Diagnosis of Fatal Attraction

1. What is the name of the movie you watched? For this assignment, I watched “Fatal Attraction. ” 2. Describe the demographics of the character of “patient” that you are evaluating. Alex Forrest was the patient in this movie. She is a white female in her 40’s. She is single and works as an editor for a publishing company, however she is not shown working after the beginning of the movie. 3. Summarize the plot of the movie. As the movie begins, Dan and his wife, Beth, go to a company party when he meets Alex Forrest for the first time.

The next morning Beth and daughter, Ellen, leave for the weekend to look at a house they are considering moving into while Dan stays at home for a business meeting. When he arrives at the meeting, Alex is also there. After the meeting is over, Alex and Dan go to have drinks; Alex asks Dan about his family life and begins to make sexually suggestive comments. They go back to Alex’s apartment and have sex together. In the morning, Dan goes home to call Beth. Immediately after Dan hangs up, Alex calls and questions Dan about why he left so early.

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He ends up taking his family dog to the park with Alex to play, they go back to Alex’s place for dinner and listen to the opera Madame Butterfly. They discuss how much they like the opera and how important it is to Dan. While eating, Alex again asks Dan about his family and he explains how lucky he believes he is and she asks “then what are you doing here? ” After eating, they have sex again and Dan tries to leave which upsets Alex. She then comes out and asks him nicely to say goodbye and Dan notices she has cut her wrists. Dan panics and takes care of her and stays the night with Alex again.

The next night after work, Dan goes home to see his family and they talk about the house and Ellen tells him about a rabbit she wants. Dan and Beth drive out to see the house the next morning, they like the house and decide to buy it. Later when Dan goes to work, Alex is at the office waiting for him. She tells him she wants to apologize and make a peace offering with two tickets to the Madame Butterfly Opera; however Dan declines the offer and asks her not to contact him anymore. The next day Alex continues to call Dan’s office, Dan tells her to stop calling the office and tells his secretary to not accept her calls.

This makes Alex mad and so she calls his house that night, Beth answers it and Alex hangs up, later that night at 2am Alex calls the house again and is furious because Dan won’t take her calls. She tells him to meet her the next day. Dan does and tells her to leave him alone; she tells him that she loves him and then tells him she is pregnant with his child. He wants her to get an abortion but she wants to keep the child and raise it whether or not he is involved. Alex continues to call Dan’s house but he has changed his number prompting Alex to go to their apartment for more information.

She meets with Beth and acts as an interested buyer of their apartment and Beth tells her all the information Dan has been trying to hide from her. That night Dan goes to Alex’s apartment and attacks her and she says she won’t leave him alone because she doesn’t want to be ignored. Dan buys Ellen the rabbit she has been asking for, on his way out of the office his secretary hands him a package (a tape from Alex). He then finds his car in the parking garage covered in acid and has to rent a car to drive home. Alex watches Dan in the parking garage and follows him home and finds out where his new house is.

She watches through the window as he was happy with his family, seeing this makes Alex sick. One day when the family was gone for a while, they came home to find Ellen’s rabbit boiling on the kitchen stove. This forces Dan to tell Beth everything about the affair. She gets upset and kicks Dan out, but before he leaves he, calls Alex to tell her that he has told Beth everything. Beth talks to Alex and tells her that if she messes with her family again, she will kill her. The next day Ellen is missing from school; Alex had kidnapped her for the afternoon.

When Beth goes out looking for Ellen she gets in an accident and is taken to the hospital. That night Dan goes to Alex’s apartment and attacks her and tries to strangle her, but then stops. While they are catching their breath Alex tries to stab Dan with a kitchen knife, but he gets it from her and leaves. Dan brings Beth home from the hospital and helps take care of her, Dan is downstairs as she starts a bath when Beth discovers Alex in the room with a knife. Alex attacks her and Dan hears the screaming and rushes in to attack Alex.

He tries to drown her in the tub, but she comes back alive and is then shot by Beth. 4. Formulate a DSM-IV-TR diagnosis for this character and outline how he or she meets each of the criteria for that disorder. After reviewing the behaviors of Alex Forrest, I have decided that a borderline personality disorder is most appropriate for her. It also seems like Alex may have a mild form of histrionic personality disorder, but does not actually meet all of the criteria to be fully diagnosed and therefore is not a comorbid diagnosis.

A list of the diagnostic criteria for borderline personality disorder and a description for how they are met is following, Alex meets six of the criterion and the DSM-IV-TR requires at least five criterion be present. Criterion 1: Frantic efforts to avoid real or imagined abandonment; note: do not include suicidal or self-mutilating behavior covered in criterion 5. Alex displayed major fears of abandonment throughout the movie. During the time period of Alex and Dan’s relationship until her death, she feared being abandoned by him and would not leave him alone.

During one fight scene in her apartment, when Dan asked her to stop contacting him and he asked why she wouldn’t, she told him it was because she didn’t want to be ignored. Alex would continuously call Dan and became mad when he wouldn’t take her calls and changed his number. Criterion 4: Impulsivity in at least two areas that are potentially self-damaging (e. g. , spending, sex, substance abuse, reckless driving, binge eating); note: do not include suicidal or self-mutilating behavior covered in criterion 5. Alex had impulsive sex during the movie with Dan after meeting him for the second time.

This was dangerous because she did not know if he was clean of all STD’s and it they did not use any forms of protection, which could and did lead to pregnancy. Alex also had a tendency to hold large kitchen knives while around others when she was angry. This could have been dangerous because she could have accidentally hurt herself worse than intended or someone else could have taken the knife from her and hurt her with it. Criterion 5: Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. After Dan tried to leave Alex’s apartment one night, she cut both of her wrists.

Her arms and hands were covered in blood. Later when Alex visited Dan at work, she apologized for her behavior and said she didn’t know what she would have done if he wasn’t there, suggesting it could have been fatal if it wasn’t for him stopping her and taking care of her. When Alex went into Beth’s bathroom while she was running her bath water, she was cutting her legs with the knife she was carrying. Criterion 6: Affective instability due to a marked reactivity of mood (e. g. , intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).

Alex displayed intense episodic dysphoria because sometimes she would be up all night thinking about Dan and one night she called him at two in the morning, implying that she lost a lot of sleep. She also appeared to have a grandiose sense of self, because she expected Dan to fall in love with her and leave his family for her. It seemed that she thought she was better than Beth and was worth leaving her for. She also displayed suicidal ideation when Dan tried to leave her after having sex with her. Alex was also extremely irritable with Dan when she expected him to stay with her and he would try to leave to go to work.

She would kick him, throw a temper tantrum, attack him and pour acid on his car. Criterion 7: Chronic feelings of emptiness. It seemed that during the scene of Alex sitting in her apartment at night after Dan declined her invite to the Madame Butterfly opera she appeared to have emptiness while sitting alone turning her light on and off. During the nights that she stays awake and calls Dan could be caused by her experiencing feelings of emptiness and loneliness. Criterion 8: Inappropriate, intense anger or difficulty controlling anger (e. g. frequent displays of temper, constant anger, recurrent physical fights). There are several altercations between Alex and Dan during the movie. She becomes angry with him easily and often becomes physically aggressive with him. Alex was not afraid to defend herself or to attack Dan. She also attacked Beth without any hesitation and without being provoked. 5. Is there an explanation of why the character has the disorder, or any “hints” as to how the disorder may have developed? If so, what is the explanation and is it consistent with what you’ve learned?

If not, what do you think could be a plausible etiology based upon what you have learned in class? There is no explanation for what causes Alex to have this disorder, since it is a personality disorder it is most likely to have originated at a young age. Although it was not mentioned if Alex experienced trauma from physical or sexual abuse as a child, she did experience an emotional trauma from the unexpected death of her father when she was young. However, it is most likely genetics that has caused Alex to experience the difficulties of borderline personality disorder.

This diagnosis is most commonly found through families, leading psychologists to believe that it is passed through family genetics. 6. Is the psychological or psychiatric treatment of the character discussed in the film? No, a treatment is not discussed in the movie. I would recommend that Alex sees a psychiatrist and starts a medication treatment to help regulate her chemical imbalances. It would be important for her psychiatrist to monitor her use of the medication closely to ensure she doesn’t try to overdose or skip taking the doeses.

It is also recommended that patients suffering from borderline personality disorder to participate in a dialectical behavior therapy (CBT). This would help Alex deal with her suicidal tendencies. Alex struggles handling her emotions and doesn’t seem to manage her suicidal triggers well on her own and I think with a balance of medication and CBT would be helpful. 7. Do you think the portrayal accurately represents someone with this disorder? If yes, why? If no, why not? Yes, Alex portrayed the borderline personality disorder well.

However, I do think that it was focused more on specific criterion more than the overall criteria specified for the disorder. It was slightly confusing due to her similarities to histrionic personality disorder (HPD). Although the character displayed some qualities that were important and not present within HPD that made it more clearly a borderline personality disorder diagnosis. 8. What are the implications of this portrayal for individuals who actually have the diagnosis that is presented in your film? For example, does the film portray the disorder in a humane way that might have positive implications for how such individuals are viewed?

Or does it serve to promote stigma and negative perceptions of psychopathology? The display of this diagnosis is in a negative style and does not allow for positive implications to be made about people with this disorder. It encourages society to place a stigma on people diagnosed with this disorder and causes those people to struggle fitting into society after receiving such a stigmatizing diagnosis. People are going to believe based on this portrayal that people with borderline personality disorder are hostile, obsessive and greatly afraid of abandonment.