Introduction
John Nash, the protagonist in the chef-d’oeuvre film, A Beautiful Mind, suffers from paranoid schizophrenia. At the start of the movie, Nash introduces himself to students and attempts to make a joke, but he offends other graduates by referring to their work as unoriginal before boasting how he would think of a novel idea and solve it. The first schizophrenic delusion emerges when he rushes to his room after this confrontation to meet Charles, his imagined roommate (Howard, 2001). Nash’s schizophrenic tendencies escalate when he joins MIT after leaving graduate school.
The Department of Defense (DoD) approaches him to decode cyphered communication by the Soviets. He becomes obsessed with finding patterns and piecing information together to the point of being paranoid. He thinks that someone from the enemy camp as he delivers his extensive findings to a certain mailbox. He also witnesses a shootout between his handler at the DoD, William Parcher, and Soviet agents before deciding to quit his assignment of decoding messages (Howard, 2001). While giving a speech at Harvard, he starts fleeing imaginary Russians that he believes are about to kill him. However, all these events take place in Nash’s mind. Parcher, Charles, and a cousin named Marcee are all imaginary people. This paper discusses John Nash’s paranoid schizophrenia as portrayed in the film A Beautiful Mind using different psychological perspectives.
Schizophrenic Nash
Nash’s schizophrenic tendencies start manifesting immediately after he joins Princeton University for his undergraduate studies. According to the social learning theory, people suffering from schizophrenia respond to the social environment inappropriately as opposed to their normal counterparts (Javed & Charles, 2018). Nash’s behavior fits this description perfectly. At the start of the film, he introduces himself to other graduates, but instead of seeking meaningful relationships based on respect for one another, he ridicules them by claiming that their ideas are unoriginal. He goes on to brag that he will come up with a novel idea and change the world through his originality. This behavior underscores an antisocial person lacking the relevant social skills to interact with other people properly. It could be categorized as flat affect, which is one of the negative symptoms associated with the condition (Marder & Galderisi, 2017). In this case, an individual has reduced emotional expressiveness on top of being extremely apathetic – attributes that come out clearly in Nash. However, the two major symptoms of schizophrenia that Nash portrays are auditory hallucinations and paranoid delusions.
Symptoms
According to the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5), paranoid delusions should be present for a patient to be diagnosed with schizophrenia (Mattila et al., 2015). Throughout the film, Nash portrays paranoid delusions on numerous occasions. First, he believes that someone from the Soviet Union is following him on his way to deliver his findings from the study on the enemy’s deciphered communication. He also witnesses an imaginary shootout between his boss at the DoD, William Parcher, and Soviet agents. However, Nash’s delusions climax when delivering a guest lecture at Harvard University. In his mind, he sees Russians in the audience and thinks that they are out to kill him. Therefore, he tries to flee, but they are standing in his way. He finally punches Dr. Rosen in the nose before being subdued and taken to a psychiatry hospital for treatment.
From these incidents, it is clear that Nash has lost contact with the real world. He lives in a world of constant threats whereby Russian mobs are out to kill him due to his imagined role of decoding Soviet communication. In another scene, Nash believes that Parcher is trying to kill Alicia Larde. Consequently, in a bid to save her, he flies across the room and knocks her down to push her out of Parcher’s bullets. Nash’s condition could also be diagnosed using the psychoanalytic theory whereby the ego has not developed from the id. According to Giersch and Mishara (2017), schizophrenics do not have a distinct ego, and thus they regress towards the primary narcissistic stage whereby they lose contact with the real world. The largest part of Nash’s life revolves around imagined events and people. Towards the end of the movie, his wife, Alicia Larde, finds out that most people in Nash’s life, including Charles, his alleged roommate, Parcher, the DoD handler, and Marcee, his cousin, are all imaginary, and thus they do not exist in the real world.
Another common symptom of schizophrenia, as displayed by Nash, is auditory hallucinations according to the DSM-5 criterion (Mattila et al., 2015). The affected individual hears voices and sounds that do not exist. At Princeton, Nash converses with Charles for long, but this roommate is imagined. Similarly, at one point after relapsing, he talks to Charles, and they agree that he (Charles) would watch over their baby. However, given that Charles is an imaginary character in Nash’s world, the baby almost dies in the tub as water fills it slowly. Kim et al. (2018) argue that “25% to 50% of subjects continue to experience auditory hallucinations despite medication and this experience can impact on the quality of life, self-esteem, anxiety, depression, suicide attempts, and cognitive function” (p. 326). Similarly, Nash’s life suffers greatly due to the voices that he keeps on hearing in his head. Towards the end of the film, his wife threatens to leave him after the baby incident, and thus he has to beg her to stay. His health has also deteriorated as he tries to cope with the condition without taking medication.
Treatment
The regimen adopted to treat Nash in the movie is also consistent with the existing approaches towards the treatment of schizophrenia. First, Nash is given antipsychotics as part of his treatment therapy. However, he soon realizes that the drugs are making him not think freely and innovatively as he would before. Specifically, he is concerned that the medications will impede his research due to his inability to think clearly. According to Ballester and Frankel (2017), pharmacological intervention is one of the available approaches that are currently being used in the management of schizophrenia. However, medications for this condition are known to deflate the brain leading to reduced activity and other related effects (Stroup & Gray, 2018). These arguments are consistent with what Nash experiences. He finally decides to stop taking the medications, but he relapses as a result. This decision has serious repercussions as he almost loses his child to drowning in a bathtub. In addition, his wife almost leaves, which threatens to destroy his family. This scene highlights an important aspect concerning the future research of schizophrenia.
While medications might be the best solution that is currently available for the management of schizophrenia, this approach might have adverse effects. Consequently, further research is needed in this area to determine what could be done to come up with a friendlier method of treating and managing the condition. Nash is also given insulin shock therapy when he is presented to the hospital for the first time. Rzesnitzek and Lang (2017) argue that insulin shock therapy, which is also known as insulin coma therapy, was a common technique used to treat schizophrenia in the 1950s. Therefore, even though the approach is no longer used, it is relevant to the movie, given that it is set in the 1950s.
Coping
Nash’s attempt to live with schizophrenia and manage it effectively to continue doing his normal day-to-day activities without significant interruptions highlights a different aspect of dealing with this condition. After he is released from the hospital, Nash has to make an important decision concerning his future. He can continue taking the medications and stop doing his research or learn a new coping mechanism and continue doing what he loves. Ultimately, he goes back to Princeton, where he agrees to work in the library for two years. This new environment allows Nash to look at his delusions differently and manage them effectively. Ultimately, Nash overcomes his psychotic tendencies, silences his delusions, and leads a normal life. In the 1970s, he is allowed to start teaching again, and in 1994, he wins the coveted Noble Prize.
One important issue that arises from this scene is the prospect that schizophrenia could be managed without medication. It does not mean that the hallucinations do not recur. On the contrary, it implies that the affected person learns how to deal with such episodes whenever they occur. For instance, when receiving the Nobel Prize, Nash sees Marcee, Parcher, and Charles standing on the sides. However, instead of reacting to their presence, as he would hitherto do, he ignores them and walks out together with his wife and son. Castelein, Bruggeman, Davidson, and van der Gaag (2015) note that social support from family members, peers, and friends plays an important role in the management of psychotic conditions. In this case, Nash gets all the support he needs from Princeton University, which explains why he manages to overcome his delusions and hallucinations.
Conclusion
Paranoid Schizophrenia is one of the common psychotic disorders affecting millions of individuals around the globe. In the movie A Beautiful Mind, John Nash, the protagonist, suffers from this condition, as shown in different scenes through his actions. After joining Princeton University for his undergraduate studies, he portrays signs of antisocial tendencies, which might be an indicator of schizophrenia. However, his condition deteriorates further when he joins the Pentagon to help the DoD decode messages from the Soviet Union. He becomes delusional and believes that someone is following him wherever he goes, especially when delivering his findings. His hallucinations are also evident throughout the film as he converses with inexistent individuals, such as Charles and Marcee. These symptoms are consistent with the current requirements of the DSM-5 criterion in the diagnosis of paranoid schizophrenia. Nash receives medications, but he chooses to deal with the condition through alternative approaches. Ultimately, he overcomes his delusions and hallucinations to resume normal duties. While medication is the best available option for treating schizophrenia, future research should focus on alternative approaches for effective management solutions.
References
Ballester, J., & Frankel, B. A. (2017). Pharmacological advances in the treatment of schizophrenia. The American Journal of Psychiatry, 11(1), 5-8.
Castelein, S., Bruggeman, R., Davidson, L., & van der Gaag, M. (2015). Creating a supportive environment: Peer support groups for psychotic disorders. Schizophrenia Bulletin, 41(6), 1211-1213.
Giersch, A., & Mishara, A. L. (2017). Is Schizophrenia a disorder of consciousness? Experimental and phenomenological support for anomalous unconscious processing. Frontiers in Psychology, 8(1659), 1-10.
Howard, R. (Director). (2001). A beautiful mind [motion picture]. United States: Universal Pictures.
Javed, A., & Charles, A. (2018). The importance of social cognition in improving functional outcomes in schizophrenia. Frontiers in Psychiatry, 9(157), 1-14.
Kim, J. H., Son, Y. D., Kim, J. H., Lee, H. J., Kang, N. I., Chung, G. H., … Chung, Y. C. (2018). Neural signature for auditory hallucinations in schizophrenia: A high-resolution positron emission tomography study with fludeoxyglucose (18f). Clinical Psychopharmacology and Neuroscience, 16(3), 324-332.
Marder, S. R., & Galderisi, S. (2017). The current conceptualization of negative symptoms in schizophrenia. World Psychiatry, 16(1), 14-24.
Mattila, T., Koeter, M., Wohlfarth, T., Storosum, J., van den Brink, W., de Haan, L., … Denys, D. (2015). Impact of DSM-5 changes on the diagnosis and acute treatment of schizophrenia. Schizophrenia Bulletin, 41(3), 637-643.
Rzesnitzek, L., & Lang, S. (2017). ‘Electroshock therapy’ in the Third Reich. Medical History, 61(1), 66-88.
Stroup, T. S., & Gray, N. (2018). Management of common adverse effects of antipsychotic medications. World Psychiatry, 17(3), 341-356.