Term Paper - Shutter Island Diagnostic AssignmentI selected this film because not only did it portray one person’s personal disorder, I was able to see numerous others. I chose to address the Diagnosis of Andrew/Teddy at the end for the simple reason I was given plenty of background information to work with.

Plot:

This film takes place in 1954 as a World War II veteran and current federal marshal Edward “Teddy” Daniels (Leonardo DiCaprio) and his new partner, Chuck (Mark Ruffalo), ferry to Shutter Island. Shutter Island is a water-bound mental hospital housing the criminally insane. Teddy and his new partner have been asked to investigate the mysterious disappearance of Rachel Solando (Emily Mortimer), a patient admitted to the asylum after she murdered her three children. “Teddy” finds a note in Rachel’s room saying, “Law of 4, who is 67,” while in reality there are only 66 patients on Shutter Island, which leads “Teddy” to believe there is a unknown patient on the island. Rachel Solondo is soon found and they tell Teddy he is free to go, but Teddy has grown suspicious about the real goings on of Shutter Island by now and is determined to confirm his beliefs. 

Teddy grows paranoid when his partner chuck presents the idea that maybe the doctor’s of Shutter Island realized he Teddy was showing to much interest so they brought him here under the pretense that he was there of his own free will. Chucj then disappears, while searching for him “Teddy” runs into the real Rachel Solondo who tells him of the Island’s plot to shut her up about what was really going on. Complicating matters further, Teddy’s interest in Shutter Island is to find the arsonist, Andrew Laeddis, who murdered his wife, Dolores Chanal, and is incarcerated on Shutter Island in order to take his revenge. Teddy starts quizzing Dr. Cawley (Ben Kingsley), the head of the institution, because he suspects that the authorities in charge might not be giving him the whole story. Teddy is determined to find evidence of brain experiments such as the ones he witnessed during his time liberating Dachau where being practiced in an old lighthouse out by the cliffs. Teddy believes that a terrible fate may befall all the patients in the Ward C, a unit devoted to the most heinous of the hospital's inmates.  All this time “Teddy” is suffering awful migraines. Driven to confront his wife's killer, and stranded on the island because of a hurricane Teddy grows more and more paranoid until Dr. Cawley confronts him in the lighthouse telling Teddy he has been a patient there for the past 2 years, that the headaches and shaking he has been experiencing have been from withdrawals from the medicine he has been on and hasn’t taken since this whole scheme began to bring him back to reality immediately. Chuck turns out to be his psychiatrist for the last 2 years and together the 2 doctors and “Teddy” bring Andrew back to reality, just in time to keep him from being lobotomized. Turns out Andrew had made up a counter personality for each him and his wife Dolores because he couldn’t handle the idea that she killed their three children and then he killed her. Andrew realizes this just in time to keep himself from being lobotomized only to then, in my opinion, pretend he wasn’t cured in order to live the rest of his life without memories. 

Main Characters:

Andrew Laeddis

The main character in Shutter Island is Andrew Laeddis. Andrew comes up with a counter personality, also an anagram, Edward “Teddy” Daniels in order to forget the traumatic experience of his wife Dolores killing their three children. Teddy begins with being very sick to his stomach, shaking, migraines, sensitivity to light and sound, as well as irritability and mood swings. Teddy has been put on chlorpromazine for the last 2 years and is slowly being taken off of it, thus some of the symptoms above being due to withdrawal. Teddy also tended to chain smoke cigarettes every time he got agitated or upset.

Teddy is paranoid, believing that the whole island is in on some evil experiments, which end up being non – bizarre delusions. Teddy also suffered from hallucinations of an imaginary Rachel Solondo talking him and later his wife, who he killed talking to him. Teddy also see’s himself shooting Dr. Crawley at the end, see’s the blood and everything but the gun ends up just a toy. He also began to believe that he was on the island because the doctor’s brought him here; tricking him into thinking it was his idea to be there. 

Through this whole ordeal Teddy shows himself to be socially savvy, high functioning in social situations, with thoughts and approaches that seem to be a little irritable but non the less relatively logical until he slips into a dream and see’s vivid images of things from his past. Teddy is a World War II veteran who liberated Dachau; he began drinking excessively after the war in order to suppress his feelings, showing here he may be suffering from posttraumatic stress disorder. 

In the end when the psychiatrist and psychologist confront Teddy about what really happened he rejects the idea. It isn’t until the doctor’s show Teddy the pictures of his dead children that Teddy makes the switch back to Andrew and realizes that his wife Dolores killed his children, including Rachel his daughter. 

Andrew at the end shows that he has been in severe denial by saying, “After she tried to kill herself the first time, Dolores told me she had an insect living inside her brain. She could feel it clicking across her skull, just pulling the wires, just for fun.  She told me that but I didn't listen. I loved her so much.” Andrew didn’t want to accept the fact his wife was suicidal so he overloaded on work and drinking in order to ignore the reality of the situation.

Last the doctors tell Andrew that one of the patients had called him Andrew Laeddis the week before and he had attacked him and injured him. They told Andrew he had been furious, that he denied being his wife’s killer, this being said he had to accept what had done and stay within reality or be lobotomized. The fear was that they had broken through once before, nine months ago and then Andrew regressed. I believe here that the he would cycle again if they had let him go on living the way he had been up to this point. In the movie he fakes being not brought back to sanity in order to live as “ good man and not as a monster.”

For all these reasons I would diagnose the following:

Andrew Laeddis  / “Teddy” DanielsDSM-IV-TR Multiaxial Evaluation Sheet

Axis 1:     297.1 Delusional Disorder, Mixed Type    300.14 Dissociative Identity Disorder (Features)    309.81 Posttraumatic Stress Disorder, Chronic     305.90 Alcohol Dependence, W/Psychological Dependence    292.0 Sedative Withdrawal         *E937.5 Chloral hydrate    305.1 Nicotine Dependence, W/Physiological Dependence    V62.82 Bereavement

Axis II:    301.0 Paranoid Personality Disorder    V15.81 Noncompliance W/Treatment 

Axis III: N/AAxis IV:    Psychosocial/ Environmental Problems – World War II Veteran    Problems W/Primary Support Group – Death of entire family    Problems W/Legal System – Arrested for murder

Axis V:   GAF: 25 

 

Dolores Chanel

Andrew’s wife Dolores is also represented in this movie as having a mental illness as well. Andrew comes up with a counter personality for her as well named Rachel Solondo, also an anagram, although in this case he used his daughter’s name as the alter personality.  

Dolores is described as being young and full of life when Andrew first meets her. Together they have three children; to my understanding her personality started changing drastically after the birth of her third. Andrew was drinking to hide his pain and in his “flashbacks” it showed Dolores getting more and more upset and stressed about this. She acts fatigued and says that she is tired because of his drinking. Andrew at the end of the show tells us, “After she tried to kill herself the first time, Dolores told me she had an insect living inside her brain. She could feel it clicking across her skull, just pulling the wires, just for fun. 

She told me that but I didn't listen. I loved her so much.” 

Dolores has turns out to have set their first house on fire in order to kill herself; she is suicidal and very serious. Andrew ignores reality and decides not to get her help. Dolores then takes her children out and drowns all three of them in the lake behind the house. When Andrew asks her where the kids where she says, at school, even though it is a Saturday and therefore there is no school. Dolores shows little remorse for what she has done, she actually thinks it’s a game and wants to dry them off and dress them up to take them on a picnic, being her “live dolls. ”  Throughout this she is very catatonic, almost robotic in the way she responds and the things she does with her eyes. She has an inappropriate giggle that she let’s out now and then. 

Dolores seemed to be home with her children most of the time; Andrew even moved them to a secluded lake house in order to be away from people who would recognize she was ill. She seemed to have no friends or interaction outside her family, showing she had some social issues. It never showed Dolores drinking or using any substance, although it was clear that she most likely needed something to be on. In the end Dolores asks to be put out her pain asking Andrew to “set her free” and so he shoots her.  

For all these reasons I would diagnose the following:

Dolores ChanelDSM-IV-TR Multiaxial Evaluation Sheet

Axis I:   296.3 Major Depressive Disorder, Recurrent, Severe W/ Mood Incongruent Psychotic Features       *Postpartum Onset Possibility   309.4 Adjustment Disorder, Chronic, W/Mixed Disturbance of Emotion and Conduct   300.02 Generalized Anxiety Disorder (Features)   V62.89 Phase of Life Problem – Becoming a care taker of children   V61.10 Partner Relational Problem   312.33 Pyromania (Features)   Suicide Attempts, Recurrent

Axis II:   301.20 Schizoid Personality Disorder   301.22 Schizotypal Personality Disorder (Features)

Axis III: N/A

Axis IV:     Problems Related to Social Environment – adjustment to becoming a care giver

Axis V: GAF: 5