REFLECTIVE CASE STUDY-SHUTTER ISLAND

Reflective Case Study-Shutter Island



Reflective Case Study-Shutter Island

Introduction

"Shutter Island" is one of those films that rips the rug out from under your expectations with the frequency and intensity of a magican's act. Initially, we think we are watching a well-intentioned U.S. Marshall named Teddy enter an insane asylum/prison hoping to uncover the whereabouts of a recently-disappeared patient/inmate. Later, our strangeness barometer begins to beep and we recalibrate our assumptions. Now we think we are witnessing a brave and bereaved soul searching for damning evidence that will expose Shutter Island as an expensive, cutting-edge torture chamber. Only during the final act (unless you've connected the foreshadowing dots), when our barometer falls off the charts, do we realize that the narrative is really about tragic psychosis and elaborate role play.

Overall, I found the film to be a very intense, somewhat entertaining discussion of lines - the kind of elusive, easily blurred lines that exist between perception and reality, normalcy and insanity, even exceptional and subpar filmmaking. There is another extremely relevant though largely ignored line of which I'd like to discuss, the line between realistic and melodramatic portraits of clinical psychology. Although issues like delusions and 20th century inpatient treatment are aggressively examined within the plot, many of it's exclamation points are in fact question marks that warrant further discussion:

Does Teddy suffer from an actual psychological disorder?

Teddy is a strange case. In retrospect he presents as an intelligent, high functioning individual, so much so that his traumatic experiences during WW II merely dented, rather than overwhelmed, his coping resources. However, the mild and (then) socially acceptable alcoholism and workaholism he exhibited as a family man provided just enough emotional detachment to blind him from the murderous insanity bubbling up within his bipolar wife. One Saturday, an unsuspecting Teddy arrived home from a work trip to his three drowned children and a creepy, suicidal wife (whom he promptly put out of misery). Although such an experience would seem to virtually garuntee the development of Post-Traumatic Stress Disorder, somewhere along the way his symptoms tipped into the very real but much less common psychiatric condition known as Delusional Disorder.

According to the DSM-IV you can be high functioning - cognitively, socially and emotionally - and not only suffer from delusions (fixed, adamant beliefs that run contrary to clear, consensual evidence) but experience such a state without clear mental hiccups. Teddy also meets this diagnosis, according to the manual, because he experiences the delusions for more then one month (don't ask me to explain the time cutoff) and not as the result of mood issues (he is not particularly depressed or anxious) drug addictions (the bottle is no longer a problem) or schizophrenia (much too socially savvy, and his delusions are not bizzare - "aliens landed in my kitchen"). As the DSM-IV further classifies Delusional Disorder via content of the delusion, a psychologist might also note that Teddy suffers from a Mixed Type. His mind generates themes of grandiosity (I'm going to uncover a ...