Hello again to all my fellow Stemians! Now here's a character that beautifully depicts one of the most exploited diagnosis in psychiatry. Unlike the last character I wrote about (Batman) this one is clearly more realistic and thus much easier to analyse in a proper way. Seeing a Bat in a psychiatric ER is kinda unlikely to happen, but to deal with someone raging as this bull does, can be considered as my day to day practice.
Back to Scorsese in another celebrated collaboration with De Niro. Let's see if we can clarify what beholds the fury of this seriously messed boxing champion. Oh yeah, and if anybody wondered why this movie was shooted in black and white,
I'll suggest my answer in this post.
ROUGH ANALYSIS OF JAKE LAMOTTA'S MENTAL STATUS (I've pin pointed few features, not the whole status)
APPEARENCE
Anybody who's into movies surely knows that De Niro's transformation in this move is one of the most obscure in the history of cinema. I mean the guy bulked around 60 pounds which was followed by a serious eating and training regime to get to shape again. Insane. I think it was this way around. What does it say about or character. Extremity would be the proper term word to summon this guy in brief.
THOUGHT PROCESS
No psychopathological verbal production in a sense that he loses his determining tendency or any other formal thought flow deviance. OK, he's rough, he swears, yells and threats throughout the movie to basically any character he encounters. Always blaming the circumstances or others for his misfortunes. For this guy everything is just black and white. One moment you're extremely beloved on his behalf and the next day he will bury you under the ground.
AFFECT, PSYCHOMOTORICS
His facial expression shows the whole range of emotions, though mostly anger and rage. Wee can see he doesn't lack any of it. On the other end, at the beginning of his romance with his future wife he seem very kind and gentle. Not for long though. It was a matter of time when will she be stepping on his toe. And he ha s a big toe. Hard to miss.
MOOD
Mostly dysphoric and angry with high frequency of mood swings. Doesn't seem to be manic at any point, so I'd exclude the bipolar affective disorder. Later in his days shows clear sings of depression following substance abuse (alcohol).
WILL
Extremely motivated to prove that he's the best boxer around (read the toughest motherfucker anybody should be afraid of). Once he achieved his goal and reaches the top, his life practically ends. Hits the bottom even worse than TRX did this days.
COGNITIVE FUNCTIONING
I'd say his IQ is somewhere in the range of median. Not that important any way. Emotionally he's basically retarded.
FUNCTIONALITY
He's highly dependent on the others, taking advantage of his nearest without any sings of gratitude. At the end of the movie you can see what he becomes without the helping hand of his brother and wife. Total rack.
INSIGHT
Lacks capacity to critically reflect on his behavior as well as to understand the emotional state of others. His psyche copes with reality through primitive, archaic defense mechanisms like projection and splitting.
BPO (borderline personality organisation)
He's a clear case of a severe structural deficiency. In Kernberg's model of personality organisation, the term "borderline" is used to describe the middle ground between neurotic and psychotic personality organization. Term "borderline" in this case shouldn't be mistaken by the diagnosis of Borderline Personality Disorder. In Kernberg's model, the term "borderline" is a much broader and includes any severe personality disorder, such as Borderline, Narcissistic, Antisocial, Schizoid, and Schizotypal Personality Disorders.
PROJECTION
Projection is a form of defense mechanism in which unwanted feelings are displaced onto another person, where they then appear as a threat from the external world.
SPLITTING
Is there any Tool fan? :)
Splitting is a term used in psychiatry to describe the inability to hold opposing thoughts, feelings, or beliefs. Some might say that a person who splits see the world in terms of black or white. It is a distorted way of thinking in which the positive or negative attributes of a person or event are neither weighed nor cohesive.
Splitting is considered a defense mechanism by which people with borderline personality disorder (BPD) can view people, events, or even themselves in all or nothing terms.
Examples:
• Things are either "always" or "never."
• People can either be "evil" and "crooked" or "angels" and "perfect."
• Opportunities can either have "no risk" or be a "complete con."
• Science, history, or news is either a "complete fact" or a "complete lie."
• When things go wrong, a person will feel "cheated," "ruined," or "screwed.
Source: https://www.verywell.com/what-is-splitting-425210
DIFFERENTIAL DIAGNOSIS
It's quite obvius that his suffering from a personality disorder from Cluster B (antisocial personality disorder, borderline personality disorder, histrionic personality disorder, and narcissistic personality disorders.)
The diagnosis of BPD is frequently missed and a misdiagnosis of BPD has been shown to delay and/or prevent recovery. Bipolar disorder is one example of a misdiagnosis as it also includes mood instability. There are important differences between these conditions but both involve unstable moods. For the person with bipolar disorder, the mood changes exist for weeks or even months. The mood changes in BPD are much shorter and can even occur within the day.
Source: https://www.borderlinepersonalitydisorder.com/what-is-bpd/bpd-overview/
source: http://www.whale.to/c/borderline_personality_disorder.html
DIAGNOSIS
Diagnosis according to ICD (International Statistical Classification of Diseases ) - 10th revision
F60.3 Borderline personality disorder
TREATMENT
A combination of medication and individual analytical treatment, and later maybe group therapy. I'd treat him with the combiantion of mood stabilizer like valproat or lithium to cope his agression and risperidone or flufenasine to cope his paranoid interpertations of reality (pathological jelousy).
