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A Beautiful Mind

Humber College
Natasha Singh

Introduction
For this assignment, I chose to analyze the movie A Beautiful Mind. This
movie is about an individual with schizophrenia. Schizophrenia is a devastating
mental health disorder that is diagnosed in about 1% of the Canadian population
(Public Health Agency of Canada, 2012). According to Fontaine (2009),
schizophrenia is defined as "a combination of disordered thinking, perceptual
disturbances, behavioral abnormalities, affective disruptions, and impaired social
competency". In other words, an individual with schizophrenia cannot think clearly,
make reasonable decisions, nor can they effectively manage their feelings because
they no longer know what is real and what is not. This disorder is incurable but the
symptoms may be managed with proper treatment and thus increase their
prognosis. This paper will summarize the movie, examine physical and psychosocial
effects of schizophrenia in the main character's case, and discuss interventions and
strategies for treatment of his area of priority.
Summary of the movie
A Beautiful Mind is a captivating, engaging, and educational movie directed
by Ron Howard. John Nash, the main character, was a professor at the University of
Princeton. He was a genius mathematician who struggled with schizophrenia which
went undiagnosed for years. His only friend was his imaginary roommate Charles.
His student Alicia pursued him and they eventually got married. The relationship
was strained as he could not open up to her, even after marriage. He began
engulfing himself into his work and became secluded from the outside world. John
believed he was a highly classified agent for the U.S military, working a decoder
under the leadership of William Parcher, trying to prevent the Russians from

detonating a bomb aimed at civilian causalities in the U.S. His first mental
breakdown came while presenting at a conference when he thought he seen the
Russians coming to capture him. John fled but was stopped by a psychiatrist who
took him in for further assessment. He was diagnosed with schizophrenia and began
treatment. Alicia and John had a child after he was released from the psychiatric
institution, however, the relationship continued to grow apart. John couldn't help
with the baby and the medication was stopping him from being intimate with Alicia.
John stopped taking his medication and relapsed. The hallucinations and delusions
started again. After almost drowning their son, John realized that his imaginary
friend was not real. He accepted his diagnosis and began following his medication
regime and ignoring the hallucinations and delusions. He had several challenges
and short episodes of relapse but eventually went back to Princeton where he was
able to effectively cope with his diagnosis and continued with his teaching career. To
conclude, despite living a lifetime with schizophrenia, John was nominated and won
the Nobel prize in 1994.
Physical effects
Physical effects of a schizophrenia patient include changes in gait and
posture and tendency for violent or harmful behaviour. In John's case, his diagnosis
physically effected him because he believed his friend Charles was with him,
encouraging him to do things that could cause harm to himself and to others around
him. For example, John left his baby in the tub with running water under the
supervision of Charles. Luckily, Alicia found the baby laying in the tub of water
before he could have drowned. Because John strongly believed Charles was real, he
treated him as if he were real and did whatever Charles influenced him to do. Thus,
his schizophrenic hallucinations almost led him to kill his own baby.

Another physical effect demonstrated in this movie would be John's inability


to have sexual relations with his wife. This is clearly evidenced when John stated he
no longer had interest for it anymore, specifically due to the medications he was
taking. This led to John's relapse because he felt the lack of sexual relations
between him and his wife was spreading them further apart so he stopped taking
his medications. This not only added stress to John but put a strain on his marriage
and added stress to Alicia as well.
The third physical effect would be his change in gait and posture. This is
known as tardive dyskinesia. According to Saltz (2009), tardive dyskinesia is a side
effect of prolonged use of antipsychotic medications. It is defined as involuntary
movements of muscles throughout the body including head bobbing, lip smacking,
and tics. This was depicted in a scene when he was sitting at home with his friend.
He was slouched over with his head bobbing and his lips were rapidly moving as if
he were going to say something but he wasn't. In this specific scene, Alicia made
him take his medication. This was purposely done to demonstrate the physical
effects the medication had on him.
Psychosocial effects
Psychosocial effects on a schizophrenic individual can range from stress and
social withdrawal to hallucinations or delusions to suicidal thoughts. Stress is a
major psychosocial effect. Both John and Alicia were struggling to cope with his
hallucinations. Alicia became the primary caregiver and financial provider for their
family. This took a great toll on Alicia. This was evidenced when she opened up to
John's friend and stated the stress, guilt and anger she felt with John and his
diagnosis.

Another psychosocial effect are delusions. Delusions are described as false or


irrational beliefs. This is a very common symptom of schizophrenia (Public Health
Agency of Canada, 2012). John's delusions were clearly evidenced by his absolute
belief that his mathematical wonders had him working on a top secret mission,
working for the U.S military, and that Russians were out to seize him. This
prevented him from teaching his class and carrying on a normal life with his wife,
friends and work.
Thirdly, hallucinations are described as seeing or hearing things that do not
exist (Public Health Agency of Canada, 2012). This is demonstrated when the
psychiatrist and Alicia discussed William Parcher and Charles and came to the
realization that they did not exist. These characters were John's hallucinations
brought on by his schizophrenia. They were present throughout the entire movie,
thus making it unknown to the viewer that they were fictitious.
Area of priority
John's area of priority would be his hallucinations and delusions and the risks
it poses on himself and his family related to his diagnosis as evidenced by irrational
behaviour, causing harm to himself and his family. The reason this is a priority is to
ensure the safety of himself and his family when his hallucinations and delusions
are exacerbated. It is also important that John's symptoms are controlled in order to
continue to function to his fullest abilities. This includes contributing to his family
life and work life. In the movie, John's hallucinations endangered his child's life when
he was influenced by Charles to leave him unattended in the bath tub. He has also
pushed Alicia and the baby to the ground because he thought William Parcher was

going to shoot them. Controlling his hallucinations and delusions will decrease
similar incidents from reoccurring.
Nursing specific interventions
Nursing interventions that can be employed to address the area of priority
will include medication compliance. This means ensuring John is adhering to his
medication regime, including administering the medication if required and watching
him closely to make sure he swallows his medication. Also, monitoring the
effectiveness of his medication by observing for no symptoms of hallucinations and
delusions.
Another intervention would be creating a therapeutic environment. This
consists of creating and maintaining an environment with structure and minimal
stressors, including following the same routine and surrounding John with familiar
people. By doing so, John's delusions will decrease and he will be more likely to
ignore his hallucinations.
Therapeutic communication will be a nursing intervention implemented as
well. Scheduled one on one time will allow an outlet for John to express concerns,
feelings, and thoughts without fear of being judged. This will also encourage John to
verbalize if he is having hallucinations and express how he's dealing with it. With
this information, a medication review can be requested.
Interprofessional collaborative strategies
When dealing with most mental health disorders, an interprofessional team
works together in treating their patients. Firstly, a psychiatrist specializes in the
diagnosis and treatment of a mental health disorder. They use psychotherapy,

medications and hospitalization according to the patients' needs. After diagnosing


the individual, the psychiatrist will prescribe medication and monitor its
effectiveness (American Psychiatric Association, 2014). In this case, the psychiatrist
will monitor the effectiveness of the medications on reducing or eliminating the
hallucinations and delusions.
Another interprofessional would be the pharmacist. A pharmacist is
responsible for dispensing medications. The pharmacist plays a role in the
treatment by ensuring the medications prescribed do not have negative
interactions. They have a thorough understanding of medications, their actions and
interactions with other medications. They can do symptom evaluation and provide
education regarding hallucinations and delusions at the time the patient refills their
prescription. They can also recommend other medications for the patient that may
have fewer side effects and a greater positive outcome (Modern Medicine Network,
2014).
In addition to the psychiatrist and pharmacist, a social worker could be
involved in treatment to facilitate group or individual counseling depending on the
individual challenges with their illness. In this case, the social worker can provide
scheduled dedicated time to allow John to express his feelings and thoughts in a
safe and non-threatening environment. The social worker can help determine the
acuity of his hallucinations and delusions and determine whether his or his family's
safety is at risk. The social worker can assist to coordinate additional resources if
needed such as child care if unsafe hallucinations or delusions arise (Social Workers,
2014).
Community resources

There are many community resources that are available to help patients and
families cope with schizophrenia. CAMH, the Center for Addiction and Mental Health
disorders enhances recovery by integrating treatment and providing education and
support for people affected by schizophrenia (CAMH, 2012). CAMH provides an 8
week program that allows for families struggling with the diagnosis to meet and
discuss their ideas and ways of handling the situation they are in (CAMH, 2012).
This resource will aid in dealing with hallucinations. These sessions explain
hallucinations and delusions and promote an understanding of their management.
They also explore how to prevent exacerbations.
Another community resource to utilize would be Schizophrenia Society of
Ontario. Their mandate is to ''educate, support and advocate'' while making a
difference in people's lives affected by schizophrenia (Schizophrenia Society of
Ontario, 2013). Similarly to CAMH, this resource increases awareness and education
of schizophrenia which in turn leads to greater education of the main symptoms,
hallucinations and delusions. The education will help people affected by
schizophrenia to cope and aid in preventing these burdensome symptoms.
Conclusion
To conclude, schizophrenia is a devastating disorder that affects everyone
surrounding the diagnosed individual. However, with medication compliance,
adherence to treatment plan, proper education and interprofessional collaboration,
schizophrenia can be effectively managed.

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