Transcript The Black Swan - Steve A. Franklin, MSW

Black Swan
• Chris Clark, Cinema St. Louis
• Steve Franklin, MSW, LCSW
• Michael Uthoff, Dance St. Louis
[email protected]
•
•
•
•
•
Natalie Portman as Nina Sayer
Vincent Cassel as Thomas Leroy
Mila Kunis
as Lily
Barbara Hershey as Erica Sayers
Winona Ryder
as Beth Macintyre
• Directed by Darren Aronofsky
• Other Oscar nominations:
– Cinematography
– Editing
– Best picture
Rated R
for
• strong sexual content
• disturbing violent images
• language and
• some drug use
• It’s just a movie…….
• What is real?
• Simply the price of great art…
• Or psychopathology?
“SANITY"
The ability to build
a construct of "reality"
with other people,
while still retaining the capacity
for autonomous perception and
judgment;
balancing our need
for private self-experience
against the equally-important need
to share experience
with the important people in our lives.
... Alex Lerman
http://www.dailykos.com/user/Alex%20Lerman
“SANITY"
The ability to build a construct of "reality"
with other people, while still retaining
the capacity for autonomous perception
and judgment; balancing our need for
private self-experience against the
equally-important need to share
experience with the important people in
our lives. ... Alex Lerman
http://www.dailykos.com/user/Alex%20Lerman
Speculation
about specific diagnoses
possibly depicted
in “The Black Swan”
Psychosis
•
•
•
•
delusions
hallucinations
disorganized speech
grossly disorganized or
catatonic behavior
• negative symptoms
(reduced emotional
expression/speech/ motivation )
Psychosis
may be associated with
Schizophrenia
or many other causes
Eating Disorder?
Anorexia Nervosa
• Body weight < 85% of normal range
• Intense fear of gaining weight
• Disturbance in the way in which one's
body weight or shape is experienced
• Amenorrhea
• “Restricting” or “Binge-Eating/Purging”
Miscellaneous Developmental
• Childhood History of Abuse?
• Ongoing unhealthy parental
relationship?
• Incomplete ego development?
Personality Disorder
•
•
•
•
•
•
•
cognition
affectivity
interpersonal functioning
impulse control
--in a range of personal/social situations
--significant distress or impairment in
--social/occupational/important areas
Borderline Personality Disorder
• unstable relationships, tending
idealize or devalue
• unstable sense of self
• inconsistent, reactive moods
• feelings of emptiness
to
BPD
•
•
•
•
•
an intense fear of abandonment
suicidal or self-mutilating behavior
often intense and sudden anger
self damaging impulsivity
stress related paranoia or
dissociation
Obsessive-Compulsive
Personality Disorder
• Preoccupation with lists, details
• Perfectionism interferes with task
completion
• Work focus out of balance with
leisure/friendships
• Overconscientious/inflexible
OCPD
•
•
•
•
Unable to discard objects
Difficulty delegating
Miserly spending style
Rigid, stubborn
Obsessive Compulsive Disorder
• Obsessions:
• Intrusive,
distressing,
recurrent
thoughts, impulses, images
--(not simply real life worries)
--that a person tries to stop
--that are recognized as self generated
OCD
•
•
•
•
or Compulsions:
repetitive behaviors driven to perform
aimed at reducing stress or
unrealistically preventing dreaded event
• Self-recognized as unreasonable
• Interfere with life,
• are time consuming (>1 hour), or distressing
Psychodynamic
• Repression of “dark impulses”
• Shadow
May disguise or deny
Black Swan
What is real?
• Director leaves it unclear
• Clients and therapists
may also be unclear
Simply the price of great art?
• What do we expect of
performers/artists/athletes?
• Perfectionism?
• Dissociation to avoid pain?
• Necessity to have ballet body type?
“SANITY"
The ability to build a construct of "reality"
with other people
while still retaining the capacity
for autonomous perception and judgment;
balancing our need for
private self-experience
against the equally-important need
to share experience
with the important people in our lives. ...
Eating Disorder?
Anorexia Nervosa
• Body weight < 85% of normal range
• Intense fear of gaining weight
• Disturbance in the way in which one's
body weight or shape is experienced
• Amenorrhea
• “Restricting” or “Binge-Eating/Purging”
Personality Disorder
• inner experience and behavior that
deviates markedly (2 or more areas):
• Cognition, affectivity, interpersonal
functioning,impulse control
• --range of personal and social situations
• --clinically significant distress/impairment
• --social/occupational/other functioning.
Obsessive Compulsive
Personality Disorder
• Preoccupation with lists, details
• Perfectionism
interferes
with
completion
• Work focus out of balance
leisure/friendships
• Overconscientious/inflexible
• Unable to discard objects
• Difficulty delegating
• Miserly spending style
• Rigid, stubborn
task
with
Borderline Personality Disorder
•
•
•
•
•
•
•
•
•
unstable relationships, idealize or devalue
unstable sense of self
inconsistent, reactive moods
feelings of emptiness
an intense fear of abandonment
suicidal or self-mutilating behavior
often intense and sudden anger
self damaging impulsivity
stress related paranoia or dissociation
Obsessive Compulsive Disorder
• Obsessions:
Intrusive,
distressing,
recurrent thoughts, impulses, images that a
person tries to stop,that are recognized as
self generated
• or Compulsions: repetitive behaviors driven
to perform aimed at reducing stress or
unrealistically preventing dreaded event
Self recognized as unreasonable; Interfere
with life… time consuming … distressing
Miscellaneous Developmental
• Childhood History of Abuse?
• Ongoing unhealthy parental
relationship?
• Incomplete ego development?
Psychodynamic
• Repression of “dark impulses”
• Shadow
Essence of the Swan Lake story
Dermatillomania
• CSP (Compulsive Skin Picking or
Chronic Skin Picking).
• impulse control disorder
• body dysmorphic disorder
Psychosis
•
•
•
•
delusions
hallucinations
disorganized speech
grossly disorganized or catatonic
behavior
• negative symptoms (reduced
emotional expression/
speech/motivation)
Schizophrenia?
• Psychosis, plus
• Social/occupational dysfunction
• 6 months of disturbance, 1 month of
symptoms
Other?
• Electrolyte imbalance
From purging?
• Drug Induced
Ecstasy?