A Dsm-Iv Diagnosis As Applied To The Portrayed Character John NAsh In The Film

A DSM-IV Diagnosis as applied to the portrayed character John Nash in the film
"A Beautiful Mind"

In the movie, "A Beautiful Mind", John Nash displays classic positive symptoms of a schizophrenic. This movie does a fair job in portraying the personality and daily suffering of someone who is affected by the disease, although the film does not give a completely historically accurate account. In the film, John Nash would fall into the category of a paranoid schizophrenic, portraying all the symptoms that are typical for this illness. Nash suffers delusions of persecution, believing that there is a government conspiracy against him. He believes that because he is supposedly a secret agent working for the government breaking Soviet codes, and that the KGB was out to get him. In addition to these delusions, Nash experiences hallucinations which are shown from the moment that he starts college at Princeton University. He hallucinates that he has a roommate, when in reality it is uncovered later in the film that he was in a single occupancy room his entire stay at Princeton. Additionally, he frequently has conversations and takes advice from this imaginary roommate. He also imagines a little girl that is introduced to him by his alleged roommate. While going about his daily life, he is constantly surrounded by these inventions. These are classic positive symptoms of the paranoid schizophrenic, which are heavily supported by DSM-IV. Psychological predictions also agree with the behavior John Nash exhibited in the movie. This movie accurately teaches the public the positive affects of a schizophrenic. The movie does not portray schizophrenia as a split of Nash's personalities, rather a split from reality. He imagines other people and hallucinates vividly throughout the movie. Even at the conclusion of the movie, John Nash learns to accept and cope with his psychological disorder. He learns to ignore his hallucinations and is very careful about whom he interacts with. At the conclusion of the movie, he is not cured of schizophrenia, but he is still recognized for his brilliance with the Nobel Prize.
DSM IV is rigorous in the definition of schizophrenia:
Diagnostic criteria for Schizophrenia: DSM IV-TR; A. Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):
(1) Delusions (2) hallucinations (3) disorganized speech (e.g., frequent derailment or incoherence) (4) grossly disorganized or catatonic behavior (5) negative symptoms, i.e., affective flattening, alogia, or avolition. Note: Only one Criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other.
B. Social/occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement).

Clearly, criterion A as portrayed by the movie alone is sufficient for a diagnosis. However it is note worthy that Ron Howard's portrayal was not historically accurate, to wit: Nash's hallucinations were exclusively auditory, and not both visual and auditory as shown in the film. It is true that his handlers, both from faculty and administration, had to introduce him to assistants and strangers. But, Nash did not actually experience visual hallucenations. However, the auditory hallucenations alone are sufficent to satisfy DSM IV criteria A. Also Needless to say, criteria B was certainly satisfied as well. For these reasons, A diagnosis of Positive Symptom Schizophrenia is the most if not the only, appropriate diagnosis given the severity of Nash's mental illness.

At the time of Nash's diagnosis, only the older treatment models for schizophrenia were available. Those models viewed patients with schizophrenia as hopeless cases who needed to stabilized with hospitalization. While being hospitalized the patients are maintained with medications, such as Thorazine. These medications had heavy tranquilizing effects and made management of patients easier. But the drugs being induced only suppressed the disease; the drugs could neither arrest nor reverse the positive symptoms. As a result Nash resisted his medications, and the positive symptoms returned. What is fascinating is that Nash himself applied a form of Self-Cognitive-Behavioral Psychotherapy, and that this actually did work. The basic premise of cognitive therapy is that beliefs, expectations, and assessments of self and the world affect how we perceive ourselves and others, how we approach problems, and how successful we are in coping and in achieving goals. This is a contemporary treatment model for schizophrenia, and certainly in the case of John Nash, is arguably indicated.
The etiology of Nash's schizophrenia is unknown, or at least not covered in the context of the film. Many theories stress unfavorable social and emotional experiences as the probable cause. In particular the schizophrenic may have been the victim of harmful family influences or faulty child-rearing practices during his formative years. What is known is that Nash began to show the first signs of his mental illness in 1958. He became paranoid and was admitted into the McLean Hospital, April-May 1959, where he was diagnosed with paranoid schizophrenia and mild depression resulting in low self-esteem. After a problematic stay in Paris and Geneva, Nash returned to Princeton in 1960. He remained in and out of mental hospitals until 1970, undergoing insulin shock therapy and other treatments. However the artistic liscense of Director Ron Howard did not provide this level of historic detail.
The story of John Nash is as inspiring and heroic as it is tragic, with the films incredible-but-true and larger than life happy ending. Unfortunately other outcomes often befall those diagnosed with schizophrenia. Wide variation occurs in the course of schizophrenia. Some people have psychotic episodes of illness lasting weeks or months with full remission of their symptoms between each episode; others have a fluctuating course in which symptoms are continuous but rise and fall in intensity; others have relatively little variation in the symptoms of their illness over time. At one end of the spectrum, the person has a single psychotic episode of schizophrenia followed by complete recovery; at the other end of the spectrum is a course in which the illness never abates and debilitating effects increase. Suicide is unfortunately one of the leading causes of death for people with schizophrenia. Upwards of 40% of people that have schizophrenia will attempt suicide at least once. Males with schizophrenia attempt suicide at a much higher rate than females; approximately 60% of them will make at least one attempt. The result of these attempts is that between 10% and 15% of people with schizophrenia have historically committed suicide. The real life story of John Nash is the very rare exception, not at all the rule.

In conclusion, I believe that the new cognitive model for schizophrenic recovery is more than the effective choice, it is the humane choice. John Nash did more than enlighten the world in Complex Game Theory. By his incredible will he showed psychologists another path to freedom. Trained mental health professionals in the field can interact with patients and can assist in helping the schizophrenic make sense of their world. The archaic dosing up with tranquilizers and telling patients that this is what life will be in it's entirety is both grim and hopeless; it should be consigned to the scrap heap of psychiatry along side the lobotomy and electric-shock therapy. It may be human nature to put the suffering behind locked doors and out of sight, but we have the ability to do otherwise if we are willing.