Is Leonardo Dicaprio’s Shutter Island based on psychological facts
This movie is about a man named Teddy Daniels. It is set in 1954. He arrives at a mental hospital in the Boston Harbor Islands accompanied by a partner named Chuck. Teddy believes they have been sent to the hospital, named Ashecliffe, to investigate the disappearance of a patient named Rachel Solando.
Teddy tells his mate that the person who killed his wife, Andrew Laeddis, must also be at Ashecliffe. Teddy also reveals that he interviewed a former Ashecliffe patient named George Noyce, who told him that Ashecliffe is conducting illegal experiments on political traitors.
Teddy learns that the mental hospital, Ashecliffe has 66 patients, he believes that Andrew Laeddis is 67th patient. Teddy suffers from a migraine and in his dream he sees Rachel, three dead children, a scarred man he believes to be Andrew Laeddis. He also sees Dolores (his wife) in his dreams who tells him to find Laeddis. Teddy wakes up and goes searching for Laeddis with Chuck in Ward C, where the most dangerous patients of the hospitals are kept. Teddy attacks one patient and follows a voice until he finds a badly scarred George Noyce, who tells Teddy his investigation is fake and to leave Dolores behind. Noyce tells Teddy that Andrew Laeddis is also being kept in the lighthouse, which is the place where lobotomies are performed.
Disturbed by Noyce’s words, Teddy becomes suspicious of Chuck and heads toward the lighthouse alone but cannot reach it due to the high tide. In a nearby cave, Teddy finds an older woman he believes to be the real Rachel Solando. The woman tells Teddy that Ashecliffe has likely been poisoning his food with psychotropic drugs, causing his migraines and dreams, and has been conducting brainwashing experiments on patients just like Nazis did on prisoners in concentration camps. Teddy climbs back up to the main road the next morning and is ferried back to Ashecliffe by a warden, where he is reprimanded by his doctor, Cawley for not trusting his “method.” Cawley also tells him that Chuck does not exist.
Later, a panicked Teddy attempts to reach the ferry but is intercepted by another doctor. Teddy attacks and sedates him when he says that teddy is a “monster” suffering from a “wound.” Teddy hijacks one of the facility’s cars but decides to go to the lighthouse instead of going to save Chuck. At the lighthouse, Teddy finds his doctor Cawley waiting for him. Cawley explains that Teddy is Andrew Laeddis, Asheliffe’s 67th patient, admitted two years prior after his suicidal wife Dolores killed their three children Henry, Simon, and Rachel. Cawley tells him that “ANDREW LAEDDIS” and “TEDDY DANIELS” are anagrams, and “RACHEL SOLANDO” and “DOLORES CHANAL” are anagrams as well.
Teddy is horrified to learn that the last two days have been “radical, cutting-edge role-play,” in which everyone around him has performed for his sake, including his psychiatrist, Dr. Sheehan, who has been posing as his partner Chuck. Cawley and Sheehan express the hope that they can rehabilitate Teddy and avoid having to perform a lobotomy, which the medical board has recommended after Teddy attacked George Noyce for calling him “Laeddis.” Cawley reveals that Teddy inhabits a delusion in which he is a U.S. Marshal investigating a disappearance, to avoid reckoning with traumatic events in his past.
Upon hearing all these things, Teddy suddenly remembers his former life as Andrew Laeddis. He also remembers the day he came home from work and killed his wife Dolores after learning she had drowned his three children in a lake. The next morning, Teddy acknowledges his traumatic memories, but Cawley warns that he has “broken through” before and subsequently regressed. Soon after, in a conversation with Chuck, Cawley’s suspicions are confirmed, as Teddy lapses back into his U.S. Marshal persona. Teddy asks Chuck whether it is better to live as a monster or die as a good man, and walks in the direction of the lighthouse with Cawley and others. So in fact Teddy has recovered as a result of this role play but decides to pretend as if he hasn’t recovered because he does not want to live.
Diagnosis
The diagnosis for Edward Daniels is Delusional Disorder, Mix Type (297.1)
· Non-Bizarre Delusions for at least one month.
Teddy experiences non-bizarre delusions for two years. The delusions are neither due to Schizoaffective Disorder, nor Mood Disorder. He does not have an alcohol dependency and neither is he chronically depressed.
· Criterion A for schizophrenia has not been met.
Teddy does not show flat inappropriate affect. He is very sociable and his delusions are not bizarre.
Apart from the impact of the delusions or its complications, functioning is not noticeably impaired and behavior is not odd or bizarre.
Teddy can function normally. He is sociable and is able to properly communicate. If mood episodes occurred alongside with delusions, their total duration was brief relative to the duration of the delusional periods.
Teddy is generally in a good mood. He is not depressed or anxious. He is always looking forward to catching new hints about Rachel. He gets angry when people refuse to give him want he thinks he needs, such as case files for patients in the mental hospital.
The disturbance is not a result of direct physiological effects of a substance (like drug abuse, a medication) or a general medical condition.
Teddy also smokes and drinks; but he does not have negative episodes that develop from substance abuse, but not alcohol dependence. He takes medications to cure migraines.
Specify Type
· Mixed Type
Delusions characteristic of more than one type.
· Grandiose Type
Delusions are inflated worth, power, knowledge, identity, or special relationship to a deity or famous person.
Teddy believes, he is a respected marshal with particular privileges to the mental hospital. He feels that people should obey their requests.
· Persecutory Type
Delusions that the person (or someone to whom the person is close enough) is being spitefully treated in some way.
Teddy has a feeling that the employees of the mental institution are trying to commit him to a patient. He feels that they are controlling him by administering him some special medications other than simple pain killers. Teddy is also convinced that the cigarettes the institution provides are laced with drugs that will make him powerless.
Inaccuracy A
· DD’s diagnosis does not specify that functioning is not markedly impaired.
· Why he doesn’t recognize people and places although he is there for 2 years.
· Does he have memory damage as well? This has not been specified either nor does it fall into the diagnostic criterion.
Inaccuracy B
· The only symptoms of DD that overlap with Schizophrenia are tactile and olfactory delusions if consistent with his primary delusion that he is a Marshal. There were multiple occasions where he has several illusions of the type. For example when he met Rachel Solandro in a cave (which did not happen in reality)
· However he experiences hallucinations relevant to PSTD (post-stress traumatic disorder). And the hallucinations have been triggered after he experiences a traumatic event that is seeing all three of his children killed by his wife. And then he killing his wife out of rage whom he loved. He was also unable to recall the events of trauma.
Accuracy of Portrayal
The portrayal of Delusional Disorder was correct throughout the whole film. It was not obvious until the end of the film that Teddy was suffering from a disorder, and was not an actual investigator. The delusions are believable to all those people who do not have a complete understanding of psychology and psychotic disorders.
Treatment
The treatment psychiatrist used in the film was ultimately performing the lobotomy. Lobotomies, in the fifties, were considered as reasonable treatments for psychotic disorders. In current treatment procedures lobotomies are unethical. The lobotomy procedure involves the use of an ice pick type probe. It is then inserted through the eye to dismantle the brain. This develops a calming effect on the patient.
The recent treatment used for Delusional Disorder includes both medications as well as psychotherapy. Medicinal treatments involve anti-psychotics and antidepressants such as SSRI and Clomipramine. Psychotherapy treatments involve supportive therapy and cognitive therapy. The treatment used for patients has to be individualized. The current treatment for Andrew Laeddis should consist of cognitive therapy combined with essential medication.
