(Student’s Full Name)
The scene in the movie that I would describe as a hallucination is when she hears the voice of her mother saying, “You broke it!” after she breaks a bottle at her art class (Uenospower Sybil).
The scene in the movie that I would describe as a delusion is when Sybil believes that Dr. Wilbur, during a session, wants to harm her in the same way that her mother did when she was growing up. As a result, Sybil tries to attack her with a pair of scissors.
The type of therapy that is identified to treat Sybil in the movie is talk therapy or psychotherapy. This treatment involves talking to the patient about her problems so as to come up with solutions without the use of medication or drugs.
The predisposing factors and comorbidities of schizophrenia include post-traumatic disorder, panic disorder, and obsessive-compulsive disorder. Post-traumatic disorder is a condition that allows a patient to experience persistent emotional and mental stress, which occurs as a result of experiencing trauma or extreme psychological shock. A panic disorder is a condition where the patient experiences on-going panic attacks. Obsessive-compulsive disorder is a condition that permits a patient to obsessions, which come in the form of undesirable thoughts, urges, and images, that cause her to become anxious and uncomfortable. The patient would then ease her mind being engaged in compulsions or repetitive behaviors.
All of Sybil’s identified personalities include the following: Peggy Lue, Peggy Ann, Mary, Victoria Antoinette Tradeaux (Vickie), Sid, Ruthie, Vanessa and Marsha.
The medications that I had anticipated for this client include the following: Clorazil, Abilify, Invegalnvega Sustenna and Invega Trinza. I believe that Clorazil will be one of those antipsychotic drugs that could treat the client’s psychotic episodes (such as hallucinations, delusions, and disordered thinking patterns) without creating side-effects such as “cognitive dulling and involuntary movements” (Goldberg par. 8). In addition, it would be able to treat any “negative symptoms” that the client may have such as “decreased motivation” from doing activities that she is interested in, which may result from hallucinations (and other psychotic episodes) similar to the one experienced in her art class (Goldberg par. 8). However, if the client’s “weight gain,” “blood sugar” “cholesterol” and the number of “white blood cells” changes as a result of being prescribed Clorazil for some period then I will prescribe Abilify (Goldberg par. 8). Even though this drug has the ability to affect the “blood sugar, cholesterol, triglyceride levels,” there will be a limited chance that the patient’s white blood cell count will be affected (Goldberg par. 10). Alternatively, I could choose to place the patient on Invegna Sustenna for four months before placing her on Invegna Trinza for “four times” annually (Goldberg par. 12). This last treatment schedule could be best for the client because she would not be forced to be on medication for a continuous period. This allows her to have a break in between taking medications without her having to relapse into her former condition.
All of the defense mechanisms used by Sybil include repression (this involves the suppression of very traumatic thoughts). The client does this whenever she is about to think of her mother physically abusing her, for instance. Sybil also uses reaction formation to deal with “unconscious anxiety,” which is changed to its “opposite in consciousness” (Reitan par. 9). This is seen when Sybil behaves as if she loves her mother and sees her in a positive light while growing up when, in fact, she hates her mother for ill-treating her when she was a young child. Another defense mechanism used by Sybil is denial. The client uses her multiple personalities to escape the idea that horrible things happened her as a young child, such as when she was being raped by her mother with a button hook. The personalities, Vanessa and Marsha, mentioned that they watched the incident happening to Sybil, but Vanessa and Marsha are a part of Sybil. Therefore, the creation of multiple personalities was Sybil’s way of denying that she was being abused and remaining removed from her main identity. In addition, Sybil directs her negative emotions that she has towards her mother to glass objects, which often breaks. Hence, Sybil uses displacement as a defense mechanism. Finally, the client uses regression as a defense mechanism when she draws pictures similar to a six year old so as to reclaim the time that she had lost while being abused by her mother.
One priority nursing diagnosis that should be considered while dealing with schizophrenic in an inpatient setting is risk for violence. A nursing intervention that should be used in such a setting is to ensure that surrounding areas are kept free from objects that create a lot of stimulation. Another nursing that should be considered while dealing with schizophrenic in an inpatient setting is inability for client to remain mentally focused. A nursing intervention that should be used in such a setting is to communicate with the client clear and direct terms.
Dissociative fugue is a condition that allows a client to undergo multiple instances of amnesia where he is unable to remember some or every critical event in his life so as to use as a defense mechanism against humiliation or a traumatic event.
Yes, this disorder was misdiagnosed. The initial diagnosis, which was given by Dr. Hatchinson, was highly suggestible hysteria and occasional psychogenic fugue.
Works Cited
Goldberg, Joseph. “Drugs to Treat Schizophrenia.” WebMD, WebMD, 21 Nov. 2015, www.webmd.com/schizophrenia/guide/schizophrenia-medications#1.
Reitan, Ann. “Remission of Schizophrenia and Defense Mechanisms.” Brain Blogger Remission of Schizophrenia and Defense Mechanisms Comments, 24 Dec. 2013, brainblogger.com/2013/12/24/remission-of-schizophrenia-and-defense-mechanisms/.
Uenospower. Sybil. Warner Bros. Television, 2007, www.youtube.com/watch?v=OPltV-_25gs.
