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Psychology of Communication A Beautiful Mind Film Analysis

By Fitto Priestaza PR 2010 009201000063

CHAPTER I CASE BACKGROUND

Schizophrenia, a term introduced by Bleuler, names a persistent, often chronic and usually serious mental disorder affecting a variety of aspects of behavior, thinking, and emotion. Patients with delusions or hallucinations may be described as psychotic. Thinking may be disconnected and illogical. Peculiar behaviors may be associated with social withdrawal and disinterest.1 A Beautiful Mind is a 2001 biographical drama films about the life of John Nash, a mathematical genius that suffering schizophrenia. The film is based on the 1998 unauthorized biographical book with the same name, written by Sylvia Nasar. The film is begun when John Nash arrives at Princeton University because of the prestigious Carnegie scholarship for mathematics. He meets some new friends and some fellow Carnegie scholarship receiver, but he is not like people very much & he rather deals with numbers than with people. In the beginning his only close friend is his roommate, Charles Herman. Herman is a cheerful & friendly man that always support and accompany Nash wherever he go. Later on, Nash is struggle in finding his original idea for his thesis and he got the idea after hanging out at the bar with his friend, and suddenly inspired by looking a girl. Nash finished his study at Princeton and surprisingly got a prestigious appointment from the Massachusetts Institute of Technology and he also invited Sol and Bender to join his work at MIT. He works a couple years at Wheeler Labs as analyst in MIT and also as a lecturer. One day while teaching he met Alicia Larde, one of Nash student in his class. Nash found that Alicia is an interesting & smart woman, and later on the two is fall in love. One day Nash visited Princeton again after a long time where he meets again with Charles Herman. In that moment, Herman also introduces his niece named Marcee. She is a cheerful and friendly girl just like her uncle. After that, Nash and Marcee easily get close to each other. 1

http://behavenet.com/schizophrenia

The next day he asked by Pentagon to come and break some Russian secret code. He did it all day without rest and noticing other people in the room. After a couple hours, he breaks the code and found some secret coordinate of the Russian. While breaking the code, he was being watched by a mysterious man. Later on Nash followed by that mysterious man and the man revealed that he is a secret agent named William Parcher who asked Nash to join a government secret operation. He followed Parcher to his secret office and got the diode implant code as the identity. The day goes by and Nash keeps working to Parcher to solve many codes and send some classified documents to government’s house. After a while, finally he married with Alicia Larde, one of his student and later his romantic interest. At the wedding party he being watched by Parcher, and the next day Parcher told Nash that his decision to have relationship with people was wrong. In the middle of his activities he started to be paranoid. He feels that he being chased by Russian agents and tries to kill him because he is the only one who can break the Russian codes. The paranoid is getting worse and start to make his wife in risk. While he keeps send some classified documents to government’s house, later on his wife feels that his behavior is getting weird. Because of her worries, Alicia decides to call the psychiatry and Nash caught in the middle of his lecturing session. The psychiatry and Alicia later reveals that Nash is suffering Schizophrenia and the paranoid thing is part of the schizophrenia symptom. From the medical report, revealed that his secret work, Charles Herman, Marcee and William are not real and part of his hallucination. In fact he is only a lecturer in MIT alongside with Sol and Bender and from the Princeton report, he never had a roommate, he was signed to live alone. And Alicia find out that there is no government house that Nash always drop the secret documents, the building is only an abandoned house. The Psychiatry force him to do the insulin shock treatment and he need to consume a medicine every day. Once he realized that the medicine effect makes him not genius as before and without his wife knowing, he stop the medication and

the hallucination starts to appear again. When Alicia found that he called the Psychiatry again and the Psychiatry told him that if he stops the medication, the hallucination will take over his mind entirely and he needs to starts the treatment all over again, but nicely rejected but he wants to find the way to solve the problem by himself. Years goes by, with the patient of Alicia to help the recovery of Nash, he finally find out how to ignore his hallucination. He later applies to Princeton as a lecturer. He starts to know how to communicate well with people and he finally found the new theory of economics and make him got the noble price award.

CHAPTER II THEORETICAL FRAMEWORK

For most of the psychological disorders considered so far, you probably experienced at least a glimmer of recognition. Everyone can identify with anxiety, the occasional obsessive thought, or even a slight case of depression. It’s only when these tendencies become excessive and interfere with normal functioning that someone is likely to be diagnosed with an actual psychological disorder. But in the case of schizophrenia, which translates literally as “split mind,” the psychological changes can be so profound that one is thrust into a world that bears little resemblance to everyday experience. A person with schizophrenia lives in an internal world marked by thought processes that have gone awry; delusions, hallucinations, and generally disordered thinking become the norm.

2.1 Definition Schizophrenia is the most chronic and disabling of the severe mental disorders,

associated with

abnormalities of

brain

structure and function,

disorganized speech and behavior, delusions, and hallucinations. It is sometimes called a psychotic disorder or a psychosis.

2.2 Description People diagnosed with schizophrenia do not always have the same set of symptoms; in addition, a given patient’s symptoms may change over time. Since the nineteenth century, doctors have recognized different subtypes of the disorder, but no single classification system has gained universal acceptance. Some psychiatrists prefer to speak of schizophrenia as a group or family of disorders (“the schizophrenias”) rather than as a single entity. A standard professional reference, The Diagnostic and Statistical Manual of Mental Disorders (also known as the DSM-IV-TR) acknowledges that its present classification of subtypes is not fully

satisfactory for either clinical or research purposes, and states that “alternative sub typing schemes are being actively investigated.” The symptoms of schizophrenia can appear at any time after age six or seven, although onset during adolescence and early adult life is the most common pattern. There are a few case studies in the medical literature of schizophrenia in children younger than five, but they are extremely rare. Schizophrenia that appears after age 45 is considered late-onset schizophrenia. About 1%–2% of cases are diagnosed in patients over 80. The onset of symptoms in schizophrenia may be either abrupt (sudden) or insidious (gradual). Often, however, it goes undetected for about two to three years after the onset of diagnosable symptoms, because the symptoms occur in the context of a previous history of cognitive and behavioral problems. The patient may have had panic attacks, social phobia, or substance abuse problems, any of which can complicate the process of diagnosis. In most cases, however, the patient’s first psychotic episode is preceded by a prodromal (warning) phase, with a variety of behaviors that may include angry outbursts, withdrawal from social activities, loss of attention to personal hygiene and grooming, anhedonia (loss of one’s capacity for enjoyment), and other unusual behaviors. The psychotic episode itself is typically characterized by delusions, which are false but strongly held beliefs that result from the patient’s inability to separate real from unreal events; and hallucinations, which are disturbances of sense perception. Hallucinations can affect any of the senses, although the most common form of hallucination in schizophrenia is auditory (“hearing voices”). Autobiographical accounts by people who have recovered from schizophrenia indicate that these hallucinations are experienced as frightening and confusing. Patients often find it difficult to concentrate on work, studies, or formerly pleasurable activities because of the constant “static” or “buzz” of hallucinated voices. There is no “typical” pattern or course of the disorder following the first acute episode. The patient may never have a second psychotic episode; others have occasional episodes over the course of their lives but can lead fairly normal lives otherwise. About 70% of patients diagnosed with schizophrenia have a second psychotic breakdown within five to seven years after the first one. Some patients

remain chronically ill; of these, some remain at a fairly stable level while others grow steadily worse and become severely disabled. 2.3 Subtypes of schizophrenia DSM-IV-TR specifies five subtypes of schizophrenia: • Paranoid type. The central feature of this subtype is the presence of auditory hallucinations or delusions alongside relatively unaffected mood and cognitive functions. The patient’s delusions usually involve persecution, grandiosity, or both. About a third of patients diagnosed with schizophrenia in the United States belong to this subtype. • Disorganized type. The core features of this subtype include disorganized speech, disorganized behavior, and flat or inappropriate affect. The person may lose the ability to perform most activities of daily living, and may also make faces or display other oddities of behavior. This type of schizophrenia was formerly called hebephrenic (derived from the Greek word for puberty), because some of the patients’ behaviors resemble adolescent silliness. • Catatonic type. Catatonia refers to disturbances of movement, whether remaining motionless for long periods of time or excessive and purposeless movement. The absence of movement may take the form of catalepsy, which is a condition in which the patient’s body has a kind of waxy flexibility and can be repositioned by others; or negativism, a form of postural rigidity in which the patient resists being moved by others. A catatonic patient may assume bizarre postures or imitate the movements of other people. • Undifferentiated type. Patients in this subtype have some of the characteristic symptoms of schizophrenia but do not meet the full criteria for the paranoid, disorganized, or catatonic subtypes. • Residual type. Patients in this category have had at least one psychotic episode, continue to have some negative symptoms of schizophrenia, but do not have current psychotic symptoms.

2.4 Causes and Symptoms 2.4.1 Causes As of 2002, schizophrenia is considered the end result of a combination of genetic, biochemical, developmental, and environmental factors, some of which are still not completely understood. There is no known single cause of the disorder. GENETIC. Researchers have known for many years that first-degree biological relatives of patients with schizophrenia have a 10% risk of developing the disorder, as compared with 1% in the general population. Themonozygotic (identical) twin of a person with schizophrenia has a 40%–50% risk. The fact that this risk is not higher, however, indicates that environmental as well as genetic factors are implicated in the development of schizophrenia. Some specific regions on certain human chromosomes have been linked to schizophrenia. In late 2001, a multidisciplinary team of researchers reported positive associations for schizophrenia on chromosomes 15 and 13. Chromosome 15 is linked to schizophrenia in European-American families as well as some Taiwanese and Portuguese families. A recent study of the biological pedigrees found among the inhabitants of Palau (an isolated territory in Micronesia) points to chromosomes 2 and 13. Still another team of researchers has suggested that a disorder known as 22q deletion syndrome may actually represent a subtype of schizophrenia, insofar as people with this syndrome have a 25% risk of developing schizophrenia. At present scientists are inclined to think that the genetic factors underlying schizophrenia vary across different ethnic groups, so that it is highly unlikely that susceptibility to the disorder is determined by only one gene. As of 2002, schizophrenia is considered a polygenic disorder. There appears to be a connection between aging and genetic mutations that increases susceptibility to schizophrenia. Arecent Israeli study found that the age of a person’s father is a risk factor for schizophrenia; the older the father, the higher the rate of mutations in sperm cells. The child of a father older than 50 is three times more likely to develop schizophrenia than children born to younger men. The researchers suggest that mutations in the sperm cells of older men help to explain

why schizophrenia has persisted in the human population even though few schizophrenics marry and have children. DEVELOPMENTAL. As of 2002, there is some evidence that schizophrenia may be a type of developmental disorder related to the formation of faulty connections between nerve cells during fetal development. The changes in the brain that normally occur during puberty then interact with these connections to trigger the symptoms of the disorder. Other researchers have suggested that a difficult childbirth may result in developmental vulnerabilities that eventually lead to schizophrenia. NEUROBIOLOGICAL. In early 2002, researchers at the NIMH demonstrated the existence of a connection between two abnormalities of brain functioning in patients with schizophrenia. The researchers used radioactive tracers and

positron

emission

tomography (PET) to show that reduced activity in a part of the brain called the prefrontal cortex was associated in the patients, but not in the control subjects, with abnormally elevated levels of dopamine in the striatum. High levels of dopamine are related to the delusions and hallucinations of psychotic episodes in schizophrenia. The findings suggest that treatment directed at the prefrontal cortex might be more effective than present antipsychotic medications, which essentially target dopamine levels without regard to specific areas of the brain. Another area of investigation concerns abnormalities in brain structure that are found in some patients with schizophrenia. One of these abnormalities is the increased size of the ventricles, which are cavities in the interior of the brain filled with cerebrospinal fluid. Another is a decrease in size of some areas of the brain. A California study of MRI scans of teenagers with earlyonset schizophrenia found that they lost over 10% of the gray matter of the brain over the course of five years. The frontal eye fields showed the most rapid rate of tissue loss—about 5% per year. A major difficulty in interpreting these findings is that these abnormalities are not found in the brains of all patients with schizophrenia. In addition, they sometimes occur in the brains of people who do not have the disorder. ENVIRONMENTAL. Certain environmental factors during pregnancy are associated with an increased risk of schizophrenia in the offspring. These include the mother’s exposure to starvation or famine; influenza during the second trimester of pregnancy; and Rh incompatibility in a second or third pregnancy.

Some researchers are investigating a possible connection between schizophrenia and viral infections of the hippocampus, a structure in the brain that is associated with memory formation and the human stress response. It is thought that damage to the hippocampus might account for the sensory disturbances found in schizophrenia. Another line of research related to viral causes of schizophrenia concerns a protein deficiency in the brain. Researchers at the University of Kiel in Germany think that the deficiency is the result of viral infections. Environmental stressors related to home and family life (parental death or divorce, family dysfunction) or to separation from the family of origin in late adolescence (going away to college or military training; marriage) may trigger the onset of schizophrenia in individuals with genetic or psychological vulnerabilities.

2.4.2 Symptoms The symptoms of schizophrenia are divided into two major categories: positive symptoms, which are defined by DSM-IV-TR as excesses or distortions of normal mental functions; and negative symptoms, which represent a loss or reduction of normal functioning. Of the two types, the negative symptoms are more difficult to evaluate because they may be influenced by a concurrent depression or a dull and unstimulating environment, but they account for much of the morbidity (unhealthiness) associated with schizophrenia. POSITIVE SYMPTOMS. The positive symptoms of schizophrenia include four socalled “first-rank” or Schneiderian symptoms, named for a German psychiatrist who identified them in 1959: • Delusions. Adelusion is a false belief that is resistant to reason or to confrontation with actual facts. The most common form of delusion in patients with schizophrenia is persecutory; the person believes that others— family members, clinical staff, terrorists, etc.—are “out to get” them. Another common delusion is referential, which means that the person interprets objects or occurrences in the environment (a picture on the wall, a song played on the radio, laughter in the corridor, etc.) as being directed at or referring to them. • Somatic hallucinations. Somatic hallucinations refer to sensations or perceptions about one’s body organs that have no known medical cause, such as feeling that snakes are crawling around in one’s intestines or that one’s eyes are emitting radioactive rays. • Hearing voices commenting on one’s behavior or talking to each other. Auditory hallucinations are the most common form of hallucination in schizophrenia, although visual, tactile, olfactory, and gustatory hallucinations may also occur. Personal accounts of recovery

from schizophrenia often mention “the voices” as one of the most frightening aspects of the disorder. • Thought insertion or withdrawal. These terms refer to the notion that other beings or forces (God, aliens from outer space, the CIA, etc.) can put thoughts or ideas into one’s mind or remove them. Other positive symptoms of schizophrenia include: • Disorganized speech and thinking. Aperson with schizophrenia may ramble from one topic to another (derailment or loose associations); may give unrelated answers to questions (tangentiality); or may say things that cannot be understood because there is no grammatical structure to the language (“word salad” or incoherence). • Disorganized behavior. This symptom includes such behaviors as agitation; ageinappropriate silliness; inability to maintain personal hygiene; dressing inappropriately for the weather; sexual self-stimulation in public; shouting at people, etc. In one case study, the patient played his flute for hours on end while standing on top of the family car. • Catatonic behavior. Catatonic behaviors have been described with regard to the catatonic subtype of schizophrenia. This particular symptom is sometimes found in other mental disorders.

NEGATIVE SYMPTOMS. The negative symptoms of schizophrenia include: • Blunted or flattened affect. This term refers to loss of emotional expressiveness. The person’s face may be unresponsive or expressionless, and speech may lack vitality or warmth. • Alogia. Alogia is sometimes called poverty of speech. The person has little to say and is not able to expand on their statements. A doctor examining the patient must be able to distinguish between alogia and unwillingness to speak. • Avolition. The person is unable to begin or stay with goal-directed activities. They may sit in one location for long periods of time or show little interest in joining group activities. • Anhedonia. Anhedonia refers to the loss of one’s capacity for enjoyment or pleasure.

CHAPTER III CASE ANALYSIS

In the film and real life, John Nash is suffering Schizophrenia. Schizophrenia is the most chronic and disabling of the severe mental disorders, associated with abnormalities of brain structure and function, disorganized speech and behavior, delusions, and hallucinations. It is sometimes called a psychotic disorder or a psychosis. From the film, John Nash begin to show Schizophrenia symptom when he attend to Princeton University. He meets some new friends and some fellow Carnegie scholarship receiver, but he is not like people very much & he rather deals with numbers than with people. A person with schizophrenia lives in an internal world marked by thought processes that have gone awry; delusions, hallucinations, and generally disordered thinking become the norm (Ellen T. & Harris M., 2003). Delusions, which are false but strongly held beliefs that result from the patient’s inability to separate real from unreal events; and hallucinations, which are disturbances of sense perception. Hallucinations can affect any of the senses, although the most common form of hallucination in schizophrenia is auditory (“hearing voices”). 2The delusions are proven when Nash had a roommate named Charles Herman. In the beginning of his years in Princeton, Herman is his only close friend. Herman is a cheerful & friendly man that always support and accompany Nash wherever he go. The next is Marcee, according to Nash’s mind she is Herman’s niece. The two get to know each other when Nash visited Princeton again after a long time where he meets again with Charles Herman. Marcee is a cheerful and friendly girl just like her uncle. After that, Nash and Marcee easily get close to each other. Besides Herman and Marcee, there is another made up personality made by Nash’s mind, he is William Parcher. According to Nash, he asked to join a government secret operation. Later on, Nash followed Parcher to his secret office and got the diode implant code as the identity. The day goes by and Nash keeps 2

Ellen, T., & Harris, M. (2003). The Gale Encyclopedia of Mental Disorders.

Michigan: Gale.

working to Parcher to solve many codes and send some classified documents to government’s house. There are some delusions that happened to Nash’s mind. Hallucination, some autobiographical accounts by people who have recovered from schizophrenia indicate that these hallucinations are experienced as frightening and confusing. The hallucinations that happened to Nash’s mind are, the first is that Nash feels he had a roommate in his time in Princeton. The second is when he meets William Parcher and followed him to Pacher’s secret office, the office contains of governmental high technology devices with many scientist operates the devices. At that time, Nash get the diode implant as the identity that he just joined a secret government operation. The next proof is, when Nash followed by Russian agents after he drop a secret document at the government’s house. The Russians agents followed him and try to kill him because Nash is the only person that can break the Russians code. A years later Nash feels followed by a mysterious person that led him into the bush, and then he reveal that there is a secret office held by Parcher. Inside the office, there are some soldiers operating some radar things for the conspiracy operation that Nash imagines. The exactly type of Nash’s schizophrenia is paranoid schizophrenia. The central feature of this subtype is the presence of auditory hallucinations or delusions alongside relatively unaffected mood and cognitive functions. The patient’s delusions usually involve persecution, grandiosity, or both. About a third of patients diagnosed with schizophrenia in the United States belong to this subtype.3 It is proven when Nash feels that he being chased by Russian agents and tries to kill him because he is the only one who can break the Russian codes. The paranoid is getting worse and start to make his wife in risk.

3

Ellen, T., & Harris, M. (2003). The Gale Encyclopedia of Mental Disorders.

Michigan: Gale.

CHAPTER IV CONCLUSION

A Beautiful Mind is a 2001 biographical drama films about the life of John Nash, a mathematical genius that suffering schizophrenia. The film is based on the 1998 unauthorized biographical book with the same name, written by Sylvia Nasar. In the film and real life, John Nash is suffering Schizophrenia. Schizophrenia is the most chronic and disabling of the severe mental disorders, associated with abnormalities of brain structure and function, disorganized speech and behavior, delusions, and hallucinations, but People diagnosed with schizophrenia do not always have the same set of symptoms; in addition, a given patient’s symptoms may change over time. From the film, John Nash begin to show Schizophrenia symptom when he attend to Princeton University. He meets some new friends and some fellow Carnegie scholarship receiver, but he is not like people very much & he rather deals with numbers than with people. The exactly type of Nash’s schizophrenia is paranoid schizophrenia. The central feature of this subtype is the presence of auditory hallucinations or delusions alongside relatively unaffected mood and cognitive functions. It is proven when Nash feels that he being chased by Russian agents and tries to kill him because he is the only one who can break the Russian codes. The paranoid is getting worse and start to make his wife in risk. In my opinion the schizophrenia in John Nash came because of the environmental factors such as the pressure when he studied in Princeton and the cold war that happened between USA and The Soviet Union, at that time the media always show some propaganda related to the war.

REFERENCES

Ellen, T., & Harris, M. (2003). The Gale Encyclopedia of Mental Disorders. Michigan: Gale. Nolen-Hoeksema, S. (2011). Abnormal Psychology (5th ed.). New York: McGraw-Hill. Nairne, J.S. (2011). Psychology, Enhanced Fifth Edition. California: Wadsworth. http://www.behavenet.com/schizophrenia http://www.imdb.com/title/tt0268978/synopsis