing lines with a razor on a mirror. (1:43)
cannabis | cocaine
Monday, January 10, 2011
Most High
The film opens with an interview in black white of a teen girl and an older man. The girl answers, "When I was younger, when I was like 10 or 11, I was anorexic for a couple years, and then I switched to cutting... started experimenting with heroin a little bit... I thought a drug addict was like... my ideal self..." A close-up of the girls right arm reveals dozens of scars. (0:01)
Now in color we see mental-health technician (?) Julius working with patient Billy at what may be a psychiatric hospital or clinic. Does Billy suffer from autism or mental retardation? (0:03)
During the rest of the film short black-and-white clips of interviews are interspersed until the end where there is a convergence in which Julius, now badly deteriorated, presumably a result of his drug use, undergoes interview in black and white.
Julius drinks while listing his excuses: "Celebrate. Drink. You're sad. You just came home, late, tired. Why don't you have a drink?" (1:15)
Julius finds his surrogate father Jack dead at the wheel of his car. Julius pours Jack's ashes on the baseball field. (0:19)
Jack's daughter Erica snorts a fingernail full of what is apparently cocaine from a small box. (0:28)
Julius helps Billy with a coloring project in the craft room. (0:30)
Interview of older man in black and white: "I'm a recovering alcoholic, addict, and chronic gambler, in recovery from all three... All the drugs and alcohol I was using stopped working." (0:36)
Erica's friend toys with cocaine on a metal tray then snorts some while describing how she had been depressed during an abusive relationship and was stalked after it ended. (0:38)
Julius snorts cocaine. (0:41)
More snorting of cocaine by Julius, Erica, and others, mostly using a rolled up bill and a mirror. (0:46, 0:47, 0:48, 0:49)
Julius snorts cocaine on the top of the toilet tank before he converses with a cockroach. Substance Intoxication Delirium? (0:54)
Erica tells Julius, "You might be able to get it up if you didn't do so much speed." (0:57)
Interview of a recovering counselor: "... being sober... What's left is death." (1:02)
Close up of mainlining, presumably heroin, but with no tourniquet. (1:08)
Syringes and other drug paraphernalia on a tabletop. (1:09)
Brief shots of a syringe with needle. (1:11, 1:12)
Julius' friends May and James present him with flowers for the "one hour anniversary of your sobriety." (1:28)
Interviews of Julius. (1:30, 1:35)
Erica in rehab (?). (1:32)
addict | addiction | Bereavement | cocaine | drug | Intoxication | recovery | self mutilation
Now in color we see mental-health technician (?) Julius working with patient Billy at what may be a psychiatric hospital or clinic. Does Billy suffer from autism or mental retardation? (0:03)
During the rest of the film short black-and-white clips of interviews are interspersed until the end where there is a convergence in which Julius, now badly deteriorated, presumably a result of his drug use, undergoes interview in black and white.
Julius drinks while listing his excuses: "Celebrate. Drink. You're sad. You just came home, late, tired. Why don't you have a drink?" (1:15)
Julius finds his surrogate father Jack dead at the wheel of his car. Julius pours Jack's ashes on the baseball field. (0:19)
Jack's daughter Erica snorts a fingernail full of what is apparently cocaine from a small box. (0:28)
Julius helps Billy with a coloring project in the craft room. (0:30)
Interview of older man in black and white: "I'm a recovering alcoholic, addict, and chronic gambler, in recovery from all three... All the drugs and alcohol I was using stopped working." (0:36)
Erica's friend toys with cocaine on a metal tray then snorts some while describing how she had been depressed during an abusive relationship and was stalked after it ended. (0:38)
Julius snorts cocaine. (0:41)
More snorting of cocaine by Julius, Erica, and others, mostly using a rolled up bill and a mirror. (0:46, 0:47, 0:48, 0:49)
Julius snorts cocaine on the top of the toilet tank before he converses with a cockroach. Substance Intoxication Delirium? (0:54)
Erica tells Julius, "You might be able to get it up if you didn't do so much speed." (0:57)
Interview of a recovering counselor: "... being sober... What's left is death." (1:02)
Close up of mainlining, presumably heroin, but with no tourniquet. (1:08)
Syringes and other drug paraphernalia on a tabletop. (1:09)
Brief shots of a syringe with needle. (1:11, 1:12)
Julius' friends May and James present him with flowers for the "one hour anniversary of your sobriety." (1:28)
Interviews of Julius. (1:30, 1:35)
Erica in rehab (?). (1:32)
addict | addiction | Bereavement | cocaine | drug | Intoxication | recovery | self mutilation
Sunday, January 9, 2011
Seance On a Wet Afternoon
Spoiler alert!
Psychic medium Myra tells her husband Billy there has been "too much sorrow" in their lives. (0:13)
Billy appears to use an inhalant like ether or chloroform to facilitate his kidnapping of Amanda. (0:27)
Billy confronts Myra that their son Arthur was "born dead." (0:35)
During the last seance Myra enters a trance-like state during which she appears to talk to Arthur. (1:47)
Does Myra's entry into a trance state during her seances represent self-hypnosis? She appears to believe that she can communicate with Arthur. Would you consider her delusional or just in a state of denial?
Bereavement | delusion | denial | hypnosis | inhalant
Psychic medium Myra tells her husband Billy there has been "too much sorrow" in their lives. (0:13)
Billy appears to use an inhalant like ether or chloroform to facilitate his kidnapping of Amanda. (0:27)
Billy confronts Myra that their son Arthur was "born dead." (0:35)
During the last seance Myra enters a trance-like state during which she appears to talk to Arthur. (1:47)
Does Myra's entry into a trance state during her seances represent self-hypnosis? She appears to believe that she can communicate with Arthur. Would you consider her delusional or just in a state of denial?
Bereavement | delusion | denial | hypnosis | inhalant
Saturday, January 8, 2011
Julia
Spoiler alert!
Based on Lillian Hellman's book Pentimento
.
Her medical student friend Julia tells aspiring writer Lillian, "... Vienna. I'll finish my medical studies there, and then I'll apply to study with Professor Freud." (0:18)
Her friend Sammy tells Lillian, "I tried to kill myself in Elba." (1:30)
Lillian discovers that nazis have killed Julia. (1:45)
Bereavement | Sigmund Freud | suicide
Based on Lillian Hellman's book Pentimento
.Her medical student friend Julia tells aspiring writer Lillian, "... Vienna. I'll finish my medical studies there, and then I'll apply to study with Professor Freud." (0:18)
Her friend Sammy tells Lillian, "I tried to kill myself in Elba." (1:30)
Lillian discovers that nazis have killed Julia. (1:45)
Bereavement | Sigmund Freud | suicide
Monday, January 3, 2011
Mr. Jones
Spoiler alert!
A study in the psychopathology and treatment challenges of Bipolar Disorder. Please do not assume the psychiatrist's boundary problems go with the territory.
Manic depressive (bipolar) carpenter Mr. Jones, exhibiting euphoric mood and grandiose thinking, makes an expansive gesture with his hammer. Tapping into his fantasies of flying, an airplane passing overhead distracts him as he stands on a roof. (0:03)
After demonstrating near psychic powers of intuition Jones gives away money to his new carpenter friend Howard. (0:05)
Even more precariously perched on the roof Jones says, "We're gonna fly." (0:07)
Psychiatrists Libbie and Patrick, making rounds in a psychiatric hospital, mention auditory hallucinations, Paranoid Schizophrenia, and Haldol as they discuss Jones, assess his level of orientation and decide to sedate him. (0:10)
In a session with Libbie her patient Amanda talks rapidly before breaking into tears. (0:14)
We see more patients, including a distraught woman and a man who produces apparently delusional talk about the Pentagon, communications from CBS news, and poison. (0:15)
Mr. Jones exhibits flight of ideas as he talks to Libbie before he leaves the hospital. In a staff meeting Libbie tells Patrick and senior psychiatrist Dr. Holland she believes Mr. Jones was misdiagnosed: "He was psychotic, but not schizophrenic. He was expansive, intrusive, inappropriate, euphoric. I think he's manic." (0:18)
Mr. Jones appears euphoric with increased energy as he sings, "I Feel Good." (0:19)
Mr. Jones withdraws all his money from the bank and pays $100 for a few hot dogs. (0:20)
Libbie with another female patient in session. (0:24)
During a performance of Beethoven's ninth symphony Jones, oblivious the inappropriateness of his behavior, walks onto the stage and begins conducting. (0:26)
Back in the hospital, Jones, now in restraints, rapidly recites numbers while Libbie and Patrick watch. Libby tells Jones, "You have a disease, manic depressive disorder. It's like having diabetes." Patrick tells him, "It's a highly treatable chemical imbalance." Jones responds, "I do not have a disease. This is who I am." When Libby tells him she wants to give him something to help him rest, he says, "Forget the Haldol." She tells him it is Amytal, "just a sedative." He accepts, and after a nurse injects him he rapidly calms. (0:27)
At a "competency hearing" Libby testifies that Jones is "suffering from bipolar manic depressive disorder. I believe that he is currently in the manic cycle... I think that his judgment is impaired and that he is a danger to himself... The manic state is usually followed by depression [with] hopelessness, despair, the inability to experience pleasure, the inability to function." (0:31)
On the witness stand Jones tells the court, "I could've done a better job conducting that Beethoven piece." I believe he means better than the conductor. (0:34)
Libbie tells Jones, "Next time you're in trouble don't ask for me." (0:35) Is this the first sign of dissolving boundaries?
Libbie asks Jones, "Do you crash? Do you get suicidal." He shows her his bottle of lithium. She screams at him to "shut up," then apologizes and gives him a ride in her car. She attempts to find out more about his past history, but Jones accuses her of rudeness. (0:36)
Jones asks Libbie to feed him. She buys him dinner. (0:38)
Jones touches Libbie then massages her neck. She tosses him the forgotten bottle of medication, and he promptly discards it. (0:44)
Jones' develops psychomotor retardation as he appears to enter a Major Depressive Episode. (0:47)
Jones' movements continue to slow, and he exhibits signs of self neglect such as failure to shave. He looks sad as he wanders aimlessly in front of traffic, apparently oblivious to his surroundings. (0:49)
Jones' friend Howard talks with Libbie by telephone while she stands in the hospital day room, patients screaming in the background. (0:50)
Libbie waits in Jones' apartment. (0:51)
Jones cries. Libbie holds him. He falls to the floor. Back in the hospital a singing mental-health technician bathes him. (0:52)
Libbie makes a videotape of Jones in her office. On her bookshelf sit numerous volumes of Freud and stacked videotapes of her patients. (0:53)
Patients engage in movement or dance treatment outdoors. (0:54)
Group psychotherapy. A nurse gives medication to Jones. He tries to work on a craft project with other patients. (0:55)
In a session with Libbie Jones talks about how his girlfriend Ellen died. (0:55)
Jones tells Libbie about a suicide attempt during college in which he took 73 aspirin tablets. (0:57)
Libbie encounters a patient who appears to have escaped from the ward. When she tries to coax him back through the doors he attacks and tries to strangle her, but Jones rescues her and talks the man down instinctively before technicians arrive and chaos ensues. (1:01)
Libbie thanks Jones for rescuing her. (1:04)
As a nurse passes out medications in the hospital day room Jones erupts. (1:09)
In a session with Libbie Jones tells her, "I really need my highs." When he begins to cry she touches him. (1:10)
Dr. Holland and Libbie meet with Amanda and her family. Amanda hugs Libbie as she leaves the hospital. (1:13)
Libbie talks to the bank teller Jones spent time with leading up to the incident at the symphony concert. Libbie refuses to answer questions about Jones. A vestige of professionalism remains. (1:15)
Libbie tries to investigate Jones' history at the music school he attended. In another session with Jones she brings up the subject of his friend Ellen. Jones tells her she is sick and accuses her of spying on him. When it surfaces that Ellen never died, Jones leaves the session angry. (1:18)
Boundaries deteriorate further: in the rain Libbie gets in her car. Jones kicks the car. Libbie gets out of the car and runs after him. He tells her, "I was too much trouble for everybody." She tells him how she would be hurt if he killed himself. He takes her hand and they kiss. (1:22)
Psychiatry staff meeting with Dr. Holland. (1:26)
Libbie in her office with a female patient. (1:27)
Libbie tries to convince Patrick to take over Jones' case, ultimately admitting, "I slept with him." So much for boundaries. Patrick agrees on condition that she sever her relationship with Jones. (1:28)
Other patients pursue Jones as he walks to Libbie's office. Technicians take him away and he appears sedated. (1:31)
On the street Jones appears euphoric and irritable. He engages in provocative intrusive behavior with strangers. (1:34)
Amanda has killed herself at her home. Libbie watches a videotape. (1:35)
Libbie tells Dr. Holland she is resigning her post at the hospital. (1:38)
Jones climbs to the roof again. Libbie follows him. He tells her he has accepted the fact that he cannot fly. He asks, "Now what?" Libbie answers, "Cup of coffee?... Decaf" (1:44)
amobarbital | anhedonia | Bipolar Disorder | boundaries | chemical imbalance | civil commitment | delusion | denial | depression | euphoria | flight of ideas | haloperidol | lithium | mania | Major Depressive Episode | mood | psychiatric hospital | psychiatrist | restraint | psychomotor retardation | sedative | Sigmund Freud | suicide
A study in the psychopathology and treatment challenges of Bipolar Disorder. Please do not assume the psychiatrist's boundary problems go with the territory.
Manic depressive (bipolar) carpenter Mr. Jones, exhibiting euphoric mood and grandiose thinking, makes an expansive gesture with his hammer. Tapping into his fantasies of flying, an airplane passing overhead distracts him as he stands on a roof. (0:03)
After demonstrating near psychic powers of intuition Jones gives away money to his new carpenter friend Howard. (0:05)
Even more precariously perched on the roof Jones says, "We're gonna fly." (0:07)
Psychiatrists Libbie and Patrick, making rounds in a psychiatric hospital, mention auditory hallucinations, Paranoid Schizophrenia, and Haldol as they discuss Jones, assess his level of orientation and decide to sedate him. (0:10)
In a session with Libbie her patient Amanda talks rapidly before breaking into tears. (0:14)
We see more patients, including a distraught woman and a man who produces apparently delusional talk about the Pentagon, communications from CBS news, and poison. (0:15)
Mr. Jones exhibits flight of ideas as he talks to Libbie before he leaves the hospital. In a staff meeting Libbie tells Patrick and senior psychiatrist Dr. Holland she believes Mr. Jones was misdiagnosed: "He was psychotic, but not schizophrenic. He was expansive, intrusive, inappropriate, euphoric. I think he's manic." (0:18)
Mr. Jones appears euphoric with increased energy as he sings, "I Feel Good." (0:19)
Mr. Jones withdraws all his money from the bank and pays $100 for a few hot dogs. (0:20)
Libbie with another female patient in session. (0:24)
During a performance of Beethoven's ninth symphony Jones, oblivious the inappropriateness of his behavior, walks onto the stage and begins conducting. (0:26)
Back in the hospital, Jones, now in restraints, rapidly recites numbers while Libbie and Patrick watch. Libby tells Jones, "You have a disease, manic depressive disorder. It's like having diabetes." Patrick tells him, "It's a highly treatable chemical imbalance." Jones responds, "I do not have a disease. This is who I am." When Libby tells him she wants to give him something to help him rest, he says, "Forget the Haldol." She tells him it is Amytal, "just a sedative." He accepts, and after a nurse injects him he rapidly calms. (0:27)
At a "competency hearing" Libby testifies that Jones is "suffering from bipolar manic depressive disorder. I believe that he is currently in the manic cycle... I think that his judgment is impaired and that he is a danger to himself... The manic state is usually followed by depression [with] hopelessness, despair, the inability to experience pleasure, the inability to function." (0:31)
On the witness stand Jones tells the court, "I could've done a better job conducting that Beethoven piece." I believe he means better than the conductor. (0:34)
Libbie tells Jones, "Next time you're in trouble don't ask for me." (0:35) Is this the first sign of dissolving boundaries?
Libbie asks Jones, "Do you crash? Do you get suicidal." He shows her his bottle of lithium. She screams at him to "shut up," then apologizes and gives him a ride in her car. She attempts to find out more about his past history, but Jones accuses her of rudeness. (0:36)
Jones asks Libbie to feed him. She buys him dinner. (0:38)
Jones touches Libbie then massages her neck. She tosses him the forgotten bottle of medication, and he promptly discards it. (0:44)
Jones' develops psychomotor retardation as he appears to enter a Major Depressive Episode. (0:47)
Jones' movements continue to slow, and he exhibits signs of self neglect such as failure to shave. He looks sad as he wanders aimlessly in front of traffic, apparently oblivious to his surroundings. (0:49)
Jones' friend Howard talks with Libbie by telephone while she stands in the hospital day room, patients screaming in the background. (0:50)
Libbie waits in Jones' apartment. (0:51)
Jones cries. Libbie holds him. He falls to the floor. Back in the hospital a singing mental-health technician bathes him. (0:52)
Libbie makes a videotape of Jones in her office. On her bookshelf sit numerous volumes of Freud and stacked videotapes of her patients. (0:53)
Patients engage in movement or dance treatment outdoors. (0:54)
Group psychotherapy. A nurse gives medication to Jones. He tries to work on a craft project with other patients. (0:55)
In a session with Libbie Jones talks about how his girlfriend Ellen died. (0:55)
Jones tells Libbie about a suicide attempt during college in which he took 73 aspirin tablets. (0:57)
Libbie encounters a patient who appears to have escaped from the ward. When she tries to coax him back through the doors he attacks and tries to strangle her, but Jones rescues her and talks the man down instinctively before technicians arrive and chaos ensues. (1:01)
Libbie thanks Jones for rescuing her. (1:04)
As a nurse passes out medications in the hospital day room Jones erupts. (1:09)
In a session with Libbie Jones tells her, "I really need my highs." When he begins to cry she touches him. (1:10)
Dr. Holland and Libbie meet with Amanda and her family. Amanda hugs Libbie as she leaves the hospital. (1:13)
Libbie talks to the bank teller Jones spent time with leading up to the incident at the symphony concert. Libbie refuses to answer questions about Jones. A vestige of professionalism remains. (1:15)
Libbie tries to investigate Jones' history at the music school he attended. In another session with Jones she brings up the subject of his friend Ellen. Jones tells her she is sick and accuses her of spying on him. When it surfaces that Ellen never died, Jones leaves the session angry. (1:18)
Boundaries deteriorate further: in the rain Libbie gets in her car. Jones kicks the car. Libbie gets out of the car and runs after him. He tells her, "I was too much trouble for everybody." She tells him how she would be hurt if he killed himself. He takes her hand and they kiss. (1:22)
Psychiatry staff meeting with Dr. Holland. (1:26)
Libbie in her office with a female patient. (1:27)
Libbie tries to convince Patrick to take over Jones' case, ultimately admitting, "I slept with him." So much for boundaries. Patrick agrees on condition that she sever her relationship with Jones. (1:28)
Other patients pursue Jones as he walks to Libbie's office. Technicians take him away and he appears sedated. (1:31)
On the street Jones appears euphoric and irritable. He engages in provocative intrusive behavior with strangers. (1:34)
Amanda has killed herself at her home. Libbie watches a videotape. (1:35)
Libbie tells Dr. Holland she is resigning her post at the hospital. (1:38)
Jones climbs to the roof again. Libbie follows him. He tells her he has accepted the fact that he cannot fly. He asks, "Now what?" Libbie answers, "Cup of coffee?... Decaf" (1:44)
amobarbital | anhedonia | Bipolar Disorder | boundaries | chemical imbalance | civil commitment | delusion | denial | depression | euphoria | flight of ideas | haloperidol | lithium | mania | Major Depressive Episode | mood | psychiatric hospital | psychiatrist | restraint | psychomotor retardation | sedative | Sigmund Freud | suicide
Sunday, January 2, 2011
Disney's A Christmas Carol
Based on the book by Charles Dickens: A Christmas Carol
As in the earlier A Christmas Carol there may be a fine line here between hallucinations and visions. In this new version, however, as the story progresses the special effects seem to become less like hallucinations and more real. Also, by comparison, the new version attends only fleetingly to the emotional impact on Scrooge of his earlier losses.
The first apparent hallucination occurs as Scrooge approaches the front door of his home. The sculpture in his door knocker appears to transform into the image of his dead partner, Marley. (0:17)
Scrooge suggests to Marley's ghost that his vision might be nothing more than a product of indigestion. Psychotic Disorder Due to a General Medical Condition? (0:22)
Looking out the window Scrooge sees visions of myriad tortured souls. (0:28)
The ghost of Christmas past appears as a burning candle. (0:30)
The ghost of Christmas present. (0:45)
Scrooge sees the visual embodiment of "want," represented by a young woman, clad in a camisole. (1:01)
Grief over the death of young Tim Cratchit. (1:14)
Bereavement | camisole | hallucination | Psychotic Disorder Due to a General Medical Condition
As in the earlier A Christmas Carol there may be a fine line here between hallucinations and visions. In this new version, however, as the story progresses the special effects seem to become less like hallucinations and more real. Also, by comparison, the new version attends only fleetingly to the emotional impact on Scrooge of his earlier losses.
The first apparent hallucination occurs as Scrooge approaches the front door of his home. The sculpture in his door knocker appears to transform into the image of his dead partner, Marley. (0:17)
Scrooge suggests to Marley's ghost that his vision might be nothing more than a product of indigestion. Psychotic Disorder Due to a General Medical Condition? (0:22)
Looking out the window Scrooge sees visions of myriad tortured souls. (0:28)
The ghost of Christmas past appears as a burning candle. (0:30)
The ghost of Christmas present. (0:45)
Scrooge sees the visual embodiment of "want," represented by a young woman, clad in a camisole. (1:01)
Grief over the death of young Tim Cratchit. (1:14)
Bereavement | camisole | hallucination | Psychotic Disorder Due to a General Medical Condition
Saturday, January 1, 2011
A Loving Father
Author Leo asks his son Paul, "Still a junkie?" (0:24)
Leo's daughter Virginia learns that Leo has been killed. (0:34)
Leo asks his son Paul, "You want more money so you can shoot up?" (0:36)
Paul, desperately trying to reconnect with his father after an extended , recites an imagined dialogue between himself and Leo about his struggles with addiction as his father stares into space:
"I was wondering, are you still doing drugs?"
"No, I quit. You quit?"
"I don't believe it."
"It's true. Look at my eyes."
"Yes, indeed, your pupils are quite normal. That's wonderful news."
"Tell me, Dad, did you ever wonder why I started shooting up?"
"Actually, it never crossed my mind."
"D'you mind if we talk about?"
"Why yes, Paul. Let's talk about it... "
"Well, you see, Dad, when I was high, I wasn't scared." (0:48)
Paul's dialogue continues: "But the hard part is quitting. When you quit, you're nothing. Nothing. You shiver,... Nothing compared to the courage it takes to quit. Nothing. You go through a nightmare when you quit. Alone!" (0:51)
Virginia, asked to identify the body, realizes it is not that of her father. (1:08)
After Paul, as a child, tries to destroy his father's work by pouring ink on the pages, Leo beats him and tries to drown him in the tub. (1:12)
On the ferry to Stockholm a young woman, seeing Leo staring over the railing, asks him, "Are you going to jump?" (1:18)
Virginia's world has been turned upside down as her fused relationship with her father, probably partly contingent upon his distance from her brother coupled with Paul's role of black sheep, has dissolved. She jumps over the railing, but Paul jumps in after her and barely saves her from drowning. (1:27)
abstinence | addiction | Bereavement | closeness/distance | emotional cutoff | fusion/intersubjective fusion | heroin | Physical Abuse of Child | recovery | suicide
Leo's daughter Virginia learns that Leo has been killed. (0:34)
Leo asks his son Paul, "You want more money so you can shoot up?" (0:36)
Paul, desperately trying to reconnect with his father after an extended , recites an imagined dialogue between himself and Leo about his struggles with addiction as his father stares into space:
"I was wondering, are you still doing drugs?"
"No, I quit. You quit?"
"I don't believe it."
"It's true. Look at my eyes."
"Yes, indeed, your pupils are quite normal. That's wonderful news."
"Tell me, Dad, did you ever wonder why I started shooting up?"
"Actually, it never crossed my mind."
"D'you mind if we talk about?"
"Why yes, Paul. Let's talk about it... "
"Well, you see, Dad, when I was high, I wasn't scared." (0:48)
Paul's dialogue continues: "But the hard part is quitting. When you quit, you're nothing. Nothing. You shiver,... Nothing compared to the courage it takes to quit. Nothing. You go through a nightmare when you quit. Alone!" (0:51)
Virginia, asked to identify the body, realizes it is not that of her father. (1:08)
After Paul, as a child, tries to destroy his father's work by pouring ink on the pages, Leo beats him and tries to drown him in the tub. (1:12)
On the ferry to Stockholm a young woman, seeing Leo staring over the railing, asks him, "Are you going to jump?" (1:18)
Virginia's world has been turned upside down as her fused relationship with her father, probably partly contingent upon his distance from her brother coupled with Paul's role of black sheep, has dissolved. She jumps over the railing, but Paul jumps in after her and barely saves her from drowning. (1:27)
abstinence | addiction | Bereavement | closeness/distance | emotional cutoff | fusion/intersubjective fusion | heroin | Physical Abuse of Child | recovery | suicide
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