Case analysis- The Queen’s Gambit

The case focuses on the life of Beth Harmon, a young woman navigating the world of chess

prodigy as the main character on the Netflix show called as The Queen’s Gambit played in

lead by Anya Taylor and is directed and developed by Scott Frank based on the 1980s novel

by Walter Tevis. She has been portrayed as complex character as someone with immense

anger and passion after the loss of her mother at the young age, her obsession towards the

game of chess and her struggles with drugs and alcohol at the later age of her life. Apart from

chess, she maintains skills in mathematics, sciences, and history. She is plainspoken,

hypercompetent young woman with high intellect and vivid imagination that allows her to

see floating chess pieces on ceilings[ CITATION Par21 \l 1033 ]. The story has discussed

multiple aversive childhood experiences leading to childhood trauma and depression at the

early age[ CITATION Dou21 \l 1033 ]. Although, the Queen’s Gambit is not a true story, but

it holds truth for the social workers plotting a familiar psychological trajectory depicting

struggles and traumatic loss of early childhood. The novel was highly praised at the time for

the technical accuracy of its depictions of chess as like many other stories about prodigies,

the series has issued numerous warnings about being genius discussing the pitfalls of

obsession, the risk of hopelessness and the dominated world[ CITATION Kat20 \l 1033 ].

Altogether the story of Beth Harmon has discussed her obsession and unresolved post-

traumatic stress which led her dependant on sedative pills flipping her internal world

outward[ CITATION Kat20 \l 1033 ]. Posttraumatic stress disorder (PTSD) is a psychiatric

disorder that may occur in people who have experienced or witnessed a traumatic event such

as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been
threatened with death, sexual violence or serious injury often triggered by a terrifying events.

PTSD symptoms are generally grouped into four types: intrusive memories, avoidance,

negative changes in thinking and mood, and changes in physical and emotional reactions.

Symptoms can vary over time or vary from person to person[ CITATION Pos21 \l 1033 ].

Clinical and survey studies show in general a significantly higher prevalence of childhood

trauma in mental disorders[ CITATION Neg15 \l 1033 ] where the risk of experiencing

childhood trauma and risk of depression is increased threefold. Many cross sectional studies

have documented the association of sexual abuse in childhood and depression in

adulthood[ CITATION Neg15 \l 1033 ]. Molnar et al. showed that among men and women

suffering from sexual abuse the risk of developing a depression was 1.8 times higher while

others discussed to be four times higher risk. However, Fernando et al. illustrated in a study

on the impact of childhood trauma on emotion regulation in borderline personality disorders

and major depression significantly higher scores on emotional abuse resulting into major

depression, posttraumatic stress disorder, and social phobia, and anxiety disorders. Many

studies have explicitly found that multiple childhood trauma might be specifically related to

chronic courses of depression. And as often in the case, Beth Harmon was addicted to drug

and alcohol use which was as a means of coping with traumatic events developing an

addiction where the trauma has profound impact on how a person thinks and perceives the

world around them[ CITATION The18 \l 1033 ].

These symptoms increases endocrine and autonomic reactivity to stress, anxiety-like

behaviour, anhedonia, cognitive impairment, pain sensitivity, and altered sleep associating

with neurobiological changes.

The studies have found that childhood trauma and other mental disorders linked with

alcoholism are likely to be developed 3.5 to 5.6 fold risk among adult children who had

suffered from traumatic childhood experience as previously published findings from the

Adverse Childhood Experiences Study reported that children’s with adverse childhood

experience has greater aggregation of alcohol and depressive disorders which is apparently

determined by the  extent of childhood trauma, such as abuse, domestic violence, and other

family dysfunction, that we found to be substantially more common in alcoholic

households[ CITATION And02 \l 1033 ]. The present case study understands the social

cognition understanding of psychological symptoms such as psychiatric disorder,

depression, and unusual personality disorders that triggers person towards psychotic

breakdown when adverse physical, social, or environmental phenomena is being encountered

tapped by unusual perceptual and cognitive experiences[ CITATION Fyf08 \l 1033 ].

Figure 1 :[ CITATION Hei08 \l 1033 ]

Personality disorders can be categorised as long-term patterns of behaviour and inner

experiences that differs significantly from what is expected. The patterns or experiences

appears in adolescence and early childhood and continued over many years, and can cause a

great deal of distress and discomfort leading to social conflicts impacting relationships, social

situations and life goals[ CITATION Sal20 \l 1033 ]. The essential feature of borderline

personality disorder is a pervasive pattern of instability of interpersonal relationships, self-

image, and affects, and marked impulsivity that begins by early adulthood and is present in a

variety of contexts. Individuals with borderline personality disorder display impulsivity in at

least two areas that are potentially self-damaging They may gamble, spend money

irresponsibly, binge eat, abuse substances, engage in unsafe sex, or drive recklessly.
Individuals with this disorder display recurrent suicidal behaviour, gestures, or threats.

Individuals with borderline personality disorder may display affective instability that is due to

a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually

lasting a few hours and only rarely more than a few days). Throughout the mini-series, Beth

was battling her own inner demons, including insecurity and self-loathing which led to self-

destructive behaviours.

As, there are multiple contexts that Beth Harmon was suffering from multiple aversive

childhood experiences leading to childhood trauma and depression at the early age leading to

Posttraumatic stress disorder (PTSD) and depression in her adulthood.

According to the DMS-5, a person must meet the following criteria to be diagnosed with a

personality disorder:

 Chronic and pervasive patterns of behaviour that affect social functioning, work,

school, and close relationships

 Symptoms that affect two or more of the following four areas: thoughts, emotions,

interpersonal functioning, impulse control

 Onset of patterns of behaviour that can be traced back to adolescence or early

adulthood

 Patterns of behaviours that cannot be explained by any other mental disorders,

substance use, or medical conditions[ CITATION Sal20 \l 1033 ]

 Erratic changes in mood and behaviour.

 Addition to drug and alcohol

Diagnosis
To diagnose post-traumatic stress disorder, your doctor will likely:

 Perform a physical exam to check for medical problems that may be causing

your symptoms

 Do a psychological evaluation that includes a discussion of your signs and

symptoms and the event or events that led up to them

 Use the criteria in the Diagnostic and Statistical Manual of Mental

Disorders (DSM-5), published by the American Psychiatric Association

Medications

There are no medications specifically approved by the Food and Drug Administration (FDA)

to treat personality disorders. However, several types of psychiatric medications may help

with various personality disorder symptoms.

 Antidepressants. Antidepressants may be useful if you have a depressed mood,

anger, impulsivity, irritability or hopelessness, which may be associated with

personality disorders.

 Mood stabilizers. As their name suggests, mood stabilizers can help even out mood

swings or reduce irritability, impulsivity and aggression.

 Antipsychotic medications. Also called neuroleptics, these may be helpful if your

symptoms include losing touch with reality (psychosis) or in some cases if you have

anxiety or anger problems.

  Anti-anxiety medications. These drugs can relieve severe anxiety and related

problems. Some anti-anxiety medications have the potential for abuse, so they are

generally used only for a short time.

 Prazosin. While several studies indicated that prazosin (Minipress) may reduce or

suppress nightmares in some people with PTSD, a more recent study showed no

benefit over placebo. But participants in the recent study differed from others in ways

that potentially could impact the results. Individuals who are considering prazosin

should speak with a doctor to determine whether or not their particular situation might

merit a trial of this drug.

Epidemiological studies have provided strong evidence that adverse experience during

childhood, such as abuse, neglect or loss, is associated with dramatic increases in the risk to

develop depression which was evident in the case as Beth Harmon loss her mother at very

age her and obsession towards the game of chess and her struggles with drugs and alcohol at

the later age of her life. The misuse of alcohol and pills was also portrayed with Beth, with

her developing dependence on sedatives, given the fictional name Xanzolam although also

referred to as Librium during her time at the orphanage.

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