week 15 identity movie paper

EBP Movie Review: Identity

Identity is a 2003 movie that was directed by James Mangold, it is about an individual with a complex psychological disorder known as dissociative identity disorder. Mangold used two settings in the movie; the first setting was a motel constructed over an Indian cemetery and the second one was in an attorney’s office where Malcolm Rivers’, a convicted criminal, the case is being revisited. In the first scene, Malcolm traps 10 individuals in the motel; a couple- Lou and Ginny, a call girl Paris, a family with George as the dad, an ex-actress Caroline, his limousine driver Ed, a desk clerk Larry, an officer, Rhodes, and a criminal Robert (Mangold, 2003). Six of the ten individuals are killed, with a key containing a number found on their dead bodies. Doctor Mallick, Malcolm’s provider, believes that Malcolm’s trauma was the cause of the split personalities that resulted in his murders, and used a pyschoevalatuaion therapy to lead to the encounter between these distinct personalities, displayed as particular killings in the film (Mangold, 2003). Mallick diagnoses him with dissociative identity disorder (Mangold, 2003). He argued that only one of Malcolm’s personalities was responsible for these murders and that with the proper treatment, Malcolm can get better. Finally, the doctor manages to diminish most of Malcolm’s personalities, and despite his efforts, fails to completely cure Malcolm, eventually dying by his hand.

Dissociative Identity Disorders

Dissociative identity disorder is a medical condition that causes extreme dissociation, resulting in the absence of connection in an individual’s memories, feelings, behaviors, sense of self-recognition, or thoughts in their psychological process. It is assumed that the integration of several influential factors, including traumatic experiences, result in the disorder like in Malcolm’s case. The dissociative concept is an assumed coping technique, where an individual separates themselves literally from a condition or experience that is too traumatic, brutal, harsh, and painful to digest with their conscious self (Reinders et al., 2019). In Malcolm’s case, he separates himself from reality as a result of his traumatic life occurrences. Studies prove that this disorder’s influential aspects are mostly a mental reaction to environmental strains and internal strains, especially during the childhood period when emotional abuse and abandonment obstruct personality growth (Reinders et al., 2019). Further, almost all individuals with this disorder have noted individual histories of frequently disturbing and traumatic experiences at a delicate growth phase during childhood, similar to Malcolm’s abuse and neglect on his childhood.

The disorder is attributed to the evidence of two or more different identities that frequently control one’s actions and thoughts. These identities are unique, including in their gender, age, nature, and posture (Reinders et al., 2019). There is also extreme forgetfulness of personal information and extreme variations in memories. Other signs of dissociative identity disorder include headaches, out-of-body experiences, losing track of time, amnesia, altered consciousness, separation from self, mood swings, and anxiety (Reinders et al., 2019). Some patients with this disorder might develop a pattern of violence, self-incrimination, self-destruction, and impulsivity.

Diagnosis

Diagnosing dissociative identity disorder is not an easy task, and assessment should be comprehensive. This is because the symptoms caused by this disorder are similar to other symptoms caused by related disorders like depression and anxiety. Effective treatment requires a proper diagnosis, and the wrong diagnosis results in ineffective treatment. In Malcolm’s case, Mallick used the DSM-4 tool for assessing Malcolm’s condition. Recently, the diagnostic and statistical manual of mental disorders-5 was approved as an assessment tool that provides guidelines and criteria for appropriately diagnosing psychological disorders, including diagnosis for dissociative identity disorder (Tolentino & Schmidt, 2018). In the guidelines, an individual with this disorder should have two or more different personalities, each having diverse thinking patterns and actions associated with environmental and self relations. Further, the individual must have amnesia, which involves gaps in recollecting significant individual information, daily incidences, and harsh occurrences. An individual with this condition should also be influenced by it, resulting in ineffectiveness in one or more significant sectors in life (Tolentino & Schmidt, 2018). Moreover, the individual’s interference is not related to common religious or cultural beliefs. This individual’s symptoms should not be influenced by substance use or a healthcare condition. Additionally, the different personalities provide different responsibilities in assisting this individual cope with life challenges.

Evidence-based Intervention

Trauma-focused psychological treatments have been proved to be effective in treating dissociative identity disorder patients. The most useful techniques in this treatment include eye movement desensitization and reprocessing, and cognitive behavioral therapy methods (Thompson et al., 2018). Cognitive-behavioral therapy involves exploring cognitive skills and behaviors, while eye movement desensitization and reprocessing involve correcting symptoms caused by unprocessed or traumatic occurrences (Shebini, 2019).  Mallick, for instance, used cognitive behavioral therapy to treat Malcolm’s symptoms. Cognitive-behavioral therapy is a process that takes about 20 sessions. The provider and the patient work collaboratively to establish troublesome thinking trends. This is performed by the patient observing disturbing occurrences and documents their thoughts in response to these occurrences (Thompson et al., 2018). In Malcolm’s case, the provider should determine his disturbed thinking process. The patient learning to regard other possible depictions follows this step. This step’s main objective is to interfere with the involuntary but deformed thoughts as they happen while learning to regard whether any other possible and more reliable depictions of the same occurrences (Thompson et al., 2018). Practice results in gradual effects, where the patient starts acting and feeling differently. In general, the patient’s primary values and beliefs are about themselves and the environment. In Malcolm’s case, the provider should try and change his perceptions about the universe being a cruel place, which results in him misreading others’ actions as hostile (Thompson et al., 2018). First, the provider would ask Malcolm to track occurrences that made him feel disturbed, and then this patient records the thoughts that occur in response to these occurrences. The provider should ask the patient to analyze the evidence that resulted in his reactions rationally. This way, the patient faces his primary beliefs and learns how to doubt them. The primary beliefs are frequently doubted with practice and are overthrown by more pliant, practical, and extensive beliefs (Thompson et al., 2018). The change in behaviors leads to other people accepting and positively treating this individual.

The EMDR is a data analyzing process that includes eight stages. It involves historic incidences that result in the formation of a basis for pathology, the present events that trigger distorted feelings, values, and standards, and the positive intervention required to promote future coping actions (Shebini, 2019). The sessions use eye movements, taps, and sounds to stimulate the brain to incorporate and process information. These help balance trauma via abreaction, enhance internal dialogue with ego state therapy, reform cognitive abnormalities, form alternative adaptive actions, enhance ego, integrate alternative personalities, and enable the formation of meaning for pain, healing, and trauma, and eliminating improvement hindrances (Shebini, 2019).

Conclusion

The film’s identity revolved around a mentally disturbed character called Malcolm. He is diagnosed with dissociative identity disorder by his care provider. The portrayal of the disorder in the film was correct. However, the treatment provided by the doctor was ineffective. According to the diagnostic and statistical manual for mental disorders-5, a person that is diagnosed with a dissociative identity disorder has two or more distinct identities, each with diverse roles in the coping mechanism, dissociative behaviors towards self and environment, gaps in recollection of memories, and individual information, and dysfunctional crucial life parts (Tolentino & Schmidt, 2018). Additionally, this individual’s symptoms should not be caused by substance vise or any other mental condition like seizures. Moreover, the person’s thought process should not be influenced by common cultural and religious beliefs (Tolentino & Schmidt, 2018). All these are evident in Malcolm, implying that this disorder is appropriately displayed in the film.

References

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