Ernest Hemingway

History of Dysfunction
MICHAEL BISHOFF, JULIE CRAIN, SHELLEY HILL, MOLLY HUSTEAD,
RACHEL LINGENFELTER
 Ernest Hemingway-61 year old Writer,
Husband, and Father

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 Presenting Problem

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 Reckless behaviors and lifestyle

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 Preoccupation with suicide and
anger towards his parents for
past abuse. When discussing his
Father's death

High and low mood swings

and his behavior is showing
severe distress, dysfunction,
deviance, and dangerous
factors, at least towards himself
(Martin, 2006, p. 354).

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 History
American novelist
Born in Oak Park, Illinois
Writing Career
Started at age of 17
Newspaper office in Kansas City
Won a Nobel Prize
55 years old

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 Grace Hemingway (Mother)
Grace and her same-sex twins
Making Ernest a girl
Making Marcelline a boy

Identical clothing and similar

hairstyles
Held Marcelline back
2 years

Ended by teacher intervention

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Clarence Hemingway (Father)
Physically punished Ernest
Spanked
Used a razor strop
Ernests fantasy
Assassinating Clarence
Aimed shotgun at Clarences
head.
Committed suicide at 56
Shot himself in the head
Ernest blamed Grace
"I hate her guts and she hates mine. She
forced my Father to suicide"
Seriously impacted Ernest
Contemplated his own suicide
Alcoholism escalated
 Alcoholism
Hospitalized
Cognac bottles in room
Happened twice

Diagnosed with hepatic

damage
Doctors recommendation
Insisted several times
Ernest refused

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Marriages and Children
Elizabeth Hadley Richardson
John (Jack) Nicanor Hemingway
Pauline Marie Pfeiffer
Patrick Hemingway
Gregory Hancock Hemingway
Martha Gellhorn
Mary Welsh
 Blows To The Head
6 significant blows
Automobile accidents
Skylight
Plane

Plane crash
African Safari
Struck abandoned telegraph wire
Boarded second plane which crashed
Severe skull fracture

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Previous Admittance
Admitted into Mayo Clinic
Hypertension
Enlarged liver
Paranoia
Depression
Electroconvulsive therapy
7 weeks
Well for a few months
 Suicide Attempts
Ernest loading shotgun
Mary intervened
Hospitalized

Requested to pick up belongings

Hospital agreed
Escorted Ernest
Hemingway grabbed shotgun
Staff disarmed him

Transferred to Mayo Clinic by plane

Plane stopped to refuel
Attempted to walk into propellers

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After The Suicide Attempts
Mayo Clinic
More electroconvulsive therapy
Discharged afterwards

Mary worried about Ernest

Claims Ernest charmed and deceived Dr. Rome to the conclusion that he was sane
Patrons at restaurant were FBI
 Diagnosis
Schizoaffective disorder- a condition involving the existence of both symptoms of
schizophrenia and major depressive or manic symptoms (Sue, et al, 2014, p. 302).
Schizophrenic symptoms-
Delusions
Paranoia
Hallucinations
Manic symptoms-
Majority of his writing is completed.
More self-confident
Lacks the need to sleep
Favor in risky behavior
Depressive symptoms-
Forgets his life duties
Not active in writing
What Is Schizoaffective Disorder?
 Diagnosis
Alcohol Abuse Disorder-a problematic
pattern of alcohol use leading to clinically
significant impairment of distress (APA,
2013, p. 491).
He was addicted to the use of alcohol. He
drank obsessively even after the doctor
warned him that it would be dangerous if he
continued.

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 Biological Dimension
Genetics-
-Father committed suicide and struggled with
depression
-Family has a history of substance related
abuse and suicide
Injuries-
-Fought in 3 wars
-2 plane crashes
-numerous car crashes
-broken or damaged bones including
head, arm, shoulder, liver, spleen,
kidney, etc.
-addicted to the use of alcohol

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Psychological Dimension
Low self-esteem
Poor relationship with his mother
Used alcohol to help cope with his problems

His use of alcohol was in one sense a defense against his

suffering, which he used perhaps to fight off his depression and
self-destructive thoughts (Martin, 2006, p.355 ).
Social Dimension
Family system was broken
Father was abusive and extremely strict
Can not keep a healthy relationship with his partners
Went through 3 divorces and 4 marriages
Social Cultural Dimension
Has a loss sense of identity
Confusion of his sexuality
Later in his childhood, he began to find a passion for hunting,
fishing, sports, fighting, and bullfighting which could have been
attempts to overcompensate for his lack of masculinity in his early
childhood.
Believes that the government is monitoring his every move.
He is extremely paranoid, especially in public situations
 Treatment
Ambulatory Treatment Program at Naukeag in Ashburnham, Massachusetts

(Ambulatory Treatment Program, 2015)

Treatment Medications:
Group therapy
Secobarital

Reserpine
Thiazide diuretics
Self help meetings
Invega

Lithobid
Abstinence education
Conclusion
New York Times Special Edition, July 3,
www.townnews.com
References
American Psychiatric Association. (2013). Diagnosis and statistical manual of mental disorders (5th
ed.). Washington, DC: American Psychiatric Association.
Martin, C. D. (2006). Ernest hemingway: A psychological autopsy of suicide. Psychiatry: Interpersonal
& Biological Processes, 69(4), 351-361.
Mayo Clinic Staff. (2014, January 24). Schizoaffective disorder. Retrieved April 15, 2015, from
http://www.mayoclinic.org/diseases-conditions/schizoaffectivedisorder/basics/definition/con-20029221
Mayo Clinic Staff. (2014, September 6). High blood pressure (hypertension). Retrieved April 15, 2015,
from http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/definition/con-20019580
Nobel Lectures. (2014). Ernest hemingway - biographical. Retrieved April 29, 2015, from
http://www.nobelprize.org/nobel_prizes/literature/laureates/1954/hemingway-bio.html
Sue, D., Sue, D. W., Sue, D., & Sue, S. (2014). Essentials of understanding abnormal behavior (Second
ed.). Belmont, CA: Wadsworth.