COPYRIGHT©2016 PERERA-W.A.

A Psychological Character Analysis

Obsessive Compulsive Disorder (OCD): A Psychological

Character Analysis

Hiran Perera-W.A.
Department of Psychology, Durham University, UK

(Revised 08.11.2016)

Abstract

The purpose of this report is to develop a psychological character analysis based on a character depicted
in the movie, As Good as It Gets. Melvin Udall, the leading character, suffers from Obsessive Compulsive
Disorder (OCD), which is being analysed in this report from his observable behaviours. However, as the
movie progress, the symptoms and the related dysfunctions gradually becomes manageable by the
character himself, displaying a state of recovery. Therefore, this report will focus on the first half of the
movie when the symptoms were at a severe state. Using a Multi Axial Diagnosis based on the DSM-IV,
this report will look at the diagnostic criteria, possible causations, and possible treatment plans available
to manage the OCD condition as a psychological disorder. Analysis from both DSM-IV and DSM-5 has
been used in this revised version for a better understanding of the OCD condition.

Keywords: As good as it gets, OCD, DSM-IV, DSM-5, Melvin Udall, Psychology

Electronic copy available at: https://ssrn.com/abstract=2732185

COPYRIGHT©2016 PERERA-W.A. A Psychological Character Analysis

Table of Content

1.0 Summary 03

2.0 Melvin and His Condition 03

3.0 Obsessive-Compulsive Disorder (OCD) 05

3.1 Specifiers 06

3.2 Associated features 06

3.3 Prevalence and gender related diagnosis 06

3.4 Diagnostic Criteria 06

4.0 Possible Causations for Onset of the Disorder 07

5.0 Multi Axial Diagnosis (based on DSM-IV) 08

6.0 Treatment Approaches 09

7.0 The Appropriate Treatment for the Condition, and Conclusion 11

References 12

Appendix 14

Electronic copy available at: https://ssrn.com/abstract=2732185

COPYRIGHT©2016 PERERA-W.A. A Psychological Character Analysis

OCD: A Psychological Character Analysis

1.0 Summary
“As good as it gets”, directed by James Brook, depicts an unconventional story that
forces a smile in the audience with an unprecedented happy ending. The movie illustrates an
acceptance among the characters with a forceful initiation led by a disordered individual (the
main character) developing ambiguous relationships with others that eventually leads to be
strong and successful. Melvin Udall the main character (played by Jack Nicholson) suffers from
Obsessive-Compulsive Disorder (OCD) leading him to live a curmudgeon life. He is a well-
established romantic novelist who lives a single life in his own apartment.

Approximately 42-year-old, Melvin had fewer close relationships with the outside
world. His homosexual neighbour Simon (played by Greg Kinnear), who is an artist, was never
fond of him due to his bizarre social behaviours. The waitress Carol (played by Helen Hunt) a
single mother with a severe asthmatic child is the only character in the movie who accepted
his disordered condition providing him daily meals at the restaurant as exactly as he requested.
The story brings the audience to an end with lots of uneasy, disagreeable, and agonizing
moments, moulding the characters that revolve around Melvin Udall, as a result of their
conceding behaviours.

2.0 Melvin and His Condition

According to the DSM-5 analysis, Melvin suffers from a psychological condition known
as Obsessive-Compulsive Disorder (OCD). The apparent behavioural symptoms in the movie
were depicted as follows,

• Wearing gloves all-day, and highly dislikes any physical contact

• Wash hands with extremely hot water using a single soap for every washing session, and
not using the same soap for a second time
• Arrangement of the soaps behind the bathroom mirror cabinet was precise and neat
• Neatly arranged house with precisely positioned CD’s and books
• Opens and closes the door locks precisely five times
• The electric switches are on and off precisely five times
• Wipe door handles before touching them

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• Dislikes walking on cracks on the road, and shows a specific pattern of stepping his foot on
the pavement
• Uses his own plastic cutlery in the restaurant due to the fear of germs
• Calls for the same waitress every time
• In the restaurant, he sits at the same table, same place every day.

Apart from his OCD Condition, the movie displayed several other scenarios that are important
in analysing his behavioural patterns,

• Melvin’s own neighbours see him as a socially awkward person where this phenomenon
was depicted at the very beginning of the movie - a lady (neighbour) goes back to her house
after seeing Melvin near the lift.
• When Melvin was asked how he writes female characters so compellingly, his reply was “I
think of a man. And I take away reason and accountability”.

These two phenomena display certain misogynistic traits; however, his later relationship with
Carol swirled this notion,

• Melvin Udall is also portrayed as a homophobic that dislikes black people. He expressed his
negative attitudes towards both Frank (Simon’s African-American agent) and Simon by
saying, “As long as you keep your work zipped up around me, I don't give a rat-crap when
or where you shove your show” followed by “are we done being neighbours for now?”.
• In one occasion, he threw his homosexual neighbour’s (Simon) dog to the trash due to its
attempted peeing in the corridor.

Melvin also displayed impulsive behaviours with sudden burst of emotions, anger, and
irritability. These dysfunctional behaviours were highly apparent when,

• A new waitress (replacing Carol) served him at the restaurant, and when she was curious
about his plastic cutlery. His emotional outburst during that time intensified the entire
situation that led him thrown out from the restaurant.
• When he went to see his therapist asking for help, the therapist asked him to make an
appointment. To which he replied, “How can you diagnose someone as having obsessive-
compulsive disorder and yet criticize him for not making an appointment?"

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• His irritability heightened, when someone knocks at the door. According to the movie,
Melvin works at home as a successful writer with 62 novels written. At the beginning of the
movie when Simon came knocking at his door asking about his dog (Vedell), he got highly
irritable and replied “don’t knock, not on this door, not for any reason”.
• Melvin’s character also displayed inability to express sympathy, empathy, understand other
people’s emotions, or even to express his own. These dysfunctional behaviours were
apparent when he replied to Carol saying, “We all gona die soon, I will, you will and sounds
like your son will too”.
• He was also unable to appreciate the help when he asked his employers husband to help
Carol’s son with his condition. When she tried to explain her own children’s progress, he
simply replied “Good, nice, thrilled, exciting, you don’t have to wait with me”.

Understanding these sociological and psychological dysfunctional characteristics, provides an

overview of his disordered condition to be further analysed in detail.

3.0 Obsessive Compulsive Disorder (OCD)

According to the DSM-5, OCD adheres recurrent obsessions or compulsions that lead
to develop marked distress or social, occupational and other significant functioning
impairments (American Psychiatric Association, 2013). Obsession is a repetitive thought or an
urge that is pleasurable or voluntary that can lead to cause marked anxiety or distress
(American Psychiatric Association, 2000 and 2013; Durand & Barlow, 2013). A compulsion is a
repetitive behaviour or a mental act that individual performs in response to an obsession
(Durand & Barlow, 2013). Furthermore, the obsession or compulsion should be time
consuming, not attributable for physiological effects of substance abuse, and should not be
explained by the symptoms of another mental disorder (American Psychiatric Association,
2013).
3.1 Specifiers
Individuals with OCD portrays dysfunctional beliefs, perfectionism, intolerance or over
importance of thoughts (American Psychiatric Association, 2013). Individuals can have a good
(fair) insight (OCD beliefs are not true), a poor insight (OCD beliefs are true) or an absent insight

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(delusional beliefs) (OCD beliefs are highly convinced as true) (American Psychiatric
Association, 2013).
3.2 Associated features
According to the diagnostic criteria, OCD varies among individuals based on themes or
dimensions such as cleaning type (constant cleaning compulsion due to contaminated
obsession), symmetry type (continuous counting), taboo type (aggressive, sexual, religious
obsessions), and harm type (fear of harming oneself or others) (American Psychiatric
Association, 2013).
3.3 Prevalence and gender related diagnosis
Males are affected in childhood, whereas females tend to get affected during adulthood
at a higher rate than males. According to the diagnostic criteria, males have an early onset than
females. In addition, males tend to develop symmetry dimensions and females are more prone
to develop cleaning dimensions (American Psychiatric Association, 2013; Durand & Barlow,
2013).
3.4 Diagnostic Criteria
Obsessive compulsive disorder exerts as a vicious cycle, where manifestation of
ritualistic compulsive behaviour in response to an obsession leads to a dysfunctional
performance. As mentioned earlier in the report, Melvin comes into the house and locks the
door five times, on and off the switches five times are clear examples of these ritualistic
behavioural patterns. He portrays behavioural characteristics of cleaning type and symmetry
type. The house is pretentiously clean with precisely arranged CDs and books. The compulsive
behaviours of repetitive actions display a symmetry theme. According to new DSM-5, the
diagnostic criteria for OCD are as follows,

Either obsessions, compulsions or both (as mentioned above, which displays

Criteria A:
by the Melvin’s behavioural patterns)
Obsessions and compulsions caused marked distress and time consuming.
Criteria B: Interfere with the socio-occupational functioning (He lacked intimate
relationships with women at the first half of the movie).
Criteria C: The symptoms are not attributed to any medical condition or substance use.

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Symptoms are not explained by the presence of another mental disorder

Criteria D: (further elaborated in the following sections)

4.0 Possible Causations for Onset of the Disorder

Different researchers have provided different age of onset and criteria of OCD
development. According to Campos, Leckman, Mercadante, Shavitt, Silva Prado, Sada, &
Miguel (2001), the earliest age of onset has identified as the age 10 (or earlier), and the late
age of onset has identified as age 17 (or later). According DSM-5, mean age of onset for OCD
has been identified as 19.5, and 25% of males have onset before the age of 10.

Melvin Udall’s childhood development was presented at a minimum level in the movie
where he expressed his childhood as, “My father didn’t leave his room for 11 years. He used to
hit me with the yardstick, if I made mistakes on the piano”. Based on these sentences, it is
possible (as assumptions only, but should not be used in diagnosing the onset of the disorder)
to assume that the onset of the illness as follows,

• Environmental factors: By witnessing Melvin’s father not leaving the house at a young age,
may have had a significant impact on his characteristic development. His father’s
occupation or the reasons for staying in the room were unknown. However, is it possible
to speculate his reasons for not leaving the house due to a severe OCD condition he was
suffering? Or, it even could be a learned behaviour. Fear of outside germs and
contaminations had a greater impact in developing personal distress and severe socio-
occupational dysfunctions. These negative behaviours would have influenced in developing
Melvin’s OCD condition.

• Genetic factors: Another speculation for his condition can be made using the reciprocal
gene theory. An individual (Melvin’s father) who has the genetic predisposition for a
disorder (OCD) have a higher tendency to develop environmental risk factors (negative
thoughts about the outside world – fear of contamination) that could influence the
development of the disorder. Is it possible to speculate the same phenomenon in Melvin,
his choice of job (as a writer at home) leading him to stay at his confined environment with
a minimum outside contact? The genetic predisposition could have been passed down to
him from his father (one may able to speculate).

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• Early childhood experiences: Evidence from previous research suggests a strict authoritarian
parenting style could have an influence in developing OCD conditions in children (Timpano,
Keough, Mahaffey, Schmidt, & Abramowitz, 2010). Melvin’s father physically punished him
when he made mistakes in his piano lessons. When there is a higher genetic predisposition,
environmental risk factors coupled with his early life experiences could easily influence in
developing this psychological disorder (Kenezloi & Nemoda, 2010). This is also known as
the Principal of Equifinality (Durand & Barlow, 2013).

5.0 Multi Axial Diagnosis (based on DSM-IV)

Axis 1 300.3 Obsessive-Compulsive Disorder

Axis 2 None
Axis 3 None
Axis 4 Socio-environmental issues (lives alone, discriminate others, etc).
Axis 5 GAF = 54 (at the beginning of the movie).
GAF = 78 (at the end of the movie).

According to an analysis conducted by Anderson (2008), 343 Japanese outpatients with

OCD found the general assessment of functioning scores to be 49.6, which highly co-morbid
with depression. However, Melvin’s behavioural patterns did not portray any depressive
symptoms.
No differential diagnosis or possible co-morbid features are required in analysing
Melvin’s OCD condition. Co-morbidity was not presented in Melvin’s character. It can be
projected mainly with his current difficulties in socialization and other dysfunctions as a result
of his OCD condition. Thus, the provisional diagnosis is more convincing in the movie to
conclude his condition as OCD.
On a personal note, there are visible traits of obsessive compulsive personality disorder
(OCPD). DSM-IV identifies OCPD as engaging in orderliness, interpersonal control, and
perfectionism. Individuals with OCPD show a rigid maintenance in rules, procedures, and
schedules. Furthermore, excessive devotion to work and minimum use of leisure time are also
visible traits (American Psychiatric Association, 2000). Melvin showed all the above-mentioned
characteristics. As mentioned earlier in this report, he is a well-established novelist. He has
dedicated almost his entire time for writing. He is in need of controlling others in every situation
possible. For instance, at the beginning of the movie when another couple preoccupied his

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regular table in the restaurant, he was restless and vocalized inappropriate content until the
couple left. However, these traits are not sufficient to warrant a differential diagnosis.

In addition, there is a discomfort in presenting and accepting emotions. For instance,

when Carol expressed her sons condition, Melvin was having a hard time listing to it.
Furthermore, when Carol read out her letter of appreciation that she wrote for him, Melvin
had a hard time listening to it. Conversely, Melvin was having trouble expressing himself to
Carol his feelings towards her at the later part of the movie. As such, there were visible traits,
but does not necessarily require a differential diagnosis. All these traits were a result of his OCD
condition.

6.0 Treatment Approaches for OCD

OCD can be treated by various treatment approaches using both clinical and
psychotherapeutic methods (Hooper & Grohol, 2013; Maltby & Tolin, 2003). Despite the
dysfunctional conditions, Melvin portrayed a positive outcome at the end of the movie. He
wanted to change his behaviours or at least wanted to control his condition. This shows a
greater insight, and self-awareness of his condition. He was willing to change.
Although numerous treatment methodologies are available for the OCD, Melvin would
benefit primarily from cognitive behaviour therapy (CBT) that involves,

▪ Exposure and response prevention (ERP)

▪ Cognitive reconstruction

Treatment for OCD using ERP may not be sufficient. However, numerous past
researches have suggested that, ERP as one of the therapeutic methods that is highly effective
(Allen, 2006; Abramowitz, Foa, & Franklin, 2003). This ERP treatment method has been
categorized under CBT, which helps the individual to identify and modify the maladaptive
thought patterns and behaviours (Allen, 2006). ERP is based on the principle of exposing (in
real life or imaginary) the individual to the stimuli that generates obsession distresses without
engaging in the ritualistic activity (Gillihan, Williams, Malcoun, Yadin, & Foa, 2012). According
to the research, this repeated exposure, and the prevention of the ritualistic behaviour may
lead to minimized distress that was associated with the stimuli and the behaviours (Foa, Yadin,
& Lichner, 2012).

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According to Abramowitz (1996), there are four dimensions of ERP that includes,

1. Who controls the exposure (either therapist or self-assigned to the individual as

homework)
2. Situation that evokes the anxiety (imagines or real life)
3. Strategy of exposure (gradual or flooding – mass exposure)
4. Degree of response prevention by abstaining from ritualistic behaviours

By repeatedly confronting the distress stimuli (for instance, walking on the cracks of the
road) the person will lean that the fear (maybe falling down) does not necessarily occur.
Sometimes, although the distress does not completely diminish, the individual may learn to
tolerate the distress that was generated by the stimuli. (This was highly apparent at the end of
the movie when Carol encouraged Melvin to walk properly on the road). Furthermore,
successful completion of the ritual prevention through exposure may also enhance the self-
efficacy of the individual when they know that they can overcome the obsession without acting
out with compulsions (Clark, 2000).
Similarly, understanding cognitive distortions (errors) are also crucial in the treatment
of OCD (OCD Centre LA, 2012). Cognitive reconstruction is the technique of directly challenging
faulty beliefs and cognitive errors that underlies in the OCD behaviours. According to Hyman &
Pedrick (2010), cognitive reconstruction helps individuals to understand how the thoughts are
interpreted, and by making different choices can also lead to different levels of intensities of
OCD behaviours. Furthermore, by enhancing the awareness of the cognitive errors may also
help individuals to become more objective rather than overreacting towards them. Previous
studies have further identified that cognitive reconstruction is best used to improve the effects
of ERP (as mentioned above) but not as a separate alternative (Hyman & Pedrick, 2008).
Challenging the faulty beliefs can occur, by identifying the those triggers i.e. situations,
thoughts, etc., then by identifying the faulty beliefs associated with those thoughts. It is highly
important to understand which situations or events activate these intrusive thoughts. Table 1
provides several examples of these triggers based on Melvin’s character in the movie.
In addition to CBT methods, selective pharmaceutical drugs may also help to control
the OCD condition in server anxious situations such as,

▪ Selective serotonin reuptake inhibitors (SSRI’s)

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▪ Depressants (to relieve anxiety)

▪ Antipsychotics
▪ Mood stabilizers

If left untreated, OCD can be transformed into a chronic illness. Using medications may
help to reduce the symptoms. SSRIs (such as Anafranil, Luvox, Zoloft, Paxil, and Celexa)
primarily affect the serotonin neurotransmitters. According to the statistics, 80 percent of the
individuals who use Anafranil (Clomipramine) have indicated symptoms reduction. Depressants
such as benzodiazepines may provide a calming effect (by reducing anxiety), if individuals
experience any anxiety due to OCD. Medications such as Buspirone can also have an effect on
some people with OCD. Antipsychotics such as Haloperidole, and mood stabilizers such as
lithium and L-trytophan may also help in reducing the symptoms of OCD (Centre for addiction
and Mental Health, 2001).

7.0 Possible Treatment for Melvin, and Conclusion

With the above analysis, following conclusions can be made. A recommendation of the
above-mentioned psychotherapeutic methods is plausible with ERP and cognitive
reconstruction without medication due his insight of the condition, and willingness to change.
Melvin’s symptoms however, reduced at the end of the movie. Hence, extensive treatment
methodologies may be unnecessary if a therapeutic method were to use to help the character
at the end of the movie. The overall diagnosis of the OCD was based on the clinical distress and
observable symptoms which were seen at the beginning of the movie. As mentioned earlier in
this report, there are also traits of other psychological disorders (such as OCPD). However, using
CBT techniques can be beneficial for the individual not as a cure, but to control the obsessions,
and the occurrence of those ritualistic compulsive behavioural patterns.

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References

1. Abramowitz, J., Foa, E., & Franklin, M. (2003). Exposure and ritual prevention for obsessive
compulsive disorder: effects of intensive versus twice-weekly sessions. Journal of Consulting and
Clinical Psychology, 71(2), 394-398.
2. Abramowitz, J. S. (1996). Variants of exposure and response prevention in the treatment of
obsessive-compulsive disorder: A meta-analysis. Behaviour Therapy, 27, 583–600,
http://dx.doi.org/10.1016/S0005-7894(96)80045-1.
3. Allen, A. (2006). Cognitive-behaviour therapy and other psychosocial interventions in the
treatment of obsessive-compulsive disorder. Psychiatric Annals, 36(7), 474-479
4. American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders. 4 th
ed. TR. APA: Washington
5. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders. 5th
ed. APA: Washington
6. Anderson, P. (February 14, 2008). Obsessive-Compulsive Disorder Not Just a North American
Phenomenon. Retrieved from http://www.medscape.com/
7. Campos, M., Leckman, J., Mercadante, M., Shavitt, R., da Silva Prado, H., Sada, P., & Miguel, E.
(2001). Adults with early-onset obsessive-compulsive disorder. American Journal of Psychiatry,
158(11), 1899-1903
8. Centre for addiction and Mental Health. (2001). Treatment for OCD: Medications. Retrieved from
http://www.camh.ca/
9. Clark, D. A. (2000). Cognitive behaviour therapy for obsessions and compulsions: New applications
and emerging trends. Journal of Contemporary Psychotherapy, 30(2), 129- 147. doi:
10.1023/A:1026562628287
10. Durand, V. M., & Barlow, D. H. (2013). Essentials of Abnormal psychology. Wadsworth, Belmont:

USA.
11. Foa, E. B., Yadin, E., & Lichner, T. K. (2012). Exposure and Response (Ritual) Prevention for

Obsessive-compulsive disorder. New York: Oxford University Press.

12. Gillihan, S., Williams, M., Malcoun, E., Yadin, E., & Foa, E. (2012). Common Pitfalls in Exposure and

Response Prevention (EX/RP) for OCD. Journal of Obsessive-Compulsive and Related Disorders,
1(4), 251-257.
13. Hooper, J. F., & Grohol, J. M (2013). Obsessive-compulsive disorder treatment. Retrieved from

http://psychcentral.com/disorders/sx25t.htm

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14. Hyman, B. M., & Pedrick, C. (2008). Obsessive-Compulsive Disorder. Brookfield, CT: Twenty-First

century books
15. Hyman, B. M., & Pedrick, C. (2010). The OCD Workbook. Your Guide to Breaking Free from

Obsessive-compulsive disorder. 3rd Ed. New Harbinger: CA.

16. IMDb (2014). As good as it gets (1997). Retrieved from http://www.imdb.com/title/tt0119822/

17. Kenezloi, E., & Nemoda, Z. (2010). [Genetic factors in obsessive-compulsive disorder: summary of

genetic studies]. Psychiatria Hungarica: A Magyar Pszichiatriai Tarsasag Tudomanyos Folyoirata,

25(5), 378-393.
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spectrum conditions: Conceptualization, theory, and practice. Brief Treatment and Crisis
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19. OCD Centre for LA. (2012). Harm OCD Treatment: Cognitive Restructuring. Retrieved from

http://www.ocdla.com/blog/harm-ocd-cognitive-restructuring-1721
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and Obsessive Compulsive Symptoms: Implications of Authoritarian Parenting. Journal of

Cognitive Psychotherapy, 24(3), 151-164. doi:10.1891/0889-8391.24.3.151

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Appendix

Table 1: Events

Event Intrusive thought False belief Cognitive errors

Touching door
“What if I contract a “Will definitely get Overestimation of
knobs without using
risks, dangers, and
tissues or wiping disease?” sick” harms
them

“Must turn on/off

“What if the light the light 5 times in a Perfectionism, and
Switching off/on a
does not stay over-evaluating
Lights repeatedly on/off?” row or something
thoughts
bad will happen”

“Must be very
“What if the door is careful and if there is
Locking the door
not locked?” a break-in, it will be
repeatedly
all my fault, and I
have to suffer”
Over-responsibility,
over-evaluation of
thoughts,
overestimating the
harm, risk and
danger

“I must sit at the

same place if not my

Sitting at the “What if the seat is seat won’t be Overestimating the

restaurant not comfortable?” thoughts, and over-
comfortable, and my
evaluation
body will start to
ache”

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