Psychiatrist Breaks Down Psychotic Episodes In Movies | GQ

Okay, do you want to play with yourself? Okay, say hello to my new friend. They greeted his little friend. That's actually a bit of a funny phrase because cocaine can also cause erectile dysfunction. That's something to keep in mind while this is happening. gq I'm Dr Eric Bender I'm a

psychiatrist

who specializes in forensic psychiatry for children, adolescents and adults and this is the first step of fight club for six months I couldn't sleep I couldn't sleep I couldn't sleep with insomnia nothing is real right away the narrator talks about being sleep deprived insomnia for six months when you are sleep deprived you don't think clearly in fact it is considered unethical to deprive someone of sleep for more than 48 hours in some places sleep deprivation is considered a form of torture everything en In the distance, everything is a copy of a copy of a copy.

You can see that quick flash of Tyler Durden approaching and he says everything is a copy of a copy of a copy and you see it as some kind of sleeping fight club. I guess it's purposely unclear. As for what's going on with the narrator here, you see him having this hallucination. This is very common with lack of sleep. When you are sleep deprived, you may first start to feel very confused and then over time you may have some delusions and some hallucinations. hallucinations and lack of sleep can be complex, in fact you can have auditory and visual hallucinations, you can have distortions even of your own body, feeling that your body is changing and as we know the narrator looks quite different from tyler durden, so there's a big change in how it seems like you can also believe you're someone else, in fact in studies of sleep deprived people, some of them said I felt like I was someone else.

A lot of themes in Fight Club have to do with consumerism and belonging to the idea that a club is Here you have a place to belong, you have this group of men fighting each other and beating each other to a pulp. You have to wonder if they are taking good hits to the head and does that really cause people to have more delusions or more hallucinations in the future? At the beginning of the movie, after he goes to the group, there is a moment where he cries and then falls asleep, it can be a very cathartic experience, that is, this release of something that helps you move forward in your life, It can be a release of emotions. when you cry and I'm not surprised he sleeps the data shows that you actually need about 50 of the sleep you've been deprived of to get back to functioning cognitively and behaviorally like before he clearly didn't do that and maybe that's why we see tyler durden more and more present because he is increasingly sleep deprived.

A study was done showing how people who were sleep deprived responded to certain texts by simply reading texts, those who were sleep deprived for about 35 hours, looked at the text and actually did a scan on the brain and showed that the connections between the amygdala, where emotions are centered, in the brain, and the frontal cortex, where you can actually organize and maintain them. stable, it doesn't connect like it should when your sleep state is really good when you're sleep deprived there's no connection instead you go into this fight or flight reaction and fight or flight club, I guess it's more appropriate in this The next case is Scarface, this is Tony Montana, who has become the emperor of cocaine.

Basically, he's so high that he missed the screens earlier and all these people are invading his house. He also becomes increasingly paranoid throughout the film when Tony talks to his sister. Here it is possible that this is part of the psychosis he is experiencing, that everything is going to be okay while he talks to his dead sister. He now he has this incredible urge to kill everyone around him. It is very possible that it is a cocaine-induced psychosis or at least the effects of cocaine use. Cocaine is a drug that can make someone feel like they have more energy.

It increases dopamine in the system by preventing the brain from absorbing dopamine. And dopamine is the pleasure chemical produced by the brain. It can also make you feel more confident. It makes you feel paranoid and delusional, so throughout the movie we've seen Tony become more paranoid. Here he is quite delusional. He's going to take out all these agents while they break into his house. Before this, you've seen a mountain of coke. his desk and he's just snorting it or even likes to drop his head on it, so there's definitely some cocaine on board. You want to play with us.

Here Paul, there is the illusion that he himself is going to take everyone out. They greeted his little friend. Actually, that's a bit of a funny phrase because cocaine can also cause erectile dysfunction, so that's something to keep in mind while this is also happening. Violence is not inherent to people who have mental illnesses. There are certain situations in which violence can occur. I talked about when someone may have a delusion and want to protect themselves and it is a problem of acute psychosis. Another place where you can have more violence is with substances and cocaine is one of those substances that you can become more aggressive with, so grabbing a grenade launcher certainly is. a sign of aggression Tony's reaction here cocaine is working on a system he doesn't feel like he's doing anything wrong or out of the ordinary he's also defending his house cocaine was originally used as an anesthetic when he was shot many times it's interesting that Not necessarily He falls down immediately, but remains upright.

It was a great anesthetic. I doubt it, but it was probably more Hollywood. It actually has some anesthetic purposes. We don't use it for that anymore. Obviously, black swan. Here we see Nina. who is working very hard and is not quite feeling herself, suddenly in the mirror it seems that her movements are not happening in real time, which can illustrate an illusion, you could see something moving but it seems that it is bigger than it is or it seems like someone she doesn't know what the hallucinations would be like if they weren't there in the first place it's not clear exactly what's going on there are so many factors that contribute to why she might be experiencing this she has this overbearing, overprotective mother this competitive enemy there are a few levels There are also some signs that she has an eating disorder and when your brain is not fed or nourished you don't think clearly, so it's possible that all of this is contributing to how she sees the world around her, which Nina sees her reflection differently.

It could be more of an illusion that she is seeing the reflection of her, that she is there, but it seems distorted. I don't know if there's any particular meaning to the fact that she's seeing herself, other than that now she's been very focused and obsessed with things, and that's what she does. There seems to be a level of obsession that can be almost

psychotic

. It is an illusion that you need to do this or this is going to happen. You're going to lose your share. You're not going to have friends, whatever it is, so there may be a level. of anxiety that almost seems delusional and maybe you are experiencing that in addition to seeing these other things, when someone has body dysmorphic disorder they see their body differently than it really is, someone might focus on their ear, think that their ear You're not shaped correctly and you see plastic surgeons and they want to change it and they just don't see how your body is the shape it really is.

If she has some form of this, it would make sense that she isn't seeing what her body looks like in the mirror correctly, but this seems more like it. like a hallucination or an illusion because she is doing things differently she is actually moving differently if nina is also sleep deprived from all the work and time she spends dancing which can also lead to some of these possible hallucinations and worries and the way she sees herself. island we are going to put them on the table andrew we will try them we will change their clothes they will be our living dolls here we see Dolores having just committed this horrible crime she is talking about her children who are deceased as if they could be living dolls she has had a story in the bipolar disorder movie that's what they at least suggest in bipolar disorder you may also have

psychotic

symptoms you may have hallucinations and it seems like she had hallucinations or some delusional beliefs about killing her children It's not clear exactly what was going on.

Was there a command auditory hallucination that told her to do this? who was psychotic and the boy actually asked him: so am I going to become a serial killer? That's not what we need to teach people that because there is a mental illness there is violence, there are some states during which someone with a mental illness might be prone to violence, but it's not because they are prone to being violent, it's They may be trying to defend themselves due to a delusional belief, that type of violence actually tends to occur more in the home, the probability of being hurt by someone who has a mental illness is much lower than the probability of being struck by lightning when pain says free me it's possible she's letting us know how much she's struggling in her life what Andrew ends up doing by killing her and then he ends up in this forensic environment on Shutter Island that's a little unlikely in reality he knows what he's doing, he knows what what he's doing is wrong and he's even crying about killing her after crying for the kids, he knows what's going on, that means you wouldn't qualify for not guilty by reason of insanity defense which actually applies in less than the one by one hundred of cases and a small fraction of them even pass that does not mean that someone gets away with it, what it really means is that someone goes to a forensic hospital where they receive treatment for the mental health problem that was present at the time of the crime to help them in some cases that amount of time takes more time than someone would have served in a prison or jail for the crime they committed.

What I think happens to Andrew is that he has a traumatic reaction and realizes it. what he's done is so atrocious to him that he dissociates, meaning he's out of touch with what's going on in the world, he's not affected by a lot of things and this exercise on Shutter Island would almost be a depersonalization, he walked away and it's this teddy bear. person in this scenario this wouldn't happen why he's in a forensic hospital when he actually knew what he was doing he knew what he was doing was wrong he'd probably be in prison the camera angle jump could possibly represent that now pains is recognizing what What has he done so suddenly that he goes from this place where he's not clear about things or maybe he had some delusional belief to realizing what happened because that's when he actually says to Andrew, set me free, divide me, kill me, no. , wait, wait, wait, wait, wait. wait wait wait wait wait wait no no no don't do that don't do that he can't handle reality the split character shows signs of what is now called dissociative identity disorder a previous term was multiple personality disorder typically someone has had a chronic trauma in their lives from the beginning and they have dissociated, meaning they have separated themselves from that experience because it is too much to handle emotionally and another personality develops, it is not another person, it is another personality and it alters the name of that other Personality develops and These alters help the individual deal with the trauma they have experienced.

My name is Jade. Has Dr. Fletcher been receiving our emails? This is what we have to do in 1008 when Ana de Paula suffered her most crushing defeat so in this scene see james mcavoy go by jade and then there's another one and there's barry everyone take a minute and then we get to the beast , the last one that supposedly all the other personalities have been helping keep these girls captive, personalities that are alters are there to help the host or the person who has all these alters deal with the trauma. They are not going to gather captives for another of the personalities.

This is not turning an individual into a weapon. This is one way to cope as you observe the changes from one altar to the next. You could then see that there was a difference in the way they spoke, which can actually happen. Research using neuroimaging to look at altars showed that altars work differently in brain regions; some have different accents that you can't have. some who are left handed, some who may be right handed, you may have some who show physical changes, in fact when you look at the latest change here in what appears to be the beast, it finally looks like james mcavoy is almost stronger in some ways.

To have a diagnosis of dissociative identity disorder it is necessary to have at least one change or additional feeling of being possessed. You can have memory lapses and you can often believe that happens when you move from one altar to another, how quickly someone makes the transition. from an altar, I think this is kind of a plot-driven device to have this all come down to this moment in the movie during therapy, you work with a therapist to ultimately,integrating personalities, but it is not so much about integrating personalities as it is about Processing the trauma that someone has gone through and understanding how this has affected their life.

How it has affected your confidence. How it has affected your sense of what is safe. I really want to work with someone in a gentle way to work through some of this trauma and as you deal with that, the idea is that some of these alters and these personalities become more integrated into the host's personality, this performance is highly dramatized. up to 100 personalities, this character has 23, the average is 10 according to the literature and some of the literature suggests that personalities can begin to develop as early as 5.9 years old. This is realistic in the sense of having multiple personalities in the host, the violent piece is not.

Exactly, you're not going to have a personality that just becomes violent again, it's going to be more protective, there may be a personality that has problems with the other personalities or other people that are in the person's life, but you don't have to someone who is going to go out and wreak havoc legally if someone actually committed a crime just because they have dissociative identity disorder doesn't mean they would go to a forensic hospital or meet the criteria to be not guilty by reason of insanity defense. You look to see if that alter knew good and evil and knew the nature and quality of what they were doing.

The primary fear is Aaron Stampler capable of murder. No, it is not. He is too traumatized to express normal anger and frustration. He keeps the emotions bottled up from him, which. That's why he created Roy, who is capable of making such an objection. Your Honor, the idea that when he's in trouble he calls you. That fits with the idea that if someone had dissociative identity disorder, their personality would be protective. It's a way of dealing with it. trauma, so it loosely fits the idea that there is some protection from the altar, what is not accurate about primal fear is the way this plays out, no more questions, your honor, where the hell do you think what will go?

Excuse me, Aaron's on trial and suddenly this Roy. alter shows up and threatens someone in court, the judge ends up ending the trial halfway through the jury and saying, "let's find this not guilty by reason of insanity." Aaron actually goes to a forensic hospital, even if he would be legally fine stopping a trial mid-stream. trial and change the way California works the legal statute is do you know what you are doing or do you know what you are doing is wrong? Roy knew what he was doing he knew what he was doing was wrong even at the end of the movie he reveals that he is faking it the way he does in the movie he wouldn't go to a forensic hospital they make it so it can't be changed in the movie, but again, the direction it's going in is a little off, there are actually steps you can take when interviewing someone to make sure they're not faking this character is doing what's called faking, i.e. , presenting as if you have a mental illness, essentially faking it to get something, usually what is called a secondary gain, meaning something outside of yourself, like food. clothing, shelter or a different treatment in this case, not going to prison and going somewhere else, if the ruling declares not guilty by reason of insanity, the individual would go to a forensic hospital and receive treatment for their mental health problem.

Simulation happens and there are ways. to detect if someone is faking or not and that is very important. That's an important role for a forensic

psychiatrist

: interviewing someone and making sure there's no evidence to suggest the person is faking symptoms just to get something. The dark knight rises. I told you he was immortal. Here Batman Bruce Wayne just had his back broken by Bane. He's alone, so there's a question of whether solitary confinement, so to speak, has caused him some hallucinations. What this might actually be is delusion. Delirium is a state in which your thinking is increasing. and waning meaning sometimes it is accurate sometimes it is not and can occur with pain can occur with an infection often happens in the hospital in the ICU for patients especially at night it can be called sunset where at night of suddenly someone is completely unsettled tries to rip out all the IVs they have maybe rip out the Foley catheter and that's part of the delirium it's this change in his cognition that might be part of what's going on bruce wayne is having ideas about why al ghul could be seeing him hallucinations may occur that's my I thought about why he could be experiencing this the way he is on the way to sleep.

Sometimes your thoughts become strange. They call that hypnagogic hallucinations, where things seem strange and when you wake up it's called hypnopompic. It is possible if you are delusional. He is friendly. on and off thinking clearly maybe your thoughts are all jumbled together the same way when you're on your way to sleep and sometimes you have an idea for something, you might have an idea like this when you're delirious it's just not clear if you really do. would you remember or who knows exactly what is going through someone's mind when this happens. It's also possible that Bruce Wayne is experiencing sensory deprivation hallucinations, meaning that he hasn't been in contact with anything in this solitary confinement that he's in.

The pain he is experiencing may also contribute to him having hallucinations. Pain may be a reason why people have hallucinations in multiple environments when they experience so much discomfort from pain that it can really cause some psychotic symptoms sometimes, man, here we see. Desu, who has been in this room and has not been allowed to leave, begins to see that there are ants coming out of his skin and all over his body, which is a visual hallucination, meaning that he is seeing something that is not there. , it is actually of a particular type. a name for this there's something called eckbomb syndrome which is when you think you're infested with parasites now ants are not parasites and I think the ants represent something particularly in this movie, but the idea that there's something infesting you, some kind parasite is a delusion, so that is a delusion, which means you believe in something that is not true.

Visual hallucinations are more common with drug and substance use, particularly stimulants, but there may be something going on here. We don't see, we don't see what they are giving him. I know the captors in his mind sometimes want to take him out of the room and bring him back, they probably do this by drugging him, so this could be a visual hallucination due to whatever they are giving him, another illusion Desu could be experiencing It's Qatar. syndrome there are a variety of things that someone with qatar syndrome can believe, but you can believe that you are rotting to death, you can actually believe that you are dead and at the end here we see him die, these are hallucinations that he is also seeing, so that this is He has a psychotic problem, so at first when you see itching in the desu, it is actually a term called formication and again, it can be due to drug use.

You might remember Chappelle's show where he gets itchy all over after using crack, that's the idea of ​​formication. everywhere and it's often because you think it's because of things crawling on your skin when someone is left in solitary confinement they can develop hallucinations. There have been all kinds of research done on the correctional population that shows even that after a few days. You can have some type of hallucinations in solitary confinement after 15 days, it is considered unethical and there is some research that suggests that even after a short period of time you could have permanent mental health problems as a result of solitary confinement, Hallucinations are things that aren't really there, so you won't die from a hallucination.

You could die if you acted on something because of delusional thoughts or because of paranoia and you act on something, then you could die. In fact, it is extremely important to ask psychotic patients. Regarding suicide, the fact that they have psychosis does not mean that they also have other symptoms of mental health problems. In approximately 15 percent of suicides, psychotic thinking or psychotic belief was involved. Thank you very much for watching these clips with me. I hope you learned something until next time.