Shutter Island

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The Law of 4: You Are the 67
 
If you have seen the movie Shutter Island, you will notice that topic is according to scrip in this film. Andrew Laeddis was a soldier who joined the World War Two and killed Germany prisoners of war in death camp. Then he became a U.S. Marshal in Boston, and became alcoholics and ignored his suicidal-wife. Her wife burned their apartment then drowning their three kids in the back yard. Andrew killed his wife to “set her free” and burned their house. According to what Dr. Cawley explain his symptoms at the very end: “You crime is terrible, one you can’t forgive yourself for, so you invented another self. You create a story which you are not a murderer, you’re a hero, still a U.S Marshal, only here because of a case”.  

This movie is based on a mental hospital/prison, so most of people in it have one kind or another abnormality. But I only focus on Andrew’s disorders. Most mental illness patient will hold multiple disorders, like he also has persecution mania and proclivity for violence. Before diagnosis his disorder, I think the background knowledge and social factors introduction for that period is necessary. The World War Two was end by 1945 and this story happened in 1954. During that time, biological perspective and psychopharmacology perspective for abnormal psychology’s treatment had a debate/war. Former emphasized use surgical intervention: psychosurgery, like Tran’s orbital lobotomy or chlorpromazine drug, to solve the problem thorough and quick. But the latter believe that spend time and money to make people “unless happy and peace” is worthy. Andrew is a serious DID patient who suffered the war and fratricidal, also with propensity to violence and paranoia. This movie describes the last psychopharmacological treatment, role play treatment, which cued him finally.  

According to the DSM-IV-TR 5-axis to diagnosis his symptom:
l  Axis I: Schizophrenia and PTSD. DID, single episode. This is obvious in the whole movie. l  Axis II: paranoid personality disorder and antisocial personality disorder. l  Axis III: the movie does not mention if he overdose or not. But he had been used chlorpromazine for two years and his hands will shake badly when he stopped taking the pills. Also, his migraine may be caused by medical conditions, too. (This is not clear in the movie). l  Axis IV: stressor from storm or water will cause migraine or vomit. Any other things about Nazi/German will cause flash back to the death camp and remember the Jewish music at that day. l  Axis V: I am affair that Andrew’s GAF score is lower than 30.  

This is so unfortunate that Andrew has so many problems. The film is only two hours but we can see the problem from his behaviors. According to diagnosis from movie: “patient is highly intelligent, highly delusional decorated army veteran, present for the liberation of Dachau former U.S. Marshal. Known proclivity from violence, shows no remorse for his crime because he denies the crime ever took place. Highly developed and fantastical narratives which preclude facing the truth of his actions.”  

First, he is obviously suffered dissociative identical disorder. He creates another self to avoid the trauma. That what the whole movie talking about. Here I had love to mention Defense mechanism which is mentioned several times in movie. Defense mechanisms are largely unconscious reactions that protect a person from unpleasant emotions such as anxiety and guilt. (Psychology: Themes & Variations 8E Briefer Version, Wayne Weiten, P382~383) People use mainly six ways to avoid negative emotions: repression, projection, displacement, reaction formation, regression, rationalization and identification.  

He use repression to keeping distressing thoughts and feelings buried in the unconscious lead him only thinks about the horrible past when he dreaming. He dreamed about his wife and house at the first time, and the Dachau camp at the second time. After he waked up, he became...
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