Borderline Personality Disorder as Shown in Girl, Interrupted free essay sample

The movie Girl, Interrupted was released in 1999 and centered on the story of an eighteen year old girl, Susanna Kaysen, who has been diagnosed with Borderline Personality Disorder. The movie takes place in the Boston area in the late 1960’s. Susanna Kaysen, is the daughter of a prominent well-known economist. The story is based around Susanna’s personal struggles and when she was admitted into a mental hospital for what she called a â€Å"half-hearted attempt† to kill herself. Throughout the movie, she further describes what made her decide to check herself into the institution, what it was like there, and other thoughts she had toward the world. Diagnosis Susanna Kaysen was admitted into Claymoore Hospital and was diagnosed with a borderline personality disorder. In the beginning of the movie she started off by saying, â€Å"People ask, how did you get in there? What they really want to know is if they are likely to end up there as well. I can’t answer the real question. All I can tell them is, it’s easy.† Kaysen continued on by explaining how it is very simple to slip into a similar universe, one that is invisible from this side, but once you are in that universe you can easily see the world that you came from. I believe that Susanna Kaysen met the criteria for a diagnosis of borderline personality disorder. The 5th edition of the Diagnostic and Statistical Manual lists several symptoms of borderline personality disorder, and to be diagnosed she had to meet at least 5 of them (American Psychiatric Association, 2000). In many cases, a person that has been diagnosed with BPD and has arrived in a mental health emergency room have intentionally hurt themselves in one way or another, ranging from alcohol and substance abuse, delinquency, unsafe sex, and reckless driving (Coffey et. al., 2011; Sherry Whilde, 2008). Other situations that can occur in a person diagnosed with BPD are shifts in their moo ds, having an unstable self-image, impulsivity, unstable relationships, anger, and physical aggression and/or violence. The first of the criteria for BPD in Girl, Interrupted, was having suicidal thoughts and doing things to contribute to a possible suicide by attempting what Susanna called a â€Å"half-hearted attempt† to kill herself by taking a bottle of aspirin with vodka. In the movie, she stated that she has a headache, which I believe could have been true to a point, but she also was feeling more and more pressure from her family and friends to be more â€Å"normal† and at the same time there was a fallout with the teacher she had been having an affair with. The second criteria was inflicting harm on the body by cutting or bruising. After she attempted suicide, she was rushed to the emergency room the camera angle switched from everybody frantically moving around to help to her wrists. She had bruises all over her wrists and she kept telling the doctors she didn ’t have any bones in her hand. It doesn’t explain how she got the bruises anywhere in the movie, but I can assume it was by some type of self-harm. Physical discomfort offers relief from emotional suffering by â€Å"snapping† them out of their â€Å"emotional overload.† The third criteria was Susanna’s attempts to remain in the relationships to avoid feeling abandoned. Toward the middle of the movie, she has a flashback of the affair she had with one of the teachers and with a guy that she met after her high school graduation. In both cases, she was having unsafe sex and staying in the relationships so that she felt wanted and loved, and not rejected. The fourth criteria was filling the emptiness that was being felt by doing something she knew wasn’t right but gave her a thrill. Susanna felt as if nothing was going how she wanted it and she was the only person feeling that way. In the movie, Susanna and Lisa, a girl in the institution, decid ed to sneak out of the institution and go on a trip to visit another girl that had been there with them, Polly. Both of them knew they could get into trouble, but the continued on anyway. The fifth criteria was when she experienced a shift in moods and felt like she had no sense of herself at all. Toward the end of the movie, there was a time Susanna was convinced she wasn’t going to get better and she got defensive over what Dr. Wick was telling her about her diagnosis. She continued on and stated how â€Å"she didn’t care† and her new favorite word to describe herself was ambivalent because she said it meant she didn’t care anymore and she was going to do whatever she felt was right. Dr. Wick continued on and asked Susanna if she knew what the word ambivalent meant, Susanna replied, â€Å"It means, I don’t care.† Dr. Wick then told her that the word actually meant undecided or in two minds, kind of like thinking, â€Å"will I stay or will I go?† and then asked Susanna if she cared about herself. I believe Susanna developed these patterns more in adulthood, but everything stemmed from her childhood events. Etiology There are several different views on how a person like Susanna could have developed BPD. One view that theorists have, is that an early lack of acceptance by parents may lead to a loss of self-esteem, increased dependence and an inability to cope with separation (Caligor Clarkin, 2010; Sherry Whilde, 2008). Children with parents that have neglected or rejected them, verbally abused them, or otherwise behaved inappropriately around them, have an increased chance of developing BPD. Multiple parent substitutes, divorce, death, physical and/or sexual abuse are also things that play a part in developing BPD. Sexual abuse is one of the most common contributors to the development of BPD and children that experience it at least four times are more likely to develop it (Huang et. al., 2010; Bradley et. al., 2005). In the movie, Susanna’s mom made a comment on when Susanna was a baby, she was changing her diaper and she turned around for a split second and that was when Susanna rolle d off the bed and broke her leg. She said the doctor put Susanna in a full body cast and her parents went on a 4,000 mile trip with Susanna buckled in the backseat in the body cast. There are also biological factors that could be contributing to BPD. Studies have shown that people with an overly active amygdale, a part of the brain that controls fear and negative emotions, and an underactive prefrontal cortex, a part of the brain linked to planning, self control, and decision making, can cause a person to develop BPD. More people that have BPD and that are more aggressive tend to have a lower serotonin activity than most people. Treatments Most clinical circles today use the dialectical behavior therapy method. This method focuses on the cognitive and behavioral techniques such as homework, assignments, psychoeducation, improving and teaching social skills. It also focuses on the humanistic and contemporary psychodynamic approaches by putting the client and therapist’s relationship in the center of their treatment, teaching the client proper boundaries and acceptance. Groups that use this method also help the clients by having them relate to others in the group and showing that they are able to receive support from them. Studies have shown that people that have been through this method have increased their ability to tolerate stress, improved their social skills, better attitudes toward life situations, maintaining a more stable identity and they are more likely to stay in the treatment. Other studies have been done to find that clients that take medications such as antidepressants, antibipolar, antianxiety, and antipsychotic drugs along with psychotherapy have benefited and fewer suicidal behaviors and hospitalizations have been reported. If I were to treat Susanna, I would most likely use the dialectical behavior therapy to treat her borderline personality disorder. The reason I would choose this is partially because it is more commonly used today within many clinical circles and I feel that having her focus on social skills, the relationship between her therapist, others in the group, and herself, realizing that she is able to receive support from others, and maintaining a healthier life would greatly benefit her. I think it would help her refrain from contemplating another suicide attempt, participating in unsafe activities and it would help control her anger, depression and any other emotions she had been feeling. Summarization The movie Girl, Interrupted was released in 1999 and centered on the story of an eighteen year old girl, Susanna Kaysen, who has been diagnosed with Borderline Personality Disorder. Susanna Kaysen was admitted into Claymoore Hospital and was diagnosed with a borderline personality disorder. In order for a person to be diagnosed, they need to meet at least five of the criteria listed in the DSM. The first of the criteria was having suicidal thoughts and doing things to contribute to a possible suicide by attempting what Susanna called a â€Å"half-hearted attempt† to kill herself by taking a bottle of aspirin with vodka. In the movie, she stated that she has a headache, which I believe could have been true to a point, but she also was feeling more and more pressure from her family and friends to be more â€Å"normal† and at the same time there was a fallout with the teacher she had been having an affair with. The second criteria was inflicting harm on the body by cutting or bruising. After she attempted suicide, she was rushed to the emergency room the camera angle switched from everybody frantically moving around to help to her wrists. She had bruises all over her wrists and she kept telling the doctors she didn’t have any bones in her hand. The th ird criteria was Susanna’s attempts to remain in the relationships to avoid feeling abandoned. Toward the middle of the movie, she has a flashback of the affair she had with one of the teachers and with a guy that she met after her high school graduation. In both cases, she was having unsafe sex and staying in the relationships so that she felt wanted and loved, and not rejected. The fourth criteria was filling the emptiness that was being felt by doing something she knew wasn’t right but gave her a thrill. In the movie, Susanna and Lisa, a girl in the institution, decided to sneak out of the institution and go on a trip to visit another girl that had been there with them, Polly. They knew they could get into trouble, but the continued on anyway. The fifth criteria was when she experienced a shift in moods and felt like she had no sense of herself at all. Dr. Wick was explaining her diagnosis and Susanna stated how she didn’t care and did her own thing for a little longer before realizing it wasn’t right. There are several different views on how a person like Susanna could have developed BPD. One view that theorists have, is that an early lack of acceptance by parents may lead to a loss of self-esteem, increased dependence and an inability to cope with separation (Caligor Clarkin, 2010; Sherry Whilde, 2008). Children with parents that have neglected or rejected them, verbally abused them, or otherwise behaved inappropriately around them, have an increased chance of developing BPD. I believe that Susanna’s development of BPD started when she was younger but developed more as she got older. I also believe it’s because of the lack of self-confidence that Susanna had growing up and once she got older that affected her BPD. If I were to treat Susanna, I would most likely use the dialectical behavior therapy to treat her borderline personality disorder. The reason I would choose this is partially because it is more commonly used today within many clinical circles and I feel that having her focus on social skills, the relationship between her therapist, others in the group, and herself, realizing that she is able to receive support from others, and maintaining a healthier life would greatly benefit her. I think it would help her refrain from contemplating another suicide attempt, participating in unsafe activities and it would help control her anger, depression and any other emotions she had been feeling. Susanna’s behaviors in the movie Girl, Interrupted are consistent with a diagnosis of borderline personality disorder, most likely contributed by events that happened in her childhood and an overly reactive amygdale, and which could be treated by the dialectical behavior therapy.