Category: Human Brain

Imagine the kid you sat next to in your high school turned into a worldwide known serial killer. As a child, there were many red flags for his personality and actions towards people and the world. Now as he grows up he is known as “Milwaukee Cannibal” or the “Milwaukee Monster” (̈Jeffrey Dahmer”). It’s Easy to see serial killers as monsters, but when we see Jeffrey Damer as a real person it is easy to see the red flags early in his childhood. Dahmer became who he was because of his family. Jeffrey Dahmer was born on May 21, 1960, in Bath Ohio, (“Jeffrey Dahmer”) at the time they seemed like a perfectly normal boy until he started to grow up. Jeffrey Dahmer’s personality as his dad wrote in his notebook called ‘A Father’s Notebook.'(Left ) in his words, it started at the age of only 4 after Dahmer had surgery and his personality never actually went back to normal. Jeffrey’s mood continues to grow darker (“Jeffrey Dahmer”). 

At age 6 states to break glass and likes to play with bones. By his teenage years, he has started his road-kill cemeteries and planted a dog’s head on a stake. By the age of 18, he has committed his first murder. (Anft ) this all may be because of his parents. At a young age moving from place to place, he was isolated with only his parents now having no social skills to make friends. “Dahmer’s father, Lionel Dahmer, was a research chemist. The bone bleaching was an extension of professional expertise,΅ (“Anft”) Dahmer caught on to this but in his way. “That’s according to Carl Wahlstrom, a forensic psychiatrist who interviewed and evaluated Dahmer and served as an expert witness in his trial. “He and his dad, as a father-son activity…bleached the connective tissue and the hair” off rodents’ corpses when they found animals who’d died under their house, says Wahlstrom” (“Cannibal and Serial Killer”). But for the most part, his father had a large absence in his life. “Jeffrey Dahmer’s mother, Joyce Dahmer, suffered from depression and attempted suicide”(Anft). 

This was very haunting to Jeffrey at a young age and learned that it was a normal thing in his family. After a couple of years his mother gave birth to his little brother David Dahmer this sparked even more anger in Dahmer’s life motivating his evil. He would go on to drop out of The Ohio State University. His father wanted him to that he join the Army. Dahmer enlisted in late December 1978 and was posted to Germany shortly thereafter. His drinking problem persisted, and in early 1981, the Army discharged him. Although German authorities would later investigate possible connections between Dahmer and murders that took place in the area during that time, it is not believed that he took any more victims while serving in the Armed Forces (“Jeffrey Dahmer”). By age 31, he was on almost every newspaper in the United States, labeled as the “Milwaukee Cannibal” or the “Milwaukee Monster”. He took into his own hands, satisfied his evil deeds, and killed 17 men. Jeffrey Lionel Dahmer had an IQ of 145, which is considered a gifted person and in the top 2% of the population of the world(“Jeffrey Dahmer”.)  Think about these multiple sources claiming that the number 13 had something to do with the crazy list of events that occurred in Dahmer’s life. Dahmer’s name was 13 letters long, his killing spree lasted 13 years, 13 people did not escape from him, and his apartment number was 13. 

Dahmer was very smart, he had a very high IQ (“Cannibal and Serial Killer”).  Dahmer sought out men, mostly African-American, at gay bars, malls, and bus stops, lured them home with promises of money or sex, and gave them alcohol laced with drugs before strangling them to death. Dahmer had many different methods during his killings, some including drugging his victims, dismembering the body after, or even pouring acid or boiling water on their heads. Dahmer’s father, Lionel Dahmer, was a research chemist. The bone bleaching was an extension of professional expertise. This is where he learned his evil ways. Jeffrey Dahmer after killing his victims, Jeffrey would sometimes even have sex with the dead bodies. To remember the victims Dahmer killed he would keep polaroids in a drawer in the kitchen, next to the freezer where he kept their heads and other body parts. There were over 100 different Polaroid pictures that he had taken which each of his victims. When law enforcement went into Dahmer’s house they found a grisly scene (Richmond ) seven skulls and four decapitated heads stuffed into a refrigerator; photographs of murder victims, in various states of dismemberment; and a 57-gallon barrel, containing multiple headless torsos and other body parts, decomposing with the assistance of corrosive chemicals. Dahmer was a really intelligent person but his crazy obsessions soon got him in trouble.   

Tracy Edwards was his last victim, and he was able to escape after fighting off Dahmer, he then turned Dahmer into the police this was the end of Dahmer (“Cannibal and Serial Killer”). Only one survived and ran to the police, 3 escaped 2 died, and didn’t make it helped. After he went to the police Jeffrey Dahmer was Arrested in 1991. At Jeffrey Dahmer’s sentencing, he was pronounced “legally sane” and sentenced to 16 life terms for the killings (Cannon). Jeffrey only survived one attempt on his life in July of 1994, but he was killed by another inmate named Christopher Scarver on November 28, 1994, in Portage Wisconsin. Scarver used a 20-inch (51 cm) metal bar, which he had removed from a piece of exercise equipment in the prison weight room, to beat Dahmer, and Jesse Anderson another known murderer. Both later Dahmer and Anderson both died from their injuries. Scarver was sentenced to two life sentences for the killings. After the murders, Christopher Scarver was interviewed, and he stated “Some people who are in prison are repentant- but he was not one of them.” (Jeffrey Dahmer) Scarver also said that Dahmer would carve what looked like human limbs out of the prison food, and apply ketchup to represent blood  (“Jeffrey Dahmer”). Scarver told the reporter that he had gone to get a mop from the backroom and was approached by three men. One of them hit him in the back and he knew it was Dahmer so he followed him to the locker room and then confronted him. Dahmer tried to escape, but Scarver reached for a metal bar and swung at his head, crushing Dahmer’s skull. Just like Dahmer would do to his victims. 

The death of Dahmer was a relief for everyone and was like a weight lifted off their shoulders. It’s easy to see serial killers as monsters, but when we see Jeffrey Dahmer as a real person it is easy to see the red flags early in his childhood. All the things early in his life made him who he was. Now imagine the kid you sat next to in your high school turned into a worldwide known serial killer. 

Works Cited

1. Anft, Michael. “Dahmer’s Dad Puts Blame on Himself.” Baltimoresun.com, 24 Oct. 2018, https://www.baltimoresun.com/news/bs-xpm-1994-03-09-1994068149-story.html.
2. “Cannibal and Serial Killer Jeffrey Dahmer Is Caught.” History.com, A&E Television Networks, 13 Nov. 2009, www.history.com/this-day-in-history/cannibal-and-serial-killer-jeffrey-dahmer-is-caught.
3. Cannon, Angie. ‘Crime Stories of the Century.’ U.S.News & World Report, Dec 1999. sirsissuesresearcher, https://explore.proquest.com/sirsissuesresearcher/document/2263045304?accountid=14934.
4. “Jeffrey Dahmer.” Biography.com, A&E Networks Television, 17 Oct. 2019, www.biography.com/crime-figure/jeffrey-Dahmer.
5. “Jeffrey Dahmer Facts.” Math, www.softschools.com/facts/biography/jeffrey_dahmer_facts/3426/.

Susanna: –

Susana Kayseen in Girl Interrupted fits the description of borderline personality disorder because A person who is suffering from borderline personality disorder they have stormy relationships with others, difficulty controlling emotions, unstable self-image, and mood swings. They may have deep emptiness inside and sometimes moods can range from anger and depression to anxiety. All kinds of characteristics are true for her because she is struggling with relationships. She already tries to kill herself. In relationships, Susana has an affair with one teacher and one guy met after the school graduation on both cases she was having unsafe sex.

Symptoms of Susana during hospital periods are mood swings, feeling alone, and unstable relationships. During the movie, she was try to cut her wrist and constantly tells the doctor there are no bones in her hand. It was some type of self-harm and physical discomfort from relations.

Susana received “Talk Therapy” treatment for borderline personality disorder. Tal therapy helps people to think in the correct ways. During the hospital period, Susana wrote a daily routine diary that is helpful to talk about herself. In three-four days she spent her time with special psychiatric and talking with her it’s also helpful to relieve BPD.

The contemporary psychology perspective in her treatment is cognitive therapy means correcting errors in thinking. Spend time talking with yourself, write down the daily diary. In a week Susana spends three to four days talking with a psychiatrist is also part of her psychological treatment.

Lisa: –

Lisa has a complicated personality. Lisa is nonconforming, selfish, relevant, and manipulative in nature. She is trying to attract others to receive their attention. She works hard to create her image and attraction.

Symptoms of Lisa Rowe is she is manipulative, impulsive, or failing to do something. During the movie, she tries to make her personality attractive to other people. Break the rules of hospitals. She left the hospital and meet after 2 or 3 days.

Lisa received sociopath treatment for her APD. Sociopath treatment includes talk therapy and psychotherapy.

What did Susana learn about?

In starting when Susana was admitted to the hospital she doesn’t believe that she is suffering from BPD. As time passes she is realized that she is suffering from BPD. She learns about mental illness. How to solve this? She is trying to build relationships with psychiatrists and try to follow her direction. Before treatment, she does not want to believe that she has BPD but during the treatment, she realized.

She is a really good friend to all of the members of the hospital. She doesn’t want to lose that relationship. She feels that all her friends in the hospital they are an important part of her life.

She builds a connection for various young women. She is a refusal to follow her parent’s rules, unsafe sexism, and after treatment, she realized about all.

There is a drastic change in Susana’s thoughts about hospitalization, therapy, and medication.

Susana’s thoughts about the hospitalization, therapy, and medication were drastic changes before treatment and after treatment. Before treatment, she doesn’t like to live in the hospital and she doesn’t like the rules and regulations in the hospital. But during treatment time and after treatment, she realized that yes she is suffering from BPD and this treatment is good for her.

Susana told Lisa “You need this place to feel alive”

Susana told Lisa “You need this place to feel alive” This means that at the end of the movie, Lisa becomes more selfish and feels jealous because Susana is leaving the hospital and then she is alone again. She is trying to kill herself. Susana told her you need this place alone because Lisa is already dead inside and there are no feelings in her heart. Her heart is cold and senseless. So that’s the reason she is coming back every time in hospital.

Susana’s diagnosis is accurate.

I feel about Susana’s diagnosis is that the way she is treated is in a perfect manner and it is accurate. Each and every disease diagnosis is easy except this because BPD diagnosis is depending on the person and some condition it’s hard to diagnose. Yes, she had a mental illness when she was admitted to the hospital. She had some kind of symptoms that describe that she is suffering from BPD. Like, mood swings, unsafe sex, try to suicide. She tries to cut her wrist and said to the doctor constantly there are no bones in her wrist. She had affairs with a teacher and one man its describe that she was having unsafe sex. She was feeling emptiness because sometimes she feels alone without her parents,

In today’s society we do not have long-term facilities like Susana was in so she will be treated in 2018 I guess it is just like taking the psychiatric appointment visit according to the time. And from today’s point of view, she is treated on based and depends on medicine. Visit to psychiatric office three times per week according to condition follow up all directions and take medicine I think this is today’s treatment.

I observed two techniques cognitive and behaviorism related to psychological perspective.

Male Psychiatric: – Behaviorism means behavior. Related to changes in behavior if you are suffering from BPD. For the treatment of female psychiatry is better.

Female Psychiatric: – cognitive therapy or talk therapy. In the movie, Dr. used talk therapy to change the behavior in Susana. It is really helpful for her. She was going to three to four days per week and talk with her.  

Consider the characterization of each of Riley’s five emotions in Inside, Out. Choose three of them. Explain what makes each distinctive in terms of their physical appearance, dialogue, types of interactions with others, and role in the film’s message/s. Write a paragraph on each of your chosen 3 emotions, referring to specific details from the film to support your insights.

Throughout the film Inside, Out each of Riley’s five emotions play an important role in the film. The characterization of each emotion is unique and distinctive, with major differences in physical appearances, interactions with others, and the messages they convey. I believe this is particularly evident in the emotions of fear, sadness, and anger.

Fear

Fear is portrayed in the film as a tall and thin character, always nervous and constantly worried about the safety of Riley. His purple skin reflects the emotion of fear, as when people are scared their face may turn purple in response. The appearance of this character is based on a raw nerve. Fear’s body language is also very reflective of the emotion he represents. His body posture is typically hunched over and closed in with his knees together, an extremely similar representation of real-life body language when scared or fearful. Fear’s main purpose throughout the movie is to keep Riley aware of possible dangers. Fears interactions are typically nervous and unsure of himself from both his perspective and Riley’s perspective. He has a tendency to exaggerate which is seen when on Riley’s first day of school: ‘Did you see that face?! They’re judging us!!!’ Fear teaches us that there is no problem with a cautious approach to daily activities, in fact, it can even be beneficial. The emotion of fear allows us to have an immediate reaction to unsettling or unusual things. This enables us to avoid dangerous situations and be safe, however, it is also made clear that fearfulness is not always a positive thing, and we must continue to live life properly.

Anger

Anger is an extremely tempered and irritable character. He is dressed in a shirt and tie and he is represented as the colour red. Red is definitely a color associated with anger and energy as the color is strong and intense. Anger’s main purpose is to make things fair for Riley. Anger’s dialogue is also very unique and distinct in the movie, with him easily reacting and his vocabulary being very simple. Through the quote: ‘So, is that how you want to play it, old man? No dessert? Oh, sure. We’ll eat our dinner right after you eat this!’ Anger’s temper and angry interactions with others are displayed. His body language directly relates to the emotion he represents. This is displayed through clenched fists and crossed arms. Facial expressions of this character including frowning and gritted teach display this emotion as in real life, when people are angry, their body language is somewhat similar to this. Anger conveys the message that emotions are complicated and when we are angry we cannot always think clearly and rationally. Even when emotions such as anger may seem like a negative thing, they are crucial to the healthy functioning of a person, and we rely on them to balance ourselves.

Sadness

Sadness is portrayed throughout Inside, Out as a sad and droopy character, always slouched and upset. She is dressed in a jumper, which was based upon the feeling of wanting to hide away in a blanket. She is a blue character, which is a color associated with tears, therefore sadness. The coloring of this character could also be related to the phrase ‘feeling blue.’ This character’s appearance is based on a teardrop, as she is fairly round in shape. Sadness’ interactions with others are very distinct. When a positive statement is made, Sadness will always look at the situation from a negative perspective. This is clearly displayed when Joy makes a positive comment about hockey and Sadness says: ‘It was the day the Prairie Dogs lost the big playoff game. Riley missed the winning shot. She felt awful.’ Sadness teaches us multiple lessons throughout the movie, with a major conveyed message being that happiness cannot be forced, and negative emotions are also necessary to be joyful. She teaches us not to suppress negative emotions, as the consequences of them are not always bad, and are in fact critical to a balanced and healthy life.

Happiness is not only about being joyful – cannot be forced

Do not suppress negative emotions, the consequences are not always bad.

Natalie Portman starred in “Black Swan” released into theaters in 2010. Although it was filmed nearly 10 years ago the storyline is still a disturbing yet beautiful film many still watch today. After reviewing this film I have come to argue the point that this film is the story of how losing one’s self is the price to pay for perfection. There have been many tales with this similar plot, yet in Black Swan, it seems so much more externalized.

Throughout the movie, there seems to be this idea of perfection. It’s all that Nina dreams and what thinks of. The opening scene is Nina dreaming of staring in the ballet as the white swan. Arising, we see her stretch in front of a mirror, you noticed that there are mirrors everywhere throughout the film. Mirrors are known to be a symbol of reflection. Reflecting light is a powerful symbol, through the light you see awareness and wisdom. The downside of mirrors is they are symbols of your truth. I believe Nina sees her flaws and once she is cast as the Swan Queen, she strives for only perfection and sees that her personality is in tune with the white swan but not the black. Within the mirrors, we can also see what facials Nina carries which is a clue to what she feels. I believe that the mirrors are used to portray what Nina is internally feeling and the strive for perfection by staring at herself often.

In the scene where Nina is told by Thomas that it’s too obvious she is faking the black swan, that it’s not authentic, she is advised to slowly start to corrupt herself. With every step closer to the performance, she starts to lose her morals. Masturbation-exploring lust, smoking, clubbing, drinking, and ingesting drugs. All these scenes make it obvious that she does all of these things not for her own pleasure, but because she constantly feels that she needs to shed her innocence to be an authentic black swan queen. It’s almost that when Nina is chosen for the part she begins to go through the rebellious teenage years. Nina looked innocent, like a child. The name Nina means little girl, it’s who she is.

Throughout scenes in the movie, we see the two personas of the swans fight with Nina. There is the innocent, fragile swan who is sheltered and dreams. Then the black swan who fights and has to work for her dreams has to let go and for once not think about everything. We see this when Nina is trying her best in the audition, but it isn’t good enough. So she bites Thoma’s lip when he kisses her during their talk about her asking for the part. It wasn’t something she planned to do, but it is that spark that symbol of the dark swan being buried deep inside.

Now there are two other people I want to discuss. First is Lily, played by Mila Kunis. Lily is the complete opposite of Nina-the embodiment of the black swan herself. Nina, who is known to obsess about perfection and pay close attention to every tiny detail watching her, analyzes Lily. Nina sees the threat of Lily and knows that the black swan would be the perfect role for her. What she didn’t see is that she has lost her innocence, she couldn’t fake the part of perfection in the white swan. In the scene at the bar when the two men ask if Lily and Nina were sisters, I see it as a way to show that the two are similar. That the two would be a perfect match for the twin swans. Nina the picture-perfect image of the white swan and Lily the image of the Black. When the lesbian hookup scene between Lily and Nina is shown, the iconic scene is often seen as just a hot sexual scene the writers needed to put in because sex sells, or that it was Nina lusting after Lily, I disagree. It is a figment of Nina’s imagination, her obsession out of control again. It’s the yearning she feels to embody Lily as the black swan, the black wings tattooed on Lily’s shoulder blades are a symbolic way of showing that. Another detail is the underwear the two chose to wear, Lily is sporting a black lingerie ensemble complete with black garters and stockings. Nina was clad in pale pink underwear and a mismatched bra, not thinking to look seductive to anyone.

The second person I want to discuss is Nina’s mother. A ballerina who had to put her career behind because she had a baby, I feel that her mother is always in some sort of resentful. Yes, Nina grew up close with her mom, sheltered and kept away. Yes, she felt joy for her daughter when she landed the part, but it was a surprise she didn’t think Nina had it in her. There is a sort of love shown in the film, perhaps her mother sheltered her to keep her out of the situations she was in herself. But it seems that once Nina is cast as the lead, envy is evident in her mother’s behavior. Her mother can’t let her go, she refuses to allow Nina to grow up and at 28 years old Nina took control of her life. She grew up, that was the crossing of the line of growing up.

My last insight has me questioning if Nina’s mother knew her daughter had/has multiple mental disorders. In scenes of the movie, we see symptoms of schizophrenia, OCD, anorexia/bulimia, and body dysmorphia. You see Nina’s obsessive-compulsive disorder in the scene where she is in her dressing room and very slowly and carefully sets her items down and line them up on her desk. Thomas tells Nina to her face that she has a tendency to obsessively look at a small detail and make sure it is perfect. She is a perfectionist, but it ruined her life. The looks in the mirror at the constant body checks, beginning of the movie her breakfast of a grapefruit half and half a fried egg is the most she is shown eating. Throwing up suggests bulimia but could just be nerves after an audition, but it is common for ballerinas to have eating disorders and to be in a negative calorie balance, but if it is self-inflicted it is dangerous. Her schizophrenic behaviors are one of the most well-known details in this film. Her rashes, her visions, hallucinations, it quite literally drives her mad. Nina’s mind plays tricks on her and she no longer strives for perfection in both roles because she loves the art. But to prove a point, that she is capable of perfection. There is no longer any passion in the fire that drives her. It is a point to prove.

Black Swan has many different interpretations, that’s one of the many things I admire about this movie, that it is a work of art. True masterpieces are never easily defined, a good song, an interesting painting, videography, or a movie, everyone processes it in their own way. The ending of the film is the opening box day. Nina has grown up, she moved out, and stopped doing everything to please others but for herself. The drop of the white swan, the stabbing of herself who was portrayed by Lily, and the captivating dance of the black swan, all led to the confusing end of the fading white light in Nina. Dying after the show, on stage, reveling in the glory of adoration from the crowd and the feeling of success of being perfect, I argue that the bleeding out of Nina was a symbolic way of showing that Nina’s innocence had gone. I believe that this was the story of the film. To truly get what you want, you have to leave everything you hold close and venture into an unfamiliar land, and to be perfect… is to completely and utterly lose yourself. Just as Thomas said. He knew exactly how to get Nina to let go and achieve perfection. But was it for better or for worse?  

The experimental film I have chosen to discuss in this following essay is Black Swan, directed by Darren Aronofsky and released on 30 November 2010. Black Swan is about a young lady (Nina) who acquires the lead role in the play “Swan Lake”. The film focuses on Nina’s psychological struggle with suffering from a mental illness. The pressure of needing to be perfect, particularly for her mother and director/instructor leads to the deterioration of her condition.

“Everyone carries a shadow and the less it is embodied in the individual’s conscious, the blacker and denser it is” –Carl Jung

Nina’s character growth is one of the important aspects of this production; from the beginning of the film, she seems to be an innocent child. Her room looks pink with children’s pop art, her mom still tucks her into bed and she still sleeps with her spinning ballerina music box, she seems pure and innocent like a child. Nina’s mother has raised her in isolation where she has certainly not experienced life like other women her age. When she is chosen to play the Swan Queen she realizes that she is unable to play the Black Swan, which is the opposite of the White Swan. Nina’s lack of experience in life leads her into obsessing over perfecting the Black Swan. In order for Nina to be able to play this role she had to lose her innocence, we see this in the use of mise en scene. The colors of her costumes in the beginning of the film were mostly white and pink, symbolizing her innocence and childlike character, when she starts to transition the colors change to grey then black which symbolizes her dark side. She finally breaks free from her mother’s control and starts drinking, doing drugs, and engaging in sexual behaviors. Nina’s journey represents growth from a child to a woman.

The symbolism through the use of mirrors is one of the unique ways to tell a story, according to Riccardo Basso in the website Tasteofcinema.com, the use of mirrors creates a unique visual moment, as well as adding psychological nuances to the film. As a ballet dancer, Nina is bound to be surrounded by mirrors, for obvious reasons such as being able to point out her mistakes while rehearsing, not only that but Nina also cannot seem to escape her reflection. We experience Nina’s self-actualization through the mirrors and her destruction. Her journey of transitioning into the Black Swan helped in finding out who she indeed was instead of the little innocent girl that her mother conditioned her to be. Her destruction came when she started hallucinating; the mirrors fed her negative images, which led Nina to her death

The director enlightens the audience about the dangers of obsessive behavior and competitiveness. According to Healthline.com, the symptoms of Obsessive-compulsive personality disorder include finding it hard to express feelings, difficulty in forming or maintaining close relationships, hardworking but their obsession with perfection can make them inefficient, social isolation, and anxiety that occurs with depression all these symptoms describe Nina. The director takes us through the life struggles of people with OCPD who deal with daily simple routines. Schizophrenia is also a mental illness that Nina suffers from whereby she cannot differentiate what is from not.

The central theme in this production is perfection, we are shown the lengths that Nina is willing to take in order to achieve perfection and how easily one can be consumed so easily by something they love. For her to keep her role as the black Swan, Nina went to extreme lengths, she went as far as subconsciously stabbing Lily to her death in order for her not to have competition. Perfection is also something that is instilled in dancers, they have to maintain a certain weight, be a certain height or walk a certain way, and the pressure they go through is enough for any being to lose their mind. “Dancers oftentimes have many pressures put on them which can lead to physical and emotional damages. These damages occur through the pressures from the media, parents, teammates, and the stereotype that society has placed on dancers” The pressure of dancers, 123helpme.com. 

The Black Swan is relevant to our production’s idea, concept, and theme because for our project we follow a contemporary dancer who suffers from Obsessive-compulsive disorder (OCD), a mental disorder according to MedlinePlus whereby survivors have unwanted and repeated thoughts, and feelings, ideas, sensations (obsession), and behaviors that drive them to do something over and over (compulsions). This affects the protagonist’s (Kim) dancing career in a way that she struggles to finish her dance routines, her dance steps are over repetitive. The protagonist’s intrusive thoughts develop into a silhouette of a man that is only visible to her which is a specific OCD type named Magical Thinking Intrusive Thoughts. “Magical Thinking Intrusive Thoughts – is the fear that even thinking about something bad will make it more likely to happen – sometimes also called ‘thought-action fusion’… They try to dispel them by performing rituals – magic rituals, in effect – that are often bizarre and time-consuming and involve linking actions or events that could not possibly be related to each other” (OCDUK, 2019). Her intrusive thoughts will inform her day-to-day actions, the OCD will cause her to perform rituals to cancel the negative thoughts that come to mind, such as feeling the need to repeat steps or go back and start again to ‘prevent’ something bad from happening. An example of an intrusive thought that would come to mind of someone with OCD would be ‘you won’t get the part’ or ‘someone is going to die’. So to prevent it from happening she feels that she has to do something to cancel it out like putting things in order. The journey Kim is going through is similar to Nina in the film Black Swan because they both want to strive for perfection.

What makes the chosen production, Black Swan experimental is how it makes you question what is real and not, it is confusing until the end where it sorts sums everything together and this was a brilliant and unique way to tell the story. At first, the production seems like a melodrama because of the elements it featured such as making us feel Nina’s emotions through the use of music and her storyline which heightens the audience’s emotions “Broadly, melodrama is a type of narrative in which the over-dramatic plot-line is designed to play on people’s emotions—sometimes at the expense of character development, sub-text, and nuance.

Moreover, melodramas tend to feature reductive plot lines and characters that are stereotypical archetypes” (White, D. 2018). There are also elements of horror whereby Nina peels off her skin and her scary hallucination, fusing these two genres together was very impressive. The use of editing when Nina fully transitions into an actual black swan was very experimental, the attention to detail whereby we can see each and every feather growing on her arms and back, her legs breaking like that of Aswan was spectacular.

Dissociative Identity Disorder in ‘Fight Club’

What is Dissociative Identity Disorder (DID)?

It is characterized by the presence of two or more distinct identities or personality states that recurrently take control of the individual’s behavior, accompanied by the inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness. The main causes of this disease are dissociation, traumatic experiences, especially severe childhood abuse. The patient creates another personality that did not suffer from abuse as a way to suppress the traumatic memories. Possible treatments for DID can include practices such as hypnosis, but the most common form of treatment is psychotherapy. Two treatments that seem to be most effective for DID are Draw-A-Person (DAP) test and Dissociative Disorders Psychotherapy Program.

Short Synopsis of ‘Fight Club’

The narrator attends support groups in an attempt to subdue his emotional state and relieve his insomniac state. When he meets Marla, his life seems to become a little more bearable. However, when he associates himself with Tyler, he is dragged into an underground fight club and soap-making scheme. Together the two men spiral out of control and engage in competitive rivalry for love and power. When the narrator is exposed to the hidden agenda of Tyler’s fight club, he also founds out that they are actually one person. Since the narrator has insomnia and can’t sleep, whenever he thinks he is (or at random parts of the day), Tyler’s persona takes over.

Symptoms of DID in the movie

In ‘Fight Club’, the narrator creates an alternative identity in the character of Tyler Durden. The main symptoms present in the movie are anxiety, insomnia, memory lapses, auditory hallucinations, and the inability to recall events. The narrator treats himself through consumerism, but it does not help. He uses his other identity as a defense mechanism to cope with his anxiety and feeling of entrapment. Tyler represents his urge to break free from the system. Nevertheless, some aspects of the disease are not very realistic: the use of violence to portray the disorder and the absence of any mention of the narrator’s past background (if he had childhood trauma, etc.).

Diagnosis of DID

The diagnosis of DID is difficult to identify and accurately distinguish, however, there are several ways to help diagnose the illness, according to Dr. Gary Peterson. First, inconsistency of the patient’s conscious mind could be the reflecting symptoms of fluctuating attentiveness, such as trance states or blackouts. Second, the forgetfulness of the patient’s autobiography paired with the inconsistencies in accessing the information, could mean an indication of a disruption in the processing of memory during early childhood development. Third, self-regulation difficulties may be reflected in the form of mood swings and behavior fluctuations. Fourth, a disorganization of the development of a consistent self may be reflected in the belief in the alternate self or imaginary acquaintances. And fifth, the subjective experience of dissociation from the physical body, as well as, the perception, may indicate derealization and depersonalization in the patient’s psyche. These assessments demonstrate detachment of primary personality and a subsequent rise in sub-personality.

Brain parts affected by DID

Smaller hippocampal volume has been reported in several stress-related psychiatric disorders. Some researchers examined hippocampal and amygdala volumes in patients with DID, a disorder that has been associated with a history of severe childhood trauma. Hippocampal volume was 19.2% smaller and amygdala volume was 31.6% smaller in the patients with DID, compared to the healthy subjects. In both animal and human studies, early stress has been shown to be associated with changes in the structure of the hippocampus, which plays a critical role in learning, memory, and stress regulation.

The movie I chose is called Girl, Interrupted. This movie is an older one but I thought it was a really well-done movie. Angelina Jolie is an absolutely phenomenal actress. Her performance alone is worth watching the movie for. The cinematography was innovative, but not distractingly so– “Girl Interrupted” shines primarily for its dramatic power, not as a mind-blowing work of art. It will certainly probe you to question your way of seeing the world– at least psychologically. 

The movie takes place primarily in the women’s ward of a mental institution and follows the dynamic friendship between Lisa (Jolie’s character) and Suzanna. Lisa is a kinetic, dynamic personality who cuts right to the “truth” of things. Her “truth” knows no boundaries, and she is a controlling person prone to violence. Her piercing insights about people and social recklessness led her to be institutionalized as a sociopath. This is not a depressing film. Rather, it is surprisingly life-affirming. 

This movie is at the forefront of portraying mental illnesses like borderline personality disorder, and Susannah from Girl Interrupted now this is the one that I mentioned earlier who was actually written with borderline personality disorder because the character Susannah is actually a real person and Girl Interrupted is a movie that’s based off of a memoir written by a lady called Susannah, so we 100% know that this character has borderline personality disorder and it’s even mentioned in the film pretty much starts with a suicide attempt that lands Susannah in hospital some people have said this is a half-hearted suicide attempt Susannah is a self Harmer, and she originally started by scratching her face but that was too obvious, so she switched to wrist banging self-harm and impulsive behavior is a symptom of borderline personality I think Susannah is fascinating because I think a lot of people would wouldn’t immediately call her borderline we like we don’t see a huge amount of symptoms reflected in the film from Susannah I think she’s a good example of a quiet borderline which I’ve not done too much research into like the science of the quiet borderline, so I don’t know if that’s kind of just a nickname or of whether that has some sort of scientific basis but it’s basically exactly what you think it would be someone who has BPD but is perhaps more on the quiet reserved side. 

We do definitely see Susanna have her moments though like when she was screaming at their mental health nurse while she was in the bathtub she’s asking the nurse what’s wrong with her what’s going on inside her head, and than she’s screaming get me out of this faster than the nurse turns around and says to her get yourself out of the bathtub and that kind of stands out in my mind as do a lot of the quotes in the film that one particularly because a lot of people say that all the line adults are kind of stuck in this childish mentality they’re stuck with childish tantrum-like behavior and although I’m not a huge fan of the wording around that sometimes I think people say it very flippantly can and it can almost be like offensive but I do think there’s something true in with stuck in the in this erratic behavior this dysregulated behavior as would a child be because the child isn’t born knowing how to regulate their emotions that’s something that they’re taught, and they develop and that stood out to me when Susanna was like get me out the bathroom the nurse was like get yourself out of the bath a lot of people with BPD identified with Lisa Moore who was king of the companion of Susanna within the Hospital um so it’s interesting to me that some people relate with her more, but she’s very much like a very brash outgoing sort of character.

In this assignment, I will deal with issues arising in a section from the US television series “Shameless” developed by John Wells on Showtime about an impoverished family with an alcoholic father and their struggles to go through life in Chicago. In the course of the essay, I will present the arguments and issues through the perspective of gender and class, with the help of the academic book series The Blackwell Companion to the Sociology of Families (2004). I will be reviewing the chapter “Inequality and the Family” by Philip N. Cohen, Irvine, and Danielle MacCartney (2004). Additionally, I will raise the subject of gender through “Feminism and the Family” by Michelle Budig (2004).

The discussed issue is inequality in families of a lower socio-economic status and the discrimination they experience. The series illuminates in a comedic style, the way that mixed-race families are depicted in the socio-cultural context. My understanding is that Chicago is just an example of the many places where families are stigmatized on the basis of their ethnicity, and American society is credited with the maintenance of these stigmas.

Shameless is an immensely colossal time Showtime TV series that is about a dysfunctional and penuriousness-stricken family. The Gallagher family is very impecunious and does whatever it takes to survive their hardships. The father is a lifetime alcoholic that doesn’t provide much for his children. Because of this, the eldest sibling and main character Fionna is stuck raising the kids being the parent of the family which becomes her life. Throughout the exhibition, the unauthentically spurious deaths and tragedies keep lurking in the bushes. The Gallagher family socializes its members to become different from any mundane family by coercing the children to grow up more expeditious and doing things that aren’t always right or legal but keeps the family afloat.

The kids in this family don’t have the same worries as every other middle-class adolescent. They worry about bills and survival. The family makes use of whatever they have and each family member pulls their own weight to pay for bills in the household. The culture they have been raised in develops this kind of mindset for them making the children different from their peers. One excellent example could be from season one when Carl, the second youngest of the Gallagher family turns nine and now receives partial responsibility of ascertaining that the light bill is paid.

In most households, there is customarily a person in charge or the head of the household. In the Gallagher family, there is no such thing. Everyone pulls their own weight and fortifies the family with whatever they have in any way they can which includes things that are very illicit. One prime example of this is when the father of the children Frank Gallagher was receiving incapacitation checks from the state for his great-aunt Ginger who passed away a couple of years earlier. To cover up Frank Gallagher’s fraud, the whole family including all the children glom a geriatric lady from the nursing home and have the geriatric lady pretend to be Aunt Ginger while the state comes in for a desultory house check to ascertain they aren’t lying or committing fraud. In this assignment, I will deal with issues arising in a section from the US television series “Shameless” developed by John Wells on Showtime about an impoverished family with an alcoholic father and their struggles to go through life in Chicago. In the course of the essay, I will present the arguments and issues through the perspective of gender and class, with the help of the academic book series The Blackwell Companion to the Sociology of Families (2004). I will be reviewing the chapter “Inequality and the Family” by Philip N. Cohen, Irvine, and Danielle MacCartney (2004). Additionally, I will raise the subject of gender through “Feminism and the Family” by Michelle Budig (2004).

The discussed issue is inequality in families of a lower socio-economic status and the discrimination they experience. The series illuminates in a comedic style, the way that mixed-race families are depicted in the socio-cultural context. My understanding is that Chicago is just an example of the many places where families are stigmatized on the basis of their ethnicity, and American society is credited with the maintenance of these stigmas.

Shameless is an immensely colossal time Showtime TV series that is about a dysfunctional and penuriousness-stricken family. The Gallagher family is very impecunious and does whatever it takes to survive their hardships. The father is a lifetime alcoholic that doesn’t provide much for his children. Because of this, the eldest sibling and main character Fionna is stuck raising the kids being the parent of the family which becomes her life. Throughout the exhibition, the unauthentically spurious deaths and tragedies keep lurking in the bushes. The Gallagher family socializes its members to become different from any mundane family by coercing the children to grow up more expeditious and doing things that aren’t always right or legal but keeps the family afloat.

The kids in this family don’t have the same worries as every other middle-class adolescent. They worry about bills and survival. The family makes use of whatever they have and each family member pulls their own weight to pay for bills in the household. The culture they have been raised in develops this kind of mindset for them making the children different from their peers. One excellent example could be from season one when Carl, the second youngest of the Gallagher family turns nine and now receives partial responsibility of ascertaining that the light bill is paid.

In most households, there is customarily a person in charge or the head of the household. In the Gallagher family, there is no such thing. Everyone pulls their own weight and fortifies the family with whatever they have in any way they can which includes things that are very illicit. One prime example of this is when the father of the children Frank Gallagher was receiving incapacitation checks from the state for his great-aunt Ginger who passed away a couple of years earlier. To cover up Frank Gallagher’s fraud, the whole family including all the children glom a geriatric lady from the nursing home and have the geriatric lady pretend to be Aunt Ginger while the state comes in for a desultory house check to ascertain they aren’t lying or committing fraud.

What is ALS? That is a common question that has plagued scientists, researchers, and ordinary people alike for many years. ALS is otherwise known as Lou Gehrig’s Disease. ALS, or Lou Gehrig’s Disease, is a progressive type of amyotrophic lateral sclerosis, which is a neurodegenerative disease. ALS affects the nerve cells in a person’s brain and spinal cord, in the areas where the nerve cells send signals to control the muscles in the body. As degenerations occur, scarring and sclerosis occur, and eventually cause the death of motor neurons in the body. This in turn causes the loss of the brain’s control over muscle movement. This causes the ability to eat, speak, move, and breathe to be lost in ALS patients.

In the United States, Sporadic ALS is the most common form of ALS. It is approximately 90%-95% of all ALS cases recorded. There are many possible causes for Sporadic ALS, although no definitive cause has been determined. The many possible causes are oxidative stress, mitochondrial dysfunction, glutamate toxicity, toxic exposures, and abnormalities of the immune system. Oxidative stress is when a person has a significant imbalance of the production of oxygen-containing molecules, and the biological system’s ability to detoxify them. Mitochondrial dysfunction involves the body’s mitochondria, which are the powerhouse of cells. Any type of abnormality in the mitochondria is possibly involved in causing ALS or exacerbating it. Glutamate toxicity occurs when the neurotransmitter chemical glutamate accumulates around a nerve cell after it has been signaled. This causes problems for the nerve cells around it. Glutamate toxicity can be caused by inadequate transportation of glutamate away from the nerve cells. Toxic exposures aren’t a clear link to ALS at the moment, but serving in the military, especially in the Gulf War, is a possible risk factor. Cyanobacteria is a microorganism that lives in desert sand. As desert sand is kicked up in dust, it is inhaled, which elevates the risk of ALS. Lead, mercury, and arsenic have also been seen to attack the nervous system, but not directly are they linked to ALS. Abnormalities in the immune system, such as immunologic cells called microglia (as microglia are found in the immune system), can be beneficial to some extent, but past that are harmful in regards to ALS, as they modify the immune system’s actions. Although these causes are probable, they haven’t been determined for one hundred percent certainty, as a known cause is difficult to determine.

Familial ALS is ALS that is considered a “genetic dominant inheritance,” meaning that it can occur multiple times in a family tree and can be passed down and inherited. It is extremely rare and is approximately 5%-10% of all ALS cases. There is a 50% chance for the ALS gene mutation to be inherited by families afflicted with familial ALS. Many mutations in genes have been determined that are linked to ALS. These include mutations in the SOD1 gene, the TDP43 protein gene, the FUS gene, the ubiquitin 2 protein gene, and the C9ORF72 gene. A mutation in the SOD1 (superoxide dismutase 1) gene is recorded in approximately 20 percent of familial ALS cases and was the first to be associated with ALS in 1993. A mutation in the TDP43 protein gene was recorded as a small percentage of familial ALS in 2009, along with a mutation in the FUS gene. In 2011, a mutation in the ubiquitin 2 protein gene was also discovered as a cause of familial ALS, along with a mutation in the C9ORF72 gene. The mutation in the C9ORF72 gene was found to be the most prominent gene mutation involved in familial ALS than any others. It is twice as common as the SOD1 mutation, and three times as common as the TDP43 and FUS gene mutations.

Guamanian ALS is extremely rare and has only been recorded a few times in the 1950s, in the United States territories of Guam and Trust.

ALS symptoms are often gradual and start off simple and escalate depending on the person. Symptoms often start with being unable to grasp and pick up objects, abnormal fatigue of body parts, a change in vocal pitch, tripping, muscle cramps/twitches, slurred speech, and/or uncontrollable fits of laughing or crying. ALS is different for every person with the disease and progresses at a different rate for every individual. Although symptoms vary based on the person, muscle weakness and eventually paralysis are experienced by most. As the breathing muscles become affected, people with ALS will need the help of permanent ventilatory support. The average survival time for someone diagnosed with ALS is three to five years, or in rare cases, ten or more years.

Diagnosis is incredibly hard to do for people affected by ALS. There are only clinical examinations and diagnostic tests to rule out other diseases, and then to rule in ALS. EMG (Electromyography), and NCV (Nerve Conduction Velocity), are electrodiagnostic tests that can be used to diagnose ALS, along with blood and urine samples, high-resolution serum protein electrophoresis, thyroid and parathyroid hormone levels, and a 24-hour urine collection for heavy metals. Other tests diagnostic tests include spinal taps, x-rays, MRIs, myelograms of the cervical spine, muscle and/or nerve biopsies, and a thorough neurological examination. Diagnosis should be done by an ALS specialist, as many diseases mimic the symptoms of ALS, and can be mistaken for it.

No treatment can undo the damage done by ALS, but treatment can slow the progression of the symptoms of ALS. Having a team of doctors trained in all different areas can help to prolong survival and the quality of life for patients with ALS. There are two drugs to treat ALS, Riluzole, and Edaravone. Riluzole (Rilutek) slows the progression of ALS by reducing the levels of glutamate in the brain. It is taken as a pill, and side effects include but are not limited to dizziness, gastrointestinal issues, and changes in liver function. Edaravone (Radicava) was FDA approved in 2017, due to the reduction of declinement in the daily functioning of ALS patients (in a six-month clinical trial). Edaravone is given through intravenous infusion for ten to fourteen days in a row every month. Side effects include bruising, gait disturbance, hives, swelling, shortness of breath, and an allergic reaction to sodium bisulfate for patients with sulfate sensitivity. Other medications can be prescribed for the many symptoms of ALS, including muscle cramps and spasms, fatigue, pain, depression, and sleep problems. Therapy is another type of treatment that can improve the quality of life for an ALS patient. These therapies include breathing therapy, occupational therapy, physical therapy, speech therapy, psychological and social support, and nutritional support. As the breathing muscles deteriorate due to ALS, breathing becomes difficult, and mechanical ventilation may be needed. A tube is inserted by a doctor in the front of the patient’s neck leading to their windpipe and is then connected to a respirator. Occupational therapy is a way for patients to remain somewhat independent, despite all challenges and resistance from their bodies. Occupational therapists show how to use adaptive equipment to perform tasks such as getting dressed, bathing, eating, and self-care. Also, the patient’s house can be modified to allow for easier accessibility. Physical therapy can help to keep a patient active while they still can be, by practicing low-impact exercises to maintain health in a fitness aspect. Exercise can help alleviate some pain and improve a patient’s “sense of well-being.” Speech therapy can help an ALS patient to discover alternate and adaptive techniques to make their speech more clear, and other methods of communicating with others. A patient can also use tablets and/or computers to use text-to-speech apps to help them communicate. Psychological and social support can help an ALS patient and their family with not only emotional support, but help with finances, insurance, and receiving the necessary equipment for everyday life. Nutritional support is needed for ALS patients to make eating food easier, as it may be hard for them to swallow solid food, while also getting all of the nutrients that are needed. Many ALS patients will eventually need a feeding tube to eat. All in all, there is no cure for ALS yet, hopefully, there will be one soon, but for now patients rely on clinical trials.

Lou Gehrig’s parents moved to America from Germany and he was born in New York on June 19th of 1903. At this time, ALS was not widely publicized or fought against, and very few people knew that it existed. For seventeen years, Gehrig played for the New York Yankees at first base. He became a household name and an extremely impressive baseball player. He even helped lead the New York Yankees to win six World Series championships. In 1938, Lou Gehrig’s athletic prowess began to decline, and he realized that he found it difficult to tie his shows. He was diagnosed with ALS at the Mayo Clinic shortly after. On July 4th of 1939, Lou Gehrig, The New York Yankees, friends, family, and fans, gathered at Yankee Stadium to hear Gehrig’s inspiring speech. Gehrig stated that he was the luckiest man on Earth, despite being diagnosed with ALS, because of everything he had been blessed with in his life. He determined that being diagnosed with ALS was only a bad break for him, but he made it clear that it wouldn’t define him. On June 2nd of 1941, when Lou Gehrig was 37 years old, he died in his sleep. Today he is seen as a courageous man who made the best out of a terrible situation. That is the reason why ALS is nicknamed “Lou Gehrig’s Disease,” because of Gehrig’s high profile and acts of courage.

The ALS Ride for Life was founded in 1997 after Chris Pendergast was diagnosed with ALS. The Ride for Life is in its 22nd year trying to achieve its goal of raising awareness and funds to discover a cure for ALS, while also supporting patients with ALS. May is ALS Awareness Month. The Ride For Life patients, supporters, and advocates, walk, ride their scooters, or get pushed in their wheelchairs for miles on end to raise awareness. Along the walk, they yell things like “Strike out ALS,” and other things related to the cause. Chris Pendergast has made journeys from Yankee Stadium all the way to Washington, D.C. to raise awareness, and he shows no sign of stopping. When he was diagnosed, Chris Pendergast was given three years to live. Today, he defies those odds by living for twenty-two years after his diagnosis, nineteen years longer than projected. Another way money was being raised was through the ALS Ice Bucket Challenge. People were challenged to pour a bucket of ice-water over themselves and post a video of it online to help raise awareness. In this video, they would challenge other people to complete the challenge and donate money to ALS research. In the end, over $155 million was raised to find a cure.

ALS is clearly no joke. Every day 15 people are diagnosed with ALS. Every year more than 5,600 people are diagnosed with ALS. Approximately 30,000 people in America currently live their everyday lives with ALS. Every year approximately 2 out of every 100,000 ALS patients die because of the disease. With the average life expectancy being 2 to 5 years for ALS patients, many of them don’t make it that far. Few are fortunate to outlive the life expectancy, like Chris Pendergast, but ALS shows no mercy for anyone: male or female. Approximately 60% of ALS patients are men, and 40% are women.

ALS shows no plans of slowing down or ending, but researchers, scientists, and doctors also don’t. Every day, money is raised to fund research for a cure. No donation is too little, as it goes a long way to improving the outlook for a person diagnosed with ALS, and in helping in the overall fight for a cure. It is my hope, that in the future, we can STRIKE OUT ALS. 

Biopsychosocial Assessment

A client has presented severe mental health symptoms while at an appointment for ongoing HIV care. The client would only be seen for his appointments in his home and refused to be seen in the clinic. Utilizing the biopsychosocial assessment outline from Sands and Gellis (p. 88-89, 2012), a brief report of the client follows (Wooldridge, 2019):

Identifying Information

The client is 50, cisgender male, Caucasian, divorced, not employed due to disability, and identifies as heterosexual. He was referred by case management staff within the local HIV clinic to receive behavioral healthcare. The client has HIV and will not leave his home for any reason.

Presenting Problem

The major problem is the client’s unwillingness to leave his home for any reason. This is a barrier to his HIV care and is a manifestation of his fear of being hurt if he leaves. When prompted by asking what would happen if he left the house to attend an appointment, the client became distressed as evidenced by tapping his feet and the speed of his words increasing. He said he would never leave for that and he would be hurt when he walked outside. When asked how he would be hurt, the client said he was unsure, but that he knew something bad would happen. When asked about fear of contracting another disease, the client cried that “leaving home is how he got HIV and he won’t do something like that again”. This inability to leave the home costs the client money for delivery services and limits his options for service providers. He has limited income due to his disability and when paying for delivery and in-home services, he reports not having enough income for food or clothing some months. He also states that his fear of leaving the house restricts his support system. He notes feeling misunderstood with his HIV diagnosis due to a lack of peer support. The isolation away from his family has further increased this gap in his well-being. The client has isolated himself, leading to overdependence on others. The client notes that his quality of care has decreased since needing home-based care. He becomes distressed when discussing or thinking about public transport, open spaces and outside, or finding ways to meet his needs outside of the home. The client has an extreme fear of disease/illness out of his control. This is evidenced by distress upon discussing exposure to the outside and other people. His history of contracting HIV while having an affair outside of his marriage manifests as a larger fear of the disease. He says the HIV causing his immune system to be weakened and causing him to get another disease when exposed to one by a stranger is his biggest fear. He has physical manifestations of this fear, including noted insomnia, shaking, heart racing, and sweating. He has these episodes when faced with leaving or discussing leaving the home. He notes that these also happen without prompting.

Current Situation

The client lives in a rented subsidized home near the city. Equitas Health has a housing program that has helped the client secure this need-based assistance for the foreseeable future. The client lives alone and has no pets. He states that the home is safe and has no infestation of animals or bugs. He moved to this home shortly after his divorce and once in case management, was referred to the housing assistance program noted. He was unable to pay for the home due to the cost of medication and had a pending eviction notice that was resolved once enrolled in the program. He has all his basic needs delivered to the home when he has the money to do so. This includes deliveries of groceries, medications, home goods, clothing, and food from restaurants. If he needs services, the appointments must take place within his home. These include medical, case management, behavioral health, and personal care appointments that would otherwise be in a professional’s office. He has these set up during daylight hours and must speak with the person who will be entering the home before their arrival. The client noted attending a non-denominational church in the past and stopped attending after his divorce. He notes having no support system outside of his care team for HIV. When asked how he would improve this, he states that it is not worth leaving his home to be with people. He has limited social interaction in the form of a chat room on a popular video game which he plays approximately 2 times per week for about 1 hour each session.

Previous Mental Health Treatment

The client has had little formal mental healthcare in the past. The only formal care he has received was couple’s therapy as a newlywed, prior to the affair and HIV diagnosis. He said the clinician was not helpful and would often side with his spouse before listening to his opinion. This caused him to stop speaking much in the appointments, leading to the couple ending their time in therapy because they saw it as a waste of money.

Background Information

The client grew up as an only child with a single mother. His mother worked long hours, leaving the client to occupy his own time while she was gone. He notes that this was often stressful. He is unaware of any medical or mental health diagnoses or cares from his childhood. He notes being kicked out of school several times due to fights related to being bullied by peers. He graduated on time and has an undergraduate degree in business. He mentioned struggling with school attendance and would often skip class to stay home. The client married his high school sweetheart during his time in undergraduate college. He states that they met in class and he liked her easy-going nature. He states that they had their first child after conceiving on their honeymoon. Their second child was born about 2 years later. Their marriage was more difficult after having children, according to the client. He would isolate himself within their home to avoid conflict with his wife or children. Both children are in college and not in contact with their father. The client notes his affair (in which he contracted HIV) began in his 40s. He states that he believed his wife was also having an affair with someone at the time. He notes that this was his first homosexual partner and although they were dating and having sexual intercourse, he has never identified as anything other than heterosexual. He and his wife divorced after his diagnosis exposed his affair. The client states that the divorce was messy and that he no longer has contact with his ex-wife or their two grown children. The client states that this is about the time his symptoms began to affect his quality of life.

Results of Mental Status Exam and Diagnosis

He had an appropriate dress with jeans and a sweater, was well groomed, was cooperative in answering any questions and providing documents, and was guarded while discussing his fears of leaving home, as evidenced by avoiding answering “what if?” questions. The client had no tremors or tics. He shook and tapped his feet and fingers while distressed. The client’s speech was normal and slightly loud. No loose associations or flight of speech. His primary language is English. He reports feeling uneasy. He maintains this and presents in a normal tone. There was no shift in mood. He is not having delusions or hallucinations. There are repetitive phobic thoughts and obsessive thoughts regarding his space and ability to remain in the home. The client is intelligent and expresses himself well. He is orientated to time/place/person. He showed no issue with memory and had a consistent recall. The client is accurate in perceiving sensations. He struggles with body/space orientation and desires more space around him within the home setting. He states while out of the house, everyone seems too close. He expresses no delusions or hallucinations. The client reports no sexual activity and is very controlled with his body and other people. He denies any sexual desires or urges to interact with others. The client is aware of his fear of leaving is not rational. He is aware of how they interfere with his HIV treatment and lack of a support system. With this insight, he still decides to not leave out of the distress leaving brings him. His judgment is influenced by the fear of being harmed or infected.

The client is diagnosed with the client is presenting with the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) defined as anxiety disordered Matchof agoraphobiaEnd Match with panic disorder (AmericanEnd MatchPsychological Association, 2013)