Over the course of the past century, the experience of losing a grip on reality has gone by innumerable names. Terminology like "insanity" and "madness" are obsolete for the now favoured term of "psychosis," a mental condition characterised by symptoms that suggest disturbed perceptions and interactions with reality. Delusions and hallucinations are examples of such symptoms (Hooley et al., 2021). Although these symptoms can be found in a number of mental illnesses, including severe mood disorders and personality disorders, they are most usually associated with Schizophrenia. As the 2011 film, Take Shelter demonstrates, schizophrenia is a serious mental condition that impacts perception, cognition, and behaviour. People frequently have persistent erroneous beliefs (delusions), such as the belief that they are being persecuted, and they frequently hear or see things that aren't there (hallucinations). Take Shelter is a fantastic film that portrays late-on-set psychosis. In the movie, Michael Shannon plays Curtis LaForche, a construction worker from a small town in Ohio, and his wife Samantha (Nichols et al., 2011). The couple's lifestyle is quite typical for the Midwest. They devote their time to caring for their small daughter, attending church, dealing with their financial difficulties, and trying to win over their in-laws. At least from the outside, it seems that way. Internally, Curtis is facing inner conflict that will eventually erupt into a full-fledged war inside his mind, as his functioning and social well-being significantly worsen due to the symptoms of schizophrenia, which is left untreated throughout the movie (Nichols et al., 2011). This blog investigates Curtis LaForche, the protagonist, to see whether his depiction of schizophrenia on screen was accurate. This blog seeks to accomplish so while noting any possible effects—both positive and negative—that the movie may have had on its audience.
Schizophrenia is a severe mental illness that is characterised by a combination of long-lasting symptoms- positive symptoms like Delusions, Hallucinations, Disorganised behaviour and/or speech, and negative symptoms (like diminished emotional expression or avolition) (Hooley et al., 2021). These symptoms heavily hamper daily functioning. As a result, research has long been intrigued by the idea of developing methods for early diagnosis and potentially even prevention of the disorder. There is research that has focused a lot on the "prodrome," a phase of impaired functioning hypothesised to precede the onset of psychotic symptoms (Larson et al., 2010). The fact that patients still have some awareness of their symptoms during the prodrome is a crucial component. In other words, a person experiencing the prodrome can still partially comprehend that their symptoms are a result of their disease and not true reality (Larson et al., 2010). Within a few years, about one-third of people who satisfy the prodrome's current diagnostic standard progress to schizophrenia (or another comparable condition with psychotic elements) (Larson et al., 2010). The movie accurately depicts a number of characteristics of the prodrome. Curtis, who is diagnosed with the illness is male (males are more likely than females to be diagnosed with psychosis) (Iacono & Beiser, 1992), has a family history of schizophrenia, (heritability rates of schizophrenia are between 82% to 85%) (Cardno et al., 1999), and is rapidly declining cognitive, emotional, and social function but still having some insight (as evidenced by the fact that he seeks out mental health services) (Nichols et al., 2011). The movie accurately captures both the facts and the depiction of emotions. Curtis initially fears that he may be losing his sense of reality, and subsequently, he fears that the end of the world is drawing closer (Nichols et al., 2011). In the film, his misery and anxiety in the prodrome are shown to have become worse with each successive dream.
Apart from all this, the depiction of these symptoms in the movie was done in an accurate manner. Initially, Curtis begins to experience night terrors, which seem to be specifically aimed at him and his daughter. He suffers from hallucinations and delusions, and after researching mental illnesses, he comes to the conclusion that he is suffering from schizophrenia (Nichols et al., 2011). He anticipates severe storms and notices storm indications that none can see, like figures in the storm, flocks of birds that aren't there, and storm sounds that aren't actually happening. Due to his symptoms, he decides to take time off work to build a storm shelter (Nichols et al., 2011). He seeks counselling, but the counsellor tells him that while she can listen to him, she cannot provide him with medication. Although Curtis' family doctor prescribes him a mild anti-anxiety medicine, he keeps his wife in the dark about his symptoms until things escalate (Hooley et al., 2021). The movie goes over some of Curtis' family histories and mentions how he was raised by his father after his mother was given a paranoid schizophrenia diagnosis and sent to a state hospital (who had recently died, exacerbating the stress Curtis was experiencing) (Nichols et al., 2011). It's interesting to notice that in their mid-30s, the symptoms of both the mother and the son first appeared. Also, after the dream incident where his dog bites him, he experiences pain in reality, though the incident occurs in the dream. Because of his dream, Curtis begins to see his dog as a threat and chooses to put him in a cage in the backyard with an iron wire fence around it (Nichols et al., 2011). However, as his delusions grow, he coerces his brother to take the dog with him. Those with paranoid schizophrenia frequently exhibit these symptoms.
Additionally, the portrayal of the therapist making changes without first informing the client could mislead viewers about the power dynamics between the therapist and the client (Furlonger et al., 2015). As it takes the client some time to open up to the therapist, the therapist cannot share the client's information with anyone else without the client's consent in accordance with client confidentiality (Gelso, Nutt & Fretz, 2014). Although it can be challenging to depict therapy in fast-paced narrative TV in an accurate and responsible way, it is feasible to do so provided you have a thorough understanding of the procedure and the interaction between the therapist and the client ( Furlonger et al., 2015 & Robison & Ogles, 2008). Although the movie is great and does a great job of portraying schizophrenia, there is one violent scene that adds to the myth that all individuals with mental illnesses are violent. One of the most basic but common myths in contemporary cinema is the connection between mental illness and violence (Hooley et al., 2021). This myth is most prevalent in movies that feature schizophrenia spectrum disorder, since the general public is uneducated about the connection between violence and mental illness, many people, misled by media accounts, are prone to exaggerate their own personal risk. They may avoid and/or alienate those exhibiting symptoms or those who have a diagnosis when engaging with someone who has a mental illness. Additionally, studies show that mental illness is neither a necessary nor sufficient justification for violent behaviour. As a result, people with mental illness are much more likely to become victims of violence than to actually engage in it (Stuart, 2003). The evidence is conflicting as to whether those who suffer from mental illness are more or less likely than the general population to retaliate violently.
References:
Cardno, A. G., Marshall, E. J., Coid, B., Macdonald, A. M., Ribchester, T. R., Davies, N. J., Venturi, P., Jones, L. A., Lewis, S. W., Sham, P. C., Gottesman, I. I., Farmer, A. E., McGuffin, P., Reveley, A. M., & Murray, R. M. (1999). Heritability estimates for psychotic disorders. Archives of General Psychiatry, 56(2), 162. https://doi.org/10.1001/archpsyc.56.2.162
Furlonger, B. (2015). The Portrayal of Counselling on Television and YouTube: Implications for Professional Counsellors. Journal of Behavioural Sciences, 25(2).
Gelso, C. J., Nutt Williams, E., & Fretz, B. R. (2014). Counseling psychology (3rd ed.). Washington, DC: American Psychological Association. https://doi.org/10.1037/14378-000 (ISBN: 978-1-4338-1711-3)
Hooley, J. M., Nock, M., & Butcher, J. N. (2021). Abnormal psychology. Pearson Education Limited
Iacono, W. G., & Beiser, M. (1992). Are males more likely than females to develop schizophrenia? American Journal of Psychiatry, 149(8), 1070–1074. https://doi.org/10.1176/ajp.149.8.1070
Larson, M. K., Walker, E. F., & Compton, M. T. (2010). Early signs, diagnosis and therapeutics of the prodromal phase of schizophrenia and related psychotic disorders. Expert Review of Neurotherapeutics, 10(8), 1347–1359. https://doi.org/10.1586/ern.10.93
Nichols, J., Davidson, T., & Lin, S. (2011). Take shelter. Retrieved November 11, 2022.
Robison, T. A., & Ogles, B. M. (2008). Effects of fictional portrayals of psychotherapy on expectations of treatment. PsycEXTRA Dataset. https://doi.org/10.1037/e528952008-001
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