Fear: The often elusive line between "going mad," and "going bad"
On Tuesday, October 27, the wind was howling outside the new, plushly Corinthean educational complex situated right above the hill on Rockwell Canyon Road in Santa Clarita. It was the first day of class for myself, the instructor, and Brandman University students. The class? Abnormal Psychology.
With it being just a few nights before Halloween, I thought I would use the movie, Fear, as a cognitive primer, to get minds going on the subject of mental heath and "madness" or mental health and "badness." The movie is admittedly a bit weak on multiple fronts, but it served the purpose of introducing one of the topics we are addressing right here, right now on this very blog----the subject of when a mental health condition ceases to be a treatable condition, requiring empathy and understanding, and when it becomes a matter of simply tossing out all hope of rehabilitation, and intervening to protecting society from an incurable psychopath.
For those who are new here, let me repeat this mantra: In my world of blog n roll, I generally provide the topics, and the tunes, and you, the student, scholar or lay person with an inquisitive mind, provide the talk. That "talk" using takes the form of addressing questions or issues raised in the general body of the blog from a psychological point of view.
Let's start with DSM diagnostic considerations. If David McCall, the psychopathic stalker in this movie, played rather deftly by Mark Wahlberg, were a court-mandated patient of yours and you were already a licensed practitioner, which particular diagnoses would you entertain for David?
Please excuse the less-than-scientific terms here, but would you regard David as "bad," "mad" or some variety of the two combined?
Would you regard him as treatable?
What dynamics between David, and Nicole Walker (played by Reese Witherspoon) tended to support a dysfunctional relationship and to feed David's deleterious predisposition towards violent obsession? How about family dynamics? How did those dynamics and the specific behaviors of individuals within the family, either foster or inhibit an unhealthy and perilous scenario from unfolding?
Here's a Halloween bonus question for you. After listening to this song, as aired on
KWMR
Halloween with Jim Beam
Dr BLT
words and music by Dr BLT copyright 2009
What would you suggest might be the reason that the song, penned by your instructor, would be offered simply as a party song to be taken with a grain of salt, and not something the good doctor would recommend to a patient, who, like Nicole in the movie, is suffering from a broken heart?
a. It does not tell the suffering person how much Jim Beam is required for the intensity of the heartbreak to dissipate.
b. It represents only a partial cure for heartbreak.
c. It could be interpreted as a recommendation to self-medicate as a way of coping with the pain associated with a broken relationship, in which the broken hearted person is encouraged to use a substance known to pose health risks and to potentially compromise a person's judgment, right during the period in which sound judgment is most needed.
d. None of the above
e. Some of the below
Have a Happy and Safe Halloween!
Posted by Bruce L Thiessen Ph D at 10/29/2009 11:15 AM 
Categories: movie analysis, song analysis
Tags: Dr BLT psychology comes alive movie analysis psychoeducation psychology song analysis
Categories: movie analysis, song analysis
Tags: Dr BLT psychology comes alive movie analysis psychoeducation psychology song analysis
Cathy Lazarus
1. David McCall has elements from both Antisocial Personality Disorder and Psychopathy. In the film, he showed signs of Antisocial Personality Disorder by his deceitfulness, aggressiveness and antisocial behavior. He showed little regard for his own safety or the safety of others. I believe he was over 18 years of age and had issues with conduct disorder before 15 years of age, showed consistent irresponsibility in work and financial matters, was impulsive, irritable and aggressive, all which fit the criteria for Antisocial Personality Disorder. He also exhibits psychopathological behaviors such as lack of empathy, inflated and arrogant self-appraisal, glib and superficial charm, and pathological lying. He lived a parasitic, socially deviant lifestyle with a need for stimulation displaying poor behavior controls. He was both bad and mad. He harbored a lot of anger, and coupled with the bad, made him a menace to society.
2. If one could get past the arrogant façade and convince David he needed help, he could be treated with electroconvulsive therapy and drugs. Lithium and anticonvulsants have had some success in treating the aggressive/impulsive behavior. Antidepressants from the SSRI category can sometimes reduce aggressive/impulsive behavior and increase interpersonal skills. Also Cognitive-Behavioral Treatments can help increase self-control, social perspective taking, teach anger management, and change antisocial attitudes. However, if none of these treatments work, the good news is that the criminal activities of many psychopaths and antisocial personalities seem to decline after the age of 40 even without treatment. The most effective prevention is to put increased effort into reaching at-risk children in the conduct disorder stage of development before they develop into our future psychopaths.
3. Nicole’s youth and lack of life experience makes her extremely vulnerable to David’s deceitful ways. She was looking to be loved and was too trusting of others. She had lived a sheltered life guarded by her overprotective father but had missed the consistency of unconditional love because of the separation of her parents and he fathers love interest in another mate. There was jealousy and competition going on for her father’s attention and a rebellion and resistance against the girlfriend imposing rules. Nicole’s typical teenage rebellion made her susceptible to challenging the rules of the household and her inexperience made her easy prey for a charming, convincing, con-man like David who offered her excitement and love. David took advantage of Nicole’s innocent youth and vulnerability and used this to his own advantage, uncaring as to the effect on both her and her family, to satisfy his own obsessive, control of his victim. The dynamics of the family, with their interpersonal conflicts, created the lack of cohesiveness in the family unit just enough to allow David to cunningly and deceitfully pry apart the weakened relationship
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1. I would suggest that David had a mix with borderline personality disorder and antisocial personality disorder.
2. David is not bad more along mad and is treatable.
3. Nicole was a virgin that played a big part in his obsession along with the Father threatening him to stay away. The step mother didn't help either by allowing David to return and going against the fathers wishes.
For the bonus Question I would say that option c would be the best answer.
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The character of David McCall is an all too real personality type seen in abusive relationships and crimes around the world. If I were a licensed practioner and David McCall were my court mandated patient I would consider the diagnosis of Sociopath as a direction of treatment. The McAfee website ( http://www.mcafee.cc/Bin/sb.html ) lists the following as some of the characteristics of sociopathic behavior:
• Glibness and Superficial Charm
• Manipulative and Conning- They appear to be charming yet are covertly hostile and domineering, seeing their victim as merely an instrument to be used. They may dominate and humiliate their victims.
• Pathological Lying
• Lack of Remorse, Shame or Guilt
• Need for Stimulation- Living on the edge. Verbal outbursts and physical punishments are normal. Promiscuity and gambling are common.
I feel David McCall encompasses all of these traits. The question was asked, “Is David ‘bad,’ ‘mad,’ or both?” Given the circumstances of his childhood I believe he is mad. He may be harboring years of rage for the lack of family he had as a boy. I would probably spend as much time as the patient would allow focusing on those years as a means of addressing his current state of mental health and behavior. While I believe that environment can play and integral role as the antecedent for ones behaviors, I also believe that the person is treatable if they are made aware of their effects on others and recognize the harm they have done.
The dynamics between David and Nicole were perfect for a tragedy to unfold. David saw a young, innocent, and impressive girl in Nicole, while Nicole saw a handsome, polite, and respectful man in David. Nicole’s volatile relationship with her father may have had her susceptible to finding a man to fill the ‘father’ role in her life. While David was looking for someone he could dominate and force to love him, possibly making up for his lack of a loving family in his childhood. David being an orphan, may have wanted to control Nicole by not allowing her to leave him or break up with him to ensure that sense of security which he never had growing up.
BONUS: C
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Thanks to all of you who have provided such insightful comments. If you've never blogged before, you may be feeling a little intimidated by the whole process. I would say just try hitting a few buttons and entering a few comments. You can't break anything, so just have fun and try it! Feel free to contact me if you get stuck.
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Well for starters David had some real serious issues to say the least. He is a pathological lier, manipulative, controlling,obsessive,possessive,cunning arrogant and parasitic in his behavior. I have been told that unresolved hurt turns into anger. No wonder he acts that way, not to excuse the behavior, but it makes sense. I'm sure that because he had a history of not being cared for by people moved from one foster home to the next. In and out of trouble, he really had no example of what real love consisted of so it's no surprise that he had no clue of what it really meant. I would say that he was a combination of both "bad and mad". If he were my patient we would focus on his demented personality and deviant behavior. Treatment focused on social skills and personal development. Personality disorders for sure. He really needs a buffet of treatments so I think that would be a good place to start.
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If I was a court appointed therapist for David, I would diagnose him as a psychopath, in distress.
I would regard David as a combination of bad and mad. I would say a bit more mad and bad. Yes, I think David is treatable.
David and Nicole have different life experiences. One similar feeling might be abandonment, by their fathers. David's to a much greater extreme. David feels he must have Nicole to himself, to protect her in an unhealthy manner.
Nicole's family dynamics are foreign to David. Nocole's family is loving and supportive and David never had a family.
The actions of Nicole's father provoked David's psychopathic personality. First by forbidding their relationship and then by vandalizing David's house.
Nicole's rejection of David sent him over the edge.
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Bonus question : B
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After I saw the movie I realize the different type of personalities that a person can have. The deviant behavior of David was a product of traumas he suffered during his childhood. Also, in the movie we saw the typical behavior of a teenager who think that she knows everything, especially after she started to be sexually active, and she does not want to listing to her father who tried to protect her. In the other hand, the obsession that David had for Nichole made him to fall deeply in a psychopath personality.
For the bonus question I answers C
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I would diagnose David with anti social personality disorder. David exhibited classic signs of antisocial personality disorder; lack of empathy, superficial charm and inflated ego.
I would say David was mad. I believe David is treatable, but success would be very limited in scope.
First off, the relationship from the start was based on lies and deceit, thus making for a disastrous outcome. Also, David saw Nicole as an object, merely something to conquer and own. Nicole was naïve and easily fooled by David’s overt charm. Nicole ignored all the warning signs, and she didn’t want to listen to her father, who was the only one aware of David’s diabolical ways. David charmed his way into the family; made friends with Nicole’s younger brother, and he engaged in a mutually flirtatious relationship with Nicole’s stepmother. David maliciously placed himself in a position of control within the family circle. David (for a brief period) was able convince the family that the father was the irrational and hostile one, while he was the sane one.
Bonus: C
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I would consider David McCall a psychopath, or sociopath (according to the text, they appear to be the same thing.) I would also say that he definitely meets the criteria for Antisocial Personality Disorder, which is often the case with psychopathy. I think that in this case, David is probably a combination of “bad” and “mad.” We don’t know specifically in this case whether David had a genetic predisposition for psychopathy, but we do know that he was in state/foster care for most of his childhood. This in itself, could make him vulnerable and cause him to develop a diathesis for disorder, and would be considered a distal factor. Proximal factors would be his infatuation with Nicole and possessive feelings toward her, only to see her male friend hugging her, and then her father confronting him and ransacking his house. I do think that the way a person turns out is usually a combination genetics and environment—however I also think that people can be born just plain “bad.” I don’t really believe David is treatable. It’s my understanding that there’s just not much that can be done to “cure” a sociopath. They don’t believe anything is wrong with them, and basically, they have no conscious. Of course you have to try, but it would probably have to be in a prison or mental hospital environment, because they aren’t going to voluntarily seek help when they don’t believe there is anything wrong with either them or their behavior.
Nicole was young and naïve, and the perfect type for David to be able to dominate. When she broke up with him the first time, then took him back, it just reinforced his behavior and his delusions. (If you’ll recall, David really seemed to believe that Nicole wanted to be with him, even as he was holding a gun to her father’s head.) The step-mother should never have supported Nicole in allowing David into their home. The father’s behavior was also instrumental in setting David off, and pushing Nicole towards David. Not that you can really blame him, but his behavior definitely did not help, especially in dealing with a psychopath.
The bonus question was entertaining, but by way of disclaimer, I would have to say the answer is “C.”
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If I were a licensed practitioner and David McCall was a court-madated client of mine, I would diagnose him with Antisocial Personality Disorder. He meets most, if not all, of the required criteria for this particular diagnosis (according to the DSM-1V-TR):
- Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
- Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
- Irritability and aggressiveness, as indicated by repeated physical fights or assaults
- Reckless disregard for safety of self of others
I would consider David to be a combination of both mad and bad. I label him as the typical "bad boy", and picture him through his adolescent teenage years as the boy girls coo over, just as Nicole did in the beginning of the movie. I would also label him as mad since his behaviors crossed over into being abnormal and actual madness with manipulation and deceit(e.g. punching himself to lead Nicole to believe it was her dad that had bruised him). Despite all of this, I would consider him to be treatable through medication and psychotherapy to change his behaviors and beliefs about himself and society.
His behaviors and lack of emotional well-being are most likely due to environmental factors throughout his life (e.g. numerous foster placements, possibly abuse, drug use, etc.). Nicole is also torn emotionally from her parent's divorce as well as the family dynamics in the home (e.g. her dad always having to leave at the last minute for business, tension between her dad and stepmom, her stepmom calling her a slut, etc).
As for the Halloween question, I'm going with "E", some of the below!
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My particular diagnosis for David McCall would be Antisocial Personality Disorder (ASPD). In Abnormal Psychology, the author James Butcher (2010) explains how, “The outstanding characteristic of people with antisocial personality
disorder (ASPD) is their tendency to persistently disregard and violate the rights of others. They do this through a combination of deceitful, aggressive, and antisocial behaviors” (p. 365). Some of the criteria for ASPD are: failure to conform to social norms and repeated lawbreaking, deceitfulness, impulsivity or failure to plan ahead, irritability and aggressiveness, reckless disregard for safety of self or others, consistent irresponsibility, and lack of remorse.
At first, David just seemed to encompass all the qualities of a “bad” boy, including the use of drugs and alcohol, and partaking in crime. However, as the movie goes on, David become extremely violent and takes on ASPD characteristics. By the end of the movie he would definitely be considered a psychopath in my book. Realistically, no I do not believe he is treatable. He has no responsible, caring support system that would guide him through a recovery. Nicole Walker was ignorant to the fact that David had a personality disorder at first, and when she finally realized it she and her family were already entangled in his violent craze.
In addition, David felt like he had a power over Nicole above anyone else, including her father, because he had taken her virginity. Ultimately, he would stop at nothing to keep his hold over her. In the midst of their relationship, Nicole felt satisfaction by rebelling against her father, who had never trusted David. However, Nicole’s stepmother trusted David and supported Nicole, which, in turn, created a rift between Steven and his family.
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1. If I were his therapist I would diagnose him with an antisocial personality disorder. When they talked about his childhood they referred to him what seemed as conduct disorder which is the diagnose under 18 years of age. As he got older, it turned into antisocial personality disorder. As per DSMIV, page 706, he failed to:
• Conform to social norms with respect to lawful behavior
• Deceitfulness, lying use of aliases, conning other into personal profit or pleasure
• Failure to plan ahead
• Irritability and aggressiveness
• Reckless disregard for safety of others or self
• Consistent irresponsibility
• Lack of remorse after having hurt, mistreated or stolen from others
David displayed these symptoms throughout the movie leading to my conclusion.
2.I would think it is a combination of bad and mad. It is clear that the environment he came from had an affect on his adult life. It is a lack of family and understanding the present family environment that lead to him to act in that manner. This person I believe would be treatable as long as he is broken down then slowly introduce to what we call today as socially acceptable.
3. Although some may think the father was overprotective, I disagree. The father was a very caring person and loved his daughter very much. Nicole was coming into his father’s life after staying with her mom until the age of fifteen. (Explained as she “moved in a year ago”) The father was busy with a new wife, son and a very demanding job. It was clear that Nicole wanted attention from her father perhaps feeling left out now that there was another woman in his father’s life. I believe she was fighting for attention when David came into her life. Nicole was left behind the mom and Dad’s work.
After Nicole explained the lack of love from her father to David, it was easy for him to manipulate Nicole and eventually intimidate her into a very violent relationship.
David was a foster child as well that had clear signs of conduct disorder as a juvenile perhaps now intensified with age and a clear lack of a family environment.
Bonus Question I would think C is the best answer.
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