Following the American Psychological Association’s Guidelines
The movie “A Beautiful Mind”, directed by Ron Howard, and released in 2001 is the true story of John Forbes Nash Jr. A leading mathematician, he is as arrogant as he is brilliant. He marries a student, Alicia, and sets himself up on the fast track in mathematics, making advancements in “game theory” which earns him accolades from his peers. Eventually, Nash is visited by CIA Agent William Parcher, who attempts to recruit him work with for code-breaking activities for the U.S. government. However, evidence begins to suggest that Nash may not perceive reality as it really is. His sanity begins to slip as his wife suspects that Nash is a paranoid schizophrenic. The rest of the movie is spent watching Nash battle mental illness while attempting to regain control of his life. Eventually he wins the Nobel Prize, though there are many obstacles along the way. Nash faces many tribulations concerning his mental health, as well as his physical health. His struggle was difficult, painful, and inspirational to witness as a human being, as well as a caregiver.
John Nash Jr. was a brilliant man. Able to calculate complicated mathematics in his mind, he was obviously bright but also very arrogant. His character was not particularly friendly, and seemed odd. There is not a particular word to describe it; despite his brilliance he seemed to lack particular social graces. In some instances he appeared socially awkward. However, he seemed very perceptive. I would make a mental note of all of these attributes in order to get to know Mr. Nash better. As his caregiver I would make it a point to learn more about my patient’s personalities and build relationships with them, no matter how feeble, in order to ease their recovery process. When conducting an official nursing assessment on Mr. Nash, assuming he has already begun to present symptoms of mental illness, I would observe his erratic behavior. I would also take note of any names he mentioned or if he protested that anybody was trying to hurt him or put his life at risk. This would indicate paranoia, even if he speaks calmly or is not acting erratically. Any mention of his being under persecution or a messenger would also be documented, as these can also be signs of psychotic mood disorders, according to “Neurocognitive Deficits, Negative Symptoms, and Insight in Schizophrenia (2011).”
One instance in the story shows us how desperate people were to find a cure for mental illness: Nash is subjected to insulin shock therapy. At Trenton Psychiatric Hospital, Nash was given high doses of insulin in order to induce hypoglycemia, according to an article published in Journal of Religion and Health, written by Donald Capps (2011). The desired effect, as told by Capps, was to relieve Nash’s symptoms, or cure him entirely. Throughout the 40’s, 50’s, and much of the 60’s, this was the primary way to control symptoms of schizophrenia and was even often used to treat anorexia. However it has now been abandoned, much like electroshock therapy, because of its harsh side effects (2011). Patients were given insulin in increased doses until they fell into a deep sleep and became comatose. Once the sufficient amount of insulin to achieve a coma was found, the patient was kept in a coma for anywhere from 30 minutes to a few hours. During this comatose state, it was possible for the patient to slip into an irreversible coma, die, or begin to convulse, as we see happens to Nash. The process is sped up in the movie. Nash is given one injection, falls into a coma, and convulses, but the idea is the same: he is being “cured” of his schizophrenia. Unfortunately the therapy does not work and his delusions return. I understood the application of insulin therapy considering the time period and the medical knowledge available, but I still found it barbaric. People who are already suffering should not be forced to suffer more, especially in such a tragic way. That this treatment went on unchecked for nearly twenty years with no sign of success further outrages me. If no patients were cured, a different treatment should have been applied.
I realized Nash was mentally ill when he witnesses a violent standoff between Soviet Agents and Will Parcher. This scene seems far-fetched; the Soviets seem wildly out of place. However, he has worked in the Pentagon before alongside Parcher so initially I accepted it as a wild plot twist until Nash, flooded with paranoia, is blackmailed by Parcher. I began to realize nobody else had seen Parcher. Some of my suspicions were confirmed when, as Nash lectures at Harvard, he attempts to flee after he thinks he sees foreign agents trying to kill him. He punches his doctor in his effort to escape and is admitted to a hospital where Rosen tells us that Nash is schizophrenic and Parcher does exist in his mind, as I suspected. I also found out that Nash’s college roommate only exists in his mind. The evidence of the illness has been there for several years but Nash had remained complacent; it was only when his paranoia surfaced that anybody noticed something was wrong. This is common with paranoid schizophrenia, according to “John Nash, Game Theory, and the Schizophrenic Brain .”
Nash’s wife, Alicia, is caught in the middle of his mental breakdown. She remains loyal and strong. As a person compassionate person who understands mental illness, I would attempt to act as Alicia did. He was unaware of his mental illness; it would not be as if he trapped me in a marriage. Learning how to live and cope with the illness would probably be more difficult and frightening for the person with the illness, than their spouse. While I understand it is difficult for all involved, I would attempt to keep these ideas in mind and remain strong by my spouse’s side as they attempted to find their footing on this new ground. While medication and therapy are often a great resource in recovery concerning mental illness, the unconditional support of loved ones can also be an unfailing source of comfort in trying times. Alicia was able to remain by Nash’s side, providing him with support. Although it was not an easy road, she seemed to keep him strong and provide him with a firm ground in which to build his new life. More support could have been offered to Alicia and her son though, despite her exhaustive efforts. The treatment staff was present for her but they did not appear to educate her very well on Nash’s condition. Society held an even stronger stigma at that time over mental illness than they do presently, meaning she received little help from community. Alicia was in the trenches, fighting by Nash as he attempted to overcome his illness. Support from the community and extended family may have helped a lot. Support groups with people in similar situations which would have allowed her or her son to relate to others would have also been a great benefit.
The movie did not change my view of mental illness. I have always thought that they should get the help that they need. I was unaware of insulin shock therapy, or how inhumane it was. When I indicate the help they need, I mean medication, or treatment that will benefit their condition without killing or irreparably damaging them. Patients with mental illnesses may be different, and they may be struggling, but they still deserve to be treated humanely. “A Beautiful Mind” only made me sympathize more with the plight of the mentally ill. There are misjudged a lot; society will often use any means necessary to quiet them, and that is not right.
Nash primarily displayed anger, fear, and frustration. This was understandable because, once he understood his condition he could not be sure what was real and what was not. Before he knew he was a paranoid schizophrenic, he feared for his life. Most often he believed that secret organizations were setting out to kill him or hurt him, which in the end were proven to be delusions. He believed that the Soviets, in particular, were trying to kill him and his partner in the CIA, Will Parcher. At one point he believed he was helping the CIA’s Defense Department break codes being sent by enemy forces. This was also proven to be a delusion. Nash also suffered from several hallucinations. Nash hallucinated an entire standoff between William Parcher and Soviet agents. He also hallucinated William Parcher himself, as well as any work he thought he had done for the Pentagon. Nash also hallucinated his roommate, Charles Herman, as well as Charles’ niece, Marcee. His erratic behavior effectively put himself and everybody near him at risk. When treating a person living with paranoid schizophrenia there is always a risk to them and yourself. The family is also at risk if they choose to be a part of the treatment process. If Nash’s outbursts had become violent and he had turned on a family member, or he had begun suspecting a member of his family or treatment staff was out to get him he could have attacked him. In his attempt to flee a suspected attempt on his life, he punched his doctor; this illustrates that, to a degree, everybody in the movie was in danger if they were near Nash.
As a nurse treating Nash as an inpatient, my first concern would be showing him respect. As previously stated, he may have a mental illness, but he is still a person. My second priority would be to follow the doctor’s treatment plan as long as it did not include insulin shock or electroshock therapy. I would administer antipsychotics and, if the doctor agreed, also administer vitamins and minerals that may improve Nash’s health. I would make sure that I could assist him throughout his treatment, because continued care by the same team is important to sustained cognitive function in many schizophrenic patients. In order to establish a basis of trust to help with self-care and other aspects of treatment, I would try to communicate with Nash. It could be about whatever he wanted. I would not entertain his delusions, but I would not demean them either. Allowing him to speak to me and trust me would hopefully help him listen to me if I gave him direction. He may also confide in me if his delusions were getting unmanageable. I could seek the doctor’s advice or intervene if he was a physical danger to himself or others.
In sum, the “A Beautiful Mind” was not an entirely accurate portrayal of mental illness, treatment, or John Nash Jr’s life, it was very insightful. The stigma surrounding mental illness was still evident. The fact that Nash suffered from schizophrenia for many years before it was noticed was also portrayed seamlessly. The movie helped raised many questions in uneducated minds as well as create awareness about a subject that many misunderstand. Though Nash suffered from a serious mental illness, he was still a brilliant man, capable of many extraordinary things. The mentally ill are often underestimated in this way. Hopefully “A Beautiful Mind” will help people see that it is time we change our perception.
References
Capps, D. (2011). John Nash, Game Theory, and the Schizophrenic Brain. Journal of Religion and Health, 145-162.
Howard, R. (Director). (2001). A Beautiful Mind [Motion Picture].
Preda, A., Bota, R., & Harvey, P. (2011). Neurocognitive Deficits, Negative Symptoms, and Insight in Schizophrenia. Springer Netherla-nds.
