Portrayal of Psychological Disorder in Shutter Island

Abstract

Shutter Island is a mind twisting roller coaster that was written by Dennis Lehane and then put on the silver screen. This movie interpretation does me no justice for putting it into words. Teddy Daniel (DiCaprio) is on a case with his new partner Chuck Aule (Ruffalo) are both sent to a shutter island to investigate a patient you the name of Rachel who escaped the day before. Once  they get on the island, you get a feeling that something’s not right. Dr. Crawley shows them Rachel’s room where we see no sign of escape. Teddy begins to interrogate the staff and the patients but she disappeared into thin air? After the interrogation’s Teddy and Chuck search the island with the security guards. After the storm starts to roll in teddy and chuck go and visit Dr. Crawley in his office which where we meet another doctor who does lobotomy’s and Dr. Crawley discusses about methods to fix or help cure the patient’s mental disorders which is why the lighthouse signifies where they perform lobotomy’s. Throughout the movie, we see the vivid reality in which Teddy lives in. This paper will examine how a mind twisting thriller movie can portray a psychological disorder. As well, we’ll see if they were portrayed correctly and if there was any form of treatments and what could’ve been done to help Teddy out.

Keywords: thriller, mind twist, delusional disorder

Portrayal of Psychological Disorder in Shutter Island 

Throughout the movie the main character suffers from Delusional disorder and most likely PTSD from the war. As we learn throughout the film that Andrew was admitted to the island 2 years ago and that was the last time that they could try to help him before they lobotomized him. Which in the end we can see that he was conscious when he made that comment to his partner “chuck” that this plan did work yet he still got a lobotomy. He developed this disorder because his wife drowned their three kids and he then shot his wife. So instead of moving on he created a character, backstory, and a fake story. Teddy’s wife Dolores was insane, manic-depressive suicidal. Dolores was suffering from bipolar disorder which drove her to the point of killing all three of her kids and telling Teddy that they should have them as dolls.

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The movie portrayed the disorder in a way that we can understand what the character feels and what he sees as true and false. Although the movie left on a mind twist because he could’ve been right about his what his brain was telling him to believe or that he could’ve been just messed up in the head because of what his wife did to their children and what he did to his wife. The movie does do this disorder some justice by enlightening the audience of what, how, why this happens and it does talk about what the psychologist might’ve done to help cure or fix their mental illnesses. Although teddy didn’t think he had a problem but instead thought that they had drugged him with the cigarettes and aspirin that he took and consumed as told by “Rachel” that he met in a cave by the cliff. This does occur in some cases of delusional disorder where some patients will either refuse help or treatment and believe there story then hear the truth which is what happened in the lighthouse when teddy was confronted by Dr. Crawley and his psychiatrist Chuck. For example, a 45 yr old man who served in the war in Iraq an Afghanistan began to be hostile towards his relatives because he saw ghost and spirits that were trying to drop a strange substance from his ceiling and that one of the apparitions fornicated with his wife and so he began to carry loaded weapons to protect himself (Riggs, S., Perry, T., Dowben, J., & Burson, R, 2017). Teddy’s wife Dolores was suffering bipolar disorder which we didn’t get her whole back story we can assume that she had this at a young age or if she developed it later on in her life. Dolores isn’t discussed much throughout the movie but we’re told that she set Teddy’s apartment on fire and that she drowned her three children in the lake. When Andrew is being asked about why he was sent to the institution he says that he shot his wife and says that she attempted to commit suicide the first time and that she told him that she felt an insect moving inside her skull pulling the wires just for fun. Andrew feels guilty for killing his kids because he didn’t pay attention to her mental problems and that he didn’t get her help. In the medical room Dr Cawley tells Andrew that he relapsed nine months ago and that he’s like a tape playing over and over. Which does happen in some cases of delusional disorder.

In the beginning of the film we see Teddy experiencing sea sickness when he’s on the boat which on its way to the island. Later on we see Teddy have headaches in Dr. Crawley give him an aspirin to alleviate the pain. During the storm his suit gets drenched which the orderly gives him spare clothes and the orderly tells him that his cigarettes were spoiled from the rain so he gives him two new packs from the island. Which later we find out that these products might’ve been tainted with a drug. Dr. Crawley said earlier in the scene where he discusses about treating patients with drugs and if none of those work then the final solution would be a

 trans-orbital lobotomy. The aspirin did help him out alleviate his migraines. Although towards the end of the movie Teddy finds out that he’s been there for 2 years. Dr Crawley confronts teddy and tells him that he wasn’t being drugged but that he was suffering from withdrawal. He was experiencing tremors, migraines, hallucinations which Chlorpromazine helped out Teddy because the medication acted as a antipsychotic. Dr Crawley explains to Teddy that he hasn’t been on the drug for 24 months now. Which is why he has trouble to come to reality and doesn’t remember his primary psychiatrist. The drugs could possibly have a negative affect on his view of what is real and what is not. Many cases of patients with schizophrenia or delusional disorder were prescribed an antipsychotic or anti- cholinergic (Canavan, M., Sipsma, H., Jack, H., Ohene, S., Rohrbaugh, R., Bradley, E., & Ofori-Atta, A., 2016). Antipsychotics can work but can have different results and affects on males and females and depends on their age and severity of the disorder. The other form of cure for Andrews delusional disorder would be to lobotomize him. Before the lobotomy the institution might’ve tried ECT which is a (Electric Convulsive Therapy). ECT was the mainstream treatment for patients suffering from severe depression and mania as well and was well effective rather than lithium (Harvard Mental Health Letter (1997)).

Chlorpromazine paved the road for effectiveness in pharmacotherapy in schizophrenia patients decades ago and stimulated key developments in psychiatry (Carpenter, W. T., & Davis, J. M., 2012). 

Although the movie never shows us what happened to Andrew at the end of the movie we can assume that he chose to get a trans orbital lobotomy because he was tired of being the monster.

Dr. Crawley and Andrews primary psychiatrist told the board that they would conduct a crazy experiment where Andrew would live out this fantasy and to see if they could bring him out of his delusion for good but as we see it did work because Andrew said a comment that wasn’t crazy like that did show the experiment did work and that Andrew did choose to go out a dying man. Of course it’s just a movie but it Gives us a view or an idea of how some one with delusional disorder or schizophrenia might act. Lobotomy’s and antipsychotic drugs can only do so much that in the end it all depends on the patient.

There was a chance of mortality post-operation 7.4% (57 deaths) with the highest rate of 17% in 1949 (Ögren, K., & Sandlund, M., 2007). Which is why the use of lobotomies quickly faded out in 1958. The operation of a Lobotomy consisted of using Electronic Convulsive Therapy on the patients prior to surgery and then when the patient was out they then lifted the eyelids and inserted a ice pick behind the eyeball and then hammered it until they reached the orbital plate on both sides of the brain this procedure was used on Andrew at the end when they escort him. We can even see  one of the orderly have a ice pick in his hand as well he has a towel which was used to cover the other side of the face when he would’ve been in operation. Trans orbital lobotomy’s were a 50/50 chance that it worked, although if it did work it might’ve left him in a robotic state or worse death.

Andrew could’ve helped his case by getting help about his ptsd from the war. That might’ve helped him out instead of bottling up his emotions or maybe he could’ve talked to his wife. Although his wife was suffering from bipolar disorder and was crazy enough to set their apartment on fire. At that point he should’ve been cautious especially since she attempted suicide before and she told him that she had something inside her head pulling the strings. At that point he should’ve got her help which we find out that is why he felt guilty for killing his kids because she told him and he didn’t pay attention which is also why his dead daughter said what didn’t you save us. He then created a false identity and backstory that when his psychiatrist did try to talk to him he would aggressively dismiss their questions. Which also led him to be violent towards George Noyce where he almost beat him up to death because he called him Laeddis because he brought up something that he’s trying to cover up with his false identity. Andrew’s psychiatrist could’ve stopped him from being lobotomized but he instead let him continue on his way to get lobotomized. Another instance where they could’ve helped out Andrew would be to let Andrew have another chance to see if maybe they could’ve helped him. If not they could’ve continued to give him medications and maybe see if he can tackle his hallucinations. Maybe Dr.Crawley could’ve tried Cognitive Therapy as a treatment instead of using drugs and avoiding a direct approach (Harvard Mental Health Letter.,1999). Which is kind of what they did but instead of forcing the truth upon him towards the scene where they’re in the light house. They could’ve done Electric Convulsive Therapy before they did the big experiment and maybe their experiment might’ve had a different outcome. Another option Andrew could’ve done was to handcuff his wife and then call the police and report the incident that way he didn’t kill his wife but instead see that she is responsible for what she did to him and maybe she would’ve been deemed by the court mental insane and could’ve been sent to Ashcliffe instead of it being the other way around. Then he could’ve gotten help from the tragedy that he experienced but instead he shots his wife and he still suffers in the long run because his dead wife is messing with his head which makes him crazy. Andrew should’ve said the truth at the end of the film and moved on from his messed up past.

 Furthermore we can see that this mind twisting movie portrays this disorder perfectly and to the point where we the audience don’t even know what’s real anymore. This movie sheds light on Delusional Disorders, and it gives us insight on how psychologist today can help people who are suffering from delusional disorder. Of course it can be hereditary and particular towards a certain gender whether the patient is male or female. Isn’t it crazy that not only is Andrew suffering from delusional disorder but his wife before him was insane, manic-depressed before him which she was the cause of all of this. Although Andrew was or might’ve have been suffering from ptsd which he got from ww2. Altogether this represents this disorder in a mindful way that enlightens its audience about a serious disorder that affects millions of people.

References

• Riggs, S., Perry, T., Dowben, J., & Burson, R. (2017). Vive La France: Three Delusional Disorders Originally Reported in the French Medical Literature. Perspectives in Psychiatric Care, 53(1), 5–9. https://ezproxy.bakersfieldcollege.edu:2136/10.1111/ppc.12176
• Canavan, M., Sipsma, H., Jack, H., Ohene, S., Rohrbaugh, R., Bradley, E., & Ofori-Atta, A. (2016). Psychoactive Prescription Practices for Serious Mental and Neurological Illness in Ghana: Data from the Mental Health and Poverty Project (MHaPP). International Journal of Mental Health, 45(4), 223–235. https://ezproxy.bakersfieldcollege.edu:2136/10.1080/00207411.2016.1215217                                     
• What is the role of ECT in the treatment of mania? (1997). Harvard Mental Health Letter, 13(12), 8. Retrieved from http://ezproxy.bakersfieldcollege.edu:2052/login.aspx?direct=true&db=pbh&AN=9707080100&site=ehost-live&scope=site
• Carpenter, W. T., & Davis, J. M. (2012). Another view of the history of antipsychotic drug discovery and development. Molecular Psychiatry, 17(12), 1168–1173. https://ezproxy.bakersfieldcollege.edu:2136/10.1038/mp.2012.121
• Ögren, K., & Sandlund, M. (2007). Lobotomy at a state mental hospital in Sweden. A survey of patients operated on during the period 1947-1958. Nordic Journal of Psychiatry, 61(5), 355–362. https://ezproxy.bakersfieldcollege.edu:2136/10.1080/08039480701643498

• Delusions and Delusional Disorders–Part II. (1999). Harvard Mental Health Letter, 15(8), 1. Retrieved from http://ezproxy.bakersfieldcollege.edu:2052/login.aspx?direct=true&db=pbh&AN=2690726&site=ehost-live&scope=site