Ayushi Ladha
Pop
culture and psychology have a tumultuous history of not aligning with each
other. Every other movie depicting a mainstream psychological phenomenon
depicts a varying ratio of accurate and inaccurate portrayals of various mental
health conditions as well as aspects. However, some psychological thrillers
force us to reckon the possible real-life implications of what is often
portrayed as fiction.
The
movie Split is a work by M. Night Shyamalan (2016) which has taken several
creative liberties in creating a chilling, if quite hyperbolized, portrayal of
the rare dissociative identity disorder (DID). While the movie has faced its
fair share of criticism for its violent portrayal of DID (Split: Why Mental
Health Experts Are Critical of the Movie, 2017), the movie,
alongside several other similar plots, raises the much more hidden question of
the approaches that psychotherapists undertake while diagnosing and attempting
to treat the extremities of rare and currently clinically uncurable mental
disorders like dissociative identity disorders. This begs to question the
vagueness that persists regarding where to draw the line between
professionalism versus the best interests of the person undergoing the disorder.
It also indicates towards the blurred boundaries of a therapist’s personal
intervention versus the decision towards institutionalization.
Split
is the story of Kevin, a character diagnosed with DID with 23 personalities
known and discovered by his psychotherapist, Dr Karen Fletcher, during his
therapy sessions (Shyamalan, 2016). While the movie focuses on an undiscovered
and dangerous 24th identity, certain approaches by Dr Fletcher
showcase the dilemma of “working hours” and the difficult boundaries of
professionalism a psychotherapist faces. Kevin, as different personalities,
tends to email Dr Fletcher at odd times of the day as well as the night to
schedule extra sessions or urgent, immediate sessions, which Dr Fletcher obliges
to (Shyamalan, 2016, 0:11:01, 0:38:12, 0:54:20, 1:10:40). While the aspect of
different personalities emailing Dr Fletcher might be contested, the scenario
unfolds a very real portrayal of psychotherapy as a profession being a choice
between regular, scheduled therapy sessions or being present for a client
undergoing a highly unpremeditated disorder. One’s own psychotherapist
understands one’s case the best after multiple sessions of diagnosis and
research, which creates for a difficult situation when the client undergoes
serious disorders due to constant need for attention and diagnosis. The
boundaries between such professionalism versus the client’s best interests are
yet not clear, and neither is there a clear choice when it comes to the
unpremeditated and often unprecedented possibilities of danger for a person
undergoing a serious mental disorder.
Another
hazy area of decision-making in psychotherapy for a disorder like the DID as
portrayed in Split is the choice between personal intervention from psychotherapists
versus institutionalizing the client or putting them under constant care. Kevin
does not seem to have any guardians or kin. The only person aware of his
disorder appears to be Dr Fletcher, who was also using her sessions with him to
conduct research on DID and its manifestations as a factor of biological
changes in the human body (Shyamalan, 2016, 0:35:49). While the science behind
her claims seemed to be under study, by the end of the movie, it becomes
consistently evident that Kevin could have been either institutionalized of
under constant care due to his dangerous actions. However, Kevin seems to be a
fully functional, self-sustained individual with a house of his own and living
a broadly normal life as viewed by Dr Fletcher, thus making it difficult to
diagnose the severity of his case. Before the movie climax, however, Dr
Fletcher suspects the severity of Kevin’s disorder to be far worse and takes it
upon herself to visit Kevin (Shyamalan, 2016, 1:11:26). In doing so, Dr
Fletcher puts her life at risk and realizes the illegal, horrendous kidnapping
and containment of three teenage girls done by Kevin as one of his
personalities (Shyamalan, 2016, 1:19:02). Dr Fletcher loses her life while
trying to save the girls (Shyamalan, 2016, 1:28:56). For a client undergoing a
severe mental disorder with dangerous implications and no guardian or family
members, their psychotherapist providing institutionalization or involuntary
constant care is widely unheard of, and vague regarding the guidelines on doing
the same. The same incident also raises the question of whether a
psychotherapist should heed to personal intervention outside of professional
capacities in case of perceived danger on a professional level as compared to
an ethical level, thus confounding the boundaries needed to be drawn between
client and therapist as part of the therapy and treatment process.
While
severe and rare disorders themselves pose as a primary dilemma concerned with
treatment methods varying from case to case, a secondary dilemma which has its
own set of vagueness is on the psychotherapist’s end: how and when to establish
boundaries in cases which are extremely involving. Immersing into a case is
extremely crucial to analyse the best methods and approaches of treatment, yet,
drawing a line on what constitutes as part and parcel of the treatment process
versus what constitutes as measures to be taken in extreme cases is crucial as
well. While close monitoring and watchlists for those in danger of severe
actions and consequences is one way to go, in cases which might even vaguely
resemble the circumstances as seen in Split might possibly need a different
approach altogether, one that currently seems to be extremely difficult to
quantify or specify. A part of the same is being informed and aware of the
actual severity of the disorder, yet, a larger part is settling the blurred
boundaries on what should constitute as part of the psychotherapist’s treatment
process and what should the methods be to approach these boundaries to achieve
a common ground between the client’s best interests as well as the therapist’s
professional foundation.
Works
Cited
Healthline. 2017. Split: Why Mental Health Experts
Are Critical of the Movie.
https://www.healthline.com/health-news/movie-split-harms-people-with-dissociative-identity-disorder
[Accessed 10 October 2022].
Night Shyamalan,
M. (Director). (2016). Split [Film]. Universal Pictures. Amazon Prime:
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