February 3, 2013
Arrrggghhh (ala ‘Charlie Brown’)! I’m-fit-to-be-tied and feel like chewing on glass!! Hollyweird has done it again…yet another misdiagnosis of a DSM IV (or is it V now?) malady!!! Since a former DSM IV contributor (Frances, 2012) has described the upcoming V to be a pharmaceutical-influenced joke (as I have been suggesting for years [as has Gwen Olsen]) – I have no desire to see if the original symptoms of bipolar disorder have been changed to meet the needs of Hollyweird and the pharmaceutical companies. So I’ll be shooting from the hip here…
I speak of “Silver Linings Playbook” in which the screenwriters completely botched a proper understanding of bipolar disorder (and only God knows what Jennifer Lawrence was suffering from)…death induced nymphomania – that never reared its head again after her first offering of sex to Brad Cooper’s character?!
First off, bipolar disorder was once-upon-a-time termed manic/depressive disorder — but as we are taught in DSM class – the name was changed because the term “manic/depressive” was too something-or-another (very similar to the re-categorization of neuroses into personality disorders and the expunging of certain categories of schizophrenia). The hallmark of manic/depressive disorder – and now, bipolar disorder is the swing between a depressed state to a manic static: cycling from a depressed state to a manic (hyper) state.
The problem with the depiction of bipolar disorder in the movie (as any psychotherapeutic practitioner knows) – is that a manic state can only be sustained for 2-3 days (hence the 5150 hold of 72 hours): the human body simply cannot perpetuate a manic state longer than this (unless assisted by a stimulant). We do get to see a-couple-of Brad Cooper’s manic episodes (with normal functioning in between) — but never see his depressed periods; and, the depressed periods should last up-to-6-weeks following the post-manic crash. But it seems Cooper’s character was facilitated into relatively normal functioning by intermittent medication (thank God the most benign of medications is still being used in lithium) and dancing – where Cooper’s character crashes through exercise exhaustion: Which I have been suggesting for-over-25-years should be the #1 healing and/or preventive measure for depression! Gwen Olsen concurs when she suggests “What pharmaceutical company is going to prescribe getting your ass off-the-couch?”
The other glaring error in the film was the mention of ADD – which even the radio schlocks are no longer doing – understanding that ADD was transmogrified in ‘93/’94 into ADHD for the DSM IV. So ADD is no longer became a viable diagnosis. But it was mentioned in this 2012 film.
The film did come close to making a family systems connection what with De Niro’s OCD and the report that his character had been barred from the Philadelphia Eagles’ stadium for fighting. This dynamic comes closer to explaining the reason for Cooper’s character becoming violent upon discovering his wife in the shower with a co-worker (and what husband wouldn’t become violent with such a revelation?). But this is situational violence and hardly warranting a DSM diagnosis.
But what really got-my-goat was the suggestion by my department chair that I go see this film. The exhortations by my students can be forgiven – they don’t know any better! But for a practitioner of psychotherapy to intimate that “Silver Linings Playbook” had something important to contribute to the mental health field has demonstrated, yet again, how Hollyweird has got our center no longer holding, and, things are simply falling apart. There are no standards for excellence any more…”SLP” was yet another Hollyweird love story, and not, the introspective look into bipolar disorder: as it is trumped up to be.
I will just keep showing “Ordinary People” to my wannabe psychotherapists — as rough and experimental as it was; at least it maintains an aura of authenticity for the mental health field. Hell! Judd Hirsch’s s psychotherapist even smokes during the sessions…we should be happy that Cooper’s therapist is an Eagles’ fan?!