Walk The Line (2005) : Summary

Walk The Line is a movie in which we discover the devastated man that was Johnny

Cash at one point in his life: Sex, Alcohol, Drugs, Marriage problems as well as with

his father and the death of his brother.

Born in Kingsland, Arkansas, to a miserable family, and bereaved in 1944 by the

accidental death of Jack, his favorite brother, Johnny Cash, after an adolescent

devoted to working the fields and studying gospel, left his native state at 18, to visit

GrossKirrscherffen, in West Germany, a garrison town where the US Air Force sent

him. There, while composing his first songs, he experimented with a unique cocktail

made from Spaten and German cognac, that is when his alcoholic journey started.

Demobilized in 1954, he married Vivian Liberto, moved to Tennessee and, to earn a

living, went door to door, trying to sell household appliances.

At the same time, he met bassist Marshall Grant and guitarist Luther Perkins, with

whom he set up his group. The trio ventures to push the door of Sun Records, in

Memphis, the phonographic company of Sam Phillips who has just discovered Elvis

Presley at the time.

Professionally fulfilled, Johnny Cash accumulates personal problems. In 1965, after

destroying several hotel room doors with an ax, stabbing a dagger in a copy of the

Mona Lisa, detonating a public toilet and lighting a brush fire in a California reserve,

Johnny Cash is apprehended at El Paso airport, in possession of 688 dexedrine pills

(amphetamines) and 475 tablets of Equanil (tranquilizers) that he has obtained in

Mexico. Released on bail, he promises to make amends. The following year, he was
arrested again in Starkville, Mississippi, for drunkenness on the public highway.

Incarcerated, he fractured his foot by shooting against the bars of his cell and ends

up admitting that he needs a hundred pills a day. Shortly after, his wife divorces,

arguing of "the extreme cruelty" of the singer.

Cash barely survives his first overdose. The last one too. Helped by the one who will

become his second wife, June Carter, he decides to drive out these demons who

persist in inhabiting him for good. He asks to be locked in a room. When he came

out, his hands bleeding and fingernails torn from scratching the walls for days on

end, he was saved.

A strange period begins in the life of Johnny Cash who, under the influence of June

Carter, falls into bigotry. While attending a religious ceremony in a Pentecostal

church near Nashville, he suddenly jumped up, struck by divine revelation: “Up to

now my whole life has been devoted to the cult of the Devil. It's over. From today, I

will only live to serve the Lord”

This movie is interesting as it tackles several aspects that surround addiction, and

brings into light the different elements that we could use in order to analyze the case

of Johnny Cash, based on the Biopsychosocial Plus approach. And in order to

analyze the media chosen using this approach, we need to understand first the

meaning of addiction.
Addiction and the BPS Plus model,

The concept of addiction is based first of all on taking into account the individual and

his mode of relationship with the addictive object and it is attached to behavior more

than to products. This issue is pretty much consensual. But it should be added that it

implies a global biopsychosocial conception of these behaviors, including

dependence. Two essential elements of the definition should therefore be retained:

We can consider that addiction begins when, for the subject, suffering supersedes

pleasure. The mention "for the subject" is fundamental here because the diagnosis

cannot ignore the subjective perception of this balance between pleasure and

suffering. In other words, addiction constitutes the perception and representation of

the failure of the quest for satisfaction, a research, which governs all substance use.

On the other hand, if this loss of control is conceived in its experiential and

biopsychosocial dimension, the addiction is reintroduced into an interface between

the individual, his history and the social. It takes on meaning, the subject regains

responsibility for himself and the social group.

The definition of addiction proposed by the American Society of Addiction Medicine

(ASAM) begins as follows: "Addiction is a primary chronic disease of brain reward,

motivation, memory and related circuitry. Dysfunction in these circuits leads to

characteristic biological, psychological, social and spiritual manifestations ”(ASAM,

2012). In short, a chronic disease of the brain. A definition and its adoption by an

association as prestigious as ASAM is not without symbolic significance and without

consequence. Proponents of a biopsychosocial Plus model could see in this the

traces of a reductive discourse and the return of a medical model that is a little too
exclusive. We first wonder about the relevance of this conception, indebted to the

advances of recent years in the field of neurosciences, but which is anchored in the

successive definitions of the National Institute on Drug Abuse (NIDA) (Kushner,

2010). In fact, the latter gives primacy to the neurobiological dimension of this

phenomenon and gives it a precedence over “biological, psychological, social and

spiritual manifestations” which would be the result.

Many scientists (Kalant, 2009; Morel, 2012) have questioned this view of addiction

as a disease of the brain, warning of the danger of confusing cause and effect.

Likewise, asserting at the outset that addiction is a chronic disease appears as

highly questionable. We certainly recognize the chronic nature of addiction in a large

number of drug addicts, particularly among those seeking treatment. Nevertheless,

several studies have documented the phenomenon of "remission without treatment,"

particularly with regard to alcohol consumption, and have shown that a significant

proportion of people with problematic alcohol use or dependence on alcohol

managed to recover from this problem without treatment. Restricting the definition of

addiction to its chronic nature seems to limit our understanding of this phenomenon

and brings us back to the model of "irreversible disease." This model was challenged

in the 1970s (Pattison, Sobell & Sobell, 1977) to be replaced by the notion of a

continuum from non-problematic consumption to dependence. We believe this is a

model that reflects much better the diversity of trajectories that consumers of alcohol

and other substances can take. Psychosocial studies reveal that, in addition to

biogenetic aspects, psychological, cultural, social and spiritual factors share a very

great influence on the trajectory of the person in the process of developing an

addiction. In this sense, biogenetic or neurochemical aspects are to some extent

mediated by psychosocial factors. Scientific literature, which represents hundreds of

studies examining the importance of risk and protective factors in the development of

a drug addiction trajectory clearly shows that addiction is not a genetic or hormonal

inevitability, but rather a path guided by a changing reality. This reality consists of

factors that could be deciphered through what we call today a BPS Plus.

The biopsychosocial + model is both a (a) theoretical model, a coherent and

articulated set of explanatory hypotheses of health and disease, and (b) a clinical

tool, a set of directly applicable diagnostic and therapeutic means.

Theoretically, it is a representation of the human being in which biological,

psychological, social, cultural and spiritual factors are considered to collectively

participate in the maintenance of health or the development of disease. None of

these categories of determinants of health is given a priori preponderance, although

it is conceivable that their relative importance may vary. The biopsychosocial +

model is thus an extension of the biopsychosocial model introduced by Engel in

1977 : biological factors keep their place. This is not a psychological or psychiatric -

or sociologizing - conception of illness. In addition, it should be emphasized that the

term "psychological" refers mainly to normal cognitive, emotional and behavioral

processes, relating among other things to the interpretation of symptoms by the

subject, and not to psychopathological aspects.

Analysis of the media piece using the BPS + model

In the case of the protagonist alcoholic in Walk The line, Johnny Cash, we can

decorticate the various dimensions that could possibly explain his addiction problem.

The first and most relevant dimension emphasized in the movie is the social

dimension. The history of his addiction goes back to a chaotic lifestyle and a series

of abuse from his, as well alcoholic father, followed by a major crisis triggered by the

death of his older brother Jack. In very direct ways, “social disadvantage and social

factors, such as access to employment, stress, and early life experiences” (Herie &

Wayne, 2014), shaped the health outcomes of Cash’s addictive behaviour. But in his

particular case, what could take us from a narrow biopsychosocial perspective to

broader biopsychosocial plus, one is the presence and absence of the spiritual

dimension, tightly related to the cultural dimension due to the background of the

patient, highly influenced by both his upbringing in his early life, and a new form of

culture to which he was introduced when he entered his fame era. A frame to which

he adjusted by adopting a number of behaviors widely common in the universe of

artists and wealthy stars; alcoholism, drug consumption, sex…

The spiritual dimension, in which music and religion are intertwined is to be

considered the shifting point that leads to his recovery. It is an indispensable factor of

which the accumulation with the other dimensions leads to the development of

addictive behavior.(Biopsychosocial-Spiritual Model). The key factor is thus a return

to a balance that was shown in the “happy ending.” The balance of these dimensions

is necessary after pointing out the degree of their importance individually and their

influence on the well being and the health of the patient.

Bibliography

Mangold, J. (Director). (2005). Walk the line [Movie]. USA: Fox 2000 Pictures

Home Entertainment.

American Society of Addiction Medicine. (n.d.). Retrieved May 28, 2021, from

https://www.asam.org/Quality-Science/definition-of-addiction

Kushner, H. (2010). Toward a cultural biology of addiction. Biosocieties, 5, 8-24.

Kalant, H. (2009). What neurobiology cannot tell us about addiction. Addiction,

105, 780-789.

Pattison, E.M., Sobell, M.B., & Sobell, L.C. (1977). Emerging Concepts of

Alcohol Dependence. New York, NY : Springer.

Herie, M., & Wayne, S. W. J. (2014). Fundamentals of addiction: a practical

guide for counsellors. Centre for Addiction and Mental Health.

Bio-Psycho social-spiritual MODEL. (n.d.). Retrieved May 28, 2021, from

https://med.unr.edu/psychiatry/education/resources/bio-psycho-social-spiritual-

model