Shutter Island - Relevance to Nursing - Movie Review Example

Shutter Island (2009 Relevance to Nursing The film Shutter Islands holds value for of psychology, psychiatry and nursing for its portrayalof complex mental illness. The film should be evaluated separately on two counts – first, its entertainment value and second, its relevance to the medical profession. Obviously, the parameters used for the respective evaluations are different. In my view, the film is highly impressive in both these counts. But this essay will focus on the second aspect, and argue that the film is full of key insights into the pathology of delusion and the range of therapeutic approaches in dealing with it. Firstly, director Scorsese intertwines war-induced mental trauma of Teddy Daniels with personal tragedy of Andrew Laeddis. This compounds the confusion for the audience, but also adds a political dimension to what is an exposition on psychiatric illness. Toward the end of the film it is unveiled how the whole of the Shutter Island is a set up to play along the illusions of Andrew Laeddis. So, when we construct the film from backwards, it is obvious that Laeddis is the only ‘patient’ there is. The mysterious disappearance of Rachel Solando is a ploy designed to put Laeddis in situations of acute emotional tension, with the aim of correcting his aberrations. Perhaps, even all the ‘inmates’ of the wards A, B and C were part of the ploy, or perhaps not as mentally ill as is conveyed to Laeddis/Daniels. As the story unfolds, we see how only a porous line separates the dreams and realities of Laeddis. At first, Laeddis, in his persona of Teddy Daniels, is given a warm welcome by the hospital staff and their chief Dr. Cawley. But soon he becomes “increasingly suspicious of the doctor and his staff, and when he begins experiencing fierce migraines and vivid visions of tragedies in his own past, he begins to fear that he has become Cawley’s latest experiment.” (Thomson, 2010) For nurses and therapists, one of the questions at the center of the film is the debate in the choice of lobotomy and drug therapy. During the 1950s when the film is being set, this was a dominant debating point in psychiatrist circles. Even Dr. John Cawley talks about this debate and his preference for non-interventionist methods. He suggests that he would first try humanitarian methods of talk-therapy, failing which the patient would be tried drug-therapy. It is only as a last resort that surgical procedure would be prescribed. This is a very sensible position to take, for today’s psychiatry suffers from ready resort to medication, eschewing thorough talk-based therapies. At the same time, today’s psychiatry is not as gung-ho about surgical interventions as was the tendency toward the latter half of the twentieth century. The lobotomies talked about by Dr. Cawley would only be applied to the rarest of rare cases today. Eventually for Laeddis, the dream sequences start to dominate his conscious-real moments, which results in everything shown onscreen becoming provisional. If this poses a lot of challenges to the audience to keep up with the plot, one can only imagine the mental turmoil that Laeddis would have suffered. In other words, both the audience and the lead character are confronted with temporal and spatial uncertainties. But for the nursing student the film offers insights on the predominant therapeutic practices of the 1950s. In some ways, the fundamental questions facing the psychiatric profession have hardly altered in the half a century since. For sure, mental pathologies themselves have not undergone any great changes over the years. (Alleva, 2010) The anatomy of mental suffering remains more or less the same, one might claim, through the breadth of recorded history. Di Caprio’s own experience in playing this overwhelming role underscores this point: "I also watched a lot of documentaries on the different forms of treatment done in those days and what people went through. The mood helped feed the over-the-top paranoia of the movie. But it was also hard to shake off. Shutter Island took such an emotional toll that there were times I wondered whether I would finish the picture…my character was going through extreme emotional trauma and its hard for those types of things not to rub off on you…” ("Scorsese Saved Me from," 2010) Laeddis’ condition is identified to be a split personality, which his mind concocted to negotiate feeling of acute guilt. But Dr. Cawley’s attempt to resolve this dichotomy by simulating the hallucinatory world fails. Upon this realization, the film makes an important statement about ‘living as a monster or dying as a hero’. This is interpreted by some as a willing suicide thus freeing Daniels of the guilt over killing his wife. Here, Fairburn’s concept of the moral defence is seen to be at play. Through this, Laeddis’ question can be interpreted as Which is best, to live as someone who is unconditionally bad or die as someone who believes that he is conditionally good? The split between the law-upholding officer and the husband guilty of neglect manifests in Laeddis’ divided personality. His frequent flashbacks that accompany his migraine headaches are an attempt to reconcile these two aspects of his life. These represent “aspects of the internalized bad objects that his being an upholder of the law is unable to repress.” (Gilbey, 2010, p. 44) Daniels would prefer to die with the comforting belief that he is a good man (even if illusory), than confessing to his immoral tendencies and tend toward restitution. In terms of Fairbairns understanding “of the balance between shoring up inner reality by reinforcing the ego-ideal versus releasing and learning to cope with the repressed bad objects, it seems as if the defence of guilt has gone too far and the internalized bad objects can never be released, faced and understood.” (Clarke, 2012) From a psychotherapeutic point of view, one could interpret how psychiatrists are instituting a novel approach by letting Laeddis act out his delusional role while at the same time bring maintained on a tranquillizing drug. The latter is to prevent him from tangentially going off on his delusions and to have a degree of control over his behaviour. The frequent migraines can thus also be read as acclimatization to this drug. From a Fairbairnian perspective “his wife is a projection of an internalized libidinal bad object and the scarred and horrible man is a projection of himself as an internalized anti-libidinal bad object. The psychiatrists aim, described in Fairbairnian terms, is to effect a cure by releasing the internalized bad objects, which are cathected by libidinal and anti-libidinal parts of himself.” (Clarke, 2012) In this context, the role of the drug and the simulation is for Laeddis to discover for himself his own split condition. He would thus be able to see clearly that he had murdered his wife, who had earlier drowned their three children. From a Fairbairnian angle, this is to “set the punitively moral part of himself, as Federal Marshall, to uncover the identity of the unconditionally bad part of himself and to realize they are parts of the same person.” (Gilbey, 2010, p. 44) Hence, in conclusion, one can see why a nursing student will benefit enormously by watching the film. It introduces her to some of the perennial debates in the field of psychiatry, as well as offering new theoretical understandings. The Fairbairnian analysis of Daniels/Laeddis’ psychopathology is of particular import. The nursing student will also be exposed to the possibility of politicization of psychiatric profession. Hereby, she’ll learn that patients could be abused for government experiments on mind control. The student also learns how complex diagnosis and prognosis of psychopathology can be, especially those involving delusional states. References Alleva, R. (2010, April 23). Twists, Turns & Bedlam; Shutter Island & The Ghost WriterCommonweal, 137(8), 19+. Clarke, G. (2012). Failures of the Moral Defence in the Films Shutter Island, Inception and Memento: Narcissism or Schizoid Personality Disorder? International Journal of Psychoanalysis, 93(1), 203+. Gilbey, R. (2010, March 15). Asylum Seekers: Scorsese Serves Up a Trashy Yet Diverting Thriller, Writes Ryan Gilbey. New Statesman (1996), 139(4992), 44. Scorsese Saved Me from Going Crazy in Asylum; LEO TELLS HOW MAKING MOVIE BEHIND BARS DROVE HIM CLOSE TO EDGE. (2010, February 16). Daily Record (Glasgow, Scotland). Read More