Running head: A BEAUTIFUL MIND 1

Critical Analysis: A Beautiful Mind

Savanna R. Chambers

University of New Brunswick Saint John

Critical Analysis: A Beautiful Mind

The film “A Beautiful Mind” illustrates the true story of John Nash, a mathematical

genius and Nobel Prize winner’s, struggle with his eventual diagnosis of what was then called

paranoid schizophrenia. Throughout the film, John experiences many symptoms of what is now

referred to by the Diagnostic and Statistical Manual of Mental Disorders 5th ed. as schizophrenia

(Grazer and Howard, 2001). The DSM-5 (American Psychiatric Association, 2013) defines

schizophrenia as “a brain disorder that generally affects mental functions and behavior”. John’s

symptoms include hallucinations, delusion, disorganized speech and grossly disorganized

behaviors. These symptoms are depicted as actively present beyond six months and are

associated with impaired occupational and social functioning (American Psychiatric Association,

2013).

Portrayal of Mental Illness

Schizophrenia was accurately depicted in the film “A Beautiful Mind”. The film

correctly portrayed the onset of schizophrenia, possible symptoms, treatments that were

practiced in the period the movie was illustrating, and the social implications of the disorder on a

person’s life (American Psychiatric Association, 2013). The movie, however, did not accurately

depict the symptoms that John Nash Jr. experienced throughout his journey with mental illness.

The film portrayed Nash as having primary visual delusions, whereas in real life his delusions

were almost exclusively mental and auditory (Nasar, 2001).

The film depicts John experiencing many delusions and hallucinations such as a

roommate during his time at Princeton University, his roommate’s young niece and a

government agent who recruits him as a secret government aide hired to discover the coordinates

of bombs throughout the country. John also experiences symptoms of grossly disorganized
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behavior such as unpredictable agitation as well as disorganized speech (Grazer and Howard,

2001). In the film, John’s delusions and hallucinations are interconnected as he experiences both

referential and persecutory delusions based on his visual hallucinations. Referential delusions are

the belief that neutral events in one’s environment have a personal meaning (American

Psychiatric Association, 2013). Referential delusions are seen in the film when Nash could pick

out specific patterns in magazines that seemed to have significant relevance which he interpreted

as Russian code (Grazer and Howard, 2001). Persecutory delusions involve paranoia and the

individual believes danger is imminent. This type of delusion was shown in the film as John is

seen growing suspicious of strangers and hallucinates dark figures following him. The delusions

John suffered from in the film would today be categorized as non-bizarre. This meaning that,

though false, these delusions are in the realm of possibility (American Psychiatric Association,

2013). The film has accurately depicted the functional consequences of schizophrenia as Nash

has limited social interaction before meeting his wife Alicia and struggles to maintain friendships

outside of his delusions. His delusions also attribute to occupational dysfunction as John

becomes obsessed with decoding magazines and does little else (Grazer and Howard, 2001).

John was first treated with insulin shock therapy to manage his symptoms of

schizophrenia (Grazer and Howard, 2001). Insulin shock therapy involves a sequence of

regulated doses of insulin injections that work neuropathically to manage the patient’s symptoms

and provide the patient with more stability. After the insulin is injected, a series of symptoms

such as drowsiness and loss of consciousness occur, eventually ending in a coma that produces

glottal and tonic extensor spasms (Scharmer, 1941). Following this comatose state, an IV, NG or

oral administration of sugar is given to the patient to interrupt the treatment and awaken the

patient. This treatment was typically administered six days a week for two months (Scharmer,
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1941). In the film “A Beautiful Mind” insulin shock therapy is accurately portrayed, with John

Nash being first strapped into a bed to avoid injury during spasms, then tongue blades were

placed between teeth to prevent tongue biting, and finally, the insulin injection was administered

by a nurse. John then was shown to be experiencing tonic extensor spasms. Though this portion

of the movie was depicted as dramatic and melancholy, nevertheless, the treatment was

accurately illustrated (Grazer and Howard, 2001).

The film does an adequate job of portraying schizophrenia and its symptoms in an

accurate way. The film also highlights the many social and occupational dysfunctions that many

patients with schizophrenia experience. However, the film depicts John experiencing visual

hallucinations, while not impossible, they are not a common symptom of schizophrenia

(American Psychiatric Association, 2013). The film avoids portraying the stereotype of a

dangerous and violent schizophrenic but rather shows that a diagnosis of schizophrenia does not

always coincide with violent behavior. In fact, the vast majority of schizophrenic patients do not

exhibit aggressive behavior and are victimized more frequently than the general public (Perciful

& Meyer, 2016). “A Beautiful Mind” also aids in eradicating the stereotype that patients with

schizophrenia experience multiple personalities as John does not exhibit these symptoms

throughout the film. Furthermore, the film depicts accurate symptoms of schizophrenia, does not

portray a stereotypical ideation of the disease and does not negate the seriousness of mental

disorders (Grazer and Howard, 2001).

Stigmatization of Schizophrenia

Stigma can be defined as ‘a sign or mark that designates the bearer as defective so

meriting less valued treatment than “normal” people’ (Gras, Swart, Slooff, Van Weeghel,

Knegtering, & Castelein, 2015). Stigma can be divided into two different categories: social
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stigma and self-stigma. Social stigma is when one is faced with prejudice and discrimination

based on their struggle with mental health. Self-stigma is characterized by feelings of shame

resulting from the internalization of the publics misunderstanding and discrimination (Corrigan

& Rao, 2012). There are still attitudes in modern society that view symptoms of mental illness as

dangerous and sinister and these attitudes often cultivate stigma and discrimination towards those

who suffer with mental health problems (Ditchman, Werner, Kosyluk, Jones, Elg & Corrigan,

2013). There is a widespread presumption of the negative implications that have been associated

with schizophrenia. The misconception that is particularly prominent in contemporary society is

that people that suffer with schizophrenia are aggressive and unpredictable. This leads to the

negative stereotypes and stigmatization of this disease and therefor discrimination (Perciful &

Meyer, 2016).

Stigma can affect an individual with mental illness in many ways, including a loss of self-

esteem and self-efficacy. This is due to the internalization of stereotypes and discrimination that

results from social stigma. Low self-esteem and self-efficacy are factors that have been shown to

lead to the negative implications of mental illness such as unemployment and homelessness

(Corrigan, Larson, and Ruch, 2013). This is due to a person with mental illness not pursuing

employment or independent living opportunities because of self-stigma and its detrimental

effects on one’s self confidence. Self-stigma is also one of the main barriers to care of the

mentally ill as it can prevent persons in need of treatment from seeking care. This results in

worsening of one’s mental health and can increase the risk of suicide (Corrigan, Larson, and

Ruch, 2013). The film “A Beautiful Mind” contributes to the stigmatization of mental illness as it

depicts students of Princeton university mocking John and discriminating against him. It should
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be noted that this was a biographical film of John Nash Jr.’s life and that is how students treated

him in real life (Grazer and Howard, 2001).

Stigma can also greatly affect families as the association with a family member that

suffers from mental illness opens the entire family unit to stigmatization. The parents of someone

with mental illness are especially vulnerable to experiencing an extension of this stigma due to

the close relationship parents share with their offspring (Eaton, Ohan, Stritzke, & Corrigan,

2016). This type of stigma is called “family stigma” and this can lead to the development of

“affiliate stigma” in parents. Affiliate stigma is a type of self-stigma and is characterized by self-

shame and doubt related to parenting abilities. Often parents with children that have a mental

illness question their parenting abilities and experience feelings of embarrassment. Affiliate

stigma (or parents’ self-shame) has been shown to increase care-giving stress and can lead to

decreased care-giver well-being (Eaton, Ohan, Stritzke, & Corrigan, 2016).

Stigmatization within the health care system has become a major problem with the rise of

mental illness and the need for specialized care (Corrigan, Larson, and Ruch, 2013). Often

patients with mental illness feel they are not being listened to and feel they are being deprived of

a standard doctor-patient relationship. Patients often are not provided with appropriate and

accurate information concerning their disease and treatment possibilities (Mestdagh & Hansen,

2014). Patients are also deprived of the right to take part in the decision-making process related

to their condition as they are deemed not capable. Patients report experiencing longer wait times

than other patients and health care providers that doubt the severity or reality of their physical

complaints based on their mental illness diagnosis (Mestdagh & Hansen, 2014). The film “A

Beautiful Mind” helped to address the stigma related to stigma in the health care system as John
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was regularly made an equal partner in decision making related to his disease and was spoken to

in a respectful way by health care professionals (Grazer and Howard, 2001).

The Role of the Nurse in Addressing Stigma

The role of the nurse in the treatment of mental illness is important as nurses often have a

more trusting relationship with the patient than any other health care provider. The first thing the

nursing profession can do to address stigma related to mental illness is to consider one’s own

preconceived ideas and personal biases about patients with mental health disorders (Gouthro,

2009). Becoming aware of these internalized ideations will not only address the issue of stigma

but allow for a more successful nurse-client relationship. Another step nurses can take to address

stigma pertaining to mental illness is advocating for their clients who suffer with mental illness

(Gouthro, 2009). Nurses can take an active role in advocating for patients who are treated

unfairly or who do not receive the full scope of treatment. The Canadian Nurses Association

(2012) states that “CNA recognizes that stigma lies at the root of discrimination related to mental

illness and believes that all health-care professionals must seek to resolve this social injustice

where people work, live and play.”. As the nursing profession holds substantial public trust this

allows for opportunities for nurses to use their impact to address misconceptions and stereotypes

in the media and make a positive impact on public opinion (Gouthro, 2009).

Conclusion

The film “A Beautiful Mind” was successful in accurately depicting mental illness, the

stigmatization and the social implications that coincide with it without negating the seriousness

of mental health. Stigma can be addressed in the health care system through nurse-centered

advocacy and interprofessional collaboration.

References

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