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KIM TALIA PILLAY

STUDENT NUMBER: 215080580

PSYC706: PSYCHOPATHOLOGY

ASSIGNMENT 1: Critically discuss a movie character with a psychological disorder

MOVIE: Shutter Island

DUE DATE: 28 August 2015

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DECLARATION

I, Kim Talia Pillay, hereby declare that this assignment submitted here is my original

work and has not been submitted before to any institution for academic purposes.

Furthermore, I have acknowledged all sources used and have cited these in the

reference section.

………………………….. ………………………………………..

SIGNATURE DATE

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Introduction

This heart wrenching movie is set in 1954 and follows the character U.S Marshall, Teddy

Daniels, the protagonist, and his partner Chuck Aule. They have been assigned to investigate

the disappearance of a patient from Boston’s Shutter Island Ashecliffe Hospital, which is an

institution that houses the criminally insane. As the movie continues it is revealed that Teddy

Daniels is actually a patient at Shutter Island and his real identity is Andrew Laeddis. It is

then clearly depicted in the movie that he suffers from psychosis and the psychologist are

attempting a new area treatment, at the time, off role playing and allowing him to live out his

fantasy, in the hopes that his eventual realization will cure his mental illness. Throughout the

duration of the movie we endure the treatment with Teddy, so that he can reach self-

realisation. In the movie there is a subtle but prevalent use of the symbolism of water and

fire, representing the barrier between his sanity and insanity and the conflict that ensues. It is

an important journey to understand why Andrew has reached this break in reality, and the

internal turmoil he faces to return to his sanity.

Andrew was once a respected U.S Marshall, returning home from an investigation to the

horrific site of his three children, having been unceremoniously drowned in the family lake,

by his mentally ill wife. Unable to face the torrid mirage of emotions, Andrew uses his

service pistol and shoots his wife, claiming he will take care of their children as she slowly

dies in his arms. Due to this traumatic event, and the unimaginable emotional stress he

endures, Andrew has a mental break and creates an alternate persona, still being a U.S

Marshall but instead has a new identity, name and no family ties. It is important to note that

this marks the beginning of his extreme mental distress, forcing his dissociation from reality.

He is admitted to an insane Asylum, however he invents an intricate mental narrative that

includes conspiracy theories about Shutter Island and an endless hunt for a patient who does

not seem to exist. This unsolvable mystery is the perfect escape mechanism and is heightened

by the fact that he is the patient he is searching for, he is patient 67. Firstly, this essay will

introduce the character of Andrew Laeddis also known as Teddy Daniels who is a patient on

Shutter Island and is evidently suffering from Dissociative Identity disorder, Schizophrenia

and the delusional disorder. Secondly the essay will explain these mental illnesses that the

protagonist suffers as well as elaborate on the symptoms of the disorders in relation to the

DSM-5, supported with valid examples from the movie. It will also briefly discuss the major

changes from the DSM-4 TR to the DSM-5 regarding these disorders. Lastly, this essay will

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provide a discussion around lobotomy, which was prevalent and used in the 1900s and is

present in the film, followed by a conclusion.

The symbolism of water and fire in Shutter Island is indicative of Andrew’s state of

sanity and insanity

The symbolism is evident within the first frame of the movie, in which the opening scene

depicts the Marshall’s, Teddy, on the boat suffering from a bout of sea sickness, he explains

that he cannot stomach the sea signifying that he cannot handle water. Water, in the movie, is

his reality as the lake plays a strong symbolic significance. The water is Teddy’s truth to who

he really is and represents the barrier between him and his sanity. This type of symbolism

occurs throughout the entire movie, strengthening the point that water plays a pivotal role in

his journey to self-realisation. With that in mind, this brings us to an important and one of my

favourite scenes of the movie. It is when Teddy, who believes he is a US Marshall, and his

partner interview a patient at Shutter Island. During this scene, it can be said that the film

maker’s intention is to mess with the minds of the audience while reminding us of the

symbolism. During their search for patient 67, Teddy conducts his investigation at Shutter

Island, unaware that this is part of his therapy. Teddy and his partner Chuck, who is actually

his primary psychologist, interrogate a patient named Bridget Kearns who starts by saying:

“Could I have a glass of water, please?”(Scorsese, Scott, Fischer, Medavoy and Messer,

2010).Chuck gets up, goes over to the steel drink dispenser by the door. The Orderlies get up

as well but Chuck waves them down. Chuck gets a glass and begins to fill it, while his back

is being turned to Teddy, and the Orderlies eyes are on Chuck. Bridget locks her eyes on

Teddy and doesn’t fail to break her gaze on him for a moment. She darts out her hand to grab

his notebook, turns it around and scribbles something down and shoves it back at him just as

Chuck turns back, returning with the water. Bridget drinks the water swiftly, as if under

duress. Teddy continues his questioning and Bridget puts down her glass, her hands down on

the table and nods, showing that she is attentive.

In this particular scene there are three camera angles, being the outside of the table, Bridget’s

view and Teddy’s view. It is important to watch this scene critically as at the patient drinks

the glass of water. From the initial view the patient drinks the water but in reality, there is no

glass. When the glass of water was supposed to end at the frame of Teddy’s view, it

disappears but when the audience sees it, it appears to be present. It can be concluded, that

this shows Teddy is actively blocking out water in his mind. It is revealed the patient stole

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Teddy’s notepad to write the word “RUN”. Consciously Teddy does not realise what this

means, but subconsciously, he does. The patient is telling the real Andrew Laeddis to escape

from this Island and leave whilst it is still possible but Teddy blocks out her warning, evident

by the water disappearing. This shows that water is thus prevalent and serves as an anchor to

the memory of Teddy and the drowning of his kids in the lake. The symbolism of fire also

makes a prevalent stand in Shutter Island, with relation to Teddy’s mental state. Every scene

that has fire present is there to mislead Teddy’s cognitive processes and results in escalating

his paranoia. Both these perspectives place the audience into the mind of an insane and

damaged individual. The first instance of fire as a symbolism is when Teddy is searching for

his missing partner on the outskirts of the Island, it is then that Teddy finally meets the

patient he is assigned to find, that is Rachel Solando. In this scene Rachel, patient 67, is

found in a cave on the edge of the island, cowering over a fire.

Teddy confronts her, introducing himself as a cop, however it is clear that she is a fictional

creation due to the fact that she states:“You’re the marshal”(Scorsese, Scott, Fischer,

Medavoy and Messer 2010). Teddy stares, dismissing the fact that she knows he is a

Marshall without having ever met him prior to this. It is unlike a Marshall to miss

investigative cues such as this, alluding to the fact that Teddy only believes what adds to his

warped reality. Rachel was used as a therapeutic gambit by his physicians, in the sense that

her back story linked her with murdering her three children, in the hopes that this would

trigger an epiphany in Teddy’s mind during the search for this patient. However when Teddy

meets this fictional creation of Rachel in a cave, she goes on to explain she never had

children or been married. She states she was an employee at Ashecliffe and was wrongly

institutionalised after threatening to expose their criminal practices within the asylum. As the

conversation continues, Rachel reveals to Teddy that the Island is a testing site for

brainwashing methods, feeding hid paranoia. If one looks carefully, the obvious source of

guiding in the scene is the camp fire. The fire represents what Teddy wants to believe, that he

is truly a US Marshal trying to solve a case, but instead it is ultimately delusional. This

divinely dark, devious brain tease of a movie concludes with Teddy breaking the symbolic

barrier of reality. He is confronted by his doctors explaining to him his entire investigation

was part of an elaborate experimental therapy involving role play. His Doctor’s tell him who

he actually is and why he is at Shutter Island. He breaks his barrier by actually breaking his

gun and if one looks closely, water comes out of his hands when he breaks the pistol which

soon jolts him back to reality, confirming the mental state of Andrew Laeddis also known as

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Teddy Daniels.In essence, he creates the government conspiracy as a red herring to justify his

fictional construct. It justifies his circumstance, giving him a legitimate reason to be on the

island investigating a conspiracy. It also demonizes the staff and Doctors, conspiring against

him. The psychologists aim to assist Teddy by revealing his reality through role play therapy,

showing how illogical and impossible his conspiracy theory is by allowing him to investigate

the case and reveal its absurdity. The title “Shutter Island” is a clear depiction of Teddy’s

state of mind, as it seems his fractured psyche has a distorted and blurred image of reality as

the world would appear to someone looking through shutters.

Disorders and symptoms in relation to the DSM-5 and the most profound changes from

DSM-4 TR to DSM-5

In the film “Shutter Island”, Teddy Daniels also known as Andrew Laeddis suffers from a

barrage of disorders, namely Dissociative Identity Disorder (DID), Schizophrenia and the

Delusional Disorder. Although, DID and Schizophrenia are present, the Delusional disorder

is more prevalent throughout the movie. Firstly, Dissociative Identity Disorder (DID) occurs

when an individual dissociates himself and creates two or more distinct personalities (Wiley,

2011). According to the DSM-5, DID symptoms entail two or more different personalities

that exist in one individual and it is important to note that one personality is always present

(American Psychiatric Association, 2013). In relation to the character, the two differing

personalities are seen firstly as Federal Marshal Teddy Daniels, who is confident and self-

assured, motivated and solely focused on his investigation. His passion for investigation

causes him to become paranoid, leading him to doubt every person he comes into contact

with and this result in a relentless and brutal search for the truth, numerous physical and

verbal altercations ensues between him and the inhabitants of the asylum.

Secondly, the audience sees Andrew Laeddis, a murderous wife slayer who cannot seem to

face the tragedy that has befallen him or his fatal actions. Teddy relapses into his initial

lifestyle prior to an event that induced his psychotic break, that is, his children being drowned

in the family lake by his suicidal and mentally insane spouse. While Teddy is on the island,

he comes to a realisation that his case is compacted by his repressed memories and as the

movie progresses he learns that there is more to his investigation being a parallel to his actual

past than the conspiracy he has constructed. Even though Teddy is an intellectual, quick

witted individual, he suffers from the traumatic experiences that he encountered in the World

War II. One could conclude that Teddy accepted working obsessively and being a functional

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alcoholic as part of his lifestyle and as an escapism from reality. He can also be diagnosed

also as a Schizophrenic as he hears and sees images that are not visible to the naked eye,

which results in a false image of the world being designed by the brain. The issue that arises

due to Schizophrenia distorts and corrupts the minds way of comprehending incoming the

real world. The symptoms of this disorder includes, delusional and disorganized thinking,

hallucinations, inappropriate emotions and actions, as well as disturbed perceptions

(American Psychiatric Association, 2013). For instance, throughout the movie, Teddy

encounters fire and he experiences vivid hallucinations in which it allows the audience to

associate fire with a disturbing memory of his past, which he is trying desperately to

suppress. However, this is not an exact description of Schizophrenia but it paints a concrete

picture of the behaviours and emotions that result from such a disorder. Therefore it can be

said that Teddy develops Schizophrenia due to the stress of him suppressing the murdering of

his wife, often surfacing as manic delusions.

Lastly, it is evident that Teddy Daniels sets out to search for an escaped patient from the

asylum, the twist we discover is that he is actually a patient on the island. He is afflicted by a

delusional disorder, by constructing a fictional reality as a form of escapism, running away

from the dark reality of his past. The Delusional Disorder is a Psychotic Disorder, which is

usually onset from middle to late adult life. However, it can also be from a young age and

with regards to the clinical picture, speech is not affected as in Schizophrenia and

Schizotypal Personality Disorder. The delusion must be present for at least one month and

there is absence of hallucinations, but if there are visual and auditory hallucinations, they are

not prominent, except for the delusion, the person’s thought processes and behaviour are not

odd and their insight is poor (Tutorial letter 503: Abnormal Behaviour and Mental Health,

2014). He displays symptoms of grandiose and persecutory delusional disorder. As per the

DSM-5, this multi-faceted type is characterised by immense narcissism, feelings of

persecution and victimisation. The Grandiose type is characterised by an individual

supposedly having some unrecognised insight, skill or making a grand discovery. The

Persecutory type applies when an individual’s delusions revolve around the belief that they

are being followed, conspired against, obstructed or harassed in attempting long-term goals

(American Psychiatric Association, 2013). In Shutter Island Teddy experiences both, in that,

he believes he is on the verge of a career changing discovery and at the same time is being

conspired against by the Doctors at the institution. An individual who possesses the

Delusional Disorder, just as in Teddy’s case, will most likely experience long durations of

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remission which would swiftly follow a subsequent relapses. Due to his enlistment in the

world war, the horrific and tragic death of his children and eventual murder of his wife,

Teddy creates an alternate identity, equipped with a new name, past, as well as profession. In

order to stiffen the truth of his reality from destroying his carefully constructed fictional

existence, Teddy rationalises that any theories or explanations put forward by the doctors are

merely part of the grand conspiracy to keep him imprisoned in the asylum. This altered

reality serves as a defence mechanism, which helps protect him from the wounds and trauma

of his past. In spite of the many associations and hints that were purposely and repeatedly

exposed throughout the therapy, Teddy battles with his persisting delusions until the closing

scenes, leaving the audience a peculiar sense of how complex and powerful the human mind

is in its defence of self-preservation. Andrew usually experienced moments of sanity which

swiftly changed into delusions and therefore he evidently suffers from the Delusional

Disorder. He created most of his delusions based on his past experiences and thoughts and

what he hoped existed which was not actually present. The film illustrates this disorder

throughout the characters development and the audience also gleams a concise account of

delusions experienced as well as the causes of them, for example, Teddy informs Rachel

Solando, “I had a friend. I was with him yesterday, but we got separated. Have you seen

him?”(Scorsese, Scott, Fischer, Medavoy and Messer, 2010). Rachel’s response to Teddy,

“Marshal, you have no friends” (Scorsese, Scott, Fischer, Medavoy and Messer, 2010). At a

later stage, teddy confronts the Doctor about his partner who is missing and the Doctor

responds by saying, he never had a partner. Therefore these incidents reveal and strengthen

the point that Teddy is suffering from delusions in reality.

With regards to the changes in the symptoms of the diagnosis of the DSM-4 TR to the DSM-

5, there has been a few changes with the DID, Schizophrenia and the Delusional disorders.

The delusional disorder in the DSM-4 TR has been contained and there have been no

significant changes, however, criterion A for the delusional disorder no longer requires that

the delusions must be non-bizarre (Varley, 2013). On the other hand the major changes with

Schizophrenia are that all the separate types, for instance paranoia, have been collapsed into

one category, for example Autism, Asperger’s and Rette’s disorder which were collapsed into

Autistic Spectrum Disorder. There have been changes with the Dissociative Identity Disorder

as well such as the name of the diagnosis which was previously called multiple personality

disorder. In terms of criteria for DID, several changes have been made which include

Criterion A being expounded on to include the possession-form phenomena as well as

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neurological symptoms in order to accommodate a diversified presentation relating to the

disorder. Criterion A states that shifts in identity can be empirical or self-reported. Criterion

B states that individuals diagnosed with DID suffer recurrent gaps in recalling past events,

not only for traumatic experiences but every day events as well (American Psychiatric

Association, 2013).

A brief account on lobotomy and its portrayal in “Shutter Island”

In the latter half of the 1940s, lobotomy became widely recognised and accepted (Collins &

Stam, 2014), whereas transorbital lobotomy was not a common practice (Hirose, 1966). It

can be noted that psychosurgical techniques had increasingly established itself as the norm in

psychiatric treatment of patients who possess mental illness. Although there has been an

estimated twenty years of experience with psychosurgery methods and techniques used, it is

never simple to acquire a definitive set of results due to the differences resulting from

research design and techniques, in follow-up processes, method of evaluating the results and

lack of adequate controls (Greenblatt, Arnot and Solomon, 1950). It is particularly evident in

Psychological studies, that we find paradoxical and inconsistent results (Klebanoff, Singer,

and Wilensky, 1954). In understanding the history behind the implementation of lobotomy,

one can look at the movie “Shutter Island” which shows the positive idea around the use of

such a treatment to the psychotic and “criminally insane” patients placed on the Island.

There is no element of doubt that the Doctor’s believe that lobotomizing patients would not

fail to cure them, however, due to the faith of Dr. Sheehan and Dr. Cawley, they devise a

treatment plan to allow Teddy to play out this self-created reality in order to confront the

truth and his reality before deciding to conduct a lobotomy treatment on him, which was the

norm in this era. It was believed that lobotomies served significantly on mitigating the

disturbed behaviour of long-term, chronic and psychotic inmates such as Andrew Laeddis. It

was common practice to lobotomize people who were incarcerated due to their mental illness

and their predisposition to acting out violently due to their fractured mental state. In “Shutter

Island”, we can see the birth of new age psychological treatments, such as counselling, role

play and regression therapy. A lot of these new age techniques, for that time period, have

now become staples of treatment plans and rehabilitation tools identified and recommended

within the DSM-5. Due to the acts of these forward thinking psychiatrists we have moved

away from archaic practices, such as shock therapy and lobotomy. These forms of therapy

have helped to facilitate the development and restoration of a cognitively fractured individual

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instead of practices that further impair ones physical and mental stability causing no

improvement but rather making individuals docile creatures that are easier to manage rather

than rehabilitate.

Conclusion

In the closing scene Teddy ponders that he has experienced this before and it dawns on him

that there is no way of escaping the bounds of Shutter Island. Initially he informs his Doctors

that he agrees with and accepts the therapeutic epiphany in order to evade labotomisation.

However whilst perched on the steps outside the entrance of the asylum, he reconsiders and

decides that lobotomy will be a merciful end to his existence instead of facing the horrific

and traumatic events of his past. He realises that they would not follow through with another

role play therapy and he, in this rare moment of sanity, decides to be lobotomised instead of

facing the monster he has become. His pain and guilt weigh so heavy upon him and instead

of living with his brutal actions and the horrific events that has befallen him, he opts to

pretend that he is Teddy Daniels and allows them to lobotomize him, symbolically finally

freeing himself of this burden.

The pivotal line in the movie, which he says to Dr. Sheehan “Is it better living as a monster,

or dying as a good man”(Scorsese, Scott, Fischer, Medavoy and Messer, 2010), means that

Andrew would rather give consent to die as Teddy Daniels than to live bearing the sins of

Andrew Laeddis. “This is a game. All of this is for you. You’re not investigating anything.

You’re a rat in a maze”(Scorsese, Scott, Fischer, Medavoy and Messer 2010). These lines

show that Teddy Daniels arrived on this Island with a visible dysfunctional mind-set of his

apparent purpose at this institution. He discovers the truth about himself, but he rather live in

denial due to the frightening and uncomfortable memories of the past. The purpose for his

arrival was not to investigate a missing patient on the island but to be monitored and

observed by Doctors and guards, as he was deemed to be a criminally violent individual. It

can be concluded that Teddy did indeed suffer from a series of severe psychological disorders

and its symptoms which lead to his mind becoming fractured, providing him with an

escapism from reality and a means of self-preservation. However it is important to note that

even in his fleeting moments of sanity he preferred his delusions over the pain of his reality,

showing how powerful the mind is when it comes to self-preservation. This essay introduced

the character of Andrew Laeddis also known as Teddy Daniels who was a patient on Shutter

Island and was evidently suffering from Dissociative Identity disorder, Schizophrenia and the

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delusional disorder. The essay further explained these mental illnesses that the protagonist

had as well as elaborated on the symptoms of the disorders in relation to the DSM-5

supported with valid examples from the movie and also briefly discussed the most profound

changes from the DSM-4 TR to the DSM-5 regarding these disorders. This essay also

provided a discussion around lobotomy, which was prevalent and used in the 1900s and is

present in the film followed by a conclusion. Finally it leaves the audience with a vital

question to ponder, from the perspective of the patient suffering from these psychosis, is it

more beneficial for their own wellbeing and self-preservation to be treated and cured to face

the tragic events that led to their break in reality, or rather to continue in their delusion and

protect themselves from the harshness and severity of reality.

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References

American Psychiatric Association.(2013). Diagnostic and statistical manual of mental

disorders. Washington, DC: American Psychiatric Association.

Collins, B. M & Stam, H. J. (2014). A transnational perspective on psychosurgery: Beyond

Portugal and the United States. Journal of the History of the Neurosciences, 23, 335–

354. http://dx.doi.org/ 10.1080/0964704X.2013.862123.

Greenblatt, M, Arnot, R & Solomon, H.C. (1950).Studies in lobotomy. (Eds.). New York:

Grune & Stratton.

Hirose, S. (1966). Present trends in psychosurgery. Folia PsychiatricaetNeurologica, 20, 361–

379.

Klebanoff, S. G, Singer, J. L & Wilensky, H. (1954).Psychological consequences of brain

lesions and ablations. Psychol. Bull, 51, 1-41.

Scorsese, M (Director/Producer), Scott, A, Fischer, B.J, Medavoy, M & Messer, A.W

(Producers). (2010). Shutter Island.[Paramount Pictures].United States.

Tutorial letter: Abnormal Behaviour and Mental Health (2014). Third Study Guide for

PYC3702.University of South Africa.Muckleneuk, Pretoria.

Varley, C.K. (2013). Overview of the DSM-5 changes.University of WA School of

Medicine.

Wiley, J. Psychology Today.(2011).Sussex Publisher.Michigan.Print.