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A Diagnoses of The Movie Clinical

Shane Brooks

Salt Lake Community College

PSY 2300: Abnormal Psychology

Professor Shannon Flynt

April 23, 2020

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Often we see Hollywood putting out movies or television shows with characters that

suffer from a mental illness. We have seen this for a while now in our films, but it goes back

further than that. There were plays and performances back in the Shakespearian time that were

portraying mental illness. In movies that we all know and love like One Flew Over the Cuckoos

Nest, and Psycho. While these are both some great movies and some of my personal favorites,

they don't portray mental illness in a somewhat accurate fashion. If you have ever read your

favorite book and then went to watch the movie, you probably left there feeling a little

disappointed because Hollywood left some things out. You see, Hollywood has to make

something that sells and to do so the embellish the mental illnesses or make fun of them. So, I

decided to dive into a newer movie to see if mental illness was present. I also wonder can I

accurately diagnose a disorder from The Desk Reference To The Diagnostic Criteria From The

DSM-5. None the less if I can see and diagnose a disorder, then Hollywood might have done a

great job portraying the disorder. Now let's see what Hollywood had in store for us in the 2017

Netflix movie Clinical.

A recap of the movie Clinical, this is an American horror film and stays true to the genre.

In the beginning, we meet a psychiatrist by the name of Dr. Jane Mathis (Jane). Now Dr. Mathis

is an expert in confrontational therapy, which resulted in her having a client, Nora. One late night

around Christmas time, Jane is staying late at the office when Nora attacks her. Nora's attack is a

violent and disturbing one ending with her attempted suicide in front of Jane. Due to the

traumatic experience of the attack, Dr. Mathis is receiving treatment for Post-Traumatic Stress

Disorder (PTSD) and Sleep Paralysis from Dr. Terry. During an early session with Dr. Terry, we

learn that Jane is dating a cop named Miles. Dr. Terry had advised Jane to stop practicing as a
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psychiatrist, but despite this, she continues and starts to treat out of her home. She did agree,

however, not to prescribe medication and to take on non-extreme clients. We then get to see clips

of Jane in session with various clients that are upset by things at work and their home. She is

bored and not enjoying this because she is doodling on the notepad instead of paying attention

(Legrand, 2017).

However, the movie takes a turn when Dr. Mathis gets a fun call from an individual

named Alex. She was hesitant to start treating me because he is an extreme client with PTSD

from a car accident that left his face scared up. Now during this treatment of Alex, which is the

core of the movie, Jane is having flashbacks to Nora. The flashbacks reveal why Nora first

started to see her, what happened before she attacked Jane, and more. While treating Alex, Jane

begins to run him through exposure therapy, which causes him to have panic attacks. He is even

caught sleepwalking around Jane's house in the middle of the night, after which she does not

want to press charges. Alex is then told that Jane cannot treat him anymore, but he calls her in

the middle of a suicide attempt from an opioid overdose. Jane agrees to treat him again and then

begin the process over, as he recalls more and more from the accident, Jane goes further and

further down her rabbit hole with Nora (Legrand, 2017).

Now Nora is seen throughout the film, but she breaks into Jane's house after being

released from the mental health institution for lack of money. During this break-in, Nora leaves

the bed covered in blood with photographs on it. Now, of course, Jane calls the police and her

boyfriend Miles shows up, this is when they learn the Nora had also been messing with the

security cameras. After all of this, Jane is home alone when she begins to hallucinate and sees

Nora trying to break back into her house, she fights her off and ends up killing her. Jane is then

placed in the same hospital room that Nora was in only to find out that she did not kill who she
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thought. Jane killed her boyfriend, Miles, and once Jane begins to put together that she was

drugged. She escapes the institution to find out that this was all the grand scheme of Alex. Alex

was in a car accident but because Nora attacked him and this was all a series of moves to get

revenge and teach Jane not to meddle in the lives of others (Legrand, 2017).

Dang, that is one intense Hollywood horror thriller with plenty of twists and turns. I want

not to focus on what might be seen as the obvious choice for a mental health disorder in the

PTSD of Jane. Instead, I want to focus on Alex; this is because Jane was being treated, but then

being drugged, I cannot say for sure if she has a disorder or not. It is certainly implied that she

does. Now Alex, on the other hand, this guy is a whole different animal, after some extensive

thought and debating back and forth. I think that I can safely make a diagnosis for Alex, with a

primary diagnosis of F 60.4 Histrionic Personality Disorder (Association, 2013). Now I am not

stopping there. I am going to put in a secondary diagnosis of F 68.10 Factitious Disorder

Imposed on Self Single Episode (Provisional). (Association, 2013) Now Alex also has some Z

and T Codes to go along with the diagnosis. I am going to give these as Z 91.5 Personal History

of Self Harm, Z 65.4 Victim of Crime, Z 62.820 Parent-Child Relational Problem, and Z 76.5

Malingering (Provisional) (Association, 2013). As we learned from the film, Alex had some

extreme scarring on his face from the encounter with his daughter. Other than this, there were no

medical conditions reported.

Coming up with this diagnosis was a tedious and challenging task. I was schlepping

through the DSM-5, trying to figure out what to diagnose Alex with, if anything. At first, I was

considering him to be lacking enough evidence to diagnose a disorder. I then went back to my

material from my abnormal psychology to try to figure this all out. That is when it hit me. I know

what Alex has. I went with the Histrionic Personality Disorder (HPD) because of the lecture in
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the class, where it was stated: " Histrionic Personality Disorder is a pattern of excessive

emotionality and attention-seeking behavior" (Flynt, 2020). With Associate Professor of

Psychology Shannon Flynt's guidance form the PowerPoint, I turned to this section in the DSM-

5. Now according to the DSM-5, Alex needs to present the ten general criteria for personality

disorders as well as 5 of the additional 8 for HPD (Association, 2013). As I went down the list,

Alex was exhibiting uncomfortable behaviors when he was not the center of attention. When

Jane told him that she could not treat him anymore, he went and attempted suicide for her

attention to be focused back on him.

While watching the film, you could see that they were portraying, and Alex was showing

rapid shifts in emotions and shallow expressions. We are on the right track now, but we need 5

out of the 8. Alex also displayed to be seeing relationships as more intimate than they are. He

was using his scars to draw attention to himself consistently while showing self-dramatization

and an impressionistic speech. I cracked the code; he has a total of 7 of the 8 required criteria for

HPD. Now I went with the provisional diagnosis on Factitious Disorder (FD). This was not a

natural choice to make. According to a lecture during our abnormal class, we could give the

provisional title if we felt that it could change based upon not enough information. I wanted to

keep this open because I don’t know what was exactly causing Alex to make up the symptoms of

PTSD to seek treatment from Jane. One of the requirements for FD is “no external incentives of

behavior” (Flynt, 2019). What associate professor of psychology Shannon Flynt stated is the

exact reason I left this as provisional, I don’t know if he was motivated by the incentive of

revenge or something else.

The choice I made here is the same reason I made the Z Code for malingering

provisional. Alex is either malingering or has FD; I just don't know which. For the rest of the Z
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and T Codes, I found those to be somewhat lucid. Alex was the victim of a crime, the attack he

sustained at the hands of his daughter Nora was a crime. His attempted suicide plus some

accounts of other indications for harming himself lead to the Z Code for a history of self-harm. I

also decided to go with the Z Code for the parent-child relational problem because of the abuse

he gave to Nora, but also the fact that Nora's institutionalization was interfering with his

treatment of his mental health diagnosis. As stated in the DSM-5," or when the quality of the

parent-child relationship is affecting the course, prognosis or treatment of a mental or other

medical disorder" (Association, 2013). For all of these reasons, I feel that I came up with an

accurate and useful diagnosis for Alex.

Naturally, there is a chance for some error; as I stated at the beginning of this piece,

Hollywood always puts its spin on things. We have seen this in action movies and biographical

movies as well, so why would it be any different for mental illness. In actuality, it is not, while

Hollywood tries to do an accurate job of portraying these disorders, they often fail. When it

comes to Clinical, I would say that this is no different. The attempt to portray PTSD was poorly

made. The way they made it seem like flashbacks took you back into that moment, and you

remember every detail. From my own experience with the disorder, I have seen this to be

different. The way they showed Jane in flashbacks was very inconclusive to what might be seen

during PTSD. Then a hallucination that resulted in the killing of her boyfriend. While the

hallucinations and blackouts do happen with PTSD, this was drug-induced but portrayed as part

of the disorder. In terms of the other ways they portrayed mental illness in this film, I found they

did an excellent job of representing HPD in Alex once I was able to see the disorder. However,

when it comes to Nora, they did not portray her and mental illness in a positive light. Instead of

showing a modern mental institution, they showed a blank white room with nothing but a bed in
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it with restraints. Nora was seen as a violent psychotic individual who only inflicts harm. Most

people with mental illnesses are non-violent, but the same was being portrayed with Alex as

well. I found this disturbing because of my own experiences with people who have disorders.

They are sometimes too afraid to show the disorder in public. The film does show the majority of

things that can be encountered. There are substance abuse, suicide attempts, murder, and more.

Overall the film was a fantastic horror thriller, and I would recommend it to anyone that this

paper did not spoil it. However, in terms of mental health portrayal, I would not recommend this

for personal reasons.

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References

Association, A. P. (2013). Desk Reference to The Diagnostic Criteria From DSM-5. (A. P.
Association, Ed.) Washington, DC: American Psychiatric Association.

Flynt, S. (2019). Factitious Disorder vs. Malingering. Lecture 7 FD vs. Malingering. Salt Lake
Community College.

Flynt, S. (2020). L9 Personality Disorders. Lecture 9 PowerPoint. Salt Lake Community College.

Legrand, A. (Director). (2017). Clinical [Motion Picture].