A Beautiful Mind: Schizophrenia Issue Revisited

Cafe Society
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First, it’s good to be back on TSD, after being relegated to never-never land for awhile (their computer glitch caused me to be a TSD non-entity for a time there).

As a sensitive adult who adores movies, I loved “A Beautiful Mind” and believed it deserved to win all the Oscars it was nominated for. As a mental health professional, I was impressed with the sensitive portrayal of a boundless genius plagued by a severe mental illness. However, there was one aspect of that portrayal that disturbed me and I see it as not only an inaccuracy, but a pretty serious one.

Persons with psychosis are typically plagued with hallucinations (the perception of something that others do not perceive) and/or delusions (false beliefs, typically of some personal significance), among other symptoms. John Nash had both, which is not unusual. What was VERY unusual in the movie was that his hallucinations (the three people who “followed” him) were not only portrayed as visual (he could see them) and auditory (he could hear them speaking to him), but also as tactile hallucinations (at least three scenes showed him touching or embracing two of the hallucinations). This would be totally out of character for psychosis. While every type of hallucination has been documented, including olfactory (smell) and gustatory (taste) as well, such elaborate combinations of senses within one hallucinatory experience is unheard of.

I was wondering if anyone else caught this inaccuracy. :slight_smile:

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I was wondering that as well…didn’t he actually pick up the little girl and carry her around for a while? I especially wondered how the hallucination was able to push a desk across the room and out the window. Talk about artistic license!

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IIRC, the hallucination had a little help from Nash . . . :slight_smile:

Caution: Beautiful Mind spoilers ahead!

I took the fact that he interacted physically with the hallucinations as mostly a matter of his own “editing” of his memories. Did you embrace your husband when you got home from work last night? And the night before that? And the night before that? In my memories, I typically just have this sort of fuzzy placeholder: “Warm greeting.” The details of it are kind of sketchy. I may recall the event as having a hug, when maybe it did or maybe it didn’t.

It might have been a little bit cooler if Ron Howard had done the scrupulous work that Shyamalan did in The Sixth Sense, where you can go back and see that . . . (er, well, I won’t spoil it, JIC.) But at the same time, since The Sixth Sense, the twist-the-end has been overused in Hollywood lately, so perhaps breaking from the rigid application of that formula was a good decision on Howard’s part.

Also, The Sixth Sense was intended as something of a puzzle for the audience. There was one scene in the Sixth Sense where I really noticed that something odd was going on. Maybe if I was a little faster on the uptake, I might have figured out the twist. Indeed, Shyamalan included certain “clues” that the alert viewer might have picked up on, and enjoyed the experience even more for being in on the joke.

However, in A Beautiful Mind, we as the audience were experiencing Nash’s delusion along with him. We weren’t supposed to figure it out–that wasn’t the point. The point was that we had to confront, along with him, the fact that experience that seemed very real to him–and to us–in fact did not happen. So it’s not quite as important that a person, on the first viewing, should be able to pick up on the fact that some things aren’t real. In fact, it would detract from being submerged in the delusion. If the audience member thinks, “Hey! How come he’s drinking from that flask alone? Why doesn’t he offer it to his friend?” then later when the world comes crashing down, they aren’t as devastated by it. They can just smugly think, “Heh. I saw that coming.” Instead, they see Nash and Charles passing the flask back and forth, and think nothing of it–just two friends sharing a drink and conversation, and when it is revealed that the conversation didn’t take place, suddenly the memory is transformed into the haunting image of a man alone on the roof of a building, drinking and talking to himself.

Let me ask you, TheLadyLion, and anyone else who works with the mentally ill . . . were you bothered at all by the impression the film gave, that schizophrenia can be controlled by force of will? Okay, yeah, it’s a real story, but they glossed over a lot of the struggles that Nash went through (multiple hospitalizations and insulin shock treatments, for example) and kind of sneaked in the fact that he was indeed taking “some of the newer medications” in the end.

I feel like a person could probably walk away from that movie thinking that those who suffer from schizophrenia just lack the willpower to get their heads on straight, and medication is only necessary for the people who are weak or not as smart. That bugs me a bit.

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Crud. Sorry 'bout the formatting. If a mod could fix up that tag, I’d appreciate it.

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Some of us feel not so much that we can “overcome schizophrenia through force of will” but that we can live with it and cope with it as well if not better without medication than we can with medication. This is due in part to our assessment of the medication, based on our personal experience with it. I will for once bypass my usual soapbox if we can agree to also dispense with the assumption that pyschiatric pharmaceuticals or shock treatments are necessarily what a schizophrenic person needs, mkay?

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Sorry, AHunter3, I didn’t intend to give offense. I don’t know much about schizophrenia so I think I’d better ask some questions before I put my foot in my mouth. :slight_smile: How common is it for schizophrenics to decline medication? Is there any special therapy or training that helps them cope with their symptoms?

I would imagine that there is a continuum of severity, where some people can get along without meds, whereas others would not be capable of functioning without chemical assitance. I worry sometimes that any movie that shows the triumph of a determined patient over an illness or disability, mental or physical, can lead to a bit of blame-the-victim sentiment. “How come Bobby can’t walk? That wheelchair guy in that one movie worked real hard, and taught himself to walk again. How come Bobby doesn’t do that? Is he just lazy?” In that paricular case, one can point to Bobby’s x-rays and explain that his spinal cord injuries were much more extensive than those of the man protrayed in the movie–though more often the differences between Our Movie Portagonist and the Real Person Living with a Disablity or Disease is not so obvious to the outside observer.

And, again apologies, I should have addressed my query in the previous post not only to those who have a professional interest in schizophernia, like TheLadyLion, but also to schizophrenics and their friends and families.

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To a certain extent, yes. The film did give the impression that Nash over time had somehow learned to ignore or supress his hallucinations to a great degree, rather than that they had become less severe with time, or due to improved medication.

My father was schizophrenic, as was my aunt (his sister), as is my cousin, as is one of my friends from high school. My father first showed signs of schizophrenia around 1955 when he was 29, about the same time period depicted in the movie. He was hospitalized several times, the first after an auto accident with a taxi when he asked the cabbie “Are you God?” He was given insulin shock treatments (that part of the movie was hard to watch) as well as medication and psychotherapy. I am not sure if he also received electroshock treatments.

None of this controlled his symptoms particularly well. However, he sometimes did stop taking his medication - like Nash, because of the side effects - and then would become worse, sometimes so bad he would become violent and end up being hospitalized again. This also sometimes happened when the doctors adjusted his dosage or otherwise changed his medication.

He became much better almost spontaneously when he was about 57. I have heard that schizophrenia sometimes “burns itself out” with age, and this seems to have been the case with my father. Perhaps improved drugs had something to do with it, but his transformation was quite sudden and did not seem to be related directly to medication. However, he never did achieve the level of “normality” shown by Nash later in the film. (I don’t think my father’s hallucinations were nearly as complex as those depicted in the film, however. As far as I know, he suffered mostly from auditory hallucinations - voices - and paranoid delusions).

My cousin, on the other hand, who is now 40, improved a great deal in recent years with some of the newer medications, much more so than with the ones that were available earlier.

Ten or fifteen years ago my high school friend at times stopped taking her medications because she said they made her feel “numb.” But when she stopped she would usually end up in the hospital again. She told me how difficult it was to have to decide between being crazy or a zombie. I haven’t spoken to her more recently to see if newer medications have improved her choices any.

Overall I found A Beautiful Mind extremely moving, especially in its depiction of the decisions faced by Nash’s wife. However, it seemed to me that, as depicted, Nash’s case wasn’t very typical regarding either the intensity or complexity of his hallucinations, or the degree to which he later recovered. But probably there is no such thing as a “typical” case of schizophrenia.

[Aside to AHunter3: I don’t want to start a debate on any of this either. My experience is, based conversations with people I know well, that medication can help some people diagnosed with schizophrenia. Others, such as my high school friend, may face very difficult dilemmas in choosing between the postive effects of medication and its detrimental side effects.]

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[QUOTE]
*Originally posted by Podkayne *
**

Let me ask you, TheLadyLion, and anyone else who works with the mentally ill . . . were you bothered at all by the impression the film gave, that schizophrenia can be controlled by force of will?

Yeah, Podkayne, as far as a message this day and age, it bothered me. However, many clients I have seen over the years who have a diagnosis of schizophrenia (or something similar, like schizoaffective disorder or delusional disorder) do try to avoid medications or other treatments. To people not experiencing the symptoms, it appears foolhardy to do this. But they have their reasons. Some of my clients try to stop their meds because they want to believe they can will themselves better… but they usually find out rapidly that they can’t. Some clients have told me that they desperately want to be “normal” (their word, not mine; I very seldom ever use that word) and try to be by stopping their treatments. AHunter3 gave another reason, in that some people are able to find creative ways to cope with their symptoms. Finally, some people experience periods of psychotic symptoms interspersed with relatively symptom-free periods.

The medications available in the 50s were state-of-the-art back then, and sadly ineffective in many cases. They afforded many people some symptom-free time. But the side effects, such as tardive dyskinesia and stupor, were unpleasant at best and debilitating at worst. Insulin shock and electroconvulsive treatments were experimental back then and essentially worthless as treatments for schizophrenia (ECT does have some therapeutic value, however, with extreme depression that does not respond to less intrusive treatments). More recently some newer medications (such as risperadone) have had improved success with many clients without the nasty side effects.

There are some mental health support groups, available in most larger communities and in some smaller ones, that can help people cope, gain a voice, be advocates for themselves or loved ones, stay on medication or get on more appropriate medication as indicated, etc. And yes, there is a huge continuum with schizophrenia, just as there is for anything in life. So different people have different symptoms and varied levels of severity, as far as different degrees of positive response to the available treatments.

Often the biggest difficulties these people face is being misunderstood by the rest of their community, who frequently turn their backs on something they know nothing about and are afraid of. I could go on about this, but that would better be served in a new thread.