Synopsis of the Movie: a Beautiful Mind - Essay Example

? A BEAUTIFUL MIND Synopsis of the movie In the year 1947, John Nash reports to Princeton Together with Martin Hansen, he is a co-recipient of the Carnegie scholarship, a prestigious Mathematics prize for top brains in mathematics. While at the reception, he meets other Science and Maths graduate scholars- Richard Sol, Ainsley and Blender. His roommate, Charles Herman arrives in his room and they begin an unlikely friendship. Charles is a literature student. As a top scholar, pressure mounts on Nash to publish, both to show satisfaction to the Mathematics department and also due to rivalry from Hansen. He does not publish and claims that until he finds for himself an original idea, he would not do so. He and fellow graduate students visit a bar to approach a group of women. His inspiration comes from here. Though Hansen proposes that every individual should make their individual approach, Nash opposes this idea and argues that each one would have better chances of success when they adopt a collective approach. Through this, he conceives the idea of ‘governing dynamics’ which he then publishes. Following this success, an opportunity for an appointment to MIT arises where Sol and Bender accompany him. Years later, Nash gets an invitation to the pentagon to unveil an encrypted enemy telecommunication. Unlike other code breakers, Nash breaks the code mentally. This astonishes everyone, including the other code breakers. His regular duties at the University are uninteresting to him and he considers the chores below his intellectual capability. He then obtains a new assignment with William Parker, a mysterious supervisor at the U. S. Department of defense to decipher patterns in newspapers and magazines to help thwart a plot by the Soviet Union. During this assignment, he becomes obsessed with this work and begins to think himself as being pursued when he delivers the results. At this time, he is asked out for dinner by a student-Alicia Larde and this culminates in love. Returning from Princeton, he comes across Charles, his former roommate who encourages him to get married to Alicia. After witnessing a shootout between the Soviet forces and Parcher, Nash begins to fear for his life. He feels at this point like quiting, but Parcher manages to let him stay. During a period of delivering a lecture at Harvard University, Nash makes an attempt to flee from whom he perceives as foreign agents, Dr. Rosen leading them. Upon an attempt to punch the figure that he perceives as Rosen, he forcibly gets sedated and sent to a psychiatric unit. However, he holds the belief that the facility is a property of the Soviets who are interested in obtaining information from him. Dr. Rosen, however, informs Alicia that Dr. Nash is schizophrenic and also that Marcee, Charles and Parcher are only existent in his imagination. Upon investigation, Alicia confronts Nash with the documents he delivered in the secret mailbox, unopened. He is then given an insulin shock therapy and then gets obtains parole. Following the side effects of the antipsychotic drugs, he stops taking them altogether. He relapses and again meets Dr. Parcher. In 1994, Professor Nash gets an honor for his profound achievements in mathematics. He won the Nobel Memorial Prize in Economics for having done a revolutionary work on the game theory. The end of the movie happens when Nash and Alicia walk down the auditorium in Stockholm. Nash sees Parcher, Marcee and Charles watching him( Howard, 2001) The axis for John Nash- John Nash suffers from paranoid schizophrenia. According to Frangou (2008), schizophrenia is a term replacing and synonymous to dementia praecox, which denotes psychosis, and characterized by changes in thought content, perception, thought processes (like hallucinations and perceptions) and general anhedonia to other people and the outside world, and with excessive focus on one’s own mental life. It is now considered a wide spectrum of disorders, rather than one disease and with reasonable distinction between process and reactive schizophrenia. The ‘split’ personality of an individual, a phenomenon in which the psychic elements of an individual separate and become autonomous often gets identified with multiple personality. The disease is commonly, though erroneously, identified with multiple personality, which occurs when complete personalities of an individual take turns in dominion in the psychic life of the patient. Schizophrenia, a Greek word, is a mental illness that appears in late adolescence or in early adulthood. It, however, may emerge at any time in life. Commonly, though, it appears between age group of 15-25 in men, and 25-35 in women. The development of the disease is so gradual that the patients barely recognize the symptoms as the disease progresses. Whereas it has been predominantly observed to have a slow onset, in other patients it has a sudden onset and develop fast (Mura et al, 2012). It is thus a complex, chronic, severe and disabling disorder of the brain which has a prevalence of about 1 percent of all the adults in the world. Psychiatrists think that this disorder is a combination of many illnesses that masquerade as one. It is hypothesized, though that it likely occurs due to flawed neuronal development in the fetus’ brain later in life showing up as full blown disorder ( Hunsley et al, 2006). Schizophrenia cannot be diagnosed by any physical or laboratory means. Psychiatrists make a diagnosis based on the clinical symptoms of the patient. However, to rule out other conditions which have similar symptoms like thyroid dysfunction, seizure disorders, brain tumors and metabolic diseases, these tests may be indicated. The symptoms and signs may vary from individual to individual, but are generally classified as follows (Pinkham et al, 2007). Nash exhibited some of these symptoms too. A) Positive symptoms- also known as psychotic symptoms, these symptoms are not found in people without schizophrenia, but are regularly found in people with schizophrenia. An example is hallucination. In the movie, Nash ‘sees’ certain people that do not exist in reality, for example, his roommate when he arrives in campus is an imaginary roommate. B) Negative symptoms- are symptoms of features which are taken away from the individual. These are normal traits or abilities that individuals who do not have schizophrenia have. An example is blunt affect. In the movie, Nash keeps to himself and does not talk to people, including his peers. He looks sullen most of the time. C) Cognitive symptoms- these refer to symptoms affecting thought processes. They may be positive or negative symptoms. An example is poor concentration, which is a negative symptom. Nash does not particularly have poor concentration, but rather he has too much concentration in activities he undertakes. He, for example, has taken to an assignment offered to him by Parker with exclusive concentration. D) Emotional symptoms- these refer to symptoms affecting the feelings of an individual. Normally, they are negative symptoms, for example, blunt affect. Sometimes Nash exhibits emotionally instability. For example, there are occasions where he cries. In terms of management of schizophrenia, the primary treatment is by use of medications called antipsychotic drugs, but this is usually combined with psychological and social support systems. Individuals who have severe episodes may be hospitalized, often because of violent behavior, either on voluntary basis or involuntarily. Long term hospitalization is uncommon due to the policy of deinstitutionalization, and individuals are given parole after improvement in their symptoms. Other modes of management include the utility of community support groups and supported employment. It has also been indicated that regular exercise has an advantageous effect on the physical symptoms of individuals who have the disorder (Weiberger, 2007). The first line medication for the psychiatric symptoms is antipsychotic medication. Antipsychotics are sub-classified into typical and atypical antipsychotics. These usually improve the symptoms of psychosis in one to two weeks. However, they do not improve the negative symptoms and cognitive impairment. Long term use significantly uses the possibility of relapse. The choice of drug depends on the perceived benefits, cost and risk. Risperidone is the most commonly used antipsychotic medication and shows very good response in between forty and fifty percent of patients, partial response in between 30 and 40 percent and resistance to treatment in about 20 percent of the patients. Clozapine is effective for those who have poor response to other drugs. However, it has the side effect of agranulocytosis (Agid et al, 2008). Typical antipsychotics have higher rates of extra-pyramidal side effects, while atypical antipsychotics are associated with diabetes, weight gain and metabolic syndrome. Atypical antipsychotics have relatively fewer extrapyramidal side effects and the effects are milder. Some atypicals like risperidone and quetiepine are linked to higher risk of death compared to perphenazine. Clozapine, however, is linked to low risk of death( Biedermann, 2011). For patients who are not compliant to medication, long acting depot preparations of drugs are administered. They decrease the chance of relapse to a higher degree compared to oral drugs. They have also been shown to increase the adherence to treatment when used together with psychosocial interventions. There are many forms of psychosocial interventions, including assertive community treatment, family therapy, supported employment, skills training, cognitive remediation, cognitive behavioral therapy, token economic interventions and also psychosocial therapeutic interventions for weight management and substance abuse (Rugerri at al, 2008). Family therapy and education addresses the family system holistically in reference to an individual and helps reduce the number of hospitalizations and relapses. CBT has not been shown to significantly reduce the symptoms and reducing relapse. Not much research has been done on drama or art therapy. In terms of ethical issues, treatment for Professor Nash for schizophrenia in the movie involved administration of insulin shock therapy. This involved giving such a therapy five times a week for a total period of 10 weeks. Insulin shock therapy was a technique used in the early part of the twentieth century, from the observation that epileptic patients who suffered from epilepsy rarely had schizophrenia. It was therefore thought that the convulsions were protective against schizophrenia. This involved making attempts through several ways to induce convulsions, including using insulin as happened with Nash. However, electroconvulsive therapy was considered as the easily controllable way to induce convulsions and the effects were often dramatic. But insulin shock therapy creates an unpopular feeling among the subjects, and they feel very uncomfortable. It would have been better if the staff obtained consent for administration of this therapy. This is obviously an ethical issue and represents maltreatment of the patient. However, mentally ill patients are often exposed to this treatment due to the fact that they do not manifest insight( Swerdlow, 2011). John Nash, underwent an insulin shock therapy without his permission, this is an ethical issue. Furthermore, the medical staffs administered a sedative through injection and John was taken to a psychiatric facility despite his resistance. Admitting the patient in a psychiatric facility without the consent in some circumstances becomes a very controversial issue. The support system for an individual may come from numerous sources, including the family, professional program provider, friends, shelter operators, churches; professional case managers etc. Individuals who are sick may obtain help from people within their community or family in a number of ways. Given the fact these patients often refuse treatment, citing the belief that the delusions and the hallucinations are real and that there is no need for helping them. The family or friends may play an important role in ensuring that the patients are evaluated by the doctor. Civil rights have affected attempts to provide treatment to the patients ( Aboleda-Florez, 2008). Legislation that protect patients from involuntary commitment have become more strict and it is not uncommon for the family or caretakers to be frustrated in their attempt to have medication for their patient when he is severely ill and needs medical help. Though ranging from state to state, when patients become dangerous to other people or themselves due to a mental illness, the police may lend help in assisting them obtain emergency psychiatric evaluation and hospitalization if need be. The community can also organize for a community mental health worker to visit the patient at his home and provide the necessary medication. In some cases, the only people who may know about certain behavior exhibited by the patient are the family members or close friends. When patients do not volunteer such information during the time of examination, the family member may request the healthcare worker to be able to speak with the patient so that all the important information may be available to the clinician ( Papastravrou, 2010). It is also important that after hospitalization, patients comply with the medication. Tai et al (2009) noted that on their own, patients may decide to stop attending follow up clinics hence resulting to the increase in the severity of the symptoms. When patients are encouraged to continue taking their medication and assisting in the process of treatment usually assists to enhance the recovery of the patient. When they miss treatment, some patients would fail to perform activities of daily living. In severe cases patients may escape to the streets. In addition to the engagement in seeking for help, the family, peer groups, friends can provide support and assist the patient to be able to regain their abilities. The goals should be realistic and attainable since patients who get burdened with additional pressures or are exposed to frequent criticism may have their symptoms worsening. It is important for the patients to understand when they are right. A positive approach or reinforcement may be more helpful in the long term outcome of the patient than criticism( Turkington, 2006). John Nash is discriminated and judged for being different and also due to his eccentricity. Though it is also possible that this could also be because he is on scholarship, his peers notice his rather strange mannerisms, but do not realize that he has a mental illness. He only gets to be diagnosed with schizophrenia after completing the university. The treatment that Nash receives from the mental health facility is quite a labeling experience, for example, the insulin shock therapy and the mode of administration of the antipsychotic drugs. It so appears that the hospital staff gave him a repudiatory treatment owing to his mental health problem. The treatment by the fellow students was also an act of labeling. He for example gets derided because of his walking style, his affect, his predilection to loneliness and overall his eccentricity. In light of the recovery model depicted in the film, the following recommendations were suggested for treatment and management of schizophrenia in patients. A suitable model should be supportive and also safe. The patient should be counseled regarding his condition in order to help him to accept it ( Insel, 2010). The National Institute of Mental Health ( NIMH) acknowledges that this approach will help the individual to be chemically dependent. It is important for the side effects arising from the medication to be managed in order to minimize discomfort in patients. Finally, according to Perry (2011) for the recovery model to be effective there should be development of new attitudes towards psychiatric illnesses. This will play a phenomenal role is demystifying schizophrenia and reducing stigma. Consequently, psychological disturbances in patients will be reduced. According to van Os and Kapur (2009), hospitalization of patients with mental illness is a controversial issue, they should be assisted to rest in mental health facilities for a period, especially when there is acute exacerbation of the aggressive behavior. When the patient is at home, the kin should help them maintain compliance to their treatment regimen by close monitoring at the times when they take their medication. The film however, having achieved to show the medication aspects of the disease management, somehow fails to underscore the place of other management modalities in treating the condition. For example, group therapy and psychotherapy are invaluable in complementing medication and helping achieve compliance with the medication. In the movie, little space has been dedicated to these forms of therapy. The movie is an important illustration of how individuals struggle with schizophrenia in everyday life. To a large extent, it has achieved to bring about an exposition on the disease in terms of the symptoms, inconveniences to individuals in their everyday life, how family and friends cope, and how the symptoms may be managed so that the symptoms become less prominent. References Agid, O., Kapur, S., & Remington, G. (2008). Emerging drugs for schizophrenia. Expert Opinion on Emerging Drugs, 13(3), 479-479. doi: 10.1517/14728214.13.3.479 Arboleda-Florez, J., & Sartorius, N. (2008). Understanding the stigma of mental illness : Theory and interventions: Theory and interventions. Chicester: John Wiley & Sons, Ltd. Biedermann, F., & Fleischhacker, W. W. (2011). Emerging drugs for schizophrenia. Expert Opinion on Emerging Drugs, 16(2), 271-282. doi: 10.1517/14728214.2011.556112 Frangou, S. (2008). Schizophrenia. Medicine, 36(8), 405-409. doi:10.1016/j.mpmed.2008.05.007 Hunsley, J., 1959, & Lee, Catherine M. 1955- (Catherine Mary). (2006). Introduction to clinical psychology: An evidence-based approach. Mississauga, Ont: Wiley. Insel, T. R. (2010). Rethinking schizophrenia. Nature, 468(7321), 187-193. doi: 10.1038/nature09552 Mura, G., Petretto, D. R., Bhat, K. M., & Carta, M. G. (2012). Schizophrenia: From epidemiology to rehabilitation. Clinical Practice and Epidemiology in Mental Health : CP & EMH, 8(1), 52-66. doi: 10.2174/1745017901208010052 Papastavrou, E., Charalambous, A., Tsangari, H., & Karayiannis, G. (2010). The cost of caring: The relative with schizophrenia. Scandinavian Journal of Caring Sciences, 24(4), 817-823. doi: 10.1111/j.1471-6712.2010.00782.x Perry, B. L. (2011). The labeling paradox: Stigma, the sick role, and social networks in mental illness. Journal of Health and Social Behavior, 52(4), 460-477. doi: 10.1177/0022146511408913 Pinkham, A. E., Penn, D. L., Perkins, D. O., Graham, K. A., & Siegel, M. (2007). Emotion perception and social skill over the course of psychosis: A comparison of individuals "at- risk" for psychosis and individuals with early and chronic schizophrenia spectrum illness. Ruggeri, M., Lasalvia, A., Lora, A., Semina, D., Bacigalupi, M., Casacchia, M., . . . . (2008). Care across all phases of schizophrenia and initiation of treatment: Discrepancy between routine practice and evidence. the SIEP-DIRECT's project. Epidemiology and Psychiatric Sciences, 17(4), 305-318. doi: 10.1017/S1121189X00000117 Tai, S., & Turkington, D. (2009). The evolution of cognitive behavior therapy for schizophrenia: Current practice and recent developments. Schizophrenia Bulletin, 35(5), 865-873. doi: 10.1093/schbul/sbp080 Swerdlow, N. R. (2011). Are we studying and treating schizophrenia correctly? Schizophrenia Research, 130(1-3), 1-10. doi: 10.1016/j.schres.2011.05.004 Turkington, D. (2006). Cognitive behavior therapy for schizophrenia, The American Journal of Psychiatry. 163, pp. 365-373. Van Os J; Pedersen CB; Mortensen PB( 2006). Hospitalization of patients with mental illness: A study on its effects. Am J Psychiatry 161:2312—2314 Weinberger, D.( 2007). Schizophrenia and its medication. Arch Gen Psychiatry 44:660—669 Read More